| Objective: The purpose of this study was to compare the efficacy of two methods of using High-frequency electric knife and Er,Cr:YSGG lasers to remove gingival cleft.And to observe the short-term postoperative pain response,soft tissue healing,and gingival index of adjacent teeth in patients with both methods.Enriching the clinical treatment plan of gingival cleft is conducive to exploring a simpler,faster and more efficient treatment method for gingival cleft.It also provides a reference for the clinical application of Er,Cr:YSGG laser in the treatment of gingival cleft.Methods: We chose to receive orthodontic treatment in the Department of Orthodontics of the Affiliated Hospital of You Jiang Medical College for Nationnalities.Young patients aged 12 to 28 had no systemic disease and no severe periodontal disease or acute inflammation of soft tissue.All patients were uniformly treated with straight wire arch correction technique,and both single-jaw or double-jaw premolars must be removed as part of their orthodontic treatment.After the tooth extraction gap was closed,patients with two or four quadrant gingival cleft with bilateral symmetry were selected.They were measured and recorded the length of the gingival cleft,the depth of the gingival cleft and the gingival index of the adjacent teeth.Subsequently,the gingival cleft resection method was randomly selected.One side used a high-frequency electric knife and the other side used Er,Cr:YSGG laser.Under local infiltration anesthesia,the gingival cleft was removed.After the operation,each patient is given the instructions of a pain visual analogue scoring form(Visual Analogue Scoring,VAS)to fill out,Instruct patients to fill in VAS based on actual pain at 2 and 24 hours after surgery,the doctor will do it on time Telephone return visit records.The patient returned to observe the soft tissue healing at 7 days after the operation and submitted the VAS index card.At the 4 week follow-up,the same doctor measured and recorded the length of the gingival cleft,the depth of the gingival cleft and the gingival index of the adjacent tooth.The data were analyzed by SPSS20.0 statistical software,and the test level was 0.05(P<0.05).The measurement data before and after operation in the group were measured by the t-test of paired design measurement data,the measurement data between the two groups were measured by the t-test of the mean of two independent samples,and the grade data were measured by the rank sum test of the two groups of quantitative data.The effects of the two surgical methods on postoperative pain response,mucosal soft tissue healing and gingival index of adjacent teeth after gingival cleft resection were evaluated.Results:(1)2h postoperative pain index: The 2h postoperative pain index of the Er,Cr:YSGG laser group is lower than that of the High-frequency electric knife group.There was statistical significance(P <0.05).(2)24h postoperative pain index: The 24 h postoperative pain index in both groups was lower than the 2h postoperative pain index.The difference in pain index between the two groups(high-frequency electrosurgical group,Er,Cr:YSGG laser group)at 24 h after surgery was statistically significant(P <0.05).(3)The mucosal color,swelling and bleeding at 7 days after surgery were significantly different between the two groups(High-frequency electric knife group,Er,Cr:YSGG laser group)(P <0.05),and the Er,Cr:YSGG laser group's level is lower than the high-frequency electric unit group.(4)Gingival cleft length at 4 weeks after surgery: After 4 weeks of gingival cleft removal with Er,Cr:YSGG laser,the gingival cleft length of this group was significantly shorter than that before resection(P <0.05).After 4 weeks of gingival cleft removal with a High-frequency electric knife,the length of gingival cleft in this group was also significantly shorter than before the removal(P <0.05).There was no significant difference in gingival cleft length changes between the two groups(Er,Cr:YSGG laser group,High-frequency electric knife group)(P> 0.05).(5)Depth of gingival cleft 4 weeks after operation: After 4 weeks of gingival cleft removal with Er,Cr:YSGG laser,the depth of gingival cleft in this group was significantly smaller than before removal(P <0.05).After 4 weeks of gingival cleft removal with a High-frequency electric knife,the depth of gingival cleft in this group was also significantly smaller than that before resection(P <0.05).There was no significant difference in the gingival cleft depth between the two groups(Er,Cr:YSGG laser group,High-frequency electric knife group)(P> 0.05).(6)Gingival index of adjacent teeth 4 weeks after surgery: After 4 weeks of gingival cleft removal with Er,Cr:YSGG laser,the gingival index of adjacent teeth in this group was significantly smaller than that before resection(P <0.05).After 4 weeks of gingival cleft removal with High-frequency electric knife,the gingival index of adjacent teeth in this group was also significantly smaller than before the removal(P <0.05).There was no significant difference in gingival index of adjacent teeth between the two groups(Er,Cr:YSGG laser group,High-frequency electric knife group)(P> 0.05).Conclusion:(1)Compared with high-frequency electric knife,applying Er,Cr:YSGG laser for gingival cleft removal has higher comfort in the early postoperative period and lower inflammatory response to wounds.(2)Two methods of gingival cleft resection,Er,Cr:YSGG laser and High-frequency electric knife,have significantly improved gingival cleft length,gingival cleft depth,and gingival index score.(3)Er,Cr:YSGG laser can be considered as a preferred method for clinical gingival cleft resection. |
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