Comparative study of diode laser 940 nm in performing frenectomy in both: Continuous and pulsed modes: An in vivo study

The Objectives of this Study: The objective of the study was to evaluate the efficiency of diode laser 940 nm in both, continuous and pulsed modes. Then compare the outcomes of frenectomy procedure, and find the best mode that satisfies the patient's and the surgeon's criteria. Materials and Methods: This study was carried out on 14 patients of which 7 were males and 7 were females with age range from 7 to 46 years. Patients underwent diode laser-assisted frenectomy in continuous wave (CW) mode with power ranging from 1.5–3 W and pulsed mode, which was subdivided into comfort pulse 0 (CP0) with 6–10 W peak power; 1.2–2 W average power and CP2with 2–10 W peak power; 1–5 W average power. Anesthesia method and need, the duration of surgery and intraoperative bleeding events were recorded in all cases. In addition, patient preoperative fear, perception and comments were reported. Ratings of the postoperative pain and the functional complications for each patient in a questionnaire survey were reported using the Wong-Baker FACES Pain Rating Scale at operation day throughout the 1st week postoperatively. All patients were examined at 2, 7, and 21 days after the operation in order to assess the surgical wound healing. Results: In the clinical study, seven patients were operated on without infiltration anesthesia (only spray anesthesia) in the pulsed mode while in CW-mode only one patient operated on with spray anesthesia in low power. Intraoperative bleeding events were bloodless to oozing. There was no preoperative fear; patients' perceptions were comfortable with satisfactory comments except in CW cases and some of the CP0 cases. Severe postoperative complications were absent in all subjects. The reported survey results indicated that the patients treated with the laser had normal day activity on operation day, less postoperative pain and fewer functional complications were noticed in the CP2mode. The surgical wound healing was within normal limits in 7–14 days. Carbonization was the main feature of cases treated with CW-mode while it was mostly absent in the pulsed mode. Conclusion: The use of CW-mode of diode laser can be considered no more suitable for performing oral soft tissues surgery. The pulsed mode was found more practical, effective and easy to carry out incisions, cuttings with less intra and postoperative complications considering its advantages in the clinical cases. The CP2pulsed mode laser treatment offers a safe, effective, acceptable, with impressive outcomes particularly for young patients.