Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series.

Introduction: Periosteal releasing incision (PRI) is nearly always essential to advance the flap sufficiently for a tension-free flap closure in bone augmentation procedures. However, hematoma, swelling, and pain are recognized as the main consequences of PRI with scalpel. The aim of this case series was to investigate the effectiveness of laser-assisted PRI in guided bone regeneration (GBR) procedure. In addition, postoperative hematoma, swelling, and pain and implant success were assessed. Methods: Seventeen patients needed GBR were included in this study. Diode laser (940 nm, 2 W, pulse interval: 1 ms, pulse length: 1 ms, contact mode, 400-μm fiber tip) was used in a contact mode to cut the periosteum to create a tension-free flap. Facial hematoma, swelling, pain, and the number of consumed nonsteroidal anti-inflammatory drugs (NSAIDs) were measured for the six postoperative days. Six months after implant loading, implant success was evaluated. Results: Minimal bleeding was encountered during the procedure. A tension-free primary closure of the flap was achieved in all cases. The clinical healing of the surgical area was uneventful. None of the patients experienced hematoma, ecchymosis, or intense swelling after surgery. The mean value of maximum pain (visual analogue scale - VAS) was 20.59 ± 12.10 mm (mild pain). Patients did not need to use NSAID after four postoperative days. All implants were successful and functional and none of them failed after 6 months of implant loading. Conclusion: This study revealed the effectiveness of laser-assisted PRI in GBR procedure. This technique was accompanied with minimal sequelae at the first postoperative week. All implants were successful and no complication was noted during the course of this study.

[1]  A. Moro,et al.  Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery. , 2016, International journal of oral and maxillofacial surgery.

[2]  Dae-Ho Leem,et al.  Clinical Study of a Flap Advancement Technique Without Vertical Incision for Guided Bone Regeneration. , 2015, The International journal of oral & maxillofacial implants.

[3]  M. Asnaashari,et al.  Diode Laser in Minor Oral Surgery: A Case Series of Laser Removal of Different Benign Exophytic Lesions. , 2015, Journal of lasers in medical sciences.

[4]  OzturanSeda,et al.  Effects of Nd:YAG Laser Irradiation for Minimizing Edema and Pain After Sinus Lift Surgery: Randomized Controlled Clinical Trial , 2015 .

[5]  S. Ozturan,et al.  Effects of Nd:YAG laser irradiation for minimizing edema and pain after sinus lift surgery: randomized controlled clinical trial. , 2015, Photomedicine and laser surgery.

[6]  G. Gasperini,et al.  Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? , 2014, International journal of oral and maxillofacial surgery.

[7]  K. E. El-Kholey Efficacy and safety of a diode laser in second-stage implant surgery: a comparative study. , 2014, International journal of oral and maxillofacial surgery.

[8]  OzturanSeda,et al.  Laser-assisted laterally positioned flap operation: A randomized controlled clinical trial , 2014 .

[9]  C. Alcântara,et al.  Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. , 2014, International journal of oral and maxillofacial surgery.

[10]  T. Gan,et al.  Impact of Perioperative Dexamethasone on Postoperative Analgesia and Side-Effects: Systematic Review and Meta-Analysis , 2013 .

[11]  T. Griffin,et al.  Comparison of double-flap incision to periosteal releasing incision for flap advancement: a prospective clinical trial. , 2013, The International journal of oral & maxillofacial implants.

[12]  Seong-Ho Choi,et al.  Flap extension attained by vertical and periosteal-releasing incisions: a prospective cohort study. , 2012, Clinical oral implants research.

[13]  N. Wongsirichat,et al.  Effect of single dose preoperative intramuscular dexamethasone injection on lower impacted third molar surgery. , 2012, International journal of oral and maxillofacial surgery.

[14]  최성호,et al.  Flap extension attained by vertical and periosteal-releasing incisions: a prospective cohort study. , 2012 .

[15]  M. Rana,et al.  3D evaluation of postoperative swelling using two different cooling methods following orthognathic surgery: a randomised observer blind prospective pilot study. , 2011, International journal of oral and maxillofacial surgery.

[16]  K. Vennila,et al.  Comparison of diode laser-assisted surgery and conventional surgery in the management of hereditary ankyloglossia in siblings: a case report with scientific review , 2011, Lasers in Medical Science.

[17]  G. Romanos Periosteal releasing incision for successful coverage of augmented sites. A technical note. , 2010, The Journal of oral implantology.

[18]  Yoshimitsu Abiko,et al.  Low-level Er:YAG laser irradiation enhances osteoblast proliferation through activation of MAPK/ERK , 2010, Lasers in Medical Science.

[19]  Y. Doshi,et al.  Advantages of Diode Laser (940 nm) over Surgical Blade in Management of Ankyloglossia: A Case Report , 2010 .

[20]  Hom-lay Wang,et al.  Sandwich Bone Augmentation for Predictable Horizontal Bone Augmentation , 2009, Implant dentistry.

[21]  Isao Ishikawa,et al.  Application of lasers in periodontics: true innovation or myth? , 2009, Periodontology 2000.

[22]  H. Karlsson The prevalence of what? , 2009, Nordic journal of psychiatry.

[23]  G. Greenstein,et al.  Flap advancement: practical techniques to attain tension-free primary closure. , 2009, Journal of periodontology.

[24]  T. Al-Khateeb,et al.  Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. , 2008, International journal of oral and maxillofacial surgery.

[25]  S. Parker,et al.  Lasers and soft tissue: 'loose' soft tissue surgery , 2007, BDJ.

[26]  S. Parker Verifiable CPD paper: Laser-tissue interaction , 2007, BDJ.

[27]  M. Peñarrocha,et al.  Pain and inflammation after periapical surgery in 60 patients. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[28]  M. Sanz,et al.  Long-term results and survival rate of implants treated with guided bone regeneration: a 5-year case series prospective study. , 2005, Clinical oral implants research.

[29]  S. Coleton Lasers in surgical periodontics and oral medicine. , 2004, Dental clinics of North America.

[30]  M. Shaban Soft Tissue Closure Over Immediate Implants: Classification and Review of Surgical Techniques , 2004, Implant dentistry.

[31]  N. Zitzmann,et al.  Long-term results of implants treated with guided bone regeneration: a 5-year prospective study. , 2001, The International journal of oral & maxillofacial implants.

[32]  O. Akhan,et al.  Determination of the anti-inflammatory effects of methylprednisolone on the sequelae of third molar surgery. , 1999, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[33]  R. Wesley,et al.  The prevalence of pain in a pediatric and young adult cancer population , 1987, PAIN®.