USE OF THE CARBON-DIOXIDE LASER IN RETARDING EPITHELIAL MIGRATION - APILOT HISTOLOGICAL HUMAN STUDY UTILIZING CASE-REPORTS

PREDICTABLE REGENERATION OF TOOTH-SUPPORTING tissues lost to periodont al disease is the aim of periodontal therapy. Often the result of conv entional treatment is healing with a long junctional epithelium along the root surface and little regeneration of the complete attachment ap paratus. The purpose of this pilot study was to evaluate whether de-ep ithelialization with a CO2 laser at the time of flap surgery and at 10 -day intervals over the first 30 days of healing has the potential to enhance the formation of a connective tissue attachment. Six mandibula r incisors in two patients were selected for the study. Each patient r eceived oral hygiene instruction and initial therapy prior to surgery. The teeth were splinted together, open flap debridement was performed on all teeth, a notch was placed on the roots at the height of the cr est of the alveolar bone, and the flaps were sutured in place. The tes t side received controled de-epithelialization of the outer (oral) gin giva with the carbon dioxide laser, and the inner gingival flap. The d e-epithelialization was repeated on the test side at 10, 20, and 30 da ys postsurgically. Controls received open debridement only. Block sect ions were taken at 90 days and processed for histologic analysis. The results showed that for both patients, junctional epithelium (JE) was formed on both test and control teeth. In all control teeth, the JE ex tended the entire length of the root to the base of the reference notc h. On the test side (laser treated) in one patient, the notch was fill ed with connective tissue and limited repair cementum. This finding wa s not seen in any control teeth. This is the first reported observatio n of human histologic evaluation utilizing the CO2 laser for de-epithe lialization and may warrant further study.