Assessment of Pain When Uncovering Implants with Er:YAG Laser or Scalpel for Second Stage Surgery.

BACKGROUND: Different methods aimed at decreasing pain during some soft tissue procedures in dentistry are still under research. Modern devices as lasers could be a method to reduce the pain and duration of second stage implant surgery.

OBJECTIVES: To assess the pain and the impression quality when uncovering implants with a laser and with a scalpel.

MATERIAL AND METHODS: The analysis included 60 implants (Dentium SuperLine, Suwon, Korea) in 30 patients (23 women and 7 men) aged 25-69. In the experimental group, 30 implants were uncovered by means of an Er:YAG laser (LiteTouch®, Syneron Dental, Yokneam, Israel) with the following fixed operation parameters: 300 mJ, 18 Hz, water cooling at 40%, energy density per pulse: 38.21 J/cm2, tip size: 1.0 × 17 mm, distance: 2 mm, tip angle set at 70°, no anesthesia. As a control, 30 implants were uncovered using a scalpel and topical application of 20% benzocaine. An 11-point numeric pain rating scale (NRS-11) was used to evaluate the pain level. A 3-point prosthetic impression scale (PIS) designed by the authors was used to assess the quality of the impression of the implant emergence profile.

RESULTS: The mean value of pain assessed on the NRS-11 for the Er:YAG laser and scalpel were 2.6 and 6, respectively. The mean value of pain for the laser and scalpel at a supracrestal height of periimplant soft tissue (SHPST) ≤ 3 mm were 1.8 and 4.7 respectively, and for SHPST > 3 mm the values were 3.3 and 7.4, respectively. The implant emergence profile impression showed satisfactory or ideal quality in 26 cases.

CONCLUSIONS: The use of Er:YAG laser reduces pain and allows minor surgical procedures to be carried out without anesthesia. The impression quality is satisfactory for the preparation of prosthetic reconstructions.