Study Design: The study sample was selected from patients who had been referred to the Department of Periodontics, Sri Aurobindo College of Dentistry, Indore (M.P), India.

Total no. of 70 patients, of age between 20-40 years, were randomly distributed in each group i.e. by scalpel and laser (35 patients in each group) Seven surgical procedures (frenectomy, vestibuloplasty, epulis excision, depigmentation, operculectomy, crown lengthening, mucocele removal, 5 patients were treated by each procedure). were performed both by scalpel and laser. A variety of procedures were performed to validate the use of laser in various soft tissue correction procedures. The study protocol was reviewed and approved by the institutional review board. Informed written consent was obtained from all patients.

After topical application of the local anaesthetic agent the diode laser with wavelength of 980nm was used for soft tissue incision with power of 1.8 watt in continuous mode. After surgical procedures analgesic were prescribed. In scalpel surgical group 2% local anaesthetic agent with adrenaline was infiltrated at the surgical site and after surgical procedures sutures were placed, wherever required. Data collection was done on subsequent recall visit.

Patient’s comfort level was assessed by VAS method (0- 10 i.e. from unsatisfied to satisfied) at 1 week postoperative period in terms of comfortable/ uncomfortable in routine activities, mood, speech, sleep and interaction with other routine activity. The VAS scores of pain during procedure and at 24-36 hours intervals were taken ranging from no pain (score-0) to severe pain (score-10). Three weeks postoperative patient’s satisfaction level was also assessed by the VAS scores ranging from not satisfied (score-0) to fully satisfied (score-10) with the treatment outcomes. Healing was assessed using the healing index [5] (Landry et al., 1988) at 1 and 2 weeks postoperatively.

Non-parametric tests were chosen for continuous variables because the data was randomly distributed. Comparisons between groups were applied using the Mann-Whitney U-test.

Results of the study are summarized, in [Table/Fig-2,3,4 and 5]. The VAS scores of patient’s comfort level 1 week postoperatively [Table/Fig-2] was significantly higher in the laser group compared to the conventional technique. [Table/Fig-3a,b] is showing the VAS scores of pain intraoperatively and 24-36 hours postoperatively. Significantly higher values for pain were observed, during procedure in laser group but after 24-36 hours postoperatively, higher pain scores were evident in scalpel group. Patient’s satisfaction data (3 weeks postoperatively) is illustrated in [Table/Fig-4] and observed that the patients treated with lasers were more satisfied as compare to patients treated with scalpel. Postoperative healing was assessed by healing index [Table/Fig-5a,b] and better healing was observed in scalpel incisions and patients were quite satisfied with the healing.

The primary goal of surgical therapy should be the achievement of postoperative satisfactory results of the treatment with no or minimal intraoperative and postoperative complications and acceptable healing phase with optimum patient’s comfort. Scalpel technique is the gold standard surgical technique as it is time tested, easy to use, inexpensive and less time consuming. In the present study patients operated with laser had experienced less postoperative pain with fewer postoperative complications with more satisfactory results. However, in this study scalpel surgery had shown better healing in early postoperative days. This may be because of the primary closure by sutures in the scalpel surgery. Delayed healing by Laser, was the only disadvantage observed in this study which may be because of the charring and carbonization created by Laser energy. But 2 weeks postoperative healing results were better with respect to laser which may be because of bandage formed over the wound by protein coagulation. The bandage protects the wound and less scar formation was observed. Previous investigators also concluded that laser has property of sealing of small blood and lymphatic vessels resulting in better haemostasis and less postoperative oedema. Disinfection of target tissues, reduced bacteraemia and mechanical trauma are also observed at laser surgical sites which can be explained as the result of local heating and production of an eschar layer which results in decreased amount of scarring due to decreased postoperative tissue shrinkage [6].

In the present study, patients treated with laser had experienced significantly less postoperative pain and discomfort with higher satisfaction level, which may be the result of the formation of protein coagulum on the wound surface by laser which act as a biologic dressing and seals the sensory nerve endings [7]. More satisfactory results were obtained in the laser surgical group as the patient in laser group experienced less scar formation and less functional complications as compared to scalpel surgery. Some other studies also suggested that laser surgical wounds heal rapidly with less scar tissue formation than conventional scalpel surgery [8,9], but the contradictory results have also reported [10].

Laser has been emerged as reliable alternative surgical tool to treat soft tissue anomalies with the advantages like bloodless field and less postoperative pain with better healing. Site of blood, injection of local anaesthetics and sutures may be the reason of dental patient’s anxiety which leads to reluctance for oral surgical procedures. These problems can be overcome by the use of laser. But as the laser is the form of light energy it can be reflected from shiny dental instrument surfaces and can injure the patient or operator or assistant. So, protective measures should be followed while using laser like protective eyewear and wet towels or gauze packs. A multicentre longitudinal study with more number of patients is required to strengthen the outcomes obtained by this study.