Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series
Journal of Lasers in Medical Sciences,
Vol. 7 No. 4 (2016),
29 October 2016
,
Page 259-264
Abstract
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.
- Laser ablation
- Alveolar Bone
- Augmentation
- Postoperative Pain
- Edema
- Hemorrhage.
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References
Zitzmann NU, Scharer P, Marinello CP. Long-term results of implants treated with guided bone regeneration: a 5-year prospective study. Int J Oral Maxillofac Implants. 2001;16:355-366.
Blanco J, Alonso A, Sanz M. Long-term results and survival rate of implants treated with guided bone regeneration: a 5-year case series prospective study. Clin Oral Implants Res. 2005;16:294-301. doi:10.1111/j.1600-0501.2005.01106.x.
Greenstein G, Greenstein B, Cavallaro J, Elian N, Tarnow D. Flap advancement: practical techniques to attain tension-free primary closure. J Periodontol. 2009;80:4-15. doi:10.1902/jop.2009.080344.
Lee A, Brown D, Wang HL. Sandwich bone augmentation for predictable horizontal bone augmentation. Implant Dent. 2009;18:282-90. doi:10.1097/id.0b013e3181ad8c6c.
Ogata Y, Griffin TJ, Ko AC, Hur Y. Comparison of double-flap incision to periosteal releasing incision for flap advancement: a prospective clinical trial. Int J Oral Maxillofac Implants. 2013;28:597-604.
Shaban M. Soft tissue closure over immediate implants: Classification and review of surgical techniques. Implant Dent. 2004;13:33-41. doi:10.1097/01.id.0000116370.67314. c0.
Romanos GE. Periosteal releasing incision for successful coverage of augmented sites. A technical note. J Oral Implantol. 2010;36:25-30. doi:10.1563/AAID-JOI-D-09-00068.
Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008;37:264-268.
Rana M, Gellrich NC, Joos U, Piffko J, Kater W. 3D evaluation of postoperative swelling using two different cooling methods following orthognathic surgery: a randomised observer blind prospective pilot study. Int J Oral Maxillofac Surg. 2011;40:690-696. doi:10.1016/j. ijom.2011.02.015.
Gasperini G, Rodrigues de Siqueira IC, Rezende Costa L. Does low-level laser therapy decrease swelling and pain resulting from orthognathic surgery? Int J Oral Maxillofac Surg. 2014;43:868-873. doi:10.1016/j.ijom.2014.02.015.
Klongnoi B, Kaewpradub P, Boonsiriseth K, Wongsirichat N. Effect of single dose preoperative intramuscular dexamethasone injection on lower impacted third molar surgery. Int J Oral Maxillofac Surg. 2012;41:376-379. doi:10.1016/j.ijom.2011.12.014.
Landucci A, Wosny AC, Uetanabaro LC, Moro A, Araujo MR. Efficacy of a single dose of low-level laser therapy in reducing pain, swelling, and trismus following third molar extraction surgery. Int J Oral Maxillofac Surg. 2016;45:392- 398. doi:10.1016/j.ijom.2015.10.023.
Alcantara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML. Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg. 2014;43:93- 98. doi:10.1016/j.ijom.2013.05.016.
Waldron NH, Jones CA, Gan TJ, Allen TK, Habib AS. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: systematic review and meta-analysis. Br J Anaesth. 2013;110:191-200. doi:10.1093/bja/ aes431.
Esen E, Tasar F, Akhan O. Determination of the anti-inflammatory effects of methylprednisolone on the sequelae of third molar surgery. J Oral Maxillofac Surg. 1999;57:1201-6. doi:10.1016/s0278-2391(99)90486-x.
Penarrocha M, Garcia B, Marti E, Balaguer J. Pain and inflammation after periapical surgery in 60 patients. J Oral Maxillofac Surg. 2006;64:429-433. doi:10.1016/j. joms.2005.11.014.
Miser AW, Dothage JA, Wesley RA, Miser JS. The prevalence of pain in a pediatric and young adult cancer population. Pain. 1987;29:73-83.
Park JC, Kim CS, Choi SH, Cho KS, Chai JK, Jung UW. Flap extension attained by vertical and periosteal-releasing incisions: a prospective cohort study. Clin Oral Implants Res. 2012;23:993-998. doi:10.1111/j.1600-0501.2011.02244.x.
Kim Y, Kim TK, Leem DH. Clinical Study of a Flap Advancement Technique Without Vertical Incision for Guided Bone Regeneration. Int J Oral Maxillofac Implants. 2015;30:1113-1118. doi:10.11607/jomi.3586.
Ishikawa I, Aoki A, Takasaki AA, Mizutani K, Sasaki KM, Izumi Y. Application of lasers in periodontics: true innovation or myth? Periodontology. 2000 2009;50:90-126. doi:10.1111/j.1600-0757.2008.00283.x.
Ozturan S, Sirali A, Sur H. Effects of Nd:YAG laser irradiation for minimizing edema and pain after sinus lift surgery: randomized controlled clinical trial. Photomed Laser Surg. 2015;33:193-199. doi:10.1111/j.1600- 0757.2008.00283.x.
El-Kholey KE. Efficacy and safety of a diode laser in second-stage implant surgery: a comparative study. Int J Oral Maxillofac Surg. 2014;43:633-638. doi:10.1016/j. ijom.2013.10.003.
Parker S. Verifiable CPD paper: Laser-tissue interaction. Br Dent J. 2007;202(2):73-81. doi:10.1038/bdj.2007.24.
Sotoode SM, Azimi S, Taheri SA, et al. Diode laser in minor oral surgery: a case series of laser removal of different benign exophytic lesions. J Lasers Med Sci. 2015;6:133-138. doi:10.15171/jlms.2015.08.
Yogesh Doshi MS, Khandge N, Sanghavi A. Advantages of diode laser (940 nm) over surgical blade in management of ankyloglossia: a case report. J Oral Laser Appl. 2010;10:165- 169.
Yilmaz E, Ozcelik O, Comert M, et al. Laser-assisted laterally positioned flap operation: a randomized controlled clinical trial. Photomed Laser Surg. 2014;32:67-74. doi:10.15171/ jlms.2015.08.
Coleton S. Lasers in surgical periodontics and oral medicine. Dent Clin North Am. 2004;48:937-962. doi:10.15171/jlms.2015.08.
Parker S. Lasers and soft tissue: ‘loose’ soft tissue surgery. Br Dent J. 2007;202(4):185-191.
Elanchezhiyan S, Renukadevi R, Vennila K. Comparison of diode laser-assisted surgery and conventional surgery in the management of hereditary ankyloglossia in siblings: a case report with scientific review. Lasers Med Sci. 2013;28:7-12. doi:10.1007/s10103-010-0761-5.
Aleksic V, Aoki A, Iwasaki K, et al. Low-level Er:YAG laser irradiation enhances osteoblast proliferation through activation of MAPK/ERK. Lasers Med Sci. 2010;25:559- 569. doi:10.1007/s10103-010-0761-5.
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