Laser Labial Frenectomy in Pediatric Patients

Abstract The paper presents the specifics of a laser-assisted labial frenectomy in a pediatric patient, with emphasis on the surgical technique, the laser parameters, patient’s compliance and postoperative outcome. A 9-year-old girl was referred to the University Department of Oral Surgery for labial frenectomy for orthodontic reasons. The clinical examination and evaluation revealed the presence of an aberrant labial frenum (class IV according to Placeket et al.) and a 3 mm wide medial diastema. A penetrating frenum caused a significant problem in the closure of the diastema during the orthodontic treatment, and a frenectomy was indicated. A conventional frenectomy is carried out with a scalpel excision followed by placement of few stitches. Some degree of post-operative discomfort as well as the need for a return visit to remove the stitches can be anticipated. The patient was in good general health but anxious about the surgical intervenetion, and hence Er. YAG laser frenectomy was suggested. The surgery was performed with Er.YAG laser (Fotona Fidelis III) and a non-contact hand piece, working with long pulse mode (LP), energy (E) of 120 mJ, frequency of 15 Hz and power of 1.80 W. The surgery was fast and easy to perform. The cooperation with the patient during treatment was excellent. The bleeding was scarce and the visibility was not compromised. Sutures were not necessary. The postoperative period was uneventful, pain-free, without swelling or signs of infection. No painkillers or antibiotics were used. A fibrin coating was visible the following day. The wound healing process was completed three weeks after surgery, with minimal scar. This laser is suitable to be used in soft-tissue proceduresin pediatric patients.