Lectura 15.pdf

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6,7,15,26-31 There is abundant evidence confirming markedly less bleeding, 11,29,30 particu- larly of highly vascular oral tissues, with laser sur- gery. 27 Some reports suggest that laser-created wounds heal more quickly and produce less scar tis- sue than conventional scalpel surgery, 28 although contrary evidence also exists. 31-33 Postoperative pain from oral and otolaryngological surgical procedures has been claimed to be reduced in laser surgery. 10,29 It is theorized that this may be due to the protein co- agulum that is formed on the wound surface, thereby acting as a biologic dressing and sealing the ends of the sensory nerves. 10,28 On the other hand, the super- pulse mode, which was used in this study, releases bursts of higher peak powers and shorter pulse dura- tions in the microsecond range. This mode allows the surgeon to deposit pulses of higher peak power into tissue with control, to confine the exposure to pulses that are within the thermalrelaxation time ofthe tissue (which is the time needed by the tissue to release the absorbed heat via conduction or circulation), and to use pulse repetition rates that allow cooling between individual pulses to reduce heat accumulation. 14,30 The use of this mode may have beneficial effects on the control of post-surgical complications by prevent- ing carbonization or charring, which may interfere with wound healing. Although it has many advantages, the laser tech- niquerequiressomeprecautions.TheCO 2 laserbeam may be reflected from shiny metal surfaces, such as retractorsormouthmirrors,andcauseeyeinjury.Pro- tective eyewear must be worn by the operator and as- sistants. The patient’s eyes, throat, and delicate oral tissues outside the surgical site must be protected from accidental beam impact through use of safety glasses and wet towels or gauze packs. Clinicians ex- perienced in CO 2 laser surgery have emphasized the need 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 properly trained staff. 4,6 ACKNOWLEDGMENT The authors thank Dr. Roland Blankenstein, London, United Kingdom, for his valuable assistance. REFERENCES 1. Takei HH, Azzi RA. Periodontal plastic and esthetic surgery. In: Newman MG, Takei HH, Carranza FA, eds. Carranza’s Clinical Periodontology . London: W.B. Saunders; 2002:870-871. 2. Fiorotti RC, Bertolini MM, Nicola JH, Nicola EM. Early lingual frenectomy assisted by CO 2 laser helps pre- vention and treatment of functional alterations caused by ankyloglossia. Int J Orofacial Myology 2004;30: 64-71. 3. Bullock N Jr. The use of the CO 2 laser for lingual frenectomy and excisional biopsy. Compend Contin Educ Dent 1995;16:1118-1123. 4. Pick RM, Colvard MD. Current status of lasers in soft tissue dental surgery. J Periodontol 1993;64:589-602.
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  • Fall '19
  • carbon dioxide laser, J Periodontol, frenectomy operations

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