Pain, Postoperative Clinical Trial
Official title:
A Comparative Evaluation of Various Patient Centered Outcomes Following Gingival Depigmentation Using Diode LASER in Different Modes: A Randomized Clinical Trial
Purpose of this study is to clinically evaluate and compare various patient centered outcomes using diode LASER in Continuous mode (CW) and Pulsed Mode (PM) using 300µm and 400µm fiber for depigmentation procedure.
The colour of gingiva has a tremendous impact on the esthetics of the smile. Clinically
gingival melanin hyperpigmentation is presented as 'black gum' which is common esthetic
problem especially for those who have gummy smile. Currently the growing aesthetic concerns
among the patients require the removal of hyper pigmented gingival areas to create an
aesthetically-pleasant smile. The harmony of the smile is determined not only by the shape,
position and colour of the teeth or lips as well as by the by the gingival tissues.Several
attempts have been made for removal of gingival pigmentation by different techniques like
scalpel, electrocautery, LASER etc. Each technique has its own advantages and disadvantages.
In the present study an effort has been made to compare two different modes viz. Continuous
mode and Pulsed mode of LASER in the treatment of depigmentation.Diode LASERs for dentistry
operate in the near infrared region. The most commonly used wavelengths are 810, 940 and 980
nm , because these wavelengths are very well absorbed by pigmented tissues, haemoglobin and
melanin.There are several different ways LASER light operates: Continuous wave (CW), Pulse
wave mode (PM). The continuous wave diodes emit continuous LASER energy with a fixed power
output for the entire duration. Pulse modulated diodes create a 'pulse' by cutting the beam
or turning LASER on & off [1s] at regular intervals.
During the first years of diode LASER treatment in dentistry only CW mode was possible but
application of 3-4 Watt in CW mode led to carbonization of the soft tissue.To approach better
results in soft tissue treatment without much carbonization it was necessary to interrupt the
CW mode. That was done by chopping the CW mode. Pulses down to several 100μs were
released.LASER in Continuous wave mode is suggested in some studies to cause increase in
surgical site temperature which may cause necrosis or jeopardize healing. Application of the
LASER in Pulsed mode prevents overheating of surrounding tissues. This study aims to
determine the comparative increase in the onsite temperature between the two modes.Decrease
in post-operative pain is likely to reduce the consumption of Non-steroidal Anti-inflammatory
Drugs (NSAID's). The study aims to quantify the need for NSAID's post-operatively in both
Pulsed and continuous wave modes and also in 300µ and 400µ fibers.
The change in the diameter of the fibers used in LASER irradiation could bring about a change
in the outcome of the procedure as small diameter fibers means high energy density, faster
cutting and more heat whereas with larger diameter fibers more energy is needed to cover a
broader area to work more quickly and less heat.
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