Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-04-20, 12:10:03 | version 1.38.0
laser_industry Fig. 18: Biomodulation spots after suturing. Figs. 19 & 20: Situation after three months. Fig. 21: Stable tissue after six months. laser 36 3+4_2016 36 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Materials and methods A standard irradiation protocol was used in each in- stance for the clinical series presented here. In all cases, an Nd:YAG laser (LightWalker ATS, Fotona, Ljubljana, Slovenia) was used in conjunction with a flat-top handpiece (Genova handpiece, Fotona, Slove- nia). The laser was used in MSP mode, which produces individual pulses with a width of 100 microseconds. An average power of 0.5 watts and a pulse repetition rate of 10 pulses per second were used in each case, and irradiance was calculated as 0.5 W/cm2. Therapy sessions occurred every other day, with the total num- ber of sessions varying in accordance with clinical judgement and the characteristics of the particular tissue target. Case 1 A 52-year-old female presented with aggressive lo- calised periodontitis. After stabilisation of the acute inflammation, the patient was checked and a deep in- frabony defect was evident on the distal aspect of tooth #23 (Fig. 1). The flap design aimed also to cor- rect the pre-existent gingival recession (Fig. 2). A careful debridement of the granulation tissue was done (Fig. 3) and, afterward, a graft with inorganic bovine-derived hydroxyapatite was placed (Fig. 4). After the surgery (Fig. 5), the area was irradiated with Nd:YAG laser (LightWalker ATS, Fotona, Slovenia) with the flat-top Genova handpiece every other day for ten days (five applications) with the following pa- rameters: 0.5 W, 10 Hz in MSP modality, and 60 sec- onds per point (Fig. 6). The healing was uneventful, with minimal pain and swelling. A control after six months showed a good stability of both the bone graft and the soft tissue (Fig. 7). Case 2 A 41-year-old male patient presented with trau- matic severe gingival recessions on the lower incisors. After a careful consultation, the patient was sched- uled for the mucogingival surgery (Fig. 8). Due to the lack of keratinised tissue and the shallow vestibule, the only possible treatment was to harvest a free gingival graft for the root coverage procedure. The recipient bed was created with a partial-thick- ness flap and all of the epithelial part was removed (Fig. 9). The graft was completely stabilised on the area with a tight suture in order to avoid the formation of a thick layer of exudate, which could jeopardise the final outcome of the procedure (Fig. 10). Biomodulation was performed every other day for 14 days (seven sessions) with the flat-top handpiece in MSP modality, 10 Hz, 0.5 W (LightWalker ATS, Fotona, Slovenia), and 60 sec per point. After the ini- tial phase of 14 days (Fig. 11) and for the whole mat- uration stage of 42 days (Fig. 12), the graft appeared successful and the root coverage was achieved. Case 3 A 65-year-old female patient showed a fracture of an implant in the frontal area and missing teeth from