Oral squamous papilloma is one of the most common benign epithelial neoplasm, frequently seen on the tongue, palate, uvula, and gingiva; and found to be associated with human papillomavirus (HPV) 6 and 11. Treatment laser-assisted surgery is common because of several advantages such as successful hemostasis, devoid of sutures, wound sterilization, and minimal postoperative pain and edema. The aim of this report is to present the case of oral squamous papilloma of the soft palate in a 57-year-old male patient and its management with a diode laser.

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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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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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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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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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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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Gingival overgrowth is associated with multiple factors including congenital diseases, hormonal disturbances, poor oral hygiene condition, inflammation, neoplastic conditions, and adverse drug reactions including anticonvulsants, calcium channel blockers, and immunosuppressants. This can have a detrimental effect on the quality of life and also on high oral bacterial load caused by plaque-retentive areas. Various treatment modalities include both surgical (gingivectomy, periodontal flap, electrosurgery, and laser excision) and nonsurgical approaches (oral hygiene measures, scaling and root planing, discontinuation of the drug, or the replacement of the drug with other alternative).

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Abnormal/aberrant frenum is very common and causes various problems in function and aesthetics. It is managed by procedures such as frenotomy and frenectomy. Lasers are currently becoming popular in various fields of dentistry and provide alternative to conventional scalpel procedures. In recent years, lasers such as CO₂, Neodymium-doped yttrium aluminum garnet, Erbium-doped yttrium aluminium garnet, and diode have been used for frenectomy. In this paper, we present a case of diode laser frenectomy and review various studies and reports conducted on diode laser frenectomy.

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Context: Use of lasers in painless contemporary restorative dentistry. Aims: To assess the extent of painless perception using lasers for tooth preparation based on visual analogue scale (VAS). To compare conventional and laser tooth preparation using VAS scale. Settings and Design: Adult patients reporting to the Department of Conservative Dentistry were selected. Fotona fidelis make for ER:YAG laser was used at preset laser settings for enamel and dentin removal with combination of air-water spray. Materials and Methods: Standardized class I tooth preparation for composite restorations were selected for individuals requiring treatment for teeth with similar enamel/dentinal configuration, that is, contralateral in the same individual. Carbide burs-SS White #245 were used for all preparations. Identical tooth preparations were carried out by the same operator for both the teeth using conventional high speed on one side and ER:YAG laser at noncontact mode on the other side. Fotona fidelis make was used at preset laser settings for enamel and dentin removal with combination of air-water spray. The patient was required to provide score according to the VAS scale. Statistical Analysis Used: Kruskal-Wallis test. Results: The median of pain while preparing tooth by conventional method is the highest in patient (8) and the smallest in ER:YAG laser (1). The P value is very small (less than the common alpha-level of 0.05), the test is significant. Thus, it is concluded that the method of tooth preparation does affect the pain perception. Conclusions: The statistical analysis of these findings comprehensively prove that laser tooth preparation is much more painless, hence comfortable for the patient, only the economics prove to be a deterrent in its widespread usage.

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Mucocele is a common lesion of the oral mucosa that results from an alteration of minor salivary glands due to a mucus accumulation. Mucocele involves mucin accumulation causing limited swelling. Two histological types exist-extravasation and retention. Mucoceles can appear at any site of the oral mucosa where minor salivary glands are present. Mostly seen on lower lip, followed by floor of the mouth and buccal mucosa being the next frequent site. This paper presents a case report of mucocele using CO ₂ laser.

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Fibrous hyperplasia is a nonneoplastic lesion of fibrous connective tissue origin considered to be a histologic variant of fibroma that causes esthetic and functional problems. The choice of treatment should always be founded on basic principles of pathology and sound surgical judgment. Diode lasers have several distinct advantages over other therapy, as they provide a bloodless field and also allow histological examination without distortion, resulting in a painless postoperative period and no collateral damage to adjacent tissues. This article present two cases of fibrous hyperplasia occurring on gingiva and labial mucosa in the second decade of life, treated by diode laser therapy with 1 year follow-up and no recurrence.

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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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The laser is a less-invasive method compared with the conventional techniques because it produces little cell destruction and less bleeding due to its hemostatic properties and requires the patient a reduced number of sessions and less chairside time for the most applications.

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Oral leukoplakia is one of the most common physiologic as well as pathologic white lesion in the oral cavity. Of the many variants, oral proliferative verrucous leukoplakia (OPVL) is a rare clinicopathological entity of unknown etiology. OPLV initially develops as a white hyperkeratotic plaque that eventually becomes a multifocal disease with confluent, exophytic and proliferative features. Published case series with long-term follow-up describes OPVL as a disease with aggressive biological behavior due to its high probability of recurrence and a high rate of malignant transformation. This article describes a rare case report of OPVL associated with oral submucous fibrosis in the light of current information with clinical and histological aspect in a young patient, which was successfully treated with CO₂Laser.

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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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The extraoral cutaneous sinus tract of dental origin is an uncommon, but well-documented condition. However, several non-odontogenic disorders may also cause an extraoral sinus tract. The diagnosis is not always easy unless the treating clinician considers the odontogenic origin. The present case report discusses diagnosis and treatment of an extraoral cutaneous sinus tract of odontogenic origin in relation to a mandibular left cannine (diagnosed as asymptomatic suppurative periradicular abscess with an extraoral cutaneous sinus tract opening in the mandibular mental region). Non-surgical endodontic therapy was performed using Nd:YAG laser. To present a case report describing the diagnosis and treatment of an extraoral cutaneous sinus tract of odontogenic origin in relation to a mandibular left cannine. The patient responded well, and the cutaneous lesions healed uneventfully.

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Oral submucous fibrosis is a premalignant condition which affects the submucosal layer of oral mucous membrane. Trismus is the most severe presentation of this disease which jeopardizes the nutrition status of the individual. To achieve the adequate mouth opening, the complete release of fibrotic tissue is essential. However, incising the fibrotic tissue with a conventional blade or electrocautery can cause bleeding, delayed healing, and recurrence of fibrosis. In this study, we have used diode laser for the fibrotomy with satisfactory results and disease-free follow-up of 1 year.

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Objective: Traditional composites are strong and esthetic, but they have no bioactive potential and require bonding agents that have been shown to leak, cause white lines, staining, and failure. ACTIVA BioACTIVE is the first composite with an ionic resin matrix and bioactive fillers that mimic the physical and chemical properties of natural teeth. The aim of the study was to compare shear bond strength of traditional composite and resin-modified glass-ionomer bioactive ionic resin-based composite after enamel preparation with erbium-doped yttrium aluminum garnet (Er:YAG) laser and conventional acid etching. Materials and Methods: Forty sound extracted molars were divided into four groups of 10 samples each. In group I, specimens were bur treated followed by bonding of composite. In group II, specimens were laser treated followed by bonding of composite. In group III, specimens were bur treated followed by bonding of Bioactive. In group IV, specimens were laser treated followed by bonding of ACTIVA BioACTIVE. Buccal tooth surfaces were prepared approximately half of the enamel depth. A tube was filled with composite and placed on the treated tooth surface. Once the curing was complete, the tube molds were removed. After thermocycling, the shear bond strength testing was performed using the Instron Testing Machine, and the data were statistically analyzed. Results: Bur preparation followed by bonding of Bioactive yielded the highest bond strength followed by laser preparation. Conclusion: Er:YAG laser preparation caused decreased shear bond strength compared to conventional bur preparation.

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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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Aim: The aim of this study was to evaluate the effect of laser-activated irrigation (LAI) on the removal of debris-mimicking hydrogel from a simulated accessory canal. Materials and Methods: The simulated accessory canal was located 3 mm from the apex, perpendicular to the straight main canal. Gelatin hydrogel as a substitute of debris was used to fill the simulated accessory canal. The root canals were irrigated for 20 or 40 seconds by LAI using an erbium: yttrium aluminum garnet (Er:YAG) laser (30 mJ, 20 pps) or for 40 seconds by syringe irrigation (SI). During LAI, the cone-shaped tip of the laser was positioned stationary at 3 or 10 mm from the apex. Irrigation was performed using 5% NaOCl. The distance over which the hydrogel was removed from the accessory canal entrance was measured and compared between the irrigation procedures. Results: Using NaOCl as the irrigant, a significant increase was observed in the distance over which the hydrogel was removed by LAI compared with that by SI. A longer irradiation period with LAI resulted in significantly greater amount of hydrogel removal. There was no significant difference in hydrogel removal when the laser tip was positioned at 3 and 10 mm from the apex. Conclusion: Within the limitations of this in vitro model, LAI removed more hydrogel from the accessory canal than SI, when using NaOCl as the irrigant. Furthermore, the irradiation time influenced the cleaning efficacy, but the tip position did not.

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The use of hydrogen peroxide (H₂O₂) for conventional bleaching was introduced way back in 1884. Today bleaching products are often found in the form of gels containing various concentrations of carbamide peroxide and H₂O₂depending on the application and methods. Laser-assisted tooth bleaching has proven faster and efficient results. This case report emphasizes on the efficacy of diode laser for tooth bleaching. Opalescent^® (Potassium nitrate and fluoride) was used as a bleaching gel. Diode laser (810 nm) was used to irradiate the tooth surfaces and microabrasion was carried out. Visible reduction in tooth discoloration was seen after a period of 3 weeks. On the basis of the results obtained, diode laser can be considered as an efficient and reliable treatment modality compared to conventional bleaching.

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Aim: The aim of the study was to evaluate the efficacy of laser-activated irrigation, the streaming pattern, and its relevance to laser-induced bubbles in a transparent simulated root canal. In addition, the effects of tip position on irrigant flow were examined. Materials and Methods: Particle image velocimetry with a high-speed camera was used, which enabled tracking of buoyant tracer movement. Recorded images were analyzed using two-dimensional fluid analysis software. The tip of an erbium: yttrium aluminum garnet (Er:YAG) laser was placed either in the coronal chamber or in the root canal. Results: On laser irradiation within the coronal chamber, rapid streaming appeared in the entire root canal immediately after the advent of the vapor bubble. Peak flow velocity was observed when the vapor bubble grew to peak size. In contrast, when the tip was placed in the root canal, rapid streaming was related to the appearance of secondary cavitation bubbles and confined to the apical region. Conclusion: The streaming pattern in laser-activated irrigation was affected by the tip position in the root canal. In addition, there was a close relation between the formation of laser-induced bubbles and rapid streaming.

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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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Lipoma, a benign tumor of adipose tissue is one of the most common benign neoplasms of the body. However, its occurrence in oral cavity is very rare. It accounts for 1-4% of benign neoplasms of mouth affecting predominantly the buccal mucosa, floor of mouth and tongue. We report two cases of intraoral lipoma both of them in buccal vestibule. An excisional biopsy with diode laser was performed and histopathology examination revealed proliferation of mature adipocytes arranged in lobules and separated by fibrous septa in the first case, and the second case was a fibrolipoma.

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Ackerman's tumour or Verucous carcinoma is a unique clinico-pathological rare variant of squamous cell carcinoma. The term "Verrucous" is used because of its fine, finger like surface projections. Verrucous carcinoma constitutes 2 to 4.5% of all forms of squamous cell carcinoma, occuring mainly in oral cavity and larynx, buccal mucosa being most commonly involved. A case of verrucous carcinoma involving mucosa of retromolar region in an adult male aged 63 years is being reported who was managed using CO ₂ lasers. Post-surgical excision was without any post-operative complications. Repithelialization was within weeks and no signs of recurrence after follow up period of about six months. Thus it is concluded that CO ₂ lasers can be good tool for surgical management.

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