Soft Tissue Lasers: Gingivectomy

Soft Tissue Lasers: Gingivectomy is a procedure used for gingiva removal. It is indicated for someone who wants to achieve esthetics. Gingivectomy may be used if the suprabony pockets have been present and there is access to the osseous structures which is not always important.

Dental lasers can be used to reshape the gums or gingiva to benefit your smile

Pain-free dental lasers are used to treat gingivectomy, gingivoplasty, and to aid in periodontitis treatments

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Soft Tissue Lasers: Gingivectomy

Soft Tissue Lasers: Gingivectomy is a procedure used for gingiva or gum removal. It is indicated for someone who wants to achieve high esthetics. A gingivectomy may be used if the suprabony pockets have been present and there is access to the osseous structures which is not always important. This procedure helps to decrease gingival tissue if there is enlargement with the altering of the fibrotic gingiva. However, this procedure is not indicated in the person who has an osseous foundation that is in critical health or if gingival attachment is absent or is minimal.

The benefits of laser gingivectomy

The observation had found out that the resecting of the gingiva using a dental laser, it will improve with the access since it increases the visualization which results in better visualization which will help with the sealing of lymphatic and capillaries when laser irradiation is used. At the beginning, the tissue healing by the use of inflammation and blades will be noted together with epithelialization and collagen production.  Myofibroblasts is present in low level when the wound site from laser resection starts to heal. This leads to no wound contraction and the scar will not be too visible.

After using the dental laser, the wound healing will depend on the device setting and the type of the laser wavelength which is already used. The experience of the dentist is also more important, even more so compared to the laser wavelength.

Instead of dental laser therapy, it is possible to use electrosurgery. This procedure will not have any defined tissue to target as the laser technology. The primary way for tissue interaction is by the use electrosurgical instrument by using heat ablation. Bipolar electrosurgery unit is improvement on monopolar unit since bipolar unit will generate no lateral heat so it may be used in the wet environment.

Laser is attracted to the specific chromophores so less power will be required in order to incise the tissue when the abundant chromophor will be present within the tissue. If the gingiva is inflamed or hyperemic, less power will be required since hemoglobins are found in high amount. This is truer to the people who have gingivectomies and they have melanin in high content. The tissue which has enough melanin, it does not need too much power compared to the gingiva that has coral and light pink while using wavelengths.

Erbium Laser

Erbium laser may be used to perform gingivectomy; however hemostasis may be problematic because of its wavelength. Some dentists choose to use the erbium laser setting which may create the laser bandage. Before, such laser bandage was known as eschar or char layer. Before, the old  laser technique were creating the char layer since they had high influences, now the new layer units cause the char tissue less often. The use of the char layer does depend on the preference of the clinician. The clinician takes into consideration the tissue’s absorption spectrum and emission spectrum. Other factors to consider are the chromophore in the tissue, the wavelength that should be emitted, pulse per second, spot size and power. The dentist should not think that increasing of the power can lead to faster cutting within the targeted tissue. The laser can generate the heat which may lead to tissue necrosis away of the lateral thermal damage. The setting is critical and it can help to perform laser therapy.

How laser gingivectomy is performed

The first incisions during the gingivectomies work the same like these that use a blade with the external bevel.  Where incision will be put starting from the coronal gingival margin; will depend on the depth of pockets with the amount of gingiva around it. The first cut should be made according to the measurement of the pocket depth.  The caution should be taken in how the tooth has to be approached and this is mostly if it is to work around the root structure since there can suffer interaction between laser and hard tissue which may lead to the tissue damage. Decreasing of the power can prevent the injury.  There are technician who use reflective barrier into the sulcus which prevent wavelength to stray so that they do not interact with a root.  When there is a soft tissue, the mylar and the metal can reflect laser energy far from a tooth.  When the gingiva is excised, the power driven ultrasonic scaling will be used for debriding root surface.

The sculpting ability of the lasers and gingivoplasty may be done at the gingival margins to ensure parabolic appearance.  Erbium laser will create the homeostasis if the procedure is done through altering the laser parameters in order to seal off the blood vessels. The technicians may use erbium laser bandage so that they can make the final procedure.  Placing the dressing or not, it will be a matter of what the clinician wants.

The gingivectomy is a type of periodontal surgery and it reforms and removes the disease of the gum tissue or if there is any other gingival build up which may be related to the underlying conditions.  For someone who is suffering chronic gingival condition, the gingivectomy may be used if other non surgical method may have been used and the gum disease had advanced and it may jeopardize bone and ligaments that supports the teeth. The procedure can be performed in the office of a dentist and the surgery has to be done first on a quadrant of a mouth or using local anesthetics. The level of the attachment on the gum with the supporting structures can determine the surgery success. The surgery needed beyond the gingivectomy will involve the regeneration of the attachment structure by the use of the bone grafts and tissue.

The periodontal surgery may be performed in order to eliminate or to alter microbial factors which may lead to periodontitis. This will stop how the disease is progressing. The periodontal disease will comprise some conditions which affect periodentium health. These factors involve the host condition and microorganisms like immune system which may affect the gums and the support the teeth.  If the gingiva had been infected by the plaque making bacteria because of immune suppression or oral hygiene, the bacterial condition for gum infection or periodontitis will begin. If the cause of the disease is not removed, then such disease will progress. In some severe cases, the graft surgery can be needed in order to restore the tissue ligaments with bone tissue which had been destroyed because of pathogens.

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