ADJUNCTIVE USAGE OF LOW-LEVEL LASER THERAPY FOR NECROTIZING ULSERATIVE GINGIVITIS

Objectives: Necrotizing ulserative gingivitis (NUG) is unique among the periodontal diseases with distinctive characteristics of rapid onset of gingival pain, interdental gingival necrosis as often described by “punched out” ulcerated papillae and bleeding. NUG is limited to lesion involving gingival tissue with no loss of periodontal attachment and bone loss. Interproximal gingival necrosis is easy to detect. The onset of NUG is associated with increased psychological stress and decreased nutrient intake.
Methods: 17 years old women was referred to the Department of Periodontology, Abant Izzet Baysal University Faculty of Dentistry with severe pain in gingival tissues. Patient has stressful because of exams and doesn’t have systemic problem. Intra-oral examination localized necrotic tissues were seen bilateral maxiller premolar interproximal region and there is continuous involuntary physical trauma inflicted by patient’s nails . In the first session only polishing and attouchement with ½ diluted 3% hydrogen peroxide were performed.Following our patient some relief, phase I periodontal treatment was applied. For pain-reducing and promoting wound healing we used low level laser theray (1W, CW mod). After healing of the necrotic tissues muscle atachments were excised and vestibul sulcus was deepened using diode laser in premolar area. Periodontal dressing was applied for one week.
Results: Patient were seen every week for 1 mouth. Healing was uneventful. There was no need to used painkiller when using laser and patient’s bad habits disappeared.
Conclusions: Clinical signs and symptoms of NUG will usually resolve within a few days after receiving adequate treatment; however, patients remain at risk for recurrences of disease. Within the limit of this case, low level laser therapy is a succesful treatment modality for wound healing process and reducing gingival pain in NUG patients. Also high muscle atachments should be excised for adequate vestibul sulcus depth so that patients can carry out proper oral hygine especially NUG.