Use of AN ER, CR:YSGG, waterlase laser in orthodontic patients with gingival overgrowth

Abstract

AIM: Gingival overgrowth is frequently encountered among patients undergoing fixed orthodontic appliance treatment causing aesthetic and functional problems. Gingivectomy using a surgical laser followed by a strict oral hygiene regimen is one recently adopted treatment measure. The aim of this study was to evaluate the application of an Er,Cr:YSGG, waterlase laser in the treatment of overgrown gingivae in patients undergoing fixed orthodontic treatment. SUBJECTS AND METHOD: Twenty-two patients (10 males, 12 females, mean age 16.5 years) who had gingival overgrowth. One hundred and eighty anterior teeth with gingival overgrowth were selected for laser surgery. At baseline, each patient received initial periodontal therapy and also maintained the recall programme after surgery. Prior to surgery, the depth of the pocket was measured and the patient was instructed to rate their level of pain on a visual analogue scale (VAS) over time. Gingivectomy and gingivoplasty was performed with an Er,Cr:YSGG, waterlase laser under topical anaesthesia with Tac 20 per cent Alternate (Professional Arts Pharmacy, Baltimore, Maryland, USA) for 5 minutes before surgery. VAS score was rated during surgery and post-operatively. Pocket depth measurement was carried out immediately after surgery and repeated. RESULTS: Statistically significant changes were found in pocket depth scores (mean reduction 2.8 mm, Student’s t-test and ANOVA, P < 0.005). Recurrence was observed in 30 of 180 surgical sites (16.7%) or three out of 22 patients (13.6%) at 3 months following surgery. The mean VAS score was 3.2 during surgery. No patient required analgesia after surgery. CONCLUSION: The Er,Cr:YSGG, waterlase laser is effective in the treatment of gingival overgrowth associated with fixed orthodontic treatment. A significant reduction in pocket depth and evident pain control can be achieved intra- and postoperatively.