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

Background: 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. Material and Methods: 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. Results: 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 f 1.396 for the scalpel group and 5.05 f 1.276 for the laser group, and 6-month values were 5.65 f 1.152 for the scalpel group and 5.50 f 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). Conclusions: 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.