Indonesian Dental Association Journal of Indonesian Dental Association http://jurnal.
id/index.
php/jida ISSN: 2621-6183 (Prin.
ISSN: 2621-6175 (Onlin.
Literature Review Comparative Evaluation of Scalpel.
Electrosurgery, and Laser in Periodontal Surgery: A Systematic Case Review Surijana Mappangara1.
Ridhayani Hatta2A.
Maya Masyita Atlanta3 1 Department of Periodontics.
Faculty of Dentistry.
Universitas Hasanuddin.
Makassar.
Indonesia 2 Department of Dental Materials Science.
University of YARSI.
Jakarta.
Indonesia 3 Department of Dental Materials Science.
The University of Sheffield.
Sheffield.
United Kingdom
KEYWORDS
periodontal surgery.
ABSTRACT
In periodontal surgery, utilizing a conservative approach yields more aesthetically pleasing outcomes while reducing patient morbidity and tissue damage.
The development of tools such as electrosurgery and lasers for periodontal treatment has facilitated the implementation of these conservative procedures.
This study aims to evaluate the efficacy, outcomes, and postoperative complications of scalpel, electrosurgery, and laser techniques in the periodontal This article was created by making a research question using the PICO method and searching for articles from PubMed/MEDLINE.
Web of Science.
Scopus.
ScienceDirect, and Google Scholar from 2019-2023.
This study used the PRISMA standard guidelines.
Almost all studies in this systematic case review compared the three therapies in treating gingival Only one study discussed the treatment of gingival enlargement using the gingivectomy method.
Laser use in periodontal surgery is best compared to electrosurgery or scalpel in effectiveness, quality, outcome, postoperative complications, and wound healing.
Dry and bloodless surgical wounds, instant sterilization of the surgical area, reduced bacteremia, mechanical trauma, minimal postoperative swelling and scarring, and minimal postoperative pain point to the effectiveness of using lasers compared to surgery with electrosurgery or scalpel techniques.
Laser therapy in periodontal surgery is superior to scalpel and electrosurgery, offering faster treatment, fewer postoperative complications, enhanced wound healing, and higher patient satisfaction.
These findings support the adoption of laser techniques for optimal clinical and patient outcomes.
A Corresponding Author E-mail address: ridhayani.
drg@gmail.
com (Hatta R) DOI: 10.
32793/jida.
Copyright: A2024 Mappangara S.
Hatta R.
Atlanta MM.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original author and sources are credited.
Journal of Indonesian Dental Association 2024 7.
, 40-45 Mappangara S, et al.
INTRODUCTION
thereby guiding future periodontal surgical practices.
In periodontal surgery, conservative surgical therapy represents the optimal approach.
1 However, even when isolated areas are addressed through traditional flap surgery techniques, this often necessitates relatively extensive incisions, extending to adjacent healthy 2 Despite the objective of such extensive tissue reflection being to enhance visibility and accessibility of the surgical field, it can lead to attachment loss in otherwise healthy areas.
3-5 This attachment loss can result in complications such as thermal sensitivity, food impaction, and aesthetic 6 Recent clinical innovations in flap design and management have enabled the performance of periodontal surgery focused solely on the damaged tissue, thereby minimizing treatment failures compared to traditional flap methods.
7 Consequently, utilizing a conservative approach yields more aesthetically pleasing outcomes while reducing patient morbidity and tissue In the medical field, the term "conservative surgical procedures" refers to the ability to execute standard surgical interventions and achieve comparable or superior outcomes using less surgical openings than conventional methods.
8 These less incisions result in less postoperative discomfort, faster healing, reduced tissue damage, and similar or improved long-term surgical Technological advancements have made it possible to access the operating area through less The development of tools such as electrosurgery and lasers for periodontal treatment has facilitated the implementation of these conservative procedures.
9 Over the past decade, numerous reports have evaluated conservative surgical procedures for the treatment of periodontal infrabony defects, utilizing flap designs with minimal incisions and adequate elevation to access the 10,11 These techniques are believed to reduce surgical trauma and enhance wound healing.
However, there are several challenges that underscore the necessity of this study.
Firstly, the lack of comprehensive comparative studies between different conservative surgical methods such as scalpel, electrosurgery, and laser creates a gap in understanding the relative effectiveness of these techniques.
Secondly, the variability in postoperative outcomes and patient complaints with each method needs systematic evaluation to inform best practices.
Thirdly, the long-term impact of these different surgical approaches on periodontal health and aesthetics remains unclear.
This systematic review aims to address these issues by evaluating the efficacy, outcomes, and postoperative complications of scalpel, electrosurgery, and laser techniques in the surgical treatment of periodontal This analysis, based on various clinical case reports, will provide a clearer understanding of the comparative benefits and limitations of each technique.
MATERIALS AND METHODS Search Methodology This study discusses the use of scalpel, electrosurgery, and laser in periodontal surgical therapy which has been reported from various published case reports in English for the last 5 years.
The case report will be reviewed to evaluate the comparison of the three periodontal surgical methods based on their efficacy, and complaints during and after treatment in patients.
Sources of articles collected from PubMed/MEDLINE.
Web of Science.
Scopus.
ScienceDirect, and Google Scholar with search methods using the keywords periodontal surgery, scalpel/conventional periodontal surgery, electrosurgery in periodontal treatment, and laser in periodontal The selected articles were published in 20192023.
Focused Questions This systematic case review used standard PRISMA guidelines (Preferred.
Reported.
Items for Systematic Review and Meta-analysi.
with a research design using observational studies in case-control articles.
Questions were also prepared using the PICO (Patients.
Intervention.
Comparison, and Outcom.
Patients: Patients undergoing periodontal surgical procedures with various surgical therapy approaches.
Intervention: Periodontal surgical therapy by producing minimally invasive surgical therapy, either conventional surgical procedures using a scalpel, electrosurgery, or Comparison: The surgical technique uses a scalpel, electrosurgery, and laser.
Conventional surgical technique is a technique that uses a scalpel to make a flap incision in the gingiva in a surgical treatment procedure.
Electrosurgery is a soft tissue surgical technique that uses an electric current converted into heat whose surgical endpoint varies based on the shape of the wave and results in drying, to provide coagulation or shallow or deep skin cutting.
12 Whereas .
Laser is an acronym that means Light Amplification by Stimulated Emission of Radiation, which is a surgical technique that uses laser light energy to cut soft tissue and hard tissue.
13 Outcome:
Analysis of the efficacy, quality, results, and postoperative complications of the three periodontal surgical techniques used.
Study Design: This study examines several case reports and interventional-based studies .
published in English.
Criteria of Eligibility Articles were selected based on inclusion criteria: .
articles relevant to periodontal surgery in dentistry, .
clinical trials, .
case reports, .
in English, and .
published in 2019-2023.
The things that are excluded from this study are reviews, letters to the editor, and article comments.
Journal of Indonesian Dental Association 2024 7.
, 40-45 Mappangara S, et al.
The general characteristics of the case reports reviewed are depicted in Table 1.
Quality Assessment of Studies Quality assessment of the included articles was carried out according to standard parameters described in the Cochrane Handbook for Systematic Reviews of Interventions .
The parameters were randomization of the type of periodontal surgery, blinding procedure, statistical analysis used and clearly stated, measurement of multiple variables, explicit inclusion and exclusion criteria, understandable examiner reliability tested, and reported all expected results.
The author reviews and surveys each selected article for predetermined consideration criteria and directs an impartial assessment, and any ambiguities are resolved by discussion and agreement or through consultation with an expert as a third reviewer.
Due to the heterogeneity of outcomes and variables in the selected studies, the research team was unable to perform a meta-analysis in the current review.
Table 1.
General characteristics of case reports based on the standard Cochrane Handbook for Systematic Review of Interventions .
Quality Assessment
RESULTS
Search Results The main search identified 98 articles based on key After that, an article search was conducted for the last 5 years, and 28 articles were filtered based on title and abstract.
The search was further narrowed, and 19 irrelevant articles were excluded.
The remaining 9 fulltext articles were assessed for eligibility.
Additionally, a further 5 full-text articles were excluded.
The 4 relevant articles were finally included and analyzed in the review.
The PRISMA flowchart for the literature search strategy is described in Figure 1.
Articles Jagannathan R, et.
Lingala S.
Chhina S.
Year Randomization Withdrawal/dr Variables many times Sample size Inclusion/exclu sion criteria Yes Yes Yes Bhasker A, et.
Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Examiner Yes Yes Yes Yes Expected Quality of study/bias risk Yes Yes Yes Low Low Low Low General Outcomes of Reviewed Studies The results shown from the various studies reviewed in this study are suggestive.
For more details, see the general results in Table 2.
DISCUSSION