Use of the carbon dioxide laser in retarding epithelial migration: A pilot histological human study utilizing case reports
The objectives of the present study were to document human responses to laser surgery evaluated by clinical and histologic means. The main purpose was to study whether de-epithelization with the CO2 laser of the outer gingival surface of a mucoperiosteal flap, at surgery and during the healing period, will retard epithelial migration and the formation of a long junctional epithelium. Six mandibular incisors with a hopeless diagnosis, demonstrated by probing depth and radiographic findings, were selected in two volunteers. A split-mouth design was used, with similar defects on the experimental and control teeth. Contralateral teeth were randomly divided into a test and control group. The test site was de-epithelized using the CO2 laser at the time of flap surgery. Repeated de-epithelization was performed at 10-day intervals for 30 days. The control site received a mucoperiosteal flap without laser treatment. Ninety days following the surgical procedure, a block section, which included gingival tissue, 2 mm of crestal alveolar bone, periodontal ligament, and a labial portion of the tooth, was surgically removed. Results showed that for both patients, junctional epithelium extended the entire length of the root to the base of the reference notch. On the test side (laser treated) in one patient, the notch was filled with connective tissue and limited repair cementum. This finding was not seen in any control teeth. This is the first reported observation of human histologic evaluation using CO2 laser for de-epithelization and may warrant further study. [P.W.]
Israel, M., J. Rossmann, and S. Froum, J Periodont, 66:197, 1995