Histological Gingival Assessment after Conventional and Laser Gingivectomy.

Background: Gingivectomy is a procedure often performed in everyday clinical practice using numerous instruments.

Aim: To evaluate and compare the gingival cut surface after gingivectomy with 6 different surgical instruments - a surgical scalpel, an Er:YAG laser, a CO2 laser, a ceramic bur, an electrocautery device, and a diode laser.

Materials And Methods: Gingivectomy using the above listed instruments was performed in 18 patients. The histological samples excised with a surgical scalpel were assigned as a control group and the other five types - as test groups. The following histological parameters were measured: coagulation layer thickness (in μm); presence or absence of a microscopic rupture and presence or absence of hemostasis in-depth.

Results: The best instrument of the above listed ones which demonstrated excellent results is the CO2 laser. The Er:YAG laser has a thin coagulation layer and lack of hemostasis in-depth. The diode laser has the widest coagulation layer which is an advantage from a clinical point of view. Electrocautery proved to be as effective as the diode laser, but it should not be used around metal restorations. The ceramic bur has less pronounced hemostasis in-depth.

Conclusions: Modern dentistry uses a wide variety of methods that are designed to be applied in everyday practice. Good knowledge of the ways to use them, their advantages and disadvantages is essential to obtaining the optimal result depending on the clinical case.