Laser treatment for gum overgrowth
There are different reasons for gingival overgrowth and patients should be carefully evaluated to determine the origin of the problem so it can diagnose and treated correctly.
It is quite common to note chronic inflammatory Gingival overgrowths during and/or post orthodontic treatment.
Video: Full (Edited) Surgical Protocol Including Preparation, Removal By Laser & Closing Suturing
Gingival enlargement is one of the most common soft tissue problems associated with orthodontic treatment. The presence of orthodontic appliances impedes oral hygiene measures and alters the oral microbial ecosystem to a more pathogenic oral biofilm. Subsequent accumulation of plaque can contribute to the development of chronic periodontal inflammation and can progress to gingival overgrowth.
Gingival overgrowth inhibits hygiene measures and cause aesthetic and functional problems. Management of gingival enlargement by non-surgical periodontal treatment is most important and effective. Optimal plaque control can be maintained by meticulous brushing, flossing and professional scaling. However, motivation of maintaining oral hygiene can be disappointing in some patients. In cases that the enlarged gingivae became fibrous, surgical treatment can be considered.
A 15 year old patient was complaining about bleeding inflamed gums that which occurred 1 year after completion of the orthodontic treatment.
In the internal oral examination, I detected inflamed gums in area 11-13. Overgrowth of the papilla 11-12. Probing depth up to 7mm and bleeding on probing.
Diagnosis: overgrowth of the papilla
Traditionally, gingivectomy was performed using scalpel under local infiltration. Since the first laser designed for dental use was introduced in 1989.
With the introduction of soft tissue lasers these problems can now be addressed more easily. Amongst many LASERS now available in Dentistry DIODE LASERS seem to be most ideal for orthodontic soft tissue applications. As newer treatments herald into minimally invasive techniques, DIODE LASERS are becoming more promising both in patient satisfaction and dentist satisfaction.
For the 15 year old patient I decided to combine laser (diode 890nm) and scalpel (blade 15c) for resolution of the overgrowth of the gingiva and to increase the crown length number 12. Soft tissue curettage with sharp curettes. Sutures was added for stabilization of the papillae in place.
Home instructions include:
- after 24 hours washing with chlorhexidine 0.2% : 30 seconds twice a day, for 1 week.
- after one-week gentle brushing modified bass techniques.
- after 1 months go back for regular brushing with electric toothbrush.
