Management of Pericoronitis using Dental Diode Laser

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Management of Pericoronitis using Dental Diode
Laser Introduction- The operculum is a soft
tissue covering the crown of a partially erupted
tooth. This area is difficult to access, and
hence the normal oral hygiene methods remain
ineffective, leading to inflammation of the soft
tissue. This inflammation of the soft tissue
surrounding the crown of a partially erupted
tooth is called pericoronitis. It is known to
appear when the third molars start to erupt, and
are most commonly seen with the partially
erupted/impacted mandibular third molars.
Pericoronitis is treated by extraction of the
third molar or by performing operculectomy.
Operculectomy is a procedure which is done by
excising the excessive soft tissue covering the
third molar. It is indicated when there is
availability of space for eruption of third
molar, presence and proper alignment of
antagonist tooth and impacted third molar in the
arch. Etiology- The most common cause behind
pericoronitis is the entrapment of plaque and
food debris between crown of tooth and overlying
gingival flap or operculum and also the constant
trauma of opposing maxillary third molar causes
pericoronal inflammation. Treatment modality
-The painful or inflamed/ infected operculum can
be removed by a wide variety of techniques like
scalpel, caustic agents, radiofrequency surgery,
electrocautery etc. The drawbacks of these
techniques are intraoperative and post-operative
bleeding, need for anaesthesia, suturing, risk
of post-operative infection, edema and impaired
visibility due to bleeding. However, Laser
therapy is an effective and noninvasive treatment
option for Operculectomy. PIOON Laser offers
different wavelengths like 450nm/810nm or 980nm.
Out of which 450nm can be used in
non-contact/contact mode whereas 810nm and 980nm
are used in contact mode to perform
operculectomy. In this case, on the basis of
radiographic and clinical findings, diagnosis of
pericoronitis was made and operculectomy
procedure was planned. Wavelength of 450nm of
PIOON laser was used in noncontact mode for the
excision of inflamed pericoronal flap under
topical anesthesia and crown of the carious
tooth was exposed which further cleared the path
of eruption. Post-operative instruction along
with maintenance of oral hygiene was advised. The
complete safety protocols were followed for the
patient, operating and assistant staff like
using laser protective eye glasses and use of
high vacuum suction. Highly reflective
instruments were avoided while using
lasers. Khan MA et al in 2017 used 980nm
wavelength for operculectomy and suggested that
due to many intraoperative and postoperative
advantages, diode laser has become a preferred
option for minor oral surgical procedures.
Fornaini C et al. in 2016 also concluded that the
450 nm wavelength works very efficiently in the
oral soft tissue surgical procedures, with faster
healing and lesser thermal damage. Rationale
behind Use of Lasers- Lasers offer certain
advantages like the excellent hemostatic
property which is of great value and allows the
surgeon to work with better
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visibility, minimum patient discomfort, reduced
post-operative pain, less chair side time,
reduced healing time, reduction in edema and
post-operative bleeding. Conclusion Taking
into consideration the excellent clinical
outcome, the dental diode lasers can be
considered as a better and acceptable alternative
for excision of pericoronal flap. References -
Khan MA et al. Diode laser A novel approach for
the treatment of pericoronitis. J Dent Lasers
20171119-21 and Fornaini C et al. 450 nm diode
laser a new help in oral surgery. World J Clin
Cases 2016 4253257.
Preoperative View (Courtesy- Dr. Sana Farista)
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Intraoperative view (Courtesy- Dr. Sana Farista)
Postoperative View (Courtesy- Dr.Sana Farista)
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By Dr. Rufi Patel MDS Periodontics Divas in
Laser
Tags
blue dental laser ,dental diode laser ,dental
laser ,Dental Soft-tissue
450nm laser,
Laser, Pericoronitis ,Pericoronitis using dental
laser ,Pericoronitis ussing laser,
Pericoronitis
with laser