J. Microbiol. Infect. Dis., (2026), Vol. 16(2): 88–92

Case Report

10.5455/JMID.2026.v16.i2.4

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Gingivoplasty of the upper central incisors using a 980 nm Diode Laser

Mariam Hassan Nghnughi^1*, Noura Ali^1,2, Moharem Altunse¹, Kathim Amhimmid Misbah¹ and Modtter Aghani¹

¹Periodontic Department, Faculty of Dentistry, Altaadhi University, Tripoli, Libya

²Libyan Biotechnology Research Center, Tripoli, Libya

*Corresponding Author: Mariam Hassan Nghnughi. Periodontic Department, Faculty of Dentistry, Altaadhi University, Tripoli, Libya. Email: Targi969 [at] yahoo.com

Submitted: 29/09/2025 Revised: 04/04/2026 Accepted: 18/04/2026 Published: 15/05/2026

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ABSTRACT

Background: The aesthetical smile is based on the interaction between teeth, lips, and gingivae. Gingival irregularities, excessive gingival exposure, and gingival hyperplasia may severely impair dental appearance.

Case Description: This case report describes the use of a 980 nm diode laser for performing a precise gingivoplasty on the upper central incisors to correct an asymmetric gingival margin and excessive gingival display (“gummy smile”). The patient showed aesthetic issues and slight gingival inflammation. The 980 nm wavelength was chosen because it shows good absorption in hemoglobin and water, so it is good in soft tissue cutting with good hemostasis and reduced thermal damages. The process was done in one visit and did not require the injection of local anesthesia, leading to high patient satisfaction, instant cosmetic enhancement, low intraoperative bleeding, and painless recovery.

Conclusion: This report shows the benefits of the 980 nm diode laser as an important instrument in predictable and patient-friendly recontouring of the gingiva.

Keywords: Diode laser, Esthetic, Gingivoplasty.

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Introduction

The aesthetical smile is based on the interaction between teeth, lips, and gingivae. Gingival irregularities, excessive gingival exposure, and gingival hyperplasia may severely impair dental appearance. ‎To deal with these concerns, gingivoplasty, the surgical recontouring of the gingival tissue to provide a more physiologic and aesthetic architecture, is a widespread procedure.

Gingiva is a keratinized epithelium in the oral cavity that surrounds the residual ridge of maxilla and mandible, and extends to the mucogingival junction in the vestibule (Bathla, 2017).

Gingivoplasty is the procedure of cutting and recontouring of the gingiva for esthetic, functional, or conservative purposes, sometimes known as crown lengthening (Nield-Gehrig, 2007). Gingivoplasty has several advantages, elimination of gingival enlargement (Hadeel et al., 2017) and increase clinical crown height (Cohen, 2009).

Traditional gingivoplasty is performed with scalpels or electrosurgery, which can be associated with intraoperative bleeding, postoperative discomfort, and slower healing (Parker, 2007). Laser technology has emerged as a precise and minimally invasive alternative. The 980 nm diode laser is particularly effective for soft tissue procedures due to its strong affinity for hemoglobin and water, enabling clean incision, simultaneous coagulation of small vessels, and a bactericidal effect (Romanos, 2002; Aoki et al., 2008). This case report demonstrates the clinical application and outcomes of a 980 nm diode laser for aesthetic gingivoplasty of the maxillary central incisors. LASER is a term used in place of the phrase Light Amplification by Stimulated Emission of Radiation. A laser system generates electromagnetic radiation in the form of light that is characterized by a defined wavelength, controlled energy output, and a specific emission frequency mode (Thyagarajan, 2010) (Convissar, 2016; Kravitz et al., 2008). Physically, laser units are differentiated according to the physical state of the active material used in the laser; it can be either a solid, liquid, a gaseous or semiconductor-based active material. In clinical practice, however, lasers are more commonly classified according to their biological application into soft-tissue and hard-tissue lasers (Chang and Weisgold, 2015; Coluzzi and Parker, 2017).

The effective implementation of laser relies greatly on the choice of radiation parameters that are favorable to the intended tissue. An unsuitable choice of parameter may lead to unwanted or even harmful tissue response (Jelínková, 2013). Although multiple wavelengths have been reported for gingivoplasty procedures, infrared and near-infrared wavelengths demonstrate superior suitability for this application (Coluzzi, 2004).Wavelength in a diode laser ranges between 800 nm and 980 nm which is in infra-red spectrum (Genovese and Olivi, 2010). Diode laser does not interact with hard tissue, that makes it among the optimal soft tissue lasers. This study indicates that gingivoplasty by 980 nm Diode laser with power density 1 W–1.5 W has more benefits than conventional gingivoplasty using scalpel including pain during and after operation, discomfort following operation, and bleeding during surgery.

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Case Details

An 18-year-old female came to the routine pathway in the Periodontology Department for gingivoplasty due to esthetic reason. Patients had full mouth charting and periodontal probing, and treatment plans were discussed. The patient was fit and healthy and no known drugs allergies in future post gingiveoplasty patient needs orthodontic assessment because of diastema and labial frenum (Fig. 1).

The objective of this case report is to establish gingivoplasty of maxillary central incisors by using a diode laser 980 nm.

Chief Complaint: "I don't like my gummy smile." The patient expressed a desire for a more symmetrical and less prominent gingival display during smiling.

Clinical examination

Extraoral: No significant findings. A high lip line revealed approximately 2–3 mm of gingival display over the maxillary central incisors during a full smile.

Intraoral: The periodontal examination revealed healthy tissues with probing depths ≤3 mm, no bleeding on probing, and good oral hygiene. The gingival biotype was medium-thick. A significant discrepancy of approximately 1.5 mm.

Diagnosis: Aesthetic gingival deformity characterized by asymmetric gingival margins and a mild excessive gingival display in the maxillary anterior region.

Treatment plan

After discussing treatment options (scalpel surgery, electrosurgery, laser), a laser-assisted gingivoplasty was selected. The treatment plan involved:

1. Recontouring the gingival margin from canine to canine maxillary region to match the zenith level.
2. Creating a harmonious scalloped architecture and subtle sluiceway contouring for maxillary central incisors.
3. Conservative recontouring of the interdental papilla.

The primary goal was symmetry and a natural, healthy gingival frame for the teeth.

Procedure

1. Pre-procedure: Oral hygiene instructions were reinforced. Photographic documentation (pre-operative) was completed.
2. Anesthesia: Due to the minimally invasive and coagulative nature of the diode laser, profound local anesthesia.
3. Laser Parameters and Technique: A 980nm diode laser (dr. smile –italy) with a 400 μm initiated fiber tip was used in continuous wave mode.

Power Setting: 1.5 W for precise incisions and 0.8 W for final sculpting/coagulation.

Technique: The tip was used in a light contact, brushing motion. The initial incision was made following a pre-marked guideline (made with a periodontal probe). The tissue was then excised. The same motion was used to recontour the labial gingiva of #11 and both papillae to achieve symmetry. Hemostasis was achieved simultaneously during cutting. The char layer (eschar) was minimal and left in place as a biological dressing (Convissar, 2016).

Fig. 1. Immediate preoperative image displaying gingivoplasty margins.

Fig. 2. Post operative gingivoplasty margins. Immediate postoperative image displaying hemostasis and tissue contour.

Fig. 3. Diode laser 980 nm (Doctor Smile Co. Italy).

4. Post-procedure Instructions: The patient was advised to avoid disturbing the area, eat soft foods for 24 hours, maintain gentle oral hygiene, and use an antiseptic mouthwash (Chlorhexidine 0.12%) twice daily for one week.

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Results

Immediate Post-op: Excellent patient tolerance. The operative site was dry and without active bleeding. The intended gingival ‎contour was instantly unveiled (Fig. 2).

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Discussion

The 980 nm diode laser was found to be an amazing instrument for this aesthetic gingivoplasty (Fig. 3). Its benefits are consistent with ‎literature results:

1. Precision and Hemostasis: The high absorption in hemoglobin made a clear bloodless field that is necessary to see and obtain correct aesthetical lines (Romanos, 2002; Aoki et al., 2008).
2. Minimal Invasiveness and Patient Comfort: The capacity of conducting the procedure without injected anesthesia ‎evidently decreases the anxiety levels of the patients and the numbness after the procedure, which improves the overall experience (Goharkhay et al., 1999).
3. Bacterial Reduction and Healing: The photothermal effect of the laser has a sterilization effect on the operative site, ‎and the remaining eschar can serve as a protective dressing that can speed up and make healing more comfortable than traditional techniques(Convissar, 2016; Cobb, 2006).
4. Predictability: There exists a close relationship between the visual outcome immediately after the treatment and the ultimate healing outcome, which makes real-time adjustments possible.

The control of thermal effects is very important with diode lasers to prevent collateral damage to the bone or tooth structure. With a light, brushing, technique and constant tip movement, as in this case, using low power in continuous wave minimizes this risk (Angiero and Benedicenti, 2009).

Follow-up

Scheduled postoperative follow-up visits at 1 week, 1 month, and 3 months were recommended to monitor healing. The patient, however, did not attend these scheduled appointments for photographic and clinical evaluation. Contact was established via telephone at the 3-month mark. The patient subjectively reported excellent resolution of the initial chief complaints, specifically the gingival recession and tooth sensitivity, and was pleased with the esthetic result. No complaints of pain, swelling, or functional impairment were reported. The lack of serial clinical photographs limits the objective assessment of healing progression and long-term tissue stability. Future cases would benefit from a structured follow-up protocol to enhance documentation.

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Conclusion

This case demonstrates that gingivoplasty using a 980 nm diode laser is a safe, effective, and patient-centered procedure for correcting minor aesthetic gingival discrepancies. The control of thermal effects is very important with diode lasers to prevent collateral damage to the bone or tooth ‎structure‎. Low power in continuous wave with a light has a great advantage with regard to accuracy, hemostasis, less postoperative morbidity, and high patient acceptance. The 980nm diode laser is a new, useful tool to the armamentarium of the periodontal ‎aesthetic surgeon.

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Acknowledgments

None.

Conflict of interest

The authors declare that there is no conflict of interest.

Funding

No funding received for this research.

Authors' contributions

All authors contributed equally to this case.

Data availability

All data were provided in the manuscript.

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