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Efficacy and safety of diode laser during circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a triple-blind randomized clinical trial

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Abstract

The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.

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References

  1. 1.

    Castro V, do Prado CJ, Neto AI, Zanetta-Barbosa D (2013) Assessment of the epidemiological profile of patients with dentofacial deformities who underwent orthognathic surgery. J Craniofac Surg 24:271–275. https://doi.org/10.1097/SCS.0b013e31828f28f3

  2. 2.

    Patcas R, Cunningham SJ, Shute J, Lloyd T, Obwegeser JA, Arjomand L, Sharma S (2017) Motivation for orthognathic treatment and anticipated satisfaction levels-a two-centre cross-national audit. J Craniomaxillofac Surg 45:1004–1009. https://doi.org/10.1016/j.jcms.2017.03.012

  3. 3.

    Proffit W, White R (1990) Who needs surgical–orthodontic treatment? Int J Adult Orthod Orthognath Surg 5:81–89

  4. 4.

    American Association of Oral and Maxillofacial Surgeons (2015) AAOMS criteria for orthognatic surgery. https://www.aaoms.org/docs/practice_resources/clinical_resources/ortho_criteria.pdf. Accessed 10 October 2017

  5. 5.

    Liboon J, Funkhouser W, Terris DJ (1997) A comparison of mucosal incisions made by scalpel, CO2 laser, electrocautery, and constant-voltage electrocautery. Otolaryngol Head Neck Surg 116:379–385. https://doi.org/10.1016/S0194-59989770277-8

  6. 6.

    Strauss RA, Fallon SD (2004) Lasers in contemporary oral and maxillofacial surgery. Dent Clin N Am 48:861–888. https://doi.org/10.1016/j.cden.2004.06.005

  7. 7.

    Jaeger F, Chiavaioli GM, de Toledo GL, Freire-Maia B, Amaral MBF, Mesquita RA (2018) High-power diode laser in the circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a prospective case series study. Lasers Med Sci 33:51–56. https://doi.org/10.1007/s10103-017-2333-4

  8. 8.

    Romanos G, Nentwig GH (1999) Diode laser (980 nm) in oral and maxillofacial surgical procedures: clinical observations based on clinical applications. J Clin Laser Med Surg 17:193–197. https://doi.org/10.1089/clm.1999.17.193

  9. 9.

    Angiero F, Parma L, Crippa R, Benedicenti S (2012) Diode laser (808 nm) applied to oral soft tissue lesions: a retrospective study to assess histopathological diagnosis and evaluate physical damage. Lasers Med Sci 27:383–388. https://doi.org/10.1007/s10103-011-0900-7

  10. 10.

    Jackson SD, Lauto A (2002) Diode-pumped fiber lasers: a new clinical tool? Lasers Surg Med 30:184–190. https://doi.org/10.1002/lsm.10023

  11. 11.

    Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol 63:834–840. https://doi.org/10.1016/j.jclinepi.2010.02.005

  12. 12.

    Nitta N, Fukami T, Nozaki K (2011) Electrocautery skin incision for neurosurgery procedures--technical note. Neurol Med Chir (Tokyo) 51:88–91

  13. 13.

    El-Kholey KE (2014) Efficacy and safety of a diode laser in second-stage implant surgery: a comparative study. Int J Oral Maxillofac Surg 43:633–638. https://doi.org/10.1016/j.ijom.2013.10.003

  14. 14.

    UStün Y, Erdogan O, Esen E, Karsli ED (2003) Comparison of the effects of 2 doses of methylprednisolone on pain, swelling, and trismus after third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:535–539. https://doi.org/10.1016/S1079210403004645

  15. 15.

    Mannion AF, Balagué F, Pellisé F, Cedraschi C (2007) Pain measurement in patients with low back pain. Nat Clin Pract Rheumatol 3:610–618. https://doi.org/10.1038/ncprheum0646

  16. 16.

    Brailo V, Zakrzewska JM (2015) Grading the intensity of nondental orofacial pain: identification of cutoff points for mild, moderate, and severe pain. J Pain Res 8:95–104. https://doi.org/10.2147/JPR.S75192

  17. 17.

    Kim NY, Yoo YC, Chun DH, Lee HM, Jung YS, Bai SJ (2015) The effects of oral atenolol or enalapril premedication on blood loss and hypotensive anesthesia in orthognathic surgery. Yonsei Med J 56:1114–1121. https://doi.org/10.3349/ymj.2015.56.4.1114

  18. 18.

    Consensus conference (1988) Perioperative red blood cell transfusion. JAMA 260:2700–2703. https://doi.org/10.1001/jama.1988.03410180108040

  19. 19.

    Carlos E, Monnazzi MS, Castiglia YM, Gabrielli MF, Passeri LA, Guimarães NC (2014) Orthognathic surgery with or without induced hypotension. Int J Oral Maxillofac Surg 43:577–580. https://doi.org/10.1016/j.ijom.2013.10.020

  20. 20.

    Cernavin I, Pugatschew A, de Boer N, Tyas MJ (1994) Laser applications in dentistry: a review of the literature. Aust Dent J 39:28–32. https://doi.org/10.1111/j.1834-7819.1994.tb05543.x

  21. 21.

    Coleton S (2004) Lasers in surgical periodontics and oral medicine. Dent Clin N Am 48:937–962. https://doi.org/10.1016/j.cden.2004.05.008

  22. 22.

    Amaral MB, de Ávila JM, Abreu MH, Mesquita RA (2015) Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial. Int J Oral Maxillofac Surg 44:1383–1389. https://doi.org/10.1016/j.ijom.2015.05.015

  23. 23.

    Moss JP, Linney AD, Lowey MN (1995) The use of three-dimensional techniques in facial esthetics. Semin Orthod 1:94–104

  24. 24.

    Haytac MC, Ozcelik O (2006) Evaluation of patient perceptions after frenectomy operations: a comparison of carbon dioxide laser and scalpel techniques. J Periodontol 77:1815–1819. https://doi.org/10.1902/jop.2006.060043

  25. 25.

    Elanchezhiyan S, Renukadevi R, Vennila K (2013) Comparison of diode laser-assisted surgery and conventional surgery in the management of hereditary ankyloglossia in siblings: a case report with scientific review. Lasers Med Sci 28:7–12. https://doi.org/10.1007/s10103-011-1047-2

  26. 26.

    Phillips C, Blakey G 3rd, Jaskolka M (2008) Recovery after orthognathic surgery: short-term health-related quality of life outcomes. J Oral Maxillofac Surg 66:2110–2115. https://doi.org/10.1016/j.joms.2008.06.080

  27. 27.

    D’Arcangelo C, Di Nardo Di Maio F, Prosperi GD, Conte E, Baldi M, Caputi S (2007) A preliminary study of healing of diode laser versus scalpel incisions in rat oral tissue: a comparison of clinical, histological, and immunohistochemical results. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:764–773. https://doi.org/10.1016/j.tripleo.2006.08.002

  28. 28.

    Jin JY, Lee SH, Yoon HJ (2010) A comparative study of wound healing following incision with a scalpel, diode laser or Er,Cr:YSGG laser in guinea pig oral mucosa: a histological and immunohistochemical analysis. Acta Odontol Scand 68:232–238. https://doi.org/10.3109/00016357.2010.492356

  29. 29.

    Kara C (2008) Evaluation of patient perceptions of frenectomy: a comparison of Nd:YAG laser and conventional techniques. Photomed Laser Surg 26:147–152. https://doi.org/10.1089/pho.2007.2153

  30. 30.

    Aras MH, Göregen M, Güngörmüş M, Akgül HM (2010) Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia. Photomed Laser Surg 28:173–177. https://doi.org/10.1089/pho.2009.2498

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Funding

This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Finance Code 001), Brazil, and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, #309322/2015-4), Brazil. R.A.M. is a CNPq research fellow. J.A.A.A. is the recipient of fellowships. Mrs. E. Greene provided English editing of the manuscript.

Author information

Correspondence to José Alcides Almeida de Arruda.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the human research Ethics Committee of the study institution (no. 53476816.9.0000.5149).

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Jaeger, F., Chiavaioli, G.M.d., de Toledo, G.L. et al. Efficacy and safety of diode laser during circumvestibular incision for Le Fort I osteotomy in orthognathic surgery: a triple-blind randomized clinical trial. Lasers Med Sci 35, 395–402 (2020). https://doi.org/10.1007/s10103-019-02832-2

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Keywords

  • Orthognathic surgery
  • Diode laser
  • High-power laser
  • Clinical trial