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ePaper created 2017-09-06, 09:11:22 | version 1.38.0
case report diode laser during orthodontic treatment Case report Discussion A 14-year-old female patient was referred to our department by the orthodontics unit because, at the end of fixed orthodontic treatment, she had developed gingival enlargement in the upper arch (Fig. 1), probably related to the fast closure of the spaces associated with very poor oral hygiene due to bleeding during toothbrushing. Just after the removal of the appliance, a topi- cal anaesthetic (EMLA, AstraZeneca) was applied to the gingivae (Fig. 2) and a gingivectomy was performed using a diode laser (XD-2, Fotona) according to the technique of removal of the inter dental papillae (Fig. 3). The parameters used were as follows: a wavelength of 808 nm, 3 W in continuous wave, a 320 μm fibre in con- tact mode. The intervention had a duration of 375 seconds, and the patient did not feel any pain (Fig. 4). After the intervention, the patient did not take any kind of pain medication, and the healing process was completed in five days (Fig. 5). The first laser appliance was built by Maiman in 1960, and some years later, it was successfully employed in medicine and in oral surgery with several advantages. It may provide excellent incision performance with sealing of small blood and lymphatic vessels, resulting in haemostasis and reduced postoperative oedema. Further- more, target tissues are disinfected as a result of local heating and production of an eschar layer, which results in a decreased amount of scarring owing to decreased post-operative tissue shrink- age, allowing one to avoid the use of sutures. Diodes, the last generation of laser used in dentistry, have several advantages, such as re- duced cost and size, and ofer the operator the possibility to work both in continuous and chopped mode. Based on our experience, we can confirm that this technology may represent a new approach to the resolution of gingival enlargement during orthodontic treatment, with better comfort for the patient during and after surgery. Editorial note: A list of references is available from the publisher. about Prof. Carlo Fornaini is a lecturer at the MICORALIS Laboratory of the Côte d’Azur University in Nice, France, and a dentist at the “Special Needs and Maxillofacial Surgery Unit” of the “Guglielmo da Saliceto” hospital in Piacenza, Italy. He can be contacted at: carlo@fornainident.it Dr Elisabetta Merigo is a lecturer at the MICORALIS Laboratory of the Côte d’Azur University in Nice, France, and a dentist at the “Special Needs and Maxillo facial Surgery Unit” of the “Guglielmo da Saliceto” hospital in Piacenza, Italy. elisabetta.merigo@gmail.com Dr Aldo Oppici is the Head of “Special Needs and Maxillofacial Surgery Unit” of the “Guglielmo da Saliceto” hospital in Piacenza, Italy. A.Oppici@ausl.pc.it Dr Luigi Cella is a maxillofacial surgeon at the “Special Needs and Maxillofacial Surgery Unit” of the “Guglielmo da Saliceto” hospital in Piacenza, Italy. L.CELLA@ausl.pc.it 18 ortho 2/2017