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| research 08 laser 4 2016 Kurz & bündig Grundlegende Untersuchungen zur Lasergewebeinteraktion eines neuen Lasertherapiegerätetyps mit einer Wellenlänge von 445 nm – blaues Farbspektrum – versprechen aufgrund der bekannten optischen Parameter ora- le Weichgewebe nachhaltige Vorteile gegenüber infraroten Lasersystemen. Im Rahmen eines Fallberichts wird das Vorgehen bei umfassenden laserbasierten Gingivektomien vor restaurativer Therapie mit diesem neuem Lasertyp vor- gestellt. Gingivektomie und adhäsive Füllungstherapie waren in einer Sitzung aufgrund der hervorragenden Blutstillung mit dem Blaulichtlaser möglich. Die Nachkontrolle zeigte eine schnelle Ausheilung der Wunde ohne Komplikationen und ohne postoperative Gingivaretraktion. Die Therapie führte bei moderatem Aufwand zu einem sehr guten ästhe tischen Ergebnis. restorations with a composite material in a multi- layertechnique(Herculite®;A3,5).Figure4showsthe situation after the restoration had been completed, including finishing and polishing of the aesthetically complex restauration. After laser treatment, haemo- staticmeasureswerenolongernecessaryforallsub- sequent treatment steps. In the post-operative recall after seven days (Fig. 5), the patient reported that there was no post-operative pain. After the proce- dure, the patient did not find it necessary to use the analgetics that had been made available. After 14 days (Fig. 6), the excision wounds had healedtoaverygreatextent.Therewasstillslightred- ness in the marginal area. No swelling occurred in the entire post-operative phase. At this time, endodontic treatment was also performed for the devitalised tooth11.Afterpreparationandsealingoftherootca- nal,thetrepanationcavitywasclosedusingacompos- ite material (Figs. 7a–c). Three months after the oper- ativeprocedure,theendodontictreatmentoftooth11 resultedinnofurtherclinicalsymptoms.Inthetreated area, the probing depth was 1.5 mm. No bleeding was foundduringprobing.Nofurtherrecessionofthegin- gival margin was found after the primary healing, ap- proximately two weeks after treatment or at the fol- low-upinspectionafterthreemonths.Gingivalcolour and surface texture (gingival stippling) corresponded to a healthy appearance (Fig. 8). To ensure long-term good oral hygiene and to prevent approximal gingival recession at 11/21 in a further step a frenectomy (laser-assisted) should be performed. Discussion The presented treatment protocol for laser-as- sisted gingivectomy enabled the badly destroyed teeth 11 and 21 to be restored in an aesthetically sat- isfactory manner. Due to the safe procedure and the drying of the surgical field after laser-assisted exci- sion,adhesivefillingswereplacedinthesamesession andexhibitednodiscolourationinthemarginalzone, even after three months. This indicates a good bond- ing between the restorative material and the dentin. There was only little discomfort for the 72-year-old patient which derived from this complex therapy. Af- teranemergencytreatment,definitiverehabilitation, including adhesive restorations and endodontics, was carried out in two sessions. The patient did not report any discomfort related to the laser treatment. The patient's aesthetic appearance in the anterior teeth of the upper jaw was restored with moderate means. This treatment procedure improves the pa- tient’s compliance, because it allows the patient to partake in a systematic care and treatment concept, which enables the continuation of additional neces- sary treatment measures._ contact Prof. Dr Matthias Frentzen Welschnonnenstraße 17 53111 Bonn, Germany Tel.: +49 228 287-22470 frentzen@uni-bonn.de Fig. 6: Follow-up inspection after 14 days. Figs. 7a–c: X-rays documentation of the endodontic treatment of 11. Fig. 8: Post-operative recall after 3 months.—Healthy gums and aesthetic restauration of the carious lesions at 11 and 21. Fig. 6 Fig. 7a Fig. 7b Fig. 7c Fig. 8 Author details Literature 42016 Tel.: +49228287-22470