DENTAL LASERS IN PREPROSTHETIC SURGERY: A NARRATIVE REVIEW

Cristian Orghidan, Decebal Vasincu, Raluca Dragomir, Alina-Elena Jehac, Ovidiu Stefănescu, Claudiu Topoliceanu, Agop-Forna Doriana

DOI : 10.62610/RJOR.2026.2.18.6

Abstract

This narrative literature review aimed to evaluate the existing evidence regarding the use of surgical lasers in preprosthetic interventions, analyzing clinical efficacy, tissue interaction mechanisms, laser parameter protocols, and postoperative outcomes across the main preprosthetic procedures: gingivectomy, frenectomy, vestibuloplasty, and post-extraction socket biostimulation. The literature search was conducted in PubMed, Scopus, and Web of Science, covering original clinical studies, in vitro and in vivo experimental studies, systematic reviews, and reference textbooks published over the last 20 years. Four major laser categories were evaluated: diode lasers (810–1064 nm), Nd:YAG (1064 nm), erbium lasers (Er:YAG 2940 nm; Er,Cr:YSGG 2780 nm), and CO₂ (10,600 nm). Laser energy interacts with oral tissues through absorption, reflection, diffusion, and transmission, generating graded photothermal effects alongside a biostimulatory response. Diode lasers, selectively absorbed by hemoglobin and melanin, are the most widely used in soft tissue preprosthetic procedures, offering excellent hemostasis and reduced postoperative morbidity. Erbium lasers are the only category effective on both soft and hard tissues, being preferred for frenectomies, vestibuloplasties, and osseous remodeling. Nd:YAG lasers provide deep hemostasis and are indicated for crown lengthening, while CO₂ lasers allow precise mucosal excision. Clinical outcome data consistently demonstrate lower VAS pain scores, reduced bleeding, faster epithelialization, and higher patient satisfaction in laser-treated groups compared to conventional surgery. Conclusions. Laser-assisted preprosthetic surgery offers significant clinical advantages over conventional techniques. The optimal laser selection depends on the target tissue type, clinical indication, and operator experience.