Novel Periodontal Plastic Surgery Using Er:YAG Laser

Objectives: Laser treatment is expected to accelerate wound healing due to its bactericidal, detoxification and ablation effects. To evaluate the clinical effectiveness of Er:YAG laser application on semilunar coronally repositioned flap procedure (SLCRF) for root coverage in the patients showing shallow gingival recession.
Methods: Forty six cases showing shallow gingival recession (Miller’s classification I or II) in 31 patients (8 males, 23 females; aged 33-68 with the mean age: 47.2 years) were performed SLCRF by laser. Eleven cases in 11 patients were carried out SLCRF by scalpel under local anesthesia as a control. A semilunar incision was placed apically to the recession at a distance from the soft tissue margin, 3 mm greater than the depth of the recession. A split thickness dissection was made. Then, the mid-facial soft tissue graft was coronally repositioned the level of the cement-enamel junction and stabilized by light pressure for 5 min. Clinical parameters including probing pocket depth, plaque index, gingival index, recession of gingiva and defect coverage were evaluated at 0, 1W, 2W, 1M, 3M, 6M, 1Y and 2Y. The amount of bleeding under surgery and total treatment time were also examined. Laser apparatus used in this experiment was Er:YAG laser with an energy output of 50-100 mJ/pulse and 10/20 Hz with water coolant (4cc/min). Laser tips were S600T, P400T and Brush type.
Results: SLCRF by laser showed 76.0% of effectiveness of root coverage in mean while scalpel procedure showed 73.1%. All clinical parameters were improved after treatment in the both groups. Laser procedure was superior to scalpel one by the amount of bleeding under surgery, total procedure time and anesthesia condition.
Conclusions: Er:YAG laser would be applicable for the semilunar coronally repositioned flap procedures. Further study will be required to establish the periodontal plastic surgery by laser.