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Erschienen in:
18.06.2018 | Original Article
Surgical laser oral depigmentation procedure: an investigation on the optimum power settings using Er:YAG laser
Erschienen in: Lasers in Dental Science | Ausgabe 3/2018
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Introduction
Gingiva hyperpigmentation is often a non-pathological problem, but clinically considered unaesthetic when the gingiva appears dark and purplish. Chemical peeling, surgery, and laser ablation are the available treatment options. Er:YAG laser is one of the common laser used in soft and hard tissue management. This study compared the Er:YAG different power settings and selected the best setting for gingival depigmentation.
Materials and methods
Two phases of studies were conducted, starting with ex-vivo animal tissue experimental phase followed by prospective human experimental phase. Twenty-four different power settings were applied for the gingival depigmentation of a recently slaughtered sheep’s head. The four best power settings applied to the human studies were selected based on the following parameters: histology, carbonization, speed, and operator controllability. Two and 4 J/cm2 fluences and short pulse (SP) 0.3 ms and very long pulse (VLP) 1 ms pulse durations were chosen. Forty adult nonsmoker patients were randomly divided into four groups of 10 patients; one power setting was applied to each group followed by clinical and biological evaluation. Pain, bleeding, satisfaction, carbonization, speed of removal, and histological investigation parameters were tested. Ablated tissue specimens were sent for histological analysis.
Results
Four power settings proved safety, patient and dentist satisfaction, and efficiency in removing pigmentations. Regarding pain, satisfaction, and bleeding presented no statistical difference. Histological analysis showed a superficial damage in lamina propria. There was obvious effect of the peak power on the speed of depigmentation procedure.
Conclusion
The higher the peak power the higher work speed and the less carbonization, but it however provided less operator controllability. The reasonable parameter for all practicing dentists is using 2 J/cm2 with very long pulse duration for laser depigmentation therapy.