FRENOTOMY PERFORMED WITH A DIODE LASER.

Anatomically speaking, the frenum is a fold of mucous membrane and connective tissue fibers that joins the gingiva, periosteum, and alveolar mucosa at the base of the cheek and lip. Placek et al. classified frenum based on the extent of attachment of the fibers: (1) mucosal, which occurs when the frenal fibers are attached up to the mucogingival junction; (2) gingival, which occurs when the fibers are inserted within attached gingiva; (3) papillary, which occurs when the fibers extend into the interdental papilla; and (4) papilla penetrating, which occurs when the frenal fibers cross the alveolar process and extend up to the palatine papilla. The typical frenum has mucosal attachment, which is thought to be the proper level of attachment. However, frenum that encroaches on the gingiva’s margin (class 2 and above) may make it difficult to remove plaque, and the tension on the frenum may eventually cause the sulcus to open, which can result in gingival recession, midline diastema, root dentine hypersensitivity, and an unsightly appearance. In order to get the ideal smile, getting dental treatment is becoming more and more important due to cosmetic considerations. modes of therapy Procedures called frenectomy or frenotomy may be used to treat the aberrant frena. A frenectomy involves removing the frenum entirely, including its connection to the underlying bone; a frenotomy involves making an incision and moving the frenal attachment. These may be completed using lasers, electrosurgery, or the standard scalpel procedure. Using a scalpel, the frenum is excised in the traditional method. But it also entails the standard dangers associated with surgery, including as edema, post-operative infection, and bleeding that impairs vision. Lasers have supplanted traditional methods since their development. Pioon laser is available in many wavelengths, such as 450nm, 810nm, or 980nm. In this instance, a tension test was carried out before to the frenotomy treatment to visually identify the aberrant frena by placing stress across the frenum. Using a wavelength of 980 nm in contact mode, this operation was performed under topical anesthetic. It began with ablating the surface layer and worked its way down to the deeper layer, eventually releasing the muscular tension. Both the patient and the doctor wore laser safety glasses, and appropriate safety measures were implemented. In 2019, Patil P et al. employed a 980nm wavelength and found that due of the patient’s comfort, the bloodless field, and the shortened healing period, it was a great substitute for traditional knife surgery. Using a 980 nm wavelength as well, Patel RM et al. (2015) came to the conclusion that diode lasers improve patient perception and provide a suitable and effective alternative for treatments. justification for using lasers Because they are less intrusive than traditional methods and generate less postoperative edema, lasers are gaining popularity. Less inflammation is produced when nerve terminals are sealed, and less pain is experienced after surgery because a protein coating forms over the incision to shield it from outside irritants. In conclusion, lasers have shown to be a reliable, secure solution that works well for frenotomy. The case report and literature review for diode laser frenectomy is Patil PP, Kabbur KJ, Madaiah H, and Satyanarayana S. J Dent Lasers 2019;13:19–22 and Patel RM, Suragimath GS, Kope SA, Kale V, and Abbayya K. comparison of the diode laser and traditional surgical methods for labial frenectomy. J Dent Lasers 2015;9:94-9

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