Clinical Comparison of Diode Laser Assisted “v-Shape Frenectomy” and Conventional Surgical Method as Treatment of Ankyloglossia

The Role of Photodynamic Therapy Mediated by Natural Photosensitisers in the Management of Peri-Implantitis: A Systematic Review

Background: Peri-implantitis, an inflammatory condition leading to progressive bone loss around dental implants, represents a significant challenge in modern implant dentistry. Conventional mechanical debridement and adjunctive antibiotics or antiseptics often fail to fully eradicate complex biofilms and may promote antibiotic resistance. Photodynamic therapy (PDT) mediated by natural photosensitizers (e.g., curcumin, riboflavin, and 5-aminolevulinic acid) has emerged as a potential adjunctive strategy for peri-implantitis management due to its targeted antimicrobial and anti-inflammatory effects. Objectives: This systematic review aimed to evaluate the antimicrobial efficacy, clinical outcomes, and safety of PDT mediated by natural photosensitizers in the treatment of peri-implantitis and to identify optimal protocols regarding photosensitizer concentrations, light source parameters, and application techniques. Methods: Following PRISMA 2020 guidelines, databases (PubMed/Medline, Embase, Scopus, and Cochrane Library) were searched from 1 January 2015 to 3 January 2025 for English-language publications. Studies assessing naturally based PDT interventions for peri-implantitis or in vitro biofilms from diseased implant surfaces were included. Quality assessment used the Revised Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and a tailored nine-item framework for in vitro studies. Eleven studies met the inclusion criteria. Results: Despite heterogeneity in methodologies, especially regarding light wavelengths, energy densities, and photosensitizer formulations, most studies reported notable reductions in bacterial viability, biofilm mass, and clinical indices (probing depth and bleeding on probing). Curcumin and riboflavin frequently demonstrated comparable antimicrobial efficacy to standard disinfectants, while 5-aminolevulinic acid (5-ALA)-based PDT also showed promising clinical and microbiological improvements. However, complete biofilm eradication was rarely achieved. Conclusions: Natural-photosensitizer-based PDT appears to be a valuable adjunct to mechanical debridement for peri-implantitis, enhancing microbial control and clinical outcomes. Standardization of PDT protocols and further well-designed clinical trials with extended follow-up periods are warranted to confirm long-term efficacy and inform evidence-based guidelines.

Blood Flow Restriction Training for Improving Body Composition of a 26-Year-Old Male With L5-S1 Disc Protrusion and Nerve Root Compression: A Case Report

This case report explores the use of blood flow restriction (BFR) training to improve body composition in a 26-year-old male with L5-S1 disc protrusion and nerve root compression. BFR training, involving low-intensity exercises with restricted blood flow, offers a promising alternative for patients unable to engage in high-intensity workouts. The patient, a recreational gymgoer with a history of a significant lower back injury from a maximal deadlift event 20 months ago, presented with chronic pain, weight gain, and decreased stamina. Two attempts at spinal steroid injections during the 20-month period yielded only temporary relief, prompting the implementation of a 12-week BFR training regimen. The program combined BFR exercises with a calorie-deficit diet, resulting in substantial improvements in body composition and strength. Over 12 weeks, the patient lost 11.68 kg, reduced his body mass index from 26.50 to 22.85, and decreased his total body fat percentage from 28% to 22.43%. His lower back pain also significantly improved. This case highlights the effectiveness of BFR training in managing obesity and enhancing physical fitness in spinal injury patients, emphasizing the need for further research on its broader application.

Maxillary labial frenectomy: a randomized, controlled comparative study of two blue (445 nm) and infrared (980 nm) diode lasers versus surgical scalpel

BACKGROUND

This study aimed to compare the intra and postoperative complications of frenectomy procedure with a surgical scalpel versus 445 nm and 980 nm diode lasers.

METHODS

This randomized controlled clinical trial was conducted on 174 patients requiring maxillary labial frenectomy. After completion of fixed orthodontic treatment and primary closure of maxillary diastema, the patients were randomly assigned into three groups (n = 58): group 1 (frenectomy via 445 nm diode laser, continuous-wave, 1.5 W), group 2 (frenectomy via 980 nm laser, continuous-wave, 1.7 W), and control group (V-Y plasty technique via scalpel). Intra-operative bleeding, discomfort in chewing and speaking, pain, and tissue healing were compared among the groups immediately, at 7 and 30 days postoperatively using the Kruskal-Wallis, Mann-Whitney, and Chi-square tests.

RESULTS

Pain scores were significantly lower in group 1 compared to group 2 (immediately and day 7, P < 0.05). Significant faster tissue healing at days 7 and 30 were observed in group 1 compared to group 2 (P < 0.05). Group 1 was superior to the control group regarding lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), lower pain (immediately and day 7), and tissue healing (day 7) (P < 0.05 for all). Group 2 was significantly superior to the control group in lower intraoperative bleeding, discomfort in chewing and speaking (immediately and day 7), and better tissue healing (day 7) (P < 0.05 for all).

CONCLUSIONS

In conclusion, diode laser frenectomy resulted in significantly lower intra and postoperative complications compared to the scalpel. Moreover, 445 nm diode laser showed significantly superior effects compared to 980 nm diode laser.

TRIAL REGISTRATION

The study protocol was registered on 29.10.2022 at the Iranian Registry of Clinical Trials ( www.irct.ir ) (registration number: IRCT20220630055326N1).

Effects of topically administered 0.6% hyaluronic acid on the healing of labial frenectomy in conventional and 940-nm indium gallium arsenide phosphide (InGaAsP) diode laser techniques in pediatric patients: a randomized, placebo-controlled clinical study

This study aimed to investigate the effects of 0.6% hyaluronic acid (HA) gel on the healing process and postoperative pain levels after diode laser-assisted labial frenectomy in pediatric patients. Ninety-six pediatric patients (females, 50 and males, 46) aged 8-14 years were randomly divided into four groups as follows: (1) conventional frenectomy with 0.6% topically administered HA (CFH, n = 24); (2) conventional frenectomy with placebo gel (CFP, n = 24); (3) frenectomy performed by diode laser with 0.6% topically administered HA (DLH, n = 24); and (4) frenectomy performed by diode laser with placebo gel (DLP, n = 24). HA application was continued for 1 week thrice daily after the frenectomy. Visual analog scale forms were collected from patients 1 week after the operation. In addition, the plaque index, gingival index, periodontal probing depth, and keratinized tissue width and thickness were recorded. This process was repeated 1 and 3 months after the first visit. The DLH group revealed significant differences in the probing depth, bleeding on probing, keratinized gingiva width, and attached gingiva width according to dual comparisons of the initial, first, and third-month values (p = 0.010, p = 0.007, p<0.001, and p = 0.001, respectively). Significant differences were observed between the CFP and CFH groups according to the initial and initial third-month values with regard to the bleeding on probing (p=0.019 and p = 0.019, respectively). The attached gingival thickness revealed significant differences between the CFP and CFH groups for the initial and initial-third-month comparisons (p = 0.005 and p = 0.007, respectively). The mean values of the initial and initial-third-month differences were significantly higher in the CFH group than those in the CFP group. HA- and laser-assisted labial frenectomies revealed better outcomes in terms of the probing depth, attached gingiva width, keratinized gingiva width, healing process, and postoperative comfort.

Treatment of Ankyloglossia: A Review

AIM

The aim of this narrative review is to analyze and compare the current scientific evidence regarding the diagnosis and treatment of hypertrophic lingual frenulum in preschool and school-age children. The treatments considered in this review are traditional surgical therapy, laser-assisted surgical therapy, and functional rehabilitation therapy.

MATERIALS AND METHODS

A comprehensive literature review was conducted using the PubMed and PubMed Central search engines, considering articles published in the English language between 1 January 2000 and 30 June 2022. The bibliographic search was performed using the following keywords as search strings: "lingual", "frenulectomy", "frenulotomy", "frenulum", "ankyloglossia", and "laser."

RESULTS

A total of 14 articles were included in this review, including four prospective observational studies, one case-control study, three cross-sectional studies, four retrospective studies, and one randomized controlled trial. The data extracted from each article are summarized in a table.

CONCLUSIONS

In the literature, there are still limited studies regarding the treatment of hypertrophic frenulum. No common indications for the treatment of ankyloglossia and universally used classification for lingual frenulum were found. Currently, clinicians prefer the use of a diode laser for treatment. This method offers several advantages over the use of a scalpel blade. Many studies agree on the usefulness of providing patients with myofunctional rehabilitation to improve lingual mobility, both prior to surgical therapy and in the postoperative period.

Management of Tongue-Tie Using Diode Laser for Speech Clarity: A Case Report

A congenital condition called ankyloglossia, or tongue tie, is characterized by an excessively short or tight lingual frenum that restricts the tongue's movement and flexibility. Although ankyloglossia, or tongue tie, is not a serious sign, it can cause a variety of challenges, such as difficulty with newborn feeding, speech problems, and many mechanical and social problems since there are restricted tongue movements, such as protrusion of the tongue. It is recommended to get a lingual frenectomy to treat ankyloglossia. A 24-year-old female patient reported to the Department of Periodontics with class II, moderate lingual tie, or ankyloglossia. Under local anesthesia, the lingual frenectomy is performed with a diode laser by placing a hemostat across the frenal attachment at the base of the tongue, and an incision is made. The laser surgery took less time and was more comfortable for the patient because there was less discomfort. There was no postoperative pain or hemorrhage. The above case report can appreciate the normal frenal attachment that is more than 16 mm, and the patient can hold the tip of the tongue and function comfortably. A follow-up visit after three months revealed normal frenal attachment and complete healing of the frenum. This case report demonstrates unequivocally that lingual frenectomy using a diode laser has advantages over traditional procedures in that it reduces or eliminates postoperative pain and minimizes hemorrhage and swelling.