Comparison of Flap Techniques for Crown Lengthening Procedures Using an All Tissue Laser (Waterlase Iplus?) and Conventional Surgical Flaps: A Cross Sectional Study
Author(s): Iram Rafique Pawane* and Sankari Malaiappan
Aim: To determine which technique is suitable for crown lengthening procedures using an all tissue laser (WATERLASE IPLUS®) and scalpel with apically displaced flap based on patient satisfaction and wound healing. Background: Lasers have been used because of several potential benefits such as antibacterial effect and stimulation of wound healing. Lasers help in hemostasis and delay epithelial migration which may facilitate the outcome of flap surgery. The all tissue laser (WATERLASE IPLUS®); composed of erbium, chromium: yttrium- scandium-gallium-garnet (Er;Cr:YSGG) is a suitable tool for soft tissue surgery such as unerupted tooth exposures, maxillary and lingual frenectomy, gingivectomy, pyogenic granuloma and pulpotomy excision. The use of this laser in minimally invasive operations is highly effective and helps manage soft tissues during restoration procedures. Materials and Methods: Twenty one patients (7 males and 14 females) aged 19-45 years, systemically healthy, with adequate width of attached gingiva (>2mm) presenting; subgingival caries, inadequate tooth structure, lack of esthetics due to gummy smile etc. Medically compromised subjects, patients with periodontitis, chronic smokers, pregnant and lactating women and patients who have previously undergone surgical procedures in the same area were excluded. 12 patients underwent laser assisted crown lengthening with osseous reduction using WATERLASE IPLUS® and 8 patients who underwent apically displaced flap with osseous reduction. All data was assessed in the form of mean ± standard deviation, statistical significance was assessed using IBM SPSS version 23, independent t test used to assess intergroup statistical significance; (p < 0.05 was considered statistically significant) Results: Intergroup comparison of the VAS scores for discomfort observed at baseline after the procedure and 7th day of the study suggested that there was a significant difference of the VAS scores, with the patients in the laser group displaying significantly lower VAS scores for discomfort compared with the scalpel. On comparing the healing scores using Landry’s simplified healing index there was no statistical difference seen (p>0.05). Conclusion: It can be concluded that using an all tissue laser assisted crown lengthening with osseous reduction showed better healing and comparatively improved patient VAS scores and compliably to the apically displaced flap using a conventional scalpel.