# Assessment of Healing after Diode Laser Gingivectomy Prior to Prosthetic Procedures
## 4 Instrument used:
The resection procedure was performed at the same visit using a diode laser with a wavelength of 810 nm (FOX, A.R.C. Lasers GmbH, Nurnberg, Germany) and a maximum power of 8 W. The fiber tip was activated by holding it on a special black paper before the procedure. The manipulation always started at the lowest laser power. It was set to a continuous mode (cw) with a power of 1.5 W, and depending on the tissue, the power could be increased to 2 W, if necessary. It worked in the contact mode, without water cooling. It was important that the tip slid through the tissue with minimal or no resistance. If this occurred, is had to be cut or replaced. Charring was a side effect that could occur either because too much power was used or because the tip moved slowly. This layer was quickly removed by irrigation with 3% hydrogen peroxide. In the diode laser technique, the tissue was cut coronally at the bleeding points level or to the desired depth in the other gingivectomy procedures. The cutting part of the laser is the tip of the optical fiber; thus, it was directed perpendicular to the surface. At the end of the procedure, the free gingival margin was beveled by tilting the tip 45 degrees to the root surface in order to eliminate the 90-degree cutting angle and obtain a smooth transition. A sweeping motion from the mesial to the distal of the cementoenamel junction (CEJ) was applied. The PPD was re-measured after the manipulation. Immediately after the procedure, the clinical efficiency was assessed (i.e., possibility to take the impression at the same visit), and, if necessary, one was taken. The duration of the manipulation was estimated with a stopwatch. The presence of bleeding during the procedure was assessed clinically. The following scale was used:  
1. None;
2. Self-limiting;
3. Requiring slight pressure to terminate it;
4. Requiring coagulation;
5. Requiring ligation of a blood vessel. The tissue adherence to the instrument was evaluated by the following criteria:  
1. None;
2. Adheres a little, which allows cleaning with damp gauze;
3. A large amount adheres, which requires mechanical removal of the optical fiber tip or replacement of the tip. Clinical observation in regard to postoperative pain, postoperative hemorrhage, and healing (tissue color, tissue contour, and appearance of the wound) was performed at the 24 th hour, 72 nd hour, and, finally, at the 1 st week and 2 nd week. Postoperative pain was measured using the 10-score visual analog scale (VAS) in which 'no pain' equaled 0 and 'the strongest pain imaginable' was 10. The patients were not shown their previous results. The presence or absence of postoperative hemorrhage on probing was reported using the WHO periodontal probe. The tissue color was evaluated visually--pink, red, livid, purple, whitened, or burned (in the case of the improper handling of the laser parameters or the slow movement of the tip). Contour assessment is determination of the gingival margin--the level at which the gingival margin is attached to the tooth. Its normal position is at the CEJ level, above that (coronally) is known as proliferation and below (apically) as recession. In the current study, the tissue, depending on its contour, was defined as normal, hyperplastic, and atrophic. The wound can be covered with fibrinous plaque and erythemat halo, granulated, necrotic, or with normal pale pink color.