Evaluating diode laser and conventional scalpel techniques in maxillary labial frenectomy for patient perception, tissue healing, and clinical efficacy: six-month results of a randomized controlled study

This study aims to compare scalpel and diode laser techniques regarding patients’ perceptions, tissue healing, diastema, and periodontal clinical parameters in the treatment of abnormal labial frenum. This prospective, randomized, controlled trial evaluated 43 patients (aged 18-55) requiring labial frenectomy, randomized to scalpel or diode laser therapy. Plaque index (PI) and gingival index (GI) were measured at baseline, 4 weeks, and 6 months post-surgery. Keratinized gingiva width (KGW) of maxillary central incisors and diastemas were measured at baseline and 6 months post-surgery. Postoperative pain was evaluated on days 1, 7, 14, 21, and 28 using a visual analog scale. Wound healing was assessed at 7 days and 4 weeks postoperatively, scored based on the degree of epithelialization and the presence of ulceration or necrosis. At 6 months, both groups showed a significant reduction in PI, GI, and diastema (P<0.05). KGW increased in both groups, with a significant increase in the laser group (P<0.05), though baseline and 6-month KGW values were not significantly different between groups: baseline values were 5.30 ± 1.396 for the scalpel group and 5.05 ± 1.276 for the laser group, and 6-month values were 5.65 ± 1.152 for the scalpel group and 5.50 ± 1.147 for the laser group (P<0.05). The diode laser group had significantly lower pain scores than scalpel group on days 1, 3, and 7 (P<0.05). however, from day 14 onward, there was no statistically significant difference in pain scores between groups (P<0.05). Tissue healing was significantly faster on day 7 in the scalpel group (P<0.05). Frenectomy with diode laser effectively reduces pain, although it may delay wound healing. Laser therapy serves as a feasible alternative to the scalpel method. However, further research is necessary to fully assess its benefits and limitations in soft tissue procedures.