According to the American Academy of Periodontology Report on lasers in periodontics published in the Journal of Periodontology in 2006, the CO2 laser is well suited for soft-tissue laser dentistry . A plethora of peer-reviewed papers on soft-tissue laser surgery in the last 25 years list a variety of periodontal applications for the CO2 dental laser: e.g., gingivectomy; gingivoplasty; frenectomy; intra- and post-operative de-epithelialization of flaps; coagulation of graft donor sites; distal wedges; removal of papillomas; and treatment of fibromas, pyogenic granulomas, lichen planus, keratotic lesions, inflammatory papillary hyperplasia, and hemorrhagic disorders in dental patients [2,3].
Many leading periodontists emphasize that advantages of CO2 dental laser treatment are excellent visibility due to a nearly dry surgical field, control of surgical and post-surgical bleeding, shorter surgery time, the ability to coagulate, vaporize, or cut by varying the power, reduced swelling, contraction of the wound and scarring, decreased post-operative pain, less damage to the adjacent tissue [2,4], easier accessibility in many areas of the mouth as a viable, and often improved, alternative to the blade.
Dr. Stuart Coleton, DDS, Diplomate of both the American Board of Periodontology and the American Board of Oral Medicine, has been using the laser in his practice since 1990. In his August 2011 interview for Laser Surgery News, he explained that he chose the CO2 dental laser over the Nd:YAG “because it was an ideal wavelength for soft-tissue surgeries, the kind of work that I do. … With the CO2 laser, given that most of the procedures are done using a local anesthetic, we have limited to no bleeding, extremely low post-operative discomfort, very little (if any) swelling, and a significant decrease in the bacterial population of the surgical site. … post-operatively, the periodontal bandage is not necessary with the laser, while it is with a scalpel. And the healing is much more comfortable with the laser… the patient appreciates that.” Among numerous advantages the CO2 dental laser has to offer to periodontists, Dr. Coleton mentioned the accessibility he gained with the flexible fiber waveguide: “With my flexible waveguide and my contra-angle tip, there’s no place in the mouth I can’t reach! Every area of the mouth is accessible, and that’s a fantastic advantage [in relation to articulated arm lasers].”