PIOON LASER - Professional Aesthetics Laser, Dental Laser

Pioon Laser([email protected]) is an innovative thinking, full service medical laser systems design and manufacturing firm specializing in laser technology for the medical market.

[pioonlaser]

Lip Depigmentation with Laser

Oral Mucosa is normally pink, although the color varies depending on location, function and underlying structures. Lips are an important part of our smiles; the shape and color are crucial elements of the lip's beauty.

The color of the lips normally varies from person to person depending on factors such as melanin production, skin color, vascularity, and dryness (dehydration) of the lips. Among these, the major factor contributing to the color of lips is melanin. Lip hyperpigmentation does not pose any medical problem, but usually considered unaesthetic and can affect the patient’s social activities and self-confidence and patients are seeking solutions.

Etiology- The most common cause is physiologic i.e. hyper-melanin pigmentation. After ruling out any malignant changes, the Laser is used electively for removing pigmentation from the lips.

Treatment modality- Many techniques have been used for the treatment of lip depigmentation. Melanin pigmentation normally exists in the epithelial layer and might reach the basal layer, making these pigmentations superficial and easy to reach and eliminate. Lip melanin depigmentation techniques includes Cryotherapy, Pink tattoo, Photodynamic therapy, Chemical peeling and Topical medicated agents such as Vit. C, arbutin, hydroquinone, and liquid nitrogen

All these treatments results have different outcomes and adverse effects and esthetic results might not be satisfactory for the patients; however, lasers achieved good acceptable results esthetically and are tolerated by patients. PIOON Laser offers different wavelengths like 450nm, 810nm/980nm which can either be used in contact or non-contact manner to perform this procedure. In this case the patient was clinically examined, an informed consent was taken after complete explanation of the procedure, and all laser safety precautions were followed.  Anesthetic gel was applied on the lips of the patient. The patient was asked to open the mouth widely and the depigmentation process was carried out from the upper lip to the lower lip in a sequential clockwise manner. Wavelength of 980 nm was used in contact mode and the laser setting was 1 Watt in continuous mode.

Sana Farista in 2012 showed case reports where diode laser was used for depigmentation of lips in a successful manner. Also, Islam Kassem in 2016 published a case report that outlines a case that have been performed using mentioned laser parameters without any adverse patient reactions.

Rationale behind Use of Lasers Laser is absorbed by pigments in the soft tissue, thus making it an excellent hemostatic agent. It also has the advantage of easy handling of tissues, less chairside time, treatment finishes in single visit and property of potential decontamination and sterilization.

Conclusion- Lip hyperpigmentation is an esthetic concern as it masks the overall appearance of the individual. The use of a diode laser was shown to be a safe and effective treatment modality to provide optimal aesthetics with reduced discomfort to the patients during the treatment.

Reference – Iyer VH, Farista S. Management of Hyperpigmentation of Lips with 940 nm Diode Laser: Two Case Reports. Int J Laser Dent 2014;4(1):31-38 and Islam Kassem et al. Lip Depigmentation (Pinkification) Using 810nm Diode Laser, Kassem’s Protocol, Initial Case Report. Smile Dental Journal | Volume 11, Issue 2 – 2016.

                    Preoperative View (Case Courtesy – Dr. Sana Farista)

                       Postoperative View (Case Courtesy – Dr. Sana Farista)

[pioonlaser]

The radial fiber is the optimal fiber for endovenous thermal ablation.

The radial fiber is the optimal fiber for endovenous thermal ablation. When combined with the 1470nm wavelength, the radial fiber can emit at 360° rather than as a thin beam straight. With the introducing kit, the radial fiber can introduce the laser energy gently and evenly into the lumen of the vein and ensure the closure of the vein based on photothermal destruction.   The radial fiber, with the encapsulated tip, smooth and atraumatic, avoids perforations of the vein wall and the associated thermal irritation of the surrounding tissue, thereby minimizing postoperative pain, ecchymosis, and other side effects. The radial fiber is not only for the EVLT, but can be used to the proctology, PLDD and so on. Please follow us and we will share the relevant posts in the next weeks.

[pioonlaser]

Are Laser Dental Procedures Better Than Traditional Treatments?

Dental laser is the use of lasers to treat a number of different dental conditions. It became commercially used in clinical dental practice for procedures involving tooth tissue in 1989.

Dental laser potentially offers a more comfortable treatment option for a number of dental procedures involving hard or soft tissue compared to drills and other non-laser tools.

Lasers can make dental treatments more efficient, cost effective, and comfortable. The Food and Drug Administration (FDA) has approved dental laser as a treatment option for several dental conditions.

The type of surgery that can be performed with a dental laser depends on the wavelength and power of the dental laser. Pioon dental laser can perform the following dental laser procedures. Including:

Teeth whitening.

Treating cold sores.

Treating a “gummy smile.”

Treating obstructive sleep apnea.

Treating tongue frenulum attachment.

Viewing tissues.

Nerve regeneration.

Crown lengthening.

Removing benign tumors.

Removing soft tissue folds.

TMJ (temporomandibular joint) treatment.

Compared to non-laser treatment, they may be less expensive because the laser treatment is usually completed in fewer sessions.

Soft tissue lasers can be absorbed through water and hemoglobin. Hemoglobin is a protein found in red blood cells.

These lasers are used to treat periodontitis, including killing bacteria and activating tissue regrowth.

Soft tissue lasers seal nerve endings and blood vessels while they penetrate the tissue. For this reason, many experience almost no pain after laser treatment. The lasers also promote faster healing of the tissue.

Benefits of using dental laser over other methods

There is potentially a decreased need for sutures with soft tissue lasers.

Bleeding is minimized in treated soft tissues, as the laser promotes blood clotting.

With some procedures, anesthesia is unnecessary.

The chance for bacterial infections is lower because the laser sterilizes the area.

Wounds can heal faster, and it’s possible for tissue to regenerate.

The procedures may involve less damage to the surrounding tissues.

[pioonlaser]

Pioon sincerely invite you to attend this newest clinical training

Pioon sincerely invite you to attend this newest clinical training with Pioon's S3/H1 dental laser in Morocco. Let's wait and see！Trainer: Dr.Lotfi LazrakTime: 26-27 February 

[pioonlaser]

PLDD-Let your intervertebral disc no longer “protrude”

Patients with intervertebral disc herniation are mostly between 30 and 50 years old, and there are more men than women. The most common site is the lumbar spine, followed by the cervical spine (because these two sites are the sites with greater spine mobility).

Lumbar disc herniation is a frequently-occurring and common disease in clinical practice, and it is the most common cause of low back and leg pain. The disease mostly occurs in young adults, and part of it occurs in the elderly. The patient suffers a lot. In severe cases, it can cause paraplegia, which can have a great impact on the life, work and labor of the patient.

The cause of lumbar disc herniation is more complicated. At present, it is generally believed that the herniated disc is mainly caused by corresponding damage on the basis of degeneration. Internal cause: The intervertebral disc tissue bears the weight of the human body's trunk and upper limbs, and is more likely to be strained than other tissues in daily life and work. With the increase of age, as well as the continuous squeeze, traction and other external forces, the intervertebral disc gradually degenerates, the nucleus pulposus water volume decreases, the elasticity is lost, the intervertebral space narrows, the ligaments relax, and the internal cause of herniation is formed. External cause: Under the action of external force, the pressure on the back of the intervertebral disc increases when bending over to lift the weight, and the annulus fibrosus ruptures and the nucleus pulposus protrudes posteriorly and laterally.

According to the diagnostic classification methods of the International Lumbar Spine Research Society (ISSL) and the American Academy of Orthopaedics (AAOS), lumbar disc herniation is divided into five types: degenerative type, bulging type, herniated type, prolapsed type, and free type:

1. Degenerative type: Early change, mostly without clinical symptoms and signs, and generally not confused with the prominent type.

2. Bulging type: it is physiological degeneration, the annulus fibrosus is loose but intact, and the nucleus pulposus shrinks. The annulus fibrosus evenly extends beyond the edge of the vertebral body endplate. Generally, there are no clinical symptoms and radicular symptoms rarely appear.

3. Protruding type: The nucleus pulposus protrudes into the spinal canal through the annulus fibrosus, and the posterior longitudinal ligament is not ruptured. The imaging manifestation is that the intervertebral disc is confined to the spinal canal. Some patients have typical radicular symptoms and signs. This type of conservative method can be relieved, and minimally invasive interventional treatment is required if necessary.

4. Prolapse type: the annulus fibrosus and posterior longitudinal ligament are completely ruptured, and the nucleus pulposus protrudes into the spinal canal. There are usually obvious symptoms and signs. The prolapse is difficult to heal itself, and most of them require minimally invasive intervention or surgical treatment.

5. Free type: the prolapsed nucleus pulposus is not connected to the corresponding intervertebral disc, and can be free to the upper and lower segments of the spinal canal disease and the intervertebral foramen. The clinical manifestation is persistent nerve root symptoms or spinal stenosis symptoms, often requiring surgical treatment .

Under traditional surgery, the trauma area of the intervertebral disc surgery and the pain suffered by the patient are relatively large. PIOON has been focusing on research and development for many years and found that combining the wavelengths of 1470nm, 15W and 980nm, 30W is the two best wavelengths for the treatment of lumbar disc herniation, and it has always been safe and effective.

[pioonlaser]

Is there a future for intravenous ablation devices?

Varicose veins refer to varicose veins and dilation caused by blood stasis, weak wall of venous canal and other factors. Varicose veins can occur in many parts of the body. For example, ulcer is actually a varicose vein. Clinically, esophageal and gastric floor varicose veins, varicocele and abdominal wall varicose veins can be seen clinically. The most common part of varicose veins is in the lower limbs. Varicose veins are tortuous, enlarged veins that typically occur in the lower extremities.

Endovenous laser ablation therapy (EVLT) is the most popular new minimally invasive treatment for varicose veins, a minimally invasive procedure that uses catheters, lasers and ultrasound to treat varicose veins.Its advantages: 1. The risk of intravenous laser treatment is small. Less bleeding.2. The efficacy is complete, and the operation is performed under direct vision.3 .The operation is simple, and the treatment time cycle is short.4 .Less severe patients can be performed in the outpatient operating room.5. Less secondary infection, less pain, and faster recovery.6 .Almost no scars after the operation.After Pioon research showed that,The 1940nm laser has been proved to be very safe and effective in using parameters, that is, the average power of GSV and SSV is 4.0 W, and the LEED is greater than 30 J/cm (average about 50 J/cm). As the ideal wavelength, 1940nm will produce the maximum possible selective damage with the greatest margin of safety and the lowest procedure-related complication rate. It achieves the best balance.

Endovenous laser ablation therapy (EVLT) has been used for the treatment of varicose veins with significant success, especially in adult populations with saphenous insufficiency. Varicose veins are a common condition in adult populations of several industrialized nations, increasingly affecting their quality of life. The global endovenous laser therapy market has made considerable strides, driven by continuous advances in techniques used in the procedures.

There are three type of endovenous ablation devices available in the market: endovenous laser ablation therapy (EVLT) devices, radiofrequency ablation (RFA) devices, and non-thermal non-tumescent (NTNT) devices. The intravenous ablation devices market is expected to gain market growth during the forecast period of 2020 to 2027. Data Bridge Market Research analyzes that the market will account for USD 2.22 billion by 2027 with a CAGR of 4.20% during the aforementioned forecast period.Rising prevalence of CVI is rapidly driving the intravenous ablation devices market.So the future market for venous ablation equipment is very vast and the benefits of investing in venous ablation equipment are substantial.

[pioonlaser]

LASER works in ENT Surgery

Thanks to the constant technological evolution, the medical laser who is still the object of ceaseless improvements continuously has been applied in ENT surgery more and more up to now.

Laser benefits in the surgical therapy of otosclerosis are the better control on bleeding and the risk reduction of “floating platina” and acoustic vibratory trauma. These advantages allow it to optimize the functional result and to reduce risks of cochlear damage connected with surgical treatment. The ideal property of tissue interaction of the laser radiation in the otosclerosis surgery is the laser’s energy absorption of the platina, that allows the vaporization and avoids the perilymph thermal dispersion. The modality of supply of the pulsate energy enables the tissue cooling between the pauses and reduces the risk of thermal damage of the surrounding structures. And the possibility of using different optical , both in “contact” and “no contact” modality, allows a very effective use in endoscopy also.

During there, Diode LASER makes great contribution with its big profit, such as more selection and less invasion in surgery procedure, which minimizes the risk and post-operative period in hospital and especially do a good job in the treatment of the nose pathology as well as the chronic tonsillitis which by diode laser should be utilized in the in contact method.

[pioonlaser]

Medica 2021 trade fair for Medical technology

PIOON  Medical Laser sincerely invite you to our booth: 9D43-2

[pioonlaser]

Soft tissue Laser Applications in Pediatrics

There are many applications for pediatric soft tissue laser procedures in oral surgery, oral pathology, periodontology and orthodontics — including frenectomies, frenotomies, operculectomies, gingivectomies, and treatment of aphthous and herpetic lesions.

Ankyloglossia of the infant is a common and well-studied condition in which the attachment of the lingual frenum is at the tip of the tongue. This is most common in boys, with a reported incidence of 4% to 5%. Ankyloglossia and restriction of tongue movement can result in poor breastfeeding and maternal nipple pain. Research shows that frenotomy can reduce maternal nipple pain, although the effect on breastfeeding quality has not been consistently proven. Frenotomy involves administering local anesthesia and using two instruments — such as a mosquito or hemostat — in a V shape to protect structures in the sublingual area, including the lingual nerve and Wharton’s duct. A scalpel, laser or electrosurgical knife is used to make a V-shaped incision separating the attachment. Advantages of using a laser include the specific interaction of the laser with treated tissue, rapid hemostasis, reduced postoperative discomfort and fast wound healing. The laser also has a decontaminating and antibacterial effect.

Laser labial frenectomy is completed in a similar fashion, but can also include surgical repositioning of the frenum attachment. While indications for labial frenectomy are varied, this procedure can improve access and cleansability of the facial surfaces of the young child’s incisors, reduce traction on the marginal gingiva, aid in orthodontic treatment of a persistent midline diastema, and modify labial or lingual anatomic issues in a multidisciplinary approach to speech development. Advantages of using a laser in frenectomy or frenotomy include reduced operating time, decreased use of local anesthetic and faster healing.

Removal of benign, diseased oral soft tissue, such as mucocele, gingival fibroma, and pyogenic granuloma, can also be achieved with a diode or Nd:YAG laser. Case reports also indicate successful use of Er-Cr:YSGG lasers for these procedures. Aphthous ulcers and herpetic ulcers may be treated with laser therapy, resulting in reduced healing time — although more high-quality studies are needed to determine effectiveness and treatment protocols.

Periodontal disease is found in a smaller percentage of pediatric patients than adults; nonetheless, teenagers and children present with various periodontal conditions. Some of the most common laser procedures performed in a pediatric population include gingivectomy, removal of operculum, or exposure of a submerged tooth for placement of an orthodontic bracket. Although laser decontamination of periodontal pockets in adults has been studied with varying results, there is little research in pediatric populations. At this time, laser therapy is best considered as an adjunct to traditional periodontal treatment.

Additionally, evolving fields in medicine and dentistry involve photobiomodulation (PBM) and low-level laser therapy (LLLT). In PBM, lasers are used to initiate a photochemical effect on a cellular level, without thermal or ablative characteristics. The majority of studies use diode lasers and attribute positive clinical changes to stimulation of mitochondrial cytochromes, eliciting increased cellular metabolism and improved cell viability. While more studies are needed, there is sufficient literature to support PBM in the treatment of oral mucositis — which is of interest to clinicians who manage patients undergoing radiation or chemotherapy.

[pioonlaser]

(LLLT)Low-level laser therapy in acclerating orthodontic tooth

Orthodontic treatment is a way of straightening or moving teeth to improve the way they look and work. By distributing the pressure of the bite to all the teeth through orthodontic treatment, it also helps to maintain the long-term health of the teeth, gums and jaw joints. The length of treatment varies depending on the severity of the problem, with some taking a few months and others two and a half years. Most people can be cured in a year or two. It is therefore of great clinical importance to explore safe and effective adjunctive interventions to accelerate orthodontic tooth movement, achieve treatment goals in as short a time as possible and achieve a healthy, functional, stable and aesthetically pleasing bite, which is a common pursuit for orthodontists and patients alike. In recent years, low-level lasers have gradually gained the attention of orthodontists due to their safety and lack of side effects as well as their simplicity, convenience and comfort.

Low-level lasers are lasers that do not cause irreversible damage to biological tissues and do not cause a significant increase in local temperature, and have a spectral range of 600-1000 nm (infrared and near-infrared light), a power density of 5 mW/cm 2 -5W/cm 2 , an energy of 1mW-10W, an action time of 30s-60s per site and a number of sites of 1-15. 1-15. The low-level laser has a range of biomodulatory or biostimulatory effects on cells and tissues, including reducing inflammation, oedema and chronic joint disorders; accelerating soft tissue and bone tissue repair to promote wound and nerve healing; promoting hair growth; relieving pain and much more.

PIOON S3 dental diode laser 650nm can be adjusted to 0.1-0.5 watts and irradiated evenly over the surface of the lesion for 15-20 seconds, repeating the procedure 2 to 3 times until the patient is pain-free. Large lesions are treated continuously at intervals of 24 to 48 hours. This method is called LLLT (low-level laser therapy).

In addition, LLLT has a pain-relieving effect by reducing the release of arachidonic acid, which reduces prostaglandin E2 levels in the body; by inducing the release of the endogenous opioid neuropeptide beta-endorphin, which exerts a potent analgesic effect; and by stabilising the cell membrane potential, which blocks the activation and transmission of pain-related signals. This shows that LLLT is a promising non-invasive adjunctive intervention for accelerating orthodontic tooth movement.

[pioonlaser]

LASER ASSISTED EXCISION OF A GINGIVAL POLYP

INTRODUCTION: Gingival polyps, are focal fibrous hyperplastic lesions, also known as, localized gingival enlargement or “epulis”. The primary reason for the occurrence of a gingival polyp or epulis is attributed to local factors such as caries, calculus and tooth malposition.

TREATMENT MODALITY: A surgical excision can be performed using a periodontal knife/scalpel/rotary coarse diamond burs/ electrocautery etc. But these techniques are prone to side effects and complications like surgical trauma, postoperative pain, swelling, bleeding after excision and poor patient acceptance.

After evolution of LASERS, these conventional techniques are replaced by LASER, owing to the various advantages associated with it, such as minimal use of anesthesia, provision of hemostasis and enabling a bloodless surgical field with a laser bandage of the wound.

Literature is replete with numerous studies1,2,3, wherein diode lasers were highly successful in the excision of localized reactive lesions of the gingiva.

PIOON Laser offers different wavelengths like 450nm/810nm or 980nm. Out of which 810nm/980nm are used in contact mode in order to perform the polyp excision.

SURGICAL PROCEDURE: The presented case shows a carious tooth with a painless reddish-pink soft gingival overgrowth of 5x3 mm size, localized to interproximal area with a pedunculated base.  Followed by scaling, a laser excision of the gingival polyp was done. The gingival overgrowth (polyp) was removed with small strokes in contact mode progressing from the palatal aspect towards the interproximal area. The entire gingival polyp was excised as per the outline marked by the laser prior to the procedure.

CONCLUSION: Diode lasers have emerged as a promising and effective tool in modern minimally invasive dentistry and have been proved successful for the treatment of reactive lesions of the gingiva such as the gingival polyp.

REFERENCES:

1. Iyer V, Sarkar S, Kailasam S. Use of the ER, CR; YSGG laser in the treatment of peripheral ossifying fibroma. Int J Laser Dent. 2012; 2: 51-5.

2. Alam T, Dawasaz AA, Thukral N, Jangam D. Surgical diode laser excision for peripheral cemento-Ossifying fibroma: A case report and literature review. J Oral Laser Appl. 2008; 8: 43-9.

3. Farista S, Butchi Babu, Farista S, Gopinath V and Agrawal V. Laser assisted excision of a gingival polyp in a pediatric patient: report of a case. EJBPS, 2015; 2(4): ,600-607.

PREOPERATIVE VIEW

POSTOPERATIVE VIEW

[pioonlaser]

ROOT CANAL DISINFECTION IN PERMANENT TOOTH USING LASER DURING ROOT CANAL PROCEDURE/ENDODONTIC TREATM

Introduction- The main goal of endodontic treatment is the effective cleaning of the root-canal system and preventing the reinfection. Traditional endodontic techniques use mechanical instruments and chemical irrigation to shape, clean and completely decontaminate the endodontic system. The complexity of the root-canal system is very well known with added fact that most of the NiTi (Nickel-Titanium) instruments work on the center body of canal leaving behind fins, isthmus, cul-de-sacs all untouched. These left out spaces harbour tissue debris, bacteria and their by-products and this insufficient root canal disinfection is the main reason for endodontic failure. LASER helps to achieve this impossible task of disinfection of root canal system as a whole including the lateral and accessory canals. As back dated, Laser technology was introduced to endodontics with the goal of improving the results obtained with traditional procedures through the use of light energy by increasing cleaning ability and improving the decontamination of the endodontic system.

Rationale for the use of Laser - Irrigation is an essential part of root canal therapy because it allows for cleaning and bacterial reduction beyond what can be achieved by root canal instrumentation alone. However, because of high surface tension, chemical reagents penetrates only upto 130 µm into dentinal tubules, while bacteria can colonize the dentinal tubules deeply up to the periodontal surface (1100 µm from the canal lumen). Whereas, agitation of the irrigants has shown to enhance the reach into the dentinal tubules upto 800µm. When we talk about Laser light, it has shown the penetration upto a depth of 1000µm and even more into the dentinal tubules. Literature shows that If Laser and the agitation of Chemical Irrigant is combined together then they exert a synergistic endodontic disinfection, much superior than the individual effect respectively.

Prerequisite for use of LASER in Permanent Tooth -

Root Canal Preparation – The minimum canal preparation for a 200µm laser tip to reach upto the apical area corresponds to ISO file size 30.

Wet canals – Any chemical irrigants can be used like sodium hypochlorite, EDTA or both one after the other. Dry canals are a complete contraindication while using laser.

Working length - It is measured 1mm short of actual working length. E.g. If the working length of a canal is 19mm. So 19-1= 18 mm. This 18mm will be the length up to which the laser tip will go inside the canal.  

Settings/parameters for laser root canal disinfection – The laser we have used is S1 Pioon Laser at 980nm wavelength and a 200µm non initiated tip is used at 2 Watt and Continuous Mode

Steps for Root Canal Disinfection - Under rubber dam isolation all the steps till chemomechanical preparation (CMP) remains the same as Laser disinfection is the final step before the obturation.

First - Irrigation- Wet the canals first with chemical reagent

Second – Use of Laser - Motion or Technique of Use of Laser is as under -

- Withdrawal of the tip from the canal is done at the rate of 2mm/second

-  Disinfection starts from apex to canal orifice

-  Move the tip in circumferential manner without touching the walls of canal

- Not more than 3 pass per canal should be done

- Total time not exceeding 30sec per canal

Third – Wait and Irrigate – Wait for 10 secs between each pass and follow it by replenishing the canal with fresh irrigant

Fourth – Repeat the process – A Maximum of 3 pass per canal can be done in a sitting.

Conclusion - Given the complex root canal anatomy and the limited ability of chemical irrigants to three-dimensionally clean and disinfect the entire endodontic space, the lasers has seen to adjunctively enhance the effectiveness of endodontic treatment, endodontic retreatment and prevent any further endodontic reinfection

References – 1) Giovanni Oliv. Laser Use in Endodontics: Evolution from Direct Laser Irradiation to Laser-Activated Irrigation. Journal of Laser Dentistry. 2013: 21(22); 58-71. 2) Giovanni Olivi, Rolando Crippa, Giuseppe Iaria, Vasilios Kaitsas, Enrico DiVito and Stefano Benedicenti, Laser in endodontics (Part I). Roots: 2011:1; 6-9.

Fig 1 – Measuring the Laser Tip before the disinfection procedure

Fig 2 – Laser Tip Placement in the apical area during Root Canal Disinfection Using Laser in a Permanent Tooth

[pioonlaser]

Happy Eid Al Adha !

Wish all  of our Muslim partners and friends a happy, peaceful and blessed Eid Al Adha~~EID MUBARAK عيد مبارك !

[pioonlaser]

FRENOTOMY USING DIODE LASER

Frenum is an anatomic structure formed by a fold of mucous membrane and connective tissue fibers that attach the lip and cheeks to the alveolar mucosa, the gingiva and the underlying periosteum. Placek et al. have classified frenum depending on the extension of attachment of fibers, (1) Mucosal: when the frenal fibers are attached up to mucogingival junction, (2) Gingival: when fibers are inserted within attached gingiva, (3) Papillary: when fibers are extending into interdental papilla, and (4) Papilla penetrating: when the frenal fibers cross the alveolar process and extend up to palatine papilla.

Frenum with mucosal attachment is the usual and is considered to be the correct level of attachment but if the frenum that encroaches on the margin of the gingiva (Class 2 and above) may interfere with plaque removal, and the tension on the frenum may tend to open the sulcus eventually leading to gingival recession, midline diastema, root dentine hypersensitivity and unaesthetic looks. Nowadays aesthetic concerns have led to an increasing importance in seeking dental treatment, with the purpose of achieving perfect smile.  

Treatment Modalities The aberrant frena can be treated by frenectomy or by frenotomy procedures. Frenectomy is the complete removal of the frenum, including its attachment to the underlying bone, while frenotomy is the incision and the relocation of the frenal attachment. These can be accomplished either by the routine scalpel technique, electrosurgery or by using lasers. The conventional technique involves excision of the frenum by using a scalpel. However, it carries the routine risks of surgery like bleeding due to which visibility is impaired, risk of post-operative infection and edema.

After evolution of LASERS, conventional techniques are replaced by LASER. PIOON Laser offers different wavelengths like 450nm/810nm or 980nm.  In this case before the frenotomy procedure tension test was performed to detect the abnormal frena visually by applying tension over the frenum. This procedure was carried out under topical anesthesia by using wavelength of 980nm in contact mode and it started from ablating superficial layer towards the deeper layer till the muscle pull was released. Laser safety glasses were worn by the clinician and the patient and proper precautions were taken.

Patil P et al in 2019 used 980nm wavelength and revealed that it provided an excellent alternative to conventional scalpel surgery because of patient comfort, bloodless field, and reduced pain and healing time. Patel R M et al in 2015 also used 980 wavelength and concluded that diode lasers provide better patient perception and an efficient and satisfactory option for procedures.

Rationale behind Use of Lasers Lasers are becoming popular over conventional techniques because they are less invasive, which result in reduced postoperative edema. The sealing of nerve endings result in reduced inflammatory response and the formation of a protein layer over the surgical wound protects the wound from external irritation, causing less post-operative pain.

                       Preoperative View (Courtesy- Dr. Sana Farista)

                 Immediate Postoperative view (Courtesy- Dr. Sana Farista)

Reference - Patil P, Kabbur KJ, Madaiah H, Satyanarayana S. Diode laser frenectomy: A case report with review of literature. J Dent Lasers 2019;13:19-22 and Patel R M, Varma S, Suragimath G, Abbayya K, Zope S A, Kale V. Comparison of labial frenectomy procedure with conventional surgical technique and diode laser. J Dent Lasers 2015;9:94-9.

[pioonlaser]

Here comes the IAACD seminar

Don't miss the session about laser dentistry given by laser specialists Dr Sana and Dr Shanin on 18th July 2021: 11am - 12:30PM.For registration, plz contact:Dr Twinkle JainTEL: 9820167063

learn more

[pioonlaser]

Pioon laser arrived in Syria, thanks for the support of very kind and professional Dr. Omar Hamadah.

[pioonlaser]

What is Operculectomy and why is it performed

What is Operculectomy?

Operculectomy is the procedure of surgically removing the operculum or the flap of gum that partially covers over a tooth. This procedure treats pericoronitis, a condition characterized by pain and inflammation of the operculum. Pericoronitis typically occurs among young adults, especially those whose wisdom tooth is starting to erupt.

What happens if Operculectomy is not performed?

1. Causes inflammation in the soft tissues surrounding the crown of the partially erupted tooth clinically called pericoronitis. It typically occurs in teeth that erupt very slowly or become impacted.

2. Penetration of bacteria into the follicular space initiates infection which is potentiated by food debris trapped in proximity to the operculum and occlusal trauma of the pericoronal tissues by the opposing tooth.

When is Operculectomy suggested?

Operculectomy is advised by the dentist when one develops Pericoronitis, which may be acute or chronic.

Acute pericoronitis: characterized by severe radiating pain, localized swelling of the pericoronal tissues, purulence or drainage, trismus, regional lymphadenopathy, painful swallowing, pyrexia, and sometimes spreading of the infection to adjacent tissue spaces.

Chronic Pericoronitis: characterized by dull pain or discomfort, often accompanied by bad taste, lasting a couple of days with remission lasting several weeks or months.

How is Operculectomy Performed?

1. Surgical excision or ablation of the operculum via a wide variety of techniques: Scalpel.

2. Excision using caustic agents, radiofrequency surgery, electrosurgery, cautery, CO2 laser, or hot-tip diode surgery.

3. Soft-tissue laser surgery or Laser-Assisted Operculectomy

Laser Assisted Opereculectomy

Soft-tissue laser ablation (and incision and excision) is a process of vaporization of cellular water due to the heat produced by the laser light within the irradiated soft tissue. Water vapors, rapidly steaming out of the intensely laser-heated soft tissue, carry with them cellular ashes and other byproducts of this fast boiling and vaporization process.

Advantages of Laser Assisted Operculectomy

The most important advantage of soft-tissue lasers over other surgical modalities is their ability to cut and provide hemostasis efficiently.