970-nm Diode Laser Versus Liquid Nitrogen Cryotherapy in Maxillary Labial Frenectomy

Maxillary labial frenulum abnormalities may be associated with diastema, plaqueaccumulation, periodontal irritation, gingival recession, oral hygiene difficulty,functional discomfort, and esthetic concerns. Frenectomy may be indicated when thefrenulum is hypertrophic, short, thick, or inserted close to the interdental papilla.Conventional scalpel frenectomy is effective but may be associated with intraoperativebleeding, need for suturing, postoperative pain, edema, and reduced patient comfort.Minimally invasive approaches such as diode laser surgery and cryotherapy may offerpotential advantages in oral soft tissue procedures.This study will compare two minimally invasive approaches for maxillary labialfrenectomy: 970‐nm diode laser and liquid nitrogen cryotherapy. Participants will berandomized into two parallel groups. In the diode laser group, frenectomy will beperformed using a 970‐nm diode laser at 2 W in continuous wave mode with a 320‐micrometersterile fiber tip using a contact technique. In the liquid nitrogen cryotherapy group,open‐spray cryotherapy will be applied to the maxillary labial frenulum region with twofreeze‐thaw cycles.The primary endpoint is the change in salivary cortisol level from baseline topostoperative day 2. Secondary endpoints include postoperative day 7 salivary cortisolchange, postoperative pain measured by visual analog scale, edema, interincisal mouthopening, total analgesic consumption, operation duration, State‐Trait AnxietyInventory‐State score, Landry, Turnbull and Howley wound healing index scores, andpostoperative complications or adverse events.All procedures and salivary sampling will be standardized and performed in the morning toreduce the influence of circadian variation on cortisol measurements. The study will beconducted at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry,Kutahya Health Sciences University.