Use of the Carbon Dioxide Laser in Retarding Epithelial Migration: A Pilot Histological Human Study Utilizing Case Reports

Abstract

Predictable regeneration of tooth-supporting tissues lost to periodontal disease is the aim of periodontal therapy. Often the result of conventional treatment is healing with a long junctional epithelium along the root surface and little regeneration of the complete attachment apparatus. The purpose of this pilot study was to evaluate whether de-epithelialization with a CO2 laser at the time of flap surgery and at 10-day intervals over the first 30 days of healing has the potential to enhance the formation of a connective tissue attachment. Six mandibular incisors in two patients were selected for the study. Each patient received oral hygiene instruction and initial therapy prior to surgery. The teeth were splinted together, open flap debridement was performed on all teeth, a notch was placed on the roots at the height of the crest of the alveolar bone, and the flaps were sutured in place. The test side received controlled de-epithelialization of the outer (oral) gingiva with the carbon dioxide laser, and the inner gingival flap. The de-epithelialization was repeated on the test side at 10, 20, and 30 days postsurgically. Controls received open debridement only. Block sections were taken at 90 days and processed for histologic analysis. The results showed that for both patients, junctional epithelium (JE) was formed on both test and control teeth. In all control teeth, the JE extended the entire length of the root to the base of the reference notch.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing

“…In the treatment of inflammatory periodontal diseases, lasers may contribute to the bacterial reduction in periodontal pockets as well as to the removal of calculus and granulation tissue and can be used for contouring hyperplastic gingiva. An interesting aspect of laser application is the possibility of flap de-epithelization resulting in a retarded epithelial migration and an increased connective tissue formation [44][45][46].…”

Effect of Diode Laser Irradiation on Root Surfacesin Vitro

“…[7][8][9][10][11][12][13] Clinical studies demonstrated a high supportive effect of many laser systems (Nd:YAG, Er:YAG, argon, CO 2 , and diode laser) when used in combination with scaling and root planing. [14][15][16][17][18][19][20] Several in vitro studies, however, indicated that lasers may severely damage root surface structures and inhibit new cellular attachment when certain energy levels are exceeded. [21][22][23][24][25][26] Moreover, the influence of pocket irradiation on collateral structures (gingiva, periodontal ligament, and alveolar bone) require considerable scientific investigations.…”

A report of laser-assisted modified Widman flap for periodontal regeneration: Clinical and radiographic evaluation

“…Various animal and human studies demonstrate that a laser has the ability to retard the epithelial downgrowth and obtain new clinical attachment with bone fill in previously diseased sites. [45]…”