J Oral Laser Applications 10 (2010), No. 4 14. June 2011
Background: Teeth are extracted for various reasons. Wound toilet is, amongst others, crucial for post-operative morbidity and uneventful healing. It has been reported that low level hard laser irradiation enhances fibroblast proliferation, which accelerates wound healing and might be advantageous for bone in-growth.
Objectives: This case report has the purpose to illustrate an indication of an Er,Cr:YSGG-laser in extraction surgery. Conventional post-extractive wound toilet with sutures is replaced by laser decontamination and relative coagulation.
Materials and Methods: In a 48 year old female tooth number 34 presents purulent discharge. Radiographic exams show an extensive periapical abscess and a fractured root. After infiltration anaesthetics, the tooth is removed. Fibre dissection and post extractive site decontamination was performed by an Er,Cr:YSGG 2780nm wavelength laser.
Results: At 24 hours follow up, a wound, completely closed by a fibrin network, was observed. Radiographic exams 1 week post-operative showed an extensive radiolucency. Neighbouring tooth #33 had on the distal a wide two-wall defect, with an radiographic angle >=90° and no more than 1mm distal bone support. Radiographic follow up showed at 1,3,6,and at 12 months resolution of the defect with evident bone in-growth and mineralization.
Conclusion: Low power Er,Cr:YSGG laser irradiation might have enhanced rapid wound closure within 24 hours after extraction. As if a natural scaffold was formed, under which osteogenic cells were able to repopulate the defect, resulting in radiographic bone regeneration. Rapid epithelium growth closing over an extraction-socket seems to avoid its down-growth in the extraction site
Keywords: Er,Cr:YSGG laser, Bone-regeneration, Natural Scaffold Formation