# Assessment of Healing after Diode Laser Gingivectomy Prior to Prosthetic Procedures
## 2 Materials and Methods  
Object of observation  
Clinical effectiveness of the healing process of the gingiva after diode laser gingivectomy.  
Units of observation  
The healing of the cut gingival surface of 41 teeth was examined for the current pilot study.  
Parameters of observation:  
Recovery time of the gingiva (24 th hour, 72 nd hour, 1 st week, and 2 nd week);  
Possibility to take the impression at the same visit (i.e., clinical effectiveness);  
Duration of the manipulation;  
Bleeding during the procedure;  
Tissue adherence to the instrument;  
Postoperative hemorrhage on probing;  
Postoperative pain;  
Wound healing in regard to:  
Tissue color;  
Tissue contour;  
Appearance of the wound.  
The methodology is a modification of that of [PERSON] et al.; [PERSON] et al.; and [PERSON] et al. [8; 9; 10].  
Venue of observation:  
Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University--Plovdiv, Bulgaria.  
Department of Periodontology and Oral Mucosa Diseases, Laser Dental Center, Faculty of Dental Medicine, Research Institute, Medical University--Plovdiv, Bulgaria (RIMUP).  
Observation members  
For maximum objectivity, four clinicians altogether assessed the results at 24 h, 72 h and at the end of the 1 st week and the 2 nd week. One was a dentist not familiar with the investigation, and the other three were researchers engaged in performing the study.  
Criteria for inclusion in the study:  
Patients undergoing soft tissue crown lengthening of front teeth with short clinical crowns and a high smile line--most often due to the fact of passive eruption;  
Patients for subgingival finish line exposure;  
Patients with deep subgingival carious lesions;  
Patients with oblique root fractures in the cervical part;  
Patients with short crowns when it is necessary to achieve a ferrule effect;  
Patients that need opercullectomy;  
The Loe and Silness gingival index of the subjects should be 0. The index is used for the assessment of the prevalence and severity of gingivitis in populations, groups, and individuals. A score from 0.1 to 1.0 signifies mild inflammation; 1.1 to 2.0 moderate inflammation, and 2.1 to 3.0 severe inflammation [1]. Criteria for exclusion from the study:  
- Patients with severe systemic diseases. They may lead to inflammation and/or bleeding, therefore compromising the results [32];  
- Presence of mental illness;  
- Presence of periodontal diseases;  
- Presence of inaccurate obturations that can interfere with biological space;  
- The subjects should not be smokers. This may lead to inflammation and/or bleeding, therefore compromising the results [33];  
- The subjects should not drink alcohol during the study (for 15 days). Alcohol consumption may lead to inflammation and/or bleeding, therefore compromising the results [34;35].  
The study was conducted in accordance with the Declaration of Helsinki and approved by the Committee of Scientific Ethics at Medical University--Plovdiv, reference number: P-7350/01.10.2015. Patients signed an informed consent form and received a document about the study.  
Entry of primary data  
In order to collect the primary data for the study, a clinical card on the patient was prepared in which the following information was filled with the name, age, sex, date, type of surgical instrument, clinical efficiency (possibility to take the impression in the same visit), duration of the manipulation, bleeding during the procedure, tissue adherence to the instrument, postoperative pain, postoperative hemorrhage, and healing in regard to: tissue color, tissue contour, and appearance of the wound (Table 1). After careful verification for adequate filling of the protocols, the primary data were entered in spreadsheets for further statistical processing and analysis.