A Novel Concept of Combined High-Level-Laser Treatment and Transcutaneous Photobiomodulation Therapy Utilisation in Orthodontic Periodontal Interface Management

This case report is aimed to demonstrate the synergetic effects of lambda 940 nm laser photobiomodulation (PBM) therapy in augmenting the advantages of high-level-laser treatment (HLLT)-mediated reaction orthodontic periodontal interface management. Materials and Methods: A 32-year-old female who presented with a persistent gummy smile of upper incisors and low upper midline frenum attachment post-orthodontic treatment, was seeking a better smile appearance. She had a history of delayed wound healing without underlying medical conditions; otherwise, she was fit and healthy. She underwent laser ablation of the upper midline frenum and gingivoplasty of the upper incisors region with lambda 940 nm and lambda 2780, respectively, as well as transcutaneous PBM therapy (lambda 940 nm) to accelerate wound healing. The laser protocols were as follows: lambda 2780 nm: power output-2 W, pulse width-60 mu s, free running pulse (FRP), spot area-0.0016 cm(2), pulse repetition rate-25 pulses per second (s), 80 mJ/pulse, 90 s, lambda 940 nm: 1.2 W, continuous wave (CW) emission mode, 300 mu m, 60 s; whereas the adjunctive lambda 940 nm induced-PBM parameters were as follows: power output-1.4 W, CW-120 s, single application, spot area-2.8 cm(2). An acceleration of the wound healing was observed on the 4th day of treatment with no immediate or post-operative complications. The results showed no functional or aesthetic relapses at a long-term follow-up of 6 months. The authors concluded that lambda 940 nm laser-PBM can provide a synergetic effect to HLLT in accelerating wound healing and offering a precision smile with minimal to none post-operative complications. It is safe and justifiable to utilise dual therapy over the conventional methods, which serves our patients' needs in our daily practice and in various clinical indications. The concept and laser protocols of this clinical case report can pave the roadmap for future extensive studies.