Background: An Aberrant frenum encroaches the gingival health when it is attached too closely to the gingival margin, either due to interference in the plaque control or due to a muscle pull. Such condition has to be treated by frenectomy which can be performed by scalpel, electrocautery, or with soft tissue lasers. Hence, the aim of the study is to compare the degree of postoperative pain and healing experienced by patients during frenectomy procedure with surgical scalpel and diode laser technique. Materials and Methods: A total of 20 subjects ranging from 16 to 40 years of age group with papillary or papillary penetrating frenal attachment in the maxillary anterior region were selected. Enrolled subjects were randomly divided into two groups as follows Group A (n = 10): Comprised of 10 subjects selected for conventional scalpel technique. Group B (n = 10): Comprised of 10 subjects selected for diode laser technique. Various parameters such as pain, inflammation, swelling, difficulty of procedure, and wound healing were evaluated at intervals of 1 week, 1 month, and 3^rd month. Results: The results indicated patients treated with the diode laser had less postoperative pain (P < 0.0001) and required fewer analgesics (P < 0.001) as compared to patients treated with the conventional scalpel technique. Wound healing at 7^th day and after 1 month for both the groups showed statistical significant difference with better outcome in Group A. However, wound healing at the end of 3 months did not show any significant difference between the groups. Conclusion: Based on current findings and clinical outcome, diode lasers provide better patient perception and an efficient and satisfactory option for procedures such as frenectomy.

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Background: Knowledge of heat transfer in biological bodies has many diagnostic and therapeutic applications involving either raising or lowering of temperature, and often requires precise monitoring of the spatial distribution of thermal histories that are produced during a treatment protocol. Aim: This paper, therefore, aims to design and implementation a laser therapeutic and imaging system used for carious tracking and drilling by developing a mathematical algorithm using Hilbert transform for edge detection of photothermal imaging. Photothermal imaging has the ability to penetrate and yield information about an opaque medium well beyond the range of conventional optical imaging. Method: Owing to this ability, Q-switching neodymium-doped yttrium aluminium garnet laser at wavelength 1064 nm has been extensively used in human teeth to study the subsurface deposition of laser radiation. Results: The high absorption coefficient of the carious as compared to the normal region contributes to a greater increase in temperature generating infrared thermal radiation captured by the high resolution thermal camera. Changing the pulse repetition frequency of the laser pulses affects the penetration depth of the laser, which can provide three-dimensional images in arbitrary planes and allow imaging deep within a solid tissue. Conclusions: Photothermal imaging with 2-D Hilbert transform algorithm is a powerful tool for human carious detection

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Aim: The aim of this study was to clinically and histologically compare mucosal incisions of oral tissues after surgical procedures with scalpel, electrocautery, and diode laser. Materials and Methods: Nine standardized incisions were performed in oral mucosa by scalpel, electrocautery, and diode laser. Specimens were classified into three groups according to tool used for surgical excision. Group A: Three specimens excised through a Bard-Parker (BP) scalpel blade no. 15c; Groups B and C included three specimens each excised through electrocautery and diode laser, respectively. Cut margins of biopsy specimens, adjacent peripheral mucosa were evaluated using light microscopy and histologic zones were identified, assessed: For epithelial changes, incision morphology, lateral tissue damage. Intra- and post-operative parameters assessed were the duration of surgery, bleeding, postoperative pain and healing. Results: Immediate hemostasis was seen with electrocautery and laser compared to scalpel (P < 0.011), mean time taken by electrocautery and laser was less compared to scalpel (P < 0.001). The analysis of regularity of incision and postoperative pain experienced by patients revealed a statistically significant difference (P < 0.01). Histologic damage was least with scalpel. The extent of degeneration was lowest with scalpel followed by laser or electrocautery (P < 0.05). Conclusion: Laser and electrocautery have upper hand over scalpel in relation to hemostasis, but have demerits such as lateral heat damage, tissue necrosis, delayed wound healing, and high cost. Even with advanced treatment modality, conventional scalpel treatment is better option in terms of precise incision, lower cost and faster reepithelization than laser and electrosurgery. Heat generating devices may not allow reliable histologic interpretations, particularly assessing margins of small biopsy specimens or malignant conditions.

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Aim: This study aims to assess the attitude, awareness, and knowledge of the dental professionals regarding dental lasers in India. Materials and Methods: This survey was conducted at the 69^th Indian Dental Conference, 2016, after approval from the organizing committee. Three-hundred copies of the questionnaire were distributed among the practitioners attending the conference. The questionnaire consisted of 23 questions. The first part of the questionnaire was about dental laser education and the second part was about the knowledge of dental laser applications. The second part was divided into six subsections. Each section consisted of several items related to the uses of laser in five different dental specialties in addition to a section on laser protection. Results: Only 21% of the respondents had received any formal training before the use of lasers. Most of the participants had insufficient knowledge regarding the applications of laser in dentistry. Students' knowledge of the uses of dental laser in periodontics, oral surgery, and operative dentistry was better than their knowledge in pediatric dentistry, orthodontic, and endodontics. Conclusion: The results of this survey suggest that there is a need to educate and train dental professionals regarding dental lasers to utilize this new technology to its full potential in future.

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Context: Cavity disinfection is recommended with the routine caries removal methods in order to eliminate the microorganisms and to reduce potential secondary caries. Aims: The aims of this study were to evaluate the antibacterial effects of Corsodyl; Cervitec; Cervitec Plus; Fluor Protector agents and FotoSan; diode laser; and erbium, chromium: yttrium, scandium, gallium, garnet (Er, Cr:YSGG) laser systems on Streptococcus mutans and Lactobacillus acidophilus as well as their effects on the microtensile bond strength. Materials and Methods: A cavity tooth model test was used to determine antibacterial activity after which the effects of the same agents and systems on the microtensile bond strength were evaluated. Eight cylindrical cavities were prepared on the dentin surface of 24 bovine incisors, and 12 of them were left in contact with S. mutans; others were left in contact with L. acidophilus. Test agents and systems were applied, and standardized amounts of dentin chips were obtained from the cavity walls. The number of bacteria recovered was counted. The effect of tested agents and systems on bond strength was evaluated with microtensile bond strength test. Statistical Analysis Used: Statistical analysis was carried out using the Kruskal–Wallis and Mann–Whitney U tests for the cavity tooth model test, and one-way ANOVA and Tukey test for microtensile bond strength test. Results: Test results showed that all of the disinfection methods demonstrated significant antibacterial activity on both S. mutans and L. acidophilus (P < 0.01). The agents used in this study significantly reduced the microtensile bond strength (P < 0.05) whereas the Er, Cr:YSGG laser significantly increased the bond strength (P < 0.01). Conclusions: Er, Cr:YSGG laser can be recommended for cavity disinfection due to its superior antibacterial activity and increased bond strength.

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Aim and Objectives: To determine the effectiveness of laser on final irrigants and observe smear layer removal from coronal, middle, and apical third region of root canal. Materials and Methods: Thirty single-rooted premolars were selected for the study. Access opening was done followed by which cleaning and shaping was completed till F3 using rotary protaper (Dentsply). The samples were randomly divided into three groups (n = 10), Group I - Hand activation using 15 no. K file, Group II - neodymium-doped yttrium aluminum garnet (Nd: YAG)-activated, and Group III - erbium-doped yttrium aluminum garnet (Er: YAG)-activated; which were further divided into two subgroups (n = 5) depending upon the final rinse used, subgroup A - 5.25% sodium hypochlorite (NaOCl) and subgroup B - 17% ethylenediaminetetraacetic acid (EDTA). The samples were then sectioned and taken for scanning electron microscope (SEM) observation. Results: Within the limitations of the study, photon-induced photoacoustic streaming, that is, Er: YAG PIPS showed maximum smear layer removal in coronal, middle and apical third region on 17% EDTA activation.

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Traumatic or irritation fibroma is a common benign exophytic oral lesion that develops secondary to tissue injury. It is the most common benign reactive lesion, and the treatment of choice is surgical excision. The use of lasers in different dental procedures has become very common. The diode laser which was introduced in dentistry since 1999. It is a solid-state semiconductor laser that typically uses a combination of gallium (Ga), arsenide (Ar), and other elements such as aluminium (Al) and indium (In). It has a wavelength ranging from 810 to 980 nm. This energy is absorbed by pigments in the soft tissues and makes the diode laser an excellent hemostatic agent and helps in ablation of soft tissue. Lasers have obvious benefits for all the patients without administering anesthetic shots and that means less time spent in the dental chair. Procedures were performed more conservatively, with less trauma for patients. Laser applications also enable the patient to enjoy a more relaxed dental experience, reducing or diminishing their fears, and resulting excellent post-operation experience for patients. This case series describes the use of diode laser on the excision of fibromas. The excision of fibroma using the diode laser was a quick clinical procedure without bleeding. During the days following surgery, the patient reported no pain or discomfort. The wound healing of the soft tissue was satisfactory and no scarring could be seen in the region of the surgery. The excision of the fibroma with the diode laser is a safe, quick procedure, with minimum postoperative discomfort and complications.

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Objectives: As bonding ability to tooth surface is an important factor in durability of composite restorations, the aim of this in vitro study was to evaluate the effect of 808 nm diode laser irradiation with different power outputs on the shear bond strength of composite bonded to the dentin before and after applying the bonding agent. Materials and Methods: A total of 35 healthy third molars were mounted in acrylic resin in a way that each molar had two test sites and divided into seven groups of 10 each. In the control group, the bonding agent was used without laser application. An 808 nm diode laser with different power outputs of 0.5, 1 and 1.5 W for a duration of 20 s was irradiated perpendicularly to the dentin surfaces in three of the experimental groups before and in the other three groups after applying the bonding agent. After composite cylinders had been adhered, they were examined to determine their shear bond strength. Results: According to the least significant difference test, the bond strength mean significantly higher in the control group (P < 0.001) and in all laser power outputs, the mean bond strength was significantly higher in the groups for which laser was irradiated before applying the bonding agent than the groups for which laser was irradiated after applying the adhesive (P < 0.05). Conclusion: Considering the higher bond strength in the control group, it seems that applying laser does not increase the bond strength of composite to the dentin.

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Objective: The aim of this study is to analyze the effect of laser treatment on surface morphology of restorative materials. Materials and Methods: The samples included 19 porcelain ceramics (Group P), 10 half yttrium stabilized zirconia (Y-TZP) and half porcelain (Group ZP), and 13 Y-TZP ceramic (Group Z). Pilot study was applied on the prepared samples to determine the effectiveness of hydroxyapatite or graphite powder before surface treatment. Following the pilot study, three laser systems were treated over all ceramic surfaces and scanning electron microscope (SEM) images were taken to do topographic analysis of the samples. Results: According to the results of pilot study; surfaces of zirconia, porcelain, and zirconia-porcelain samples were covered with graphite powder and then treated by CO ₂ laser, erbium:Yttrium-aluminum-garnet (Er:YAG) and neodymium:YAG (Nd:YAG) laser. SEM observations were reported for all laser types and all laser parameters that were chosen. Conclusion: The three types of laser products; CO ₂ , Er:YAG, and Nd:YAG are also effective on different output powers on different types of restorative materials.

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Melanin, carotene, and hemoglobin are the most common natural pigments contributing to the natural color of the gums. Although physiologic and ethnic melanin pigmentation is not a medical problem, complaints about "black gums" are common. Gingival depigmentation has been carried out using surgical, chemical, electrosurgical and cryosurgical procedures. Recently, "laser ablation" has been recognized as one of the most effective, pleasant and reliable techniques. Effective depigmentation of the gingiva requires removal of all or most of the melanocytes from the basal layer of gingival epithelium. In present case report the efficacy of gingival depigmentation using neodymium:yttrium-aluminium-garnet (Nd:YAG) and erbium:YAG (Er:YAG) lasers in same patient was evaluated.

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Mucocele is commonly occurring lesion in the oral cavity, mostly involving minor salivary glands, resulting from rupture or obliteration of the ducts leading to their glandular contents (mucinous) being released subepithelially. Etiological factors include trauma, parafunctional habits, lip biting, etc.; and if left untreated may lead to permanent bump in the area of occurrence. Various treatment modalities have been advocated for mucocele among which lasers being the most recent and advanced. In the present case reports, diode laser was used for the excision of mucocele on the lower lip, the advantages being minimal discomfort, bleeding, recurrence, and better compliance among patients.

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Pyogenic granuloma (PG) is a tumor-like growth in the oral cavity. It is manifested as a painless sessile or pedunculated, erythematous, exophytic and specific papular or nodular with a smooth or lobulated surface, which may have a fibrinous covering. The lesion usually bleeds easily on a slight provocation. PG is considered to be a non-neoplastic in nature. It is a reactive lesion, also classified in pregnancy associated gingival diseases. It occurs due to irritation or physical trauma from calculus or cervical restorations as also some contribution by hormonal factors and usually affects the gingiva, but can be seen in areas of frequent trauma such as lower lip, tongue, oral mucosa, and palate. The growth is typically seen on or after the third month of pregnancy and may grow rapidly to acquire a large size, thus, requiring surgical removal. The diode laser has also been used as an alternative treatment modality. This is a case report of PG in a patient treated with the diode laser.

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Regenerative periodontal surgical procedures attempt to restore lost periodontal structure and functional attachment through the regeneration of cementum, periodontal ligament, and alveolar bone. Although meticulous debridement using surgical instrumentation reduces the bacterial burden, it fails to kill the periopathogens. To overcome this shortcoming, the development of alternative adjunctive or exclusive antibacterial therapeutic strategies, therefore, becomes important in the evolution of methods to control microbial growth in the oral cavity. The following case report explores the use of antimicrobial photodynamic therapy as an adjunct to regenerative periodontal therapy for the management of intrabony defects which was evaluated over a period of 6 months.

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Aim and Objective: To evaluate the bactericidal efficacy of the Nd:YAG laser and the Diode laser at different parameters to that of calcium hydroxide, and to know the effect of increase in lasing time on degree of disinfection. Materials and Methods: Fifty human single-rooted teeth were taken and were kept in 3% NaOCl for 15 mins and access cavities were prepared, the apical third of these roots was gradually enlarged until reaching the ISO 40- K file. Later the teeth were autoclaved and mounted on 2.5 ml eppendorf tubes filled with BHI medium which was autoclaved again. The teeth were inoculated with a standard strain of Enterococcus faecalis and incubated for one week. They were randomly divided into five groups and treated as follows, G-I: - Negative control. G-II:- 980 nm diode laser irradiation for five seconds and five cycles at 2W power, 10 Hz frequency and pulsed mode. G-III:- 980 nm diode laser irradiation for 10 seconds and five cycles at 2W power, 10 Hz frequency and pulsed mode. G-IV:- Nd:YAG laser irradiation for five seconds and five cycles at 2 W power, 15 Hz frequency and pulsed mode. G-V:- Nd:YAG laser irradiation for 10 seconds and five cycles at 2 W power, 15 Hz frequency and pulsed mode. The dentin dust was collected from superficial and deep dentin of coronal and apical halves of all the samples and CFU/ ml were evaluated after three days. Results: The results were calculated and statistical analysis was done using Kruskal Wallis ANOVA test by ranks and Mann Whitney's U test. Comparisons were done between the superficial and deep dentin of different groups and between the groups. Conclusion: Under the parameters of the samples tested Nd:YAG laser provided the best results for disinfection compared to Diode laser. However, both the Nd:YAG and Diode lasers provided clinically acceptable disinfection.

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Statement of Problem: Low-level laser has been shown to be beneficial in reducing significantly chemotherapy-induced mucositis. However, the approach has not gained wide acceptance, so far. Purpose: The aim of this study was to evaluate the effect of low-level laser therapy clinically in prevention of chemotherapy-induced oral mucositis in patients suffering acute hematologic cancers. Materials and Methods: 40 patients who aged 12 and older, who had acute myeloid / lymphoid leukemia and were receiving myeloablative chemotherapy regimen were included. Patients were randomly divided into the control and the experiment groups. A diode laser (Aluminum Gallium Indium; Azor-2k-02, Russia, λ = 660 nm, power: 25 mw, spot size: 2 mm, continuous mode, Energy: 1.5 J per point) was applied on 12 points for one month, twice weekly. Results: Based on the WHO scales, In the fourth session, the people suffering from mucositis were increased to 18 people, 12 of which were in the control group. This increasing trend has been also observed in NCI scales, so that in the fourth session, the number of people suffering from mucositis reached to 12 persons and the severity and degree of leisure reached to 3, 4. Conclusion: Low level laser could reduce the severity and the pain of the mucositis.

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A significant cause of relapse of orthodontically treated teeth is thought to be the gingival and transseptal fibers of the periodontium, which are stretched and twisted as the tooth is rotated. To relieve the rotated tooth from forces exerted by the stretched fibers, circumferential supracrestal fiberotomy (CSF) was introduced. In simple CSF using a scalpel blade, intergingival, transgingival, transseptal, and semicircular fibers are transected. CSF helps the tissue remodelling and decreases relapse of orthodontically treated teeth. Laser offers numerous advantages compared with surgery. Laser CSF is expected to prevent relapse of orthodontically treated teeth. This study was conducted to evaluate the effectiveness and periodontal side effects of laser CSF on orthodontically rotated tooth. The aims were to compare the: amount of relapse and sulcus depth.The study involves 10 patients between age group of 14- 30 years. Patients with extraction site closure were included with the teeth adjacent to the extracted tooth involved in the study. A split mouth design was made with the maxillary right side as control whereas laser CSF was performed only on the maxillary left side. Laser diode of 980nm wavelength will be used. Evaluation after CSF was done after 4 weeks.

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Low-level laser therapy (LLLT) refers to irradiation with red-beam or near-infrared lasers that are typically of narrow spectral width to pathology to reduce inflammation, pain, and promote tissue regeneration. Lasers have varied and growing applications in the field of medicine. This technology has attracted major interest in the field of tissue engineering and healing. The goal of this review is to present the biological action of LLLT on various growth factors involved in oral healing. This article highlights the series of photochemical reactions, mechanism of action, and synthesis of several cytokines. Furthermore, it elucidates the cellular responses to LLLT providing insight into the current strategies that promote healing. This review was based on electronic search of scientific papers from 2000 to 2017 which was accomplished using PubMed and MEDLINE search engines to include relevant scientific citations from the peer-reviewed journals published in English. A total of 68 articles were included, of which 23 were excluded based on the exclusion criteria. The remaining 45 articles were evaluated, and specific information was retrieved from relevant 22 articles. The 22 articles included review articles and in vivo and in vitro studies that discussed in detail the effect of lasers on various growth factors. LLLT has a biomodulating effect on oral healing. LLLT influences the release of chemical mediators, reduces the duration of inflammation, and consequently promotes tissue repair. LLLT has therapeutic actions on the growth factors involved in oral healing and hence accelerates healing.

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Eruption cysts are benign cysts that appear on the mucosa of a tooth shortly before its eruption. They may disappear by themselves but if they are hurt, bleed, or are infected, they may require surgical treatment to expose the tooth and drain the contents. Here we present a clinical case of a 12-year-old child with an eruption cyst in mandibular right second molar treated using diode laser. No hemorrhage, swelling, infection or postoperative pain was observed. Treatment of eruption cysts with this technique facilitates obtaining a cooperative behavior from pediatric patients and makes behavior management easier.

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Objective: To evaluate the effect of low power diode laser (LPDL) 810 nm as an adjunct to nonsurgical treatment of mild to moderate aggressive periodontitis (AgP). Background: AgP is a rapidly progressive severe form of periodontitis; conventional treatment depends on the concept of plaque control and bacterial eradication. Scaling and root planning (SRP) is the basic periodontal treatment, has its limitations, so new treatment modalities are needed. Materials and Methods: The use of low power laser was suggested as an adjunct to periodontal treatment, as it was proven earlier to have a positive biomodulatory effect on biological tissues if suitable parameters were used for the condition in hand. A split-mouth design clinical trial was performed. The laser group received both SRP plus laser, and the control group only received SRP. The clinical evaluation included periodontal pocket depth (PPD), clinical attachment loss (CAL), plaque index (PI), modified gingival index (MGI), and gingival recession (GR), were taken at baseline and at 3 months. Transforming growth factor beta 1 (TGF-β1) was screened by sampling gingival crevicular fluid (GCF) at baseline and at 1, 2, 3, and 4 weeks after treatment. Results: Showed a significant decrease of PPD and CAL in favor of laser group. PI, MGI, and GR showed no significant difference between both groups. TGF-β1 mean percentage showed a significant steady decrease in the laser group. Conclusion: Low power laser parameters in this clinical trial can be used as an adjunct to SRP in treatment of mild to moderate AgP.

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Aim: A comparative evaluation of the gingival depigmentation by using a surgical blade and a diode laser; 6 months follow-up. Materials and Methods: Four systemically healthy patients who were aged 21-28 years were selected for the study and were treated with different gingival depigmentation techniques. Diode laser and surgical blade was used for the depigmentation in either of the arches. Pain levels were assessed using a visual analog scale (VAS) during the surgery, 1 day, 3 days and 1 week postoperatively. The recurrence of pigmentation was assessed with melanin pigmentation index (MPI). Results: The gingiva appeared pink and healthy after both the procedures and there was no recurrence of pigmentation. The clinical results obtained with the diode laser were esthetically pleasing with great patient comfort and satisfaction compared to the surgical blade. There was a statistically significant difference between the levels of pain during the procedure and 3 ^rd postoperative day between the two groups. Conversely there was no difference in the levels of pain 24 hours postoperatively and 1 week postoperatively among the two groups. Conclusion: The laser approach resulted in not as much of bleeding and pain as with scalpel technique. Although no difference in effectiveness and esthetic outcome were found between the two approaches, further well-conducted randomized trials would assist to make the absolute conclusion.

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Introduction: The effect of low-level laser therapy (LLLT) on wound healing has been evaluated in several studies; however, little is known about the molecular mechanisms that underlies the biostimulatory effect of this treatment modality. Aim: to evaluate the effect of LLLT on gene expression of vascular endothelial growth factor (VEGF) and interleukin-1beta (IL-1 b) during healing of wounds created by surgical blade and by surgical laser in order to have a better image of their interactive role influenced by the laser irradiation. Materials and Methods: 40 male Wister rats were randomly assigned into four groups (A, B, C and D). In groups A and C, an incision was made in the gingival and mucosal tissues using a surgical scalpel. A similar incision was made in groups B and D using 980 nm diode laser. Group A and B were subjected twice to low level 870 nm diode laser 3 h and 24 h after the incision while group C and D served as controls. 30 min after the second irradiation, the rats belonging to all groups were euthanized, and the wound area was excised. Quantitative reverse-transcriptasepolymerase chain reaction was used to measure the gene expression of VEGF and IL-1b. Results and Discussion: LLLT caused an increase in VEGF gene expression in scalpel-induced wounds and a corresponding decrease in laser-induced wounds but without significant differences. LLLT inhibited the gene expression of IL-1b in both types of wounds, but this inhibition was only significant in scalpel wounds. Conclusion: Biostimulatory effect of LLLT could be mediated through modulation of the immune response by the inhibition of IL-1b.

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The Objectives of this Study: The objective of the study was to evaluate the efficiency of diode laser 940 nm in both, continuous and pulsed modes. Then compare the outcomes of frenectomy procedure, and find the best mode that satisfies the patient's and the surgeon's criteria. Materials and Methods: This study was carried out on 14 patients of which 7 were males and 7 were females with age range from 7 to 46 years. Patients underwent diode laser-assisted frenectomy in continuous wave (CW) mode with power ranging from 1.5–3 W and pulsed mode, which was subdivided into comfort pulse 0 (CP₀) with 6–10 W peak power; 1.2–2 W average power and CP₂with 2–10 W peak power; 1–5 W average power. Anesthesia method and need, the duration of surgery and intraoperative bleeding events were recorded in all cases. In addition, patient preoperative fear, perception and comments were reported. Ratings of the postoperative pain and the functional complications for each patient in a questionnaire survey were reported using the Wong-Baker FACES Pain Rating Scale at operation day throughout the 1^st week postoperatively. All patients were examined at 2, 7, and 21 days after the operation in order to assess the surgical wound healing. Results: In the clinical study, seven patients were operated on without infiltration anesthesia (only spray anesthesia) in the pulsed mode while in CW-mode only one patient operated on with spray anesthesia in low power. Intraoperative bleeding events were bloodless to oozing. There was no preoperative fear; patients' perceptions were comfortable with satisfactory comments except in CW cases and some of the CP₀ cases. Severe postoperative complications were absent in all subjects. The reported survey results indicated that the patients treated with the laser had normal day activity on operation day, less postoperative pain and fewer functional complications were noticed in the CP₂mode. The surgical wound healing was within normal limits in 7–14 days. Carbonization was the main feature of cases treated with CW-mode while it was mostly absent in the pulsed mode. Conclusion: The use of CW-mode of diode laser can be considered no more suitable for performing oral soft tissues surgery. The pulsed mode was found more practical, effective and easy to carry out incisions, cuttings with less intra and postoperative complications considering its advantages in the clinical cases. The CP₂pulsed mode laser treatment offers a safe, effective, acceptable, with impressive outcomes particularly for young patients.

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Background and Objectives: In recent years, there has been a growing interest in the use of dental lasers for treatment of periodontal diseases. Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. Aim: The aim of this study was to evaluate the clinical efficacy of PDT as an adjunct to nonsurgical mechanical therapy (SRP) in the treatment of chronic periodontitis. Materials and Methods: In a single-centered randomized and controlled clinical trial, 24 patients with untreated chronic periodontitis were assigned in a split-mouth design into two treatment groups which included: Group I: SRP only (control group), Group II: SRP and PDT (1% methylene blue solution) (test group). Clinical parameters such as plaque index (PI), gingival index (GI), modified sulcular bleeding index (mSBI), probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 1, 3 and 6 months after therapy. Results: Inter-group and intra-group statistical analyses were performed. The improvement in clinical parameters was significantly greater in Group II as compared to Group I. The mean PD (mm) reduction from baseline to 6 months in Group I was 2.50 ± 0.54, Group II was 2.57 ± 0.53. The mean CAL (mm) gain from baseline to 6 month in Group I was 2.63 ± 0.47, Group II was 2.55 ± 0.44. A statistically significant decrease in PI, GI, mSBI scores was seen in Group II at the end of 6 month (P < 0.001). Conclusion: The present study suggests that an additional application of single episode of PDT could be beneficial adjunct to nonsurgical treatment of chronic periodontitis in terms of clinical parameters as compared to scaling and root planing. Direct subgingival delivery of methylene blue in different concentrations should be performed to further investigate the potential antimicrobial effect of soft lasers in the human periodontal disease.

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Aim: To compare the microhardness and microstructural changes induced in pits and fissure following a fissurotomy procedure using three different light amplification by stimulated emission of radiation (LASER) systems. Materials and Methods: Thirty caries free premolars, extracted atraumatically for orthodontic treatment were included in the study. Using a diamond low-speed disc, enamel blocks containing the pits and fissure were cut from the tooth and divided into three groups containing 10 samples in each (G1 - diode, G2 - carbon dioxide [CO ₂ ], and G3 - erbium). The enamel blocks were mounted using self-cure acrylic resin and irradiated using the three LASER systems at lower energy densities. Post irradiation, the microhardness of enamel in the pit and fissure region was measured using Vickers microhardness test. Scanning electron microscopy analysis was done to check the microstructural changes of the lased enamel. Data obtained were subjected to Kolmogorov-Smirnov test and ANOVA with statistical significance set at P ≤ 0.05. Results: All three groups showed an increase in microhardness when compared to the value taken as control (control - 209.6, diode - 237.56 ± 19.27, CO ₂ -294.92 ± 29.38, erbium - 264.39 ± 11.83). ANOVA test revealed a highly significant (P = 0.001) difference between the means of the three groups. Tukey post-hoc analysis showed that CO ₂ LASER showed a higher increase in microhardness followed by erbium and diode LASER. Conclusion: This study revealed that the increase in microhardness and microstructural changes obtained with CO ₂ LASER was higher than the other two LASER systems. Furthermore, diode LASER can be used as a viable option for fissurotomy procedure as it improves the hardness of enamel, with a homogenous sealing effect of the pits and fissure.

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Background: Various surgical techniques can be done for depigmentation but recurrence is the limiting factor for many surgical procedures, and the aim of the present study was to evaluate quantitatively the rate of repigmentation postoperatively after using scalpel and diode lasers for depigmentation. Materials and Methods: A total of 20 systemically healthy patients of 18 males and two females, within the age group of 18-40 years with an esthetic complaint of hyperpigmented gingiva were enrolled in this study. The patients were briefed about the surgical procedure and obtained the informed consent; they were randomly divided into two groups. Group A: 10 patients - depigmentation with scalpel technique. Group B: 10 patients - depigmentation with diode lasers (Biolase^; ) and followed for 6 months. Results: The results of this study had shown that there is a statistically significant difference in the pre- and post-operative values in scalpel surgical technique with a (P = 0.005), and there is no statistically significant (P = 0.20) difference in the diode laser technique. Statistical Analysis Used: Wilcoxon Signed rank test and Mann-Whitney test. Conclusion: By using diode lasers, the rate of repigmentation is higher than scalpel method; however, it has been documented that there is minimal postoperative bleeding, pain, wound healing, discomfort, and ease of the procedure with diode laser and finally, each technique has its own advantages and disadvantages.

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