The Comparison Of The Clinical Efficacy Between The Genius Laser And Traditional Surgery On Gingival Hyperplasia

Background: Gingival hyperplasia is one of the frequent features of periodontal diseases,which can be caused by dental plaque biofilm or other factors.It is treated by initial therapy.If the gingival hyperplasia isn't obvious recession,it will be treated by operations.Traditional surgical methods are using a scaple and a high frequency electrotome.Those affect the ability to speak/chew,and make patients feel discomfort and the edema of surgery area.As a new treatment,the laser has the advantages of a clear field of view,an excellent hemostatic effect,making patients feel comfort and so on.The application has been carried out in the medicine.Genius laser is a new water-cooled Nd:YAG laser,it can be used for periodontal soft tissue surgery.,such as gingivectomy and gingivoplasty Regardless of the wavelength of the laser,when it irradiates periodontal tissue,it can affect the concentration the GCF and cytokines,as well as the healing rate of the irradiated tissue.GCF is an inflammatory exudate that contained a rich array of cellular and biochemical molecules associated with disease activity,such as neutrophils,antibodies,complement proteins and cytokines.Biochemical analysis of GCF features a non-invasive means of measuring inflammatory response in periodontal disease.Cytokines in GCF are secreted by active immune cells and some stromal cells,its main functions are mediating immune responses and regulating immunological reactions.Particulary,IL-8 and IL-1? levels are positively correlated with the severity of periodontal diseases,and can be also used as important indicators for monitoring wound healing after the periodontal flap surgery.TGF-?1 is one of the most important anti-inflammatory factors and plays an important role in wound healing.MMP-8 is the biochemical indictor of tissue inflammation.Objective:The comparation of the wound healing and the difference of comfort of the water-cooled Nd:YAG laser,scalpel and electro-cautery surgery on the gingivectomy and gingivoplasty.so as to provide theoretical guidance basis for cliniciains.Methods: The present study was a randomized controlled clinical trial with split-mouth-design with 43 patients with 270 anterior teeth were enrolled,which divided into laser group(concluded 95 teeth),scalpel surgery group(concluded 95 teeth)and electro-cautery group(concluded 80 teeth).GCF samples were collected preoperatively,one week and two weeks postoperatively respectively.And compare the differences of GCF,IL-8,IL-1?,MMP-8,TGF-?1 and postoperative pain(VAS Scores)and bleeding.Result:The amount of GCF,the levels of TGF-?1 and IL-1? in laser group were significantly lower than that in the scalpel surgery group and the electro-cautery group at one week and two weeks postoperatively respectively(P<0.05,P<0.05;P<0.05,P<0.01;P<0.05,P<0.05).At one week postoperatively,the levels of IL-8 and TGF-?1 in laser group were lower than that in the scalpel surgery group and the electro-cautery group significantly(P<0.05,P<0.05).But there were no difference about the levels of IL-8 and TGF-?1 in there groups at one week postoperatively(P>0.05,P>0.05).Postoperative pain in laser group was lower than that in the scalpel surgery group and the electro-cautery group significantly at postoperative day 1,2 and 3(P<0.05).And there was no bleeding case in laser group and the electro-cautery group,but there had 3 cases at the first day in the scalpel surgery group.Conclusion:Our study demonstrated that the better results of gingivectomy and gingivoplasty with Genius laser than conventional surgery with respect to postoperative wound healing,inflammatory reaction and patient comfort degree.Genius laser is a preferred method in periodontal surgery.