Case Report
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Laser Biostimulation of Free Gingival Grafts Around Dental Implants

Year 2016, Volume: 19 Issue: 3, 181 - 188, 24.03.2017

Hatice Balcı Yüce

https://doi.org/10.7126/cumudj.296979

Abstract

Objective: Long-term
edentulousness causes big alterations in mandible such as keratinized tissue is
reduced or lost and vestibular sulcus becomes too shallow. As a consequence,
free gingival autograft is usually mandatory. The aim of this case report was
to evaluate the effect of diode laser bio-stimulation on FGG procedure around
dental implants in edentulous patients.

Material and Methods: 
Three edentulous female patients (59 and 64 and 79 years old) were
referred to our department in different time periods. All patients had serious
alveolar bone loss because of prolonged edentulism. In clinical and
radiographical examinations, it is observed that patients had lack of
keratinized tissue around 6 dental implants placed in mandibular canine
positions. The healing caps had been placed and there were severe soft tissue
problems and disorientations and also ulcerations around healing caps. Patients
were really uncomfortable and in pain because of ulcerated mucosa. Conventional
vestibuloplasty and gingivectomy procedures were performed in one patient. The
problem continued, lips covered healing caps again and patient was suffering
from the pain again. After then in order to reduce the pain and stimulate soft
tissue healing, diode laser bio-stimulation were performed in all three
patients along with the FGG procedure. Totally six FGG procedures were
performed in three patients.

Results: Mild pain was observed in donor
site and other than that there was no pain or discomfort in all patients. After
30 days, the keratinized tissues around dental implants were increased and the
discomfort and pain were gone. Healing caps were placed again and the patients
were treated successfully.







Conclusion: Diode laser bio-stimulation reduced the
post-surgical pain and discomfort caused by FGG procedure around dental
implants in elderly patients.

Keywords

Diode laser Bio-stimulation FGG Dental implants

References

  • 1. Miller PD Jr. Regenerative and reconstructive periodontal plastic surgery. Mucogingival surgery. Dent Clin North Am 1988;32:287-306.
  • 2. Consensus report. Mucogingival therapy. Ann Periodontol 1996;1:702‑6.
  • 3. Muller HP, Eger T, Schorb A. Gingival dimensions after root coverage with free connective tissue grafts. J Clin Periodontol 1998;25:424-430.
  • 4. Agudio G, Nieri M, Rotundo R, Franceschi D, Cortellini P, Pini Prato GP. Periodontal conditions of sites treated with gingival-augmentation surgery compared to untreated contralateral homologous sites: a 10- to 27-year long-term study. J Periodontol 2009;80:1399-1405.
  • 5. Björn H. Free transplantation of gingiva propria. Sven Tandlaek Tidskr 1963;22:684-689.
  • 6. Trey E, Bernimoulin JP. Influence of free gingival grafts on the health of the marginal gingiva. J Clin Periodontol 1980;7:381-393.
  • 7. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. J Clin Periodontol 1980;7:316-324.
  • 8. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. A four year report. J Periodontol 1982;53:349-352.
  • 9. Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. J Clin Periodontol 1974;1:185-196.
  • 10. Bruggenkate CM, Krekeler G, van der Kwast WA, Oosterbeek HS. Palatal mucosa grafts for oral implant devices. Oral Surg Oral Med Oral Pathol. 1991;72:154-158.
  • 11. Lauer G, Schwarz U, Schilli W. Transalveolar fixation of the peri-implant soft tissue in the mandible: surgical method and clinical follow-up. J Oral Maxillofac Surg. 1996;54:690-697.
  • 12. Mester E, Spiry T, Szende B, Tota JG. Effect of laser rays on wound healing. Am J Surg 1971;122:532-5.
  • 13. Marques MM, Pereira AN, Fujihara NA, Nogueira FN, Eduardo CP. Effect of low-power laser irradiation on protein synthesis and ultrastructure of human gingival fibroblasts. Lasers Surg Med 2004;34:260-5.
  • 14. Hashmi JT, Huang YY, Osmani BZ, Sharma SK, Naeser MA, Hamblin MR. Role of low level laser therapy in neurorehabilitation. PM R. 2010; 2:292-305.
  • 15. Walsh LJ. The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Aust Dent J 1997;42:247-254.
  • 16. Sato T, Kawatani M, Takeshige C, Takeshige C, Matsumoto I. Ga-Al-As laser irradiation inhibits neuronal activity associated with inflammation. Acupunct Electrother Res 1994;19:141–151.
  • 17. Fávaro-Pípi E, Ribeiro DA, Ribeiro JU, et al.: Low-level laser therapy induces differential expression of osteogenic genes during bone repair in rats. Photomed Laser Surg 2011, 29: 311–317.
  • 18. Silveira PC, Silva LA, Freitas TP, et al. Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing. Lasers Med Sci 2011, 26: 125–131.
  • 19. Tsuchiya K, Kawata`ni M, Takeshige C, Matsumoto I. Laser irradiation abates neuronal responses to nociceptive stimulation of rat paw skin. Brain Res Bull 1994;34:369–374.
  • 20. Miller PD Jr. Root coverage using the free soft tissue autograft following citric acid application. III. A successful and predictable procedure in areas of deep-wide recession. Int J Periodontics Restorative Dent 1985;5:14–37.
  • 21. Wennstrom JL, Zucchelli, G. & Pini Prato, G. Mucogingival therapy – Periodontal plastic surgery. In: Lindhe J, Lang, N. P. & Karring, T, ed. Clinical periodontology and implant dentistry. vol. 5th edition,: Oxford: Blackwell Munksgaard., 2008:955–1028.
  • 22. Prato GP, Clauser C, Cortellini P. Periodontal plastic and mucogingival surgery. Periodontol 2000 1995;9:90-105.
  • 23. Kennedy JE, Bird WC, Palcanis KG, Dorfman HS. A longitudinal evaluation of varying widths of attached gingiva. J Clin Periodontol 1985;12:667-675.
  • 24. Prato GP, Cairo F, Tinti C, Cortellini P, Muzzi L, Mancini EA. Prevention of alveolar ridge deformities and reconstruction of lost anatomy: a review of surgical approaches. Int J Periodontics Restorative Dent. 2004;24:434-445.
  • 25. Thoma DS, Buranawat B, Hammerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol 2014;41 Suppl 15:S77-91.
  • 26. Thoma DS, Benic GI, Zwahlen M, Hammerle CH, Jung RE. A systematic review assessing soft tissue augmentation techniques. Clin Oral Implants Res. 2009;20 4:146-165.
  • 27. Rocha AM, Junior, Vieira BJ, Andrade LC, Monteiro A. Effects of low-level laser therapy on the progress of wound healing in humans: The contribution of in vitro and in vivo experimental studies. J Vasc Bras. 2007;6:258–266.
  • 28. Conlan MJ, Rapley JW, Cobb CM. Biostimulation of wound healing by low-energy laser irradiation. J Clin Periodontol 1996;23:492–496.
  • 29. Rocha AM, Jr, Oliveira RG, Farias RE, Andrade LC, Aarestrup FM. Modulação da proliferação fibroblástica e da resposta inflamatória pela terapia a laser de baixa intensidade no processo de reparo tecidual. An Bras Dermatol 2006;81:150–156.
  • 30. Saygun I, Karacay S, Serdar M, Ural AU, Sencimen M, Kurtis B. Effects of laser irradiation on the release of basic fibroblast growth factor (bFGF), insulin like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from gingival fibroblasts. Lasers Med Sci 2008;23:211–215.
  • 31. Kreisler M, Christoffers AB, Willershausen B, d’hoedt B. Effect of low-level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: An in vitro study. J Clin Periodontol 2003;30:353–358.
  • 32. Magnusson I, Runstad L, Nyman S, Lindhe J.A long junctional epithelium- A locus minoris resistentiae in plaque infection? J Clin Periodontol 1983:10:333-340.
  • 33. Noguchi T, Sanaoka A, Fukuda M, Suzuki S, Aoki T. Combined effects of Nd:YAG laser irradiation with local antibiotics applications into periodontal pockets. J Clin Periodontol 2005;32:670-676.
  • 34. Finkbeiner RL. The results of 1328 periodontal pockets treated with the argon laser: Selective pocket thermolysis. J Clin Laser Med Surg 1995;13:273-81.
  • 35. Tuner J, Hode L. Some Basic Laser Physics. 2nd ed. Grangesberg (Sweden): Prima Books; 2007: 317-38.
  • 36. Lagan KM, Clements BA, McDonough S, Baxter GD. Low intensity laser therapy (830nm) in the management of minor postsurgical wounds: A controlled clinical study. Lasers Surg Med 2001;28:27-32.
  • 37. Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: A controlled clinical pilot study. J Clin Periodontol 2008;35:250-4.
  • 38. Allendorf JD, Bessler M, Huang J, Kayton ML, Laird D, Nowygrod R, et al. Helium-neon laser irradiation at fluences of 1, 2, and 4 J/cm2 failed to accelerate wound healing as assessed by wound contracture rate and tensile strength. Lasers Surg Med 1997; 20:340–5.
  • 39. Hunter J, Leonard L, Wilson R, Snider G, Dixon J. Effects of low energy laser on wound healing in a porcine model. Lasers Surg Med 1984;3:285–290.

Year 2016, Volume: 19 Issue: 3, 181 - 188, 24.03.2017

Hatice Balcı Yüce

https://doi.org/10.7126/cumudj.296979

Abstract

References

  • 1. Miller PD Jr. Regenerative and reconstructive periodontal plastic surgery. Mucogingival surgery. Dent Clin North Am 1988;32:287-306.
  • 2. Consensus report. Mucogingival therapy. Ann Periodontol 1996;1:702‑6.
  • 3. Muller HP, Eger T, Schorb A. Gingival dimensions after root coverage with free connective tissue grafts. J Clin Periodontol 1998;25:424-430.
  • 4. Agudio G, Nieri M, Rotundo R, Franceschi D, Cortellini P, Pini Prato GP. Periodontal conditions of sites treated with gingival-augmentation surgery compared to untreated contralateral homologous sites: a 10- to 27-year long-term study. J Periodontol 2009;80:1399-1405.
  • 5. Björn H. Free transplantation of gingiva propria. Sven Tandlaek Tidskr 1963;22:684-689.
  • 6. Trey E, Bernimoulin JP. Influence of free gingival grafts on the health of the marginal gingiva. J Clin Periodontol 1980;7:381-393.
  • 7. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. J Clin Periodontol 1980;7:316-324.
  • 8. Dorfman HS, Kennedy JE, Bird WC. Longitudinal evaluation of free autogenous gingival grafts. A four year report. J Periodontol 1982;53:349-352.
  • 9. Edel A. Clinical evaluation of free connective tissue grafts used to increase the width of keratinised gingiva. J Clin Periodontol 1974;1:185-196.
  • 10. Bruggenkate CM, Krekeler G, van der Kwast WA, Oosterbeek HS. Palatal mucosa grafts for oral implant devices. Oral Surg Oral Med Oral Pathol. 1991;72:154-158.
  • 11. Lauer G, Schwarz U, Schilli W. Transalveolar fixation of the peri-implant soft tissue in the mandible: surgical method and clinical follow-up. J Oral Maxillofac Surg. 1996;54:690-697.
  • 12. Mester E, Spiry T, Szende B, Tota JG. Effect of laser rays on wound healing. Am J Surg 1971;122:532-5.
  • 13. Marques MM, Pereira AN, Fujihara NA, Nogueira FN, Eduardo CP. Effect of low-power laser irradiation on protein synthesis and ultrastructure of human gingival fibroblasts. Lasers Surg Med 2004;34:260-5.
  • 14. Hashmi JT, Huang YY, Osmani BZ, Sharma SK, Naeser MA, Hamblin MR. Role of low level laser therapy in neurorehabilitation. PM R. 2010; 2:292-305.
  • 15. Walsh LJ. The current status of low level laser therapy in dentistry. Part 1. Soft tissue applications. Aust Dent J 1997;42:247-254.
  • 16. Sato T, Kawatani M, Takeshige C, Takeshige C, Matsumoto I. Ga-Al-As laser irradiation inhibits neuronal activity associated with inflammation. Acupunct Electrother Res 1994;19:141–151.
  • 17. Fávaro-Pípi E, Ribeiro DA, Ribeiro JU, et al.: Low-level laser therapy induces differential expression of osteogenic genes during bone repair in rats. Photomed Laser Surg 2011, 29: 311–317.
  • 18. Silveira PC, Silva LA, Freitas TP, et al. Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing. Lasers Med Sci 2011, 26: 125–131.
  • 19. Tsuchiya K, Kawata`ni M, Takeshige C, Matsumoto I. Laser irradiation abates neuronal responses to nociceptive stimulation of rat paw skin. Brain Res Bull 1994;34:369–374.
  • 20. Miller PD Jr. Root coverage using the free soft tissue autograft following citric acid application. III. A successful and predictable procedure in areas of deep-wide recession. Int J Periodontics Restorative Dent 1985;5:14–37.
  • 21. Wennstrom JL, Zucchelli, G. & Pini Prato, G. Mucogingival therapy – Periodontal plastic surgery. In: Lindhe J, Lang, N. P. & Karring, T, ed. Clinical periodontology and implant dentistry. vol. 5th edition,: Oxford: Blackwell Munksgaard., 2008:955–1028.
  • 22. Prato GP, Clauser C, Cortellini P. Periodontal plastic and mucogingival surgery. Periodontol 2000 1995;9:90-105.
  • 23. Kennedy JE, Bird WC, Palcanis KG, Dorfman HS. A longitudinal evaluation of varying widths of attached gingiva. J Clin Periodontol 1985;12:667-675.
  • 24. Prato GP, Cairo F, Tinti C, Cortellini P, Muzzi L, Mancini EA. Prevention of alveolar ridge deformities and reconstruction of lost anatomy: a review of surgical approaches. Int J Periodontics Restorative Dent. 2004;24:434-445.
  • 25. Thoma DS, Buranawat B, Hammerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol 2014;41 Suppl 15:S77-91.
  • 26. Thoma DS, Benic GI, Zwahlen M, Hammerle CH, Jung RE. A systematic review assessing soft tissue augmentation techniques. Clin Oral Implants Res. 2009;20 4:146-165.
  • 27. Rocha AM, Junior, Vieira BJ, Andrade LC, Monteiro A. Effects of low-level laser therapy on the progress of wound healing in humans: The contribution of in vitro and in vivo experimental studies. J Vasc Bras. 2007;6:258–266.
  • 28. Conlan MJ, Rapley JW, Cobb CM. Biostimulation of wound healing by low-energy laser irradiation. J Clin Periodontol 1996;23:492–496.
  • 29. Rocha AM, Jr, Oliveira RG, Farias RE, Andrade LC, Aarestrup FM. Modulação da proliferação fibroblástica e da resposta inflamatória pela terapia a laser de baixa intensidade no processo de reparo tecidual. An Bras Dermatol 2006;81:150–156.
  • 30. Saygun I, Karacay S, Serdar M, Ural AU, Sencimen M, Kurtis B. Effects of laser irradiation on the release of basic fibroblast growth factor (bFGF), insulin like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from gingival fibroblasts. Lasers Med Sci 2008;23:211–215.
  • 31. Kreisler M, Christoffers AB, Willershausen B, d’hoedt B. Effect of low-level GaAlAs laser irradiation on the proliferation rate of human periodontal ligament fibroblasts: An in vitro study. J Clin Periodontol 2003;30:353–358.
  • 32. Magnusson I, Runstad L, Nyman S, Lindhe J.A long junctional epithelium- A locus minoris resistentiae in plaque infection? J Clin Periodontol 1983:10:333-340.
  • 33. Noguchi T, Sanaoka A, Fukuda M, Suzuki S, Aoki T. Combined effects of Nd:YAG laser irradiation with local antibiotics applications into periodontal pockets. J Clin Periodontol 2005;32:670-676.
  • 34. Finkbeiner RL. The results of 1328 periodontal pockets treated with the argon laser: Selective pocket thermolysis. J Clin Laser Med Surg 1995;13:273-81.
  • 35. Tuner J, Hode L. Some Basic Laser Physics. 2nd ed. Grangesberg (Sweden): Prima Books; 2007: 317-38.
  • 36. Lagan KM, Clements BA, McDonough S, Baxter GD. Low intensity laser therapy (830nm) in the management of minor postsurgical wounds: A controlled clinical study. Lasers Surg Med 2001;28:27-32.
  • 37. Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G. Improved wound healing by low-level laser irradiation after gingivectomy operations: A controlled clinical pilot study. J Clin Periodontol 2008;35:250-4.
  • 38. Allendorf JD, Bessler M, Huang J, Kayton ML, Laird D, Nowygrod R, et al. Helium-neon laser irradiation at fluences of 1, 2, and 4 J/cm2 failed to accelerate wound healing as assessed by wound contracture rate and tensile strength. Lasers Surg Med 1997; 20:340–5.
  • 39. Hunter J, Leonard L, Wilson R, Snider G, Dixon J. Effects of low energy laser on wound healing in a porcine model. Lasers Surg Med 1984;3:285–290.
There are 39 citations in total.

Details

Subjects Health Care Administration
Journal Section Case Reports
Authors

Hatice Balcı Yüce

Publication Date March 24, 2017
Submission Date May 19, 2015
Published in Issue Year 2016Volume: 19 Issue: 3

Cite

EndNote Balcı Yüce H (March 1, 2017) Laser Biostimulation of Free Gingival Grafts Around Dental Implants. Cumhuriyet Dental Journal 19 3 181–188.
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Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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