6,7,15,26-31There is abundant evidenceconfirming markedly less bleeding,11,29,30particu-larly of highly vascular oral tissues, with laser sur-gery.27Some reports suggest that laser-createdwounds heal more quickly and produce less scar tis-sue than conventional scalpel surgery,28althoughcontrary evidence also exists.31-33Postoperative painfrom oral and otolaryngological surgical procedureshas been claimed to be reduced in laser surgery.10,29It is theorized that this may be due to the protein co-agulum that is formed on the wound surface, therebyacting as a biologic dressing and sealing the ends ofthe sensory nerves.10,28On the other hand, the super-pulse mode, which was used in this study, releasesbursts of higher peak powers and shorter pulse dura-tions in the microsecond range. This mode allows thesurgeon to deposit pulses of higher peak power intotissue with control, to confine the exposure to pulsesthat are within the thermalrelaxation time ofthe tissue(which is the time needed by the tissue to release theabsorbed heat via conduction or circulation), and touse pulse repetition rates that allow cooling betweenindividual pulses to reduce heat accumulation.14,30The use of this mode may have beneficial effects onthe control of post-surgical complications by prevent-ing carbonization or charring, which may interferewith wound healing.Although it has many advantages, the laser tech-niquerequiressomeprecautions.TheCO2laserbeammay be reflected from shiny metal surfaces, such asretractorsormouthmirrors,andcauseeyeinjury.Pro-tective eyewear must be worn by the operator and as-sistants. The patient’s eyes, throat, and delicate oraltissues outside the surgical site must be protectedfrom accidental beam impact through use of safetyglasses and wet towels or gauze packs. Clinicians ex-perienced in CO2laser surgery have emphasized theneed for an adequate shield, such as a flat-bladed in-strument or silver foil, between the gingiva and teeth.Finally, an important part of laser safety is a properlytrained staff.4,6ACKNOWLEDGMENTThe authors thank Dr. Roland Blankenstein, London,United Kingdom, for his valuable assistance.REFERENCES1. Takei HH, Azzi RA. Periodontal plastic and estheticsurgery. In: Newman MG, Takei HH, Carranza FA, eds.Carranza’sClinicalPeriodontology.London:W.B.Saunders; 2002:870-871.2. Fiorotti RC, Bertolini MM, Nicola JH, Nicola EM. Earlylingual frenectomy assisted by CO2laser helps pre-vention and treatment of functional alterations causedby ankyloglossia.Int J Orofacial Myology2004;30:64-71.3. Bullock N Jr. The use of the CO2laser for lingualfrenectomy and excisional biopsy.Compend ContinEduc Dent1995;16:1118-1123.4. Pick RM, Colvard MD. Current status of lasers in softtissue dental surgery.J Periodontol1993;64:589-602.
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