980 nm Diode Laser-assisted periodontal curettage Posted on 20 Jan 22:03 , 0 comments
A 54-year-old Caucasian female presented with Type II periodontal disease (generalized 4 mm to 5 mm pockets) of unknown duration (Figure 1). All areas were charted, probed using a probe (CPITN-E probe), and treatment planned for scaling and root planing with utilization of laser in diseased areas. One manageable treatment section of scaling and root planing was conducted using 1 carpule of 2 percent lidocaine (Septocaine 1:100,000) infiltrated into the surrounding tissue. Traditional root planing and scaling were performed prior to the lasing procedure to allow improved pocket access for the fiber. A 400-micron fiber was applied directly to the diseased pocket using a light touch. Laser-assisted periodontal curettage using a diode laser at a setting of 0.6 watts in continuous wave mode in conjunction with root planing and scaling procedures were then performed.
Treatment began at the gingival margin holding the fiber parallel to the tooth and slightly angled toward the diseased tissues using a deliberate, erasure-like, crosshatching motion. The fiber tip was inspected frequently to remove accumulated tissue on a 2 x 2 gauze. Typically, each pocket had a 30- to 40-second lasing treatment time, which varied depending on type of tissue and severity of disease. The procedure was evaluated as complete by evidence of a new wound site with bleeding or fresh bleed (Figure 2).
Postoperative instructions included warm saltwater rinses twice daily and an extra-soft-bristle toothbrush to be used at next brush session. (Figure 6 demonstrates postoperative healing after one month.) Healing was assessed at a one-month recare visit where tissues appeared firm, pink, and slightly stippled. Patient was evaluated at future recare visits, and full probing was performed. Any remaining pockets over 3 mm with hemorrhage would require further lasing. In this specific case, no relasing was required.
Written by Lori Trost, DMD and Karen Kaiser, RDH