Open Access
Table III
Summary of the ten included studies comparing laser and conventional surgery to perform frenectomy.
| 1st Author / Study design | Patients (n per condition) | Frenum | Indication | Study duration | Evaluative parameters | Results |
|---|---|---|---|---|---|---|
| Haytac et al./Randomized controlled trial (II) | 40 patients (NS) | Maxillary or mandibular labial frenum | Papilla attachment | 7 days | – Postoperative: Pain: VAS (0–10)/Discomfort during eating and speaking: VAS (0–10)/Analgesics use: NS | Pain and discomfort were significantly lower in the laser group after 1 and 7 days. Analgesics used during the first postoperative week: 85% of patients treated by scalpel versus 33.3% of patients treated by laser. |
| Kara et al./Randomized controlled trial (II) | 40 patients (Scalpel then laser: n = 20, Laser then scalpel: n = 20) | Both maxillary and mandibular labial frenum with 1 week interval | Periodontic: Papilla or transpapillary attachment | 7 days | – Preoperative: Anxiety: VAS (0–10) – Postoperative: Satisfaction: VAS (0–10)/Pain: VAS (0–10) /Discomfort during eating and speaking: VAS (0–10)/Analgesics use: NS |
No significant difference before the 1st surgery/Patients who first experienced laser were significantly less anxious before the 2nd surgery. Scores for satisfaction were significantly higher after laser surgery. The VAS scores for pain, chewing and speaking were significantly lower at 3 h, 1 day, and 1 wk postoperatively after laser surgery. 5% of patients in laser group required post-operative analgesics versus 92.5% of patients in the conventional group. |
| Jùnior R. et al./Intervention study (III-2) | 40 patients (Scalpel: n = 22, Laser n = 18) | Maxillary or mandibular anterior labial frenum | Orthodontic, prosthetics, periodontic, speech: Gingival, papilla or transpapillary attachment. | 15 days | Pre-operative: fear VNS (0–10) Per-operative: Anesthetic use: number of vial/ Duration: minutes /Bleeding: absent to abundant /Suture: yes/no Post-operative: Pain: VNS (0–10)/Analgesics use: NS/Discomfort during eating and speaking: VAS (0–10)/Complications |
Pre-operative fear was similar in both groups. Similar quantity of anesthetic used. Laser significantly reduced bleeding and surgery duration (10.2 ± 1.8 versus 7.7 ± 1.9). Suturing was necessary in all patients in scalpel group versus 0% in laser group. No significant difference regarding postoperative pain, analgesic consumption and functional discomfort. Three patients experienced postsurgical complications (laser: 2; scalpel: 1). |
| Akpinar et al./Randomized controlled trial (II) | 89 patients (Scalpel: n = 44, Laser: n = 45) | Maxillary or mandibular anterior labial frenum | Orthodontic, prosthetics, periodontic, speech | 10 days | Per-operative: Duration: minutes Post-operative: Pain: VAS (0–100)/Discomfort during eating and speaking: VAS (0–100)/Bleeding: NS |
Surgery duration was similar in both groups (9.93 ± 3.32 versus 8.84 ± 3.11) No post-operative bleeding observed in both groups. Pain and discomfort were significantly decreased in the laser group at day 1, day + 1 and day + 3. |
| Uraz et al. (2018)/Randomized controlled trial (II) | 36 patients (Scalpel: n = 16, Laser: n = 20) | Maxillary anterior labial frenum | Orthodontic, prosthetics and periodontic: Papilla attachment | 3 months | – Per-operative: Anesthetic use: yes/no /Suturing: yes/no – Post-operative: pain: VAS (0–10)/swelling: VAS (0–10)/redness: VAS (0–10) /Discomfort during eating and speaking : VAS (0–10)/analgesics use: (NS) |
Anesthesia was necessary in all patients in scalpel groupversus 40% in laser group. Suturing was necessary in all patients in scalpel group versus 0% in laser group. No significant differences for pain, swelling, redness or speaking. Chewing discomfort was significantly higher in the scalpel group on the 1st and 2nd days. Patients treated with laser required less analgesics. |
| Calisir et al./Randomized controlled trial (II) | 40 patients (Scalpel then laser: n = 20, Laser then scalpel: n = 20) | Both maxillary and mandibular labial frenum with 2 weeks interval | Orthodontic, prosthetics, periodontic and speech: Papilla attachment | 10 days | – Postoperative: Pain: VAS (0–10)/Discomfort during eating and speaking: VAS (0–10)/Patient preference (laser vs blade) | Significant less pain and discomfort at speaking at day 0 and day 1 after laser surgery. No significant difference for all parameters after 3, 7 and 10 days. Significantly more patients preferred laser over conventional surgery. |
| Bista et al./Randomized controlled trial (II) | 20 patients (Scalpel: n = 10, Laser: n = 10) |
Maxillary anterior labial frenum | Placek insertion type III or IV | 7 days | – Postoperative: Pain: VAS (0–10)/Analgesic use: NS | Pain was significantly lower at d + 1 after laser surgery, whereas no significant difference was observed after 7 days. Number of analgesics used was significantly lower after laser surgery. |
| Stojanovska et al./Intervention study (III-2) | 36 patients (Scalpel: n = 18, Laser: n = 18) |
Maxillary anterior labial frenum | Orthodontic, periodontic: Placek insertion type III or IV | 3 days | – Pre-operative: Fear: NRS (0–10) – Per-operative: Anesthetic: yes/no,/Duration: minutes/ Bleeding: absent to intensive/ Suturing: yes/no – Post-operative: Pain: NRS (0–10)/discomfort during eating and speaking: NRS (0–10) |
Pre-operative fear was not different between groups. Significantly less patients required anesthetic infiltration and surgery duration was significantly shorter with laser (11.6 ± 2.3 versus 6.1 ± 1.9 min). No intra-operative bleeding in 83.3% of patients treated with laser versus 0%. Suturing was necessary in all patients in scalpel group versus 0% in laser group. Post-operative pain and discomfort were significantly lower after 3d in laser group. |
| Patel RM. et al./Randomized controlled trial (II) | 20 patients (Scalpel: n = 10, Laser: n = 10) | Maxillary anterior labial frenum | Papilla or transpapillary attachment |
3 months | Per-operative: Bleeding: none to severe/Surgical difficulty for the surgeon: 1–4 score Post-operative: Pain: VAS (0–10)/Analgesic use: NS/Wound healing: 1–4 score |
Perioperative bleeding was significantly increased with scalpel and laser surgery was significantly easier. Pain at day 1 and 7, and analgesics use were significantly lower in the laser group. Scalpel group showed significantly better healing at day 7 and 1 month, without significant difference after 3 months. |
| Butchibabu et al./Randomized controlled trial (II) | 10 patients (Scalpel: n = 5, Laser: n = 5) |
Maxillary anterior labial frenum | Papilla or transpapillary attachment |
7 days | Post-operative: Pain: VAS (0–100)/discomfort during eating and speaking: VAS (0–100) | Post-operative pain and discomfort were significantly lower in the laser group after 1,3 and 7 days. |
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