Comparative evaluation of pain in vestibular depth extension procedure using scalpel, electrocautery and diode laser

The oral rehabilitation of patients after loss of teeth has made much progress in recent times. Whenever there is an inadequate vestibular depth present to maintain oral hygiene and to increase the retention and stability of the denture, deepening of the vestibule is considered. The vestibular depth depends on various factors such as age, physical status, amount and consistency of mucous membrane, amount of alveolar and basal bone, positon and tension of adjacent muscles, presence of bony projections and ridges and neurovascular foramina. One of the main objectives of periodontal therapy is to achieve an area which permits an optimal level of oral hygiene. A shallow labial vestibule hampers the proper placement of a tooth brush. As a result, a decreased depth of the vestibule is often associated with plaque accumulation and consequently marginal gingival inflammation. Vestibuloplasty is the surgical procedure whereby the oral vestibule is deepened by changing the soft tissue attachments. The most common procedures in vestibuloplasty are submucosal vestibuloplasty, secondary epithelial vestibuloplasty, soft tissue graft vestibuloplasty and Edlanplasty. Although vestibular depth extension procedure remains relatively painless under local anesthesia on the first day of surgery, there is a subtle increase in pain on the second day relative to the first. The present study was conducted to measure and compare pain by 3 different scales i.e., visual analogue scale, numerical rating scale, faces rating scale in vestibular extension procedure done by scalpel, laser and electrocautery. The pain was measured at baseline, 1 day post-operative, 1 week post-operative. Data thus collected was put to statistical analysis.