Title: Effect of Low Level Laser Therapy on Wound Healing After Gingival Depigmentation Procedure by Scalpel Technique

Authors: Dr Maya Indurkar, Dr Ketaki Dhumal

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.57

Abstract

Introduction

Low-level laser treatment, also called ‘Soft Laser Therapy’ was first introduced by Mester and his colleagues.1 These lasers work in the milliwatt range with wavelengths in the red or near infrared spectrum (400–900nm). Low-level lasers do not cut or ablate the tissues. The basic principle of low-level laser therapy (LLLT) is based on the biostimulation or the biomodulation effect which consists of the fact that irradiation at a specific wavelength is able to alter cellular behaviour.2 Low level laser is a red light or infrared light whose wave length has a low absorption power in water and is capable of penetrating into soft and hard tissues in a depth of 3mm-15mm. These lasers act on subcellular photo-receptors, especially the electron transfer chain of the mitochondrial membrane resulting in the enhancement of ATP formation, increase in electrical potential of mitochondrial membrane, activation of the nucleus and its synthesis result into an increase in the driving force to the cells.1

Gingival hyper pigmentation is increased pigmentation beyond normally expected degree of the oral mucosa.3 The Gingival pigmentation occurs due to non-keratinocytes called as melanocytes. These cells are present in gingival epithelium as in other malpighian epithelia. Melanocytes are dendritic cells located in the basal and spinous layers of the gingival epithelium. They synthesize melanin in organelles called pre-melanosomes or melanosomes.4

Gingival depigmentation is a periodontal plastic surgical procedure whereby the  hyper pigmenta-tion is removed or reduced by various techniques. The patient demand for improved esthetics is the first and foremost indication for depigmentation. One of the most common techniques to beemployed is the surgical removal of pigmentation using scalpels. This procedure involves surgical removal of gingival epithelium with a layer of the underlying connective tissue and allowing the denuded connective tissue to heal by secondary intention.5 The raw surface that forms after the surgical procedure may cause discomfort to the patient while speaking or having food. Low level laser therapy can be effectively used in these patients to reduce their postoperative pain and discomfort. The purpose of using LLLT as a part of postoperative therapy is to provide patients with minimal discomfort or pain and a shortened healing period.

References

  1. Sobouti F, Khatami M, Heydari M, Barati M. The Role of Low-Level Laser in Periodontal Surgeries. J Lasers Med Sci 2015;6(2):45-50
  2. Ozcelik O, Haytac MC, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study. J Clin Periodontol 2008; 35: 250–254.
  3. Chawla K, Lamba AK, Tandon S, Faraz F, Gaba V. Effect of low‑level laser therapy on wound healing after depigmentation procedure: A clinical study. J Indian Soc Periodontol 2016;20:184‑8.
  4. Carranza Kaustubh P Patil, Vaibhav Joshi,  Vijay Waghmode, and Vinayak KanakdaeGingival depigmentation: A split mouth comparative study between scalpel and cryo-surgery Contemp Clin Dent. 2015 Mar; 6 (Suppl 1): S97–S101
  5. Landry R, Turnbull R, Howley T. Effectiveness of benzydamine HCl in the treatment of periodontal post-surgical patients. Res Clin Forums 1988;10:105-118.
  6. J. Walsh. The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Australian Dental Journal 1997;42:(4):247-54.

Corresponding Author

Dr Ketaki Dhumal

GDC Aurangabad