Principles of cosmetic dentistry in orthodontics: part 2. Soft tissue laser technology and cosmetic gingival contouring.

Most orthodontists are familiar with the term “laser” but don’t really know much about them or their applications in orthodontic practice. The most frequent applications of lasers in dentistry include gingivectomy, frenectomy, removal of mucocutaneous lesions, and gingival sculpting associated with implants and mucogingival surgery. Rossman and Cobb summarized the advantages of lasers in soft tissue surgery: (1) the laser cut is more precise than that of a scalpel, (2) the cut is more visible initially because the laser seals off blood vessels and lymphatics, leaving a clear dry field, (3) the laser sterilizes as it cuts, reducing the risk of blood-borne transmission of disease, (4) minimal postoperative pain and swelling have been reported, (5) less postoperative infection has been reported because the wound is sealed with a biological dressing, (6) less wound contraction occurs during mucosal healing, thus scars do not develop, and (7) less damage occurs to adjacent tissues. These qualities result in a shorter operative time and faster postoperative recuperation. Our interest in soft tissue lasers came through our increasing application of principles of cosmetic dentistry, which allow us to finish the esthetics of the smile to a much finer degree. These principles were covered in Part 1 of this 3-part series.