Laser-Assisted Esthetic Crown Lengthening: Open-Flap Versus Flapless

Area of Science:

• Periodontology
• Laser Dentistry
• Esthetic Dentistry

Background:

• Altered passive eruption requires esthetic crown lengthening (ECL) for optimal restorative and esthetic outcomes.
• Er,Cr:YSGG (2,780 nm) lasers offer a precise tool for periodontal surgical procedures like gingivectomy and ostectomy.
• Comparing open-flap (OF) and flapless (FL) surgical approaches is crucial for understanding clinical predictability.

Purpose of the Study:

• To compare the clinical outcomes of Er,Cr:YSGG laser-assisted open-flap (OF) versus flapless (FL) esthetic crown lengthening (ECL).
• To evaluate the effect of periodontal phenotype and tooth location on gingival margin level (GML) and supracrestal gingival tissue dimension.
• To assess the predictability and efficacy of laser-assisted ECL in treating altered passive eruption.

Main Methods:

• Thirty-six patients with altered passive eruption were randomized into OF and FL groups.
• Er,Cr:YSGG laser was used for gingivectomy and ostectomy in both groups.
• Periodontal condition and gingival margin level (GML) were assessed at baseline, immediately post-surgery, and at 1, 3, and 9 months post-surgery.

Main Results:

• A significant difference in mean GML was observed at most time points, except between 3 and 9 months.
• Mean tissue rebound after 9 months was comparable between OF (0.25 ± 0.3 mm) and FL (0.26 ± 0.3 mm) groups.
• Tissue rebound was significantly higher in patients with thick periodontal phenotypes.

Conclusions:

• Er,Cr:YSGG laser-assisted ECL is a predictable technique for treating altered passive eruption.
• Both open-flap and flapless approaches using this laser achieve similar clinical outcomes.
• This laser-assisted technique provides valuable esthetic and restorative opportunities for clinicians.