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| case report laser-assisted treatment Fig. 6 Fig. 8 Fig. 7a Fig. 7b Fig. 7c fected area. The gingivectomy was carried out using a 445 nm diode laser (Sirona K-Laser blu, Sirona) with a power output of 1.5 W in cw mode and an appli- cation tip with a diameter of 320 µm. This device is a pre-serial model equivalent to SIROLaser Blue (Sirona). The resection was carried out in six minutes. The surgical procedure was performed with no pain. After finishing the gingival excision, the surgical field was bloodless and dry (Fig. 3), so that the tem- porary fillings at 11 and 21 could be removed and the caries completely excavated under visual control. The defects were treated with adhesive restorations with a composite material in a multi-layer technique (Herculite®; A3,5). Figure 4 shows the situation after the restoration had been completed, including fin- ishing and polishing of the aesthetically complex restauration. After laser treatment, haemostatic measures were no longer necessary for all subse- quent treatment steps. In the postoperative recall after seven days (Fig. 5), the patient reported that there was no postoperative 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 healed to a very great extent. There was still slight redness in the marginal area. No swelling occurred in the entire postoperative phase. At this time, endo- dontic treatment was also performed for the devital- ised tooth 11. After preparation and sealing of the root Fig. 6: Follow-up inspection after 14 days. Figs. 7a–c: X-rays documentation of the endodontic treatment of 11. Fig. 8: Postoperative recall after three months.—Healthy gums and aesthetic restauration of the carious lesions at 11 and 21. contact Prof. Matthias Frentzen Welschnonnenstraße 17 53111 Bonn, Germany Tel.: +49 228 287-22470 frentzen@uni-bonn.de 28 roots 2 2017 canal, the trepanation cavity was closed using a com- posite material (Figs. 7a–c). Three months after the op- erative procedure, the endodontic treatment of tooth 11 resulted in no further clinical symptoms. In the treated area, the probing depth was 1.5 mm. No bleed- ing was found during probing. No further recession of the gingival margin was found after the primary heal- ing, approximately two weeks after treatment or at the follow-up inspection after three months. Gingival colour and surface texture (gingival stippling) corre- sponded to a healthy appearance (Fig. 8). To ensure long-term good oral hygiene and to prevent approxi- mal gingival recession at 11/21 in a further step a frenectomy (laser-assisted) should be performed. Discussion The presented treatment protocol for laser-assisted gingivectomy enabled the badly destroyed teeth 11 and 21 to be restored in an aesthetically satisfactory man- ner. Due to the safe procedure and the drying of the surgical field after laser-assisted excision, adhesive fill- ings were placed in the same session and exhibited no discoloration in the marginal zone, even after three months. This indicates a good bonding between the re- storative material and the dentin. There was only little discomfort for the 72-year-old patient which derived from this complex therapy. After an emergency treat- ment, definitive rehabilitation, including adhesive res- torations and endodontics, was carried out in two ses- sions. The patient did not report any discomfort related to the laser treatment. The patient's aesthetic appear- ance in the anterior teeth of the upper jaw was restored with moderate means. This treatment procedure im- proves the patient’s compliance, because it allows the patient to partake in a systematic care and treatment concept, which enables the continuation of additional necessary treatment measures._ Editorial note: A list of references is available from the publisher. This article was first published in laser magazine 4/2016.