The Clinical Efficacy of Laser-Assisted Crown Lengthening Compared to the Conventional Technique: A Systematic Review

Abstract

Background: Crown lengthening is a surgical procedure aimed at exposing an adequate amount of the dental crown structure through the resection of soft tissue, either independently or in combination with osseous resection. Numerous studies have elucidated the advantages of laser technology in crown lengthening procedures. However, there is a lack of evidence comparing the clinical outcomes of flapless crown lengthening using laser in adult patients and conventional crown lengthening using the blade. This review aims to compare both methods in terms of clinical outcomes following the crown lengthening procedure.

Methods: we conducted searches on PubMed-MEDLINE and EMBASE to identify relevant studies. Eligible studies were randomised controlled trials and clinical trials published between 2014 and 2024, which compared flapless and conventional crown lengthening procedures in adult patients.

Results: 100 unique titles were identified, incorporating 3 randomised clinical trials and one clinical controlled trial. The review encompassed both aesthetic and functional crown lengthening. The findings indicate that laser crown lengthening is correlated with a more pronounced reduction in both intraoperative and postoperative pain in comparison to conventional crown lengthening methods. Furthermore, it was observed that laser crown lengthening yields a more aseptic surgical site. The review also revealed superior soft tissue healing outcomes associated with laser crown lengthening as opposed to conventional techniques. The comparison of gingival margin stability and bone level stability between the laser and conventional groups did not yield significant statistical differences. However, the laser group exhibited a reduction in changes in the gingival margin compared to the conventional group.

Conclusion: Laser assisted crown lengthening is an effective, viable alternative to conventional crown lengthening, particularly in patients with high anxiety levels. Laser- assisted crown lengthening demonstrates superior efficacy in pain reduction and promotes more pronounced healing of soft tissue when compared to conventional crown lengthening. Further clinical investigations using standardised measurement methods are needed to conclusively prove the benefits of laser crown lengthening over conventional methods and its potential to facilitate earlier final restoration placement.