Effectiveness of laser-assisted gingivectomy compared to surgical methods: a systematic review

Background: Lasers have demonstrated their potential as an effective alternative to the scalpel for gingivectomy procedures. Therefore, it is essential to evaluate their efficacy and safety. This article summarizes human studies comparing the effectiveness of laser-assisted gingivectomy with conventional surgical methods. Methods: A comprehensive electronic search was conducted in Cochrane, PubMed/MEDLINE, ScienceDirect, and Google Scholar using the terms “Gingivectomy”, “Gingivoplasty”, “Crown lengthening”, “Gingival surgery”, and “LASER” to identify human studies that compared laser-assisted gingivectomy with traditional surgical methods up until December 2022. The inclusion criteria were as follows: English language, use of laser as the primary treatment tool, and study designs including randomized controlled trials, controlled clinical trials, clinical trials, and comparative studies. Results: Twenty-two studies met the inclusion criteria and were analyzed. Diode lasers (810–940 nm) and Erbium, chromium-doped yttrium scandium gallium garnet laser (Er,Cr:YSGG) lasers caused less postoperative pain than conventional flap surgery, while the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser resulted in higher initial pain. The diode 808 nm laser yielded mixed results—one study reported pain levels comparable to those of scalpels, while another noted reduced pain with laser use. However, one study indicated greater use of analgesics in laser-treated patients, suggesting increased discomfort. Lasers, particularly carbon dioxide (CO2) and diode 810 nm lasers, provided superior hemostasis compared to scalpels, with the Er,Cr:YSGG laser in flapless osteotomy minimizing bleeding. Additionally, no sutures were required in the laser-treated groups. The stability of the gingival margins after laser treatment was found to be similar to that of the scalpel. Discussion: All lasers discussed in this article can be safely and effectively used for gingivectomy as an alternative to conventional surgical methods. Laser treatment demonstrated superior clinical outcomes in terms of pain, patient satisfaction, hemostasis, recovery period, and periodontal health.