Diode versus CO2 Laser Therapy in the Treatment of High Labial Frenulum Attachment: A Pilot Randomized, Double-Blinded Clinical Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Blinded Methodology
2.2. Randomization
2.3. Dimension of Sample and Inclusion Criteria
- Wound healing was clinically evaluated considering the residual amount of fibrin after oral surgery treatment. Unfortunately, there are no evaluative scales about wound healing process, hence according to what is explained in the book (Oral Wound Healing), it has been estimated: score 1 (wound totally covered by fibrin); score 2 (wound partially covered by fibrin); score 3 (complete healing without fibrin) [26].
- Gingival Recession was clinically evaluated through the use of a periodontal probe (P.C.P 15). Only patients with recession class I were considered, and it has been estimated: score 1 (0 to 1 mm of recession) score 2 (2 mm of recession) score 3 (3 mm of recession) [23].
- Clinical attachment loss was clinically evaluated through the use of a periodontal probe (P.C.P 15). Furthermore, for clinical attachment, only patients with stage I and II were considered and it has been estimated: score 1 (0–1 mm of probing); score 2 (2–3 mm of probing); score 3 (4 mm of probing) [24].
- Pain was calculated thought the use of the Numerical Rating Scale (NRS) which evaluation interval is from number 0 to 10.
2.4. Surgical Protocol
2.5. Clinical Case
2.6. Statistical Methodology
3. Results
- In the manner of patients’ bleeding. In particular, after six months passed after the treatment, using CO2 caused fewer bleeding cases on average compared to the Diode Laser treatment. Specifically, we observed this impact on female patients more significantly rather than male patients
- In the manner of wound healing there is very strong evidence that after the treatment with the Diode Laser, patients’ wounds showed fast healing with respect to CO2 treatment
- In the manner of gingival recession, there is very strong evidence that the treatment with Diode Laser causes reducing patients’ gingival recession that is, on average, significantly better than the CO2 treatment. In particular, gingival recession of male patients decreases fast compared to female patients with Diode Laser treatment, whereas CO2 treatment has a better outcome on the reduction of gingival recession in female patients rather than male patients.
- In the manner of CAL, it can be said that after six months of the treatment with Diode Laser, the improvement of CAL is statistically significant and firmly reducing the periodontal pocket occurrence, whereas, there is no significant finding related to CAL after CO2 treatment
- Lastly, in the manner of NRS, it can be said that both methods reduce the pain very efficiently, Diode Laser treatment removes the pain faster than CO2 treatment. In fact, during the first fourteen days after the treatment, there was a reduction by 89% of pain in the group where it was used diode laser technique. On the other hand, in the same time rate, the reduction of pain was by 65% in the group where a CO2 laser was used. Notably, it is found that male patients got over the pain with Diode Laser easier than female patients, whilst CO2 treatment helped to remove the pain more effectively on female patients with respect to male patients.
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Periodontal Phenotype | Plaque Index | |||||
---|---|---|---|---|---|---|
A1 | A2 | B | 1 | 2 | 3 | |
CO2 | 1 | 7 | 5 | 10 | 0 | 3 |
Diode Laser | 1 | 4 | 8 | 8 | 2 | 3 |
Type | Diode | CO2 |
---|---|---|
Name | Raffaello Bio | Smart US20D |
Wavelength | 980-nm | 10.600 nm |
Power | 2.5 W | 4.5 W |
Modality of pulse | Continuous | Super pulse wave |
Frequency | 1.000 Hz | 80 Hz |
Medical class/Laser | IIB/IV | IIB/IV |
Number of sessions | Single surgery session | Single surgery session |
Production site. | DMT Dental Medical Technology | Deka |
Bleeding | Wound Healing | Gingival Recession | CAL | NRS | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | SEM | Mean | SD | SEM | Mean | SD | SEM | Mean | SD | SEM | Mean | SD | SEM | ||
Diode Laser | T0 | 1.15 | 0.55 | 0.15 | 3.00 | 0.00 | 0.00 | 1.69 | 0.63 | 0.17 | 1.46 | 0.66 | 0.18 | 0.00 | 0.00 | 0.00 |
T1 | 1.62 | 0.65 | 0.18 | 1.69 | 0.48 | 0.13 | 1.62 | 0.51 | 0.14 | 1.46 | 0.66 | 0.18 | 3.62 | 2.96 | 0.82 | |
T2 | 1.31 | 0.63 | 0.17 | 1.92 | 0.28 | 0.08 | 1.62 | 0.51 | 0.14 | 1.46 | 0.66 | 0.18 | 1.54 | 1.56 | 0.43 | |
T3 | 1.15 | 0.55 | 0.15 | 2.54 | 0.66 | 0.18 | 1.00 | 0.00 | 0.00 | 1.15 | 0.38 | 0.10 | 0.08 | 0.28 | 0.08 | |
T4 | 1.15 | 0.55 | 0.15 | 2.77 | 0.60 | 0.17 | 1.00 | 0.00 | 0.00 | 1.08 | 0.28 | 0.08 | 0.00 | 0.00 | 0.00 | |
N | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | |
CO2 | T0 | 1.00 | 0.00 | 0.00 | 3.00 | 0.00 | 0.00 | 1.38 | 0.77 | 0.21 | 1.31 | 0.63 | 0.17 | 0.00 | 0.00 | 0.00 |
T1 | 2.00 | 0.58 | 0.16 | 1.92 | 0.49 | 0.14 | 1.38 | 0.77 | 0.21 | 1.31 | 0.63 | 0.17 | 3.38 | 2.26 | 0.63 | |
T2 | 1.38 | 0.51 | 0.14 | 1.92 | 0.28 | 0.08 | 1.23 | 0.60 | 0.17 | 1.23 | 0.44 | 0.12 | 1.38 | 1.33 | 0.37 | |
T3 | 1.00 | 0.00 | 0.00 | 2.23 | 0.93 | 0.26 | 1.08 | 0.49 | 0.14 | 1.23 | 0.44 | 0.12 | 0.23 | 0.83 | 0.23 | |
T4 | 1.00 | 0.00 | 0.00 | 2.54 | 0.97 | 0.27 | 1.00 | 0.41 | 0.11 | 1.15 | 0.38 | 0.10 | 0.00 | 0.00 | 0.00 | |
N | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 |
Diode Laser | CO2 | ||||||
---|---|---|---|---|---|---|---|
t-Test | p-Value | SEM | t-Test | p-Value | SEM | ||
Bleeding | Female | 2.828 | 0.030 ** | 0.571 | 4.582 | 0.004 ** | 1 |
Male | 1.581 | 0.175 | 0.333 | 3.873 | 0.012 ** | 1 | |
Total | 3.207 | 0.008 ** | 0.462 | 6.245 | 0.000 *** | 1.000 | |
Wound Healing | Female | −3.873 | 0.008 ** | −0.714 | −1.441 | 0.199 | −0.429 |
Male | −2.236 | 0.076 * | −0.500 | −1 | 0.363 | −0.333 | |
Total | −4.383 | 0.000 *** | 0.616 | −1.806 | 0.096 * | −0.385 | |
Gingival Recession | Female | 2.121 | 0.078 * | 0.429 | 2.828 | 0.030 ** | 0.571 |
Male | 5 | 0.004 *** | 0.833 | 1 | 0.363 | 0.167 | |
Total | 4.382 | 0.000 *** | 0.615 | 2.739 | 0.018 ** | 0.385 | |
Periodontal Pocket | Female | 2.827 | 0.031 ** | 0.572 | 1 | 0.356 | 0.143 |
Male | 1 | 0.363 | 0.167 | 1 | 0.360 | 0.165 | |
Total | 2.612 | 0.017 ** | 0.384 | 1.477 | 0.165 | 0.154 | |
NRS | Female | 2.547 | 0.043 ** | 2.857 | 4.831 | 0.002 ** | 3.285 |
Male | 3.737 | 0.013 ** | 4.5 | 2.976 | 0.031 ** | 3.572 | |
Total | 4.405 | 0.000 *** | 3.615 | 5.409 | 0.000 *** | 3.385 |
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Sfasciotti, G.L.; Zara, F.; Vozza, I.; Carocci, V.; Ierardo, G.; Polimeni, A. Diode versus CO2 Laser Therapy in the Treatment of High Labial Frenulum Attachment: A Pilot Randomized, Double-Blinded Clinical Trial. Int. J. Environ. Res. Public Health 2020, 17, 7708. https://doi.org/10.3390/ijerph17217708
Sfasciotti GL, Zara F, Vozza I, Carocci V, Ierardo G, Polimeni A. Diode versus CO2 Laser Therapy in the Treatment of High Labial Frenulum Attachment: A Pilot Randomized, Double-Blinded Clinical Trial. International Journal of Environmental Research and Public Health. 2020; 17(21):7708. https://doi.org/10.3390/ijerph17217708
Chicago/Turabian StyleSfasciotti, Gian Luca, Francesca Zara, Iole Vozza, Veronica Carocci, Gaetano Ierardo, and Antonella Polimeni. 2020. "Diode versus CO2 Laser Therapy in the Treatment of High Labial Frenulum Attachment: A Pilot Randomized, Double-Blinded Clinical Trial" International Journal of Environmental Research and Public Health 17, no. 21: 7708. https://doi.org/10.3390/ijerph17217708