Elafifi Ebeid Haitham, Altayeb Walid, Parada Avendaño Isabel, Abad-Sanchez Daniel, Arnabat-Domínguez Josep
Faculty of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain.
Surgery Department, Master of Oral Laser Applications (EMDOLA), University of Barcelona, 08908 Barcelona, Spain.
Dent J (Basel). 2024 Dec 20;12(12):418. doi: 10.3390/dj12120418.
In recent years, erbium-doped yttrium aluminum garnet (Er:YAG) and erbium, chromium/yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers have been introduced as another possibility to perform less-invasive flapless (FL) crown-lengthening (CL) procedures.
The aim of this review is to describe the outcomes and complications of this approach.
A literature review was conducted to retrieve clinical studies and case reports that analyze different variables related to laser-assisted flapless crown lengthening and report their outcomes in terms of gingival margin level stability (GMLS), and postoperative complications.
A total of five studies were included in the final qualitative analysis; two of them were randomized controlled trials (RCTs) and the rest were case reports. The common variable measured in all studies was the GMLS, finding good stability in the FL groups at 3 months follow-up, but more tissue rebound was observed in patients with the thick biotype. Other variables were reported in different articles as the plaque index (PI), gingival index (GI), bone margin level, biotype, bleeding on probing (BP), probing depth (PD), and postoperative pain by the numeric rating scale (NRS).
There are a wide range of heterogenous clinical variables used to evaluate outcomes, as well as variations in the type of laser used and its parameters in terms of the applied technique. However, most analyzed studies showed better GMLS for the flapless technique, as well as less postoperative inflammation.
The included studies showed promising clinical outcomes in the FL laser-assisted CL groups concerning GMLS at the 3-month postoperative period. However, more RCTs are needed with respect to fixed laser parameters and patient biotype selection to reach a definitive clinical protocol.
近年来，掺铒钇铝石榴石（Er:YAG）激光和铒铬/钇钪镓石榴石（Er,Cr:YSGG）激光被引入，成为进行微创无瓣（FL）牙冠延长术（CL）的另一种选择。
本综述旨在描述该方法的治疗效果和并发症。
进行文献综述，检索分析与激光辅助无瓣牙冠延长术相关的不同变量，并报告其在牙龈边缘水平稳定性（GMLS）和术后并发症方面治疗效果的临床研究和病例报告。
最终的定性分析共纳入五项研究；其中两项为随机对照试验（RCT），其余为病例报告。所有研究中测量的共同变量是GMLS，发现在3个月随访时FL组具有良好的稳定性，但在厚生物型患者中观察到更多的组织反弹。不同文章还报告了其他变量，如菌斑指数（PI）、牙龈指数（GI）、骨边缘水平、生物型、探诊出血（BP）、探诊深度（PD）以及采用数字评分量表（NRS）评估的术后疼痛。
用于评估治疗效果的临床变量种类繁多且存在异质性，所用激光类型及其应用技术参数也存在差异。然而，大多数分析研究表明，无瓣技术的GMLS更好，术后炎症也更少。
纳入的研究表明，FL激光辅助CL组在术后3个月时GMLS方面具有良好的临床治疗效果。然而，需要更多关于固定激光参数和患者生物型选择的RCT，以达成明确的临床方案。
