Endoluminal sclerosis with diode laser in the treatment of orofacial venous malformations.

INTRODUCTION: The appearance of vascular anomalies in the orofacial area is a common condition, which represents about 50% of these malformations. Traditional treatment approach, such as surgery and chemical sclerosis has been given way to a few less-invasive options, as the use of the 810 nm diode laser to induce the sclerosis of the venous malformation by intralesional photocoagulation. OBJECTIVES: The objective of this study was to determine the efficacy of the diode laser in the intralesional treatment of the orofacial venous malformations (OFVM), describing the recommended surgical approach, as well as to report the main associated complications. PATIENTS AND METHODS: 10 cases of OFVM, diagnosed and treated at the Oral Surgery Department of the Dental Clinic of the University of Barcelona, between January, 2009 and April, 2011. Every case was treated under local anesthesia, performing at least one intralesional session of diode laser, applying an 1W active optic fiber, in continuous mode, inserted into the interior of the lesion through an intramuscular needle, from the deepest portion to the surface of the lesion. Postoperative medication was indicated and follow-up visits were perform during a period of at least 6 months. RESULTS: Of a total of 10 cases of OFVM, mean age of 25.4 years, 8 required just a single session with intralesional laser diode, before the clinical verification of a total reduction of size of the lesion. In 2 of these cases, were needed at least 2 sessions of intralesional photocoagulation to reach a satisfactory cosmetic result. No complications of any kind occurred. After a follow-up period of at least 6 months only a case of recurrence was described. DISCUSSION AND CONCLUSIONS: The advantages associated to the use of non-invasive techniques in the treatment of OVM, along with the success rate and low number of relapses, shows the use of the diode laser as a therapy to be considered in the treatment of these lesions. A higher case mix would be essential for definitive conclusions.

Success Rate of Benign Oral Squamous Papilloma Treatments After Different Surgical Protocols (Conventional, Nd:YAG, CO2 and Diode 980 nm Lasers): A 34-Year Retrospective Study.

Objective: The aim of our retrospective study is to compare the long-term recurrence rate of the benign oral squamous papilloma (OSP) with different laser-assisted treatments and conventional procedures (use of scalpels) aiming to suggest the most suitable surgical protocol showing the lowest recurrence rate. Background: A retrospective multicenter DATA collection between 1985 and 2019 covering 781 OSP cases concerning different surgical protocols used for the treatment of OSP was done and included the use of different laser wavelengths [neodymium-doped yttrium-aluminum-garnet (Nd:YAG), carbon dioxide (CO2), and Diode 980 nm] and the conventional surgeries using the scalpel. The age, sex, and the oral location of the OSP were noted. Methods: Three different surgical protocols were selected in our study: protocol 1 regrouped surgical procedures performing the excision of OSP with an in-depth safety margin of 1 mm and just at the base of the tumor with reduced excision of the grossly normal marginal mucosa around the tumor (0-1 mm). Protocol 2 and 3 were similar to protocol 1, but with an additional excision of 1-2 mm and ≥3 mm of the grossly normal marginal mucosa, respectively, for group 2 and 3. All laser-treated OSP wounds were left without sutures. In the conventionally treated OSP, sutures were regularly performed. Follow-up was done after 15 days and at 1, 6, and 18 months. The three included wavelengths were Nd:YAG (1064 nm), CO2 laser (10,600 nm), and diode laser (980 nm). Results: After 18 months of follow-up, the highest success rate was obtained with protocol 3 (100% with Nd:YAG, 99% with CO2, 98.4% with diode, and 99% with the scalpel), which was significantly higher than the values of protocol 2 (96.6% with Nd:YAG, 91% with CO2, 96% with diode, and 95% with the scalpel) and the protocol 1 (38% with Nd:YAG, 29% with CO2, 33% with diode, and 30% with the scalpel). The oral locations of OSP were 30% on palates, 30% on the tongue, 16% on cheek, 14% on lips, and 10% on other locations. Conclusions: The lowest recurrence rate was observed when a minimum of three millimeters (≥3 mm) of grossly normal aspect mucosa around the OSP was included in the excisions. The laser wavelengths and the use of scalpel did not show any significant difference in terms of recurrence.

Advantages and esthetic results of erbium, chromium:yttrium-scandium-gallium-garnet laser application in second-stage implant surgery in patients with insufficient gingival attachment: a report of three cases.

Traditional implant placement involves two surgical stages. Although the second stage is comparatively less aggressive for the patient, postoperative pain and swelling can be further reduced by the use of laser instead of a scalpel. Correct handling of peri-implant soft tissue is of major importance in obtaining adequate gingival tissue attachment around implants. The presence of this keratinized gingiva ensures adequate esthetic results and maintains implant health. We report on three patients with implants in the anterior area who were operated on under the above conditions. Traditionally, the tissue overlying the implants is removed and eliminated. In seeking a way to preserve the attached gingiva, we raised a trapezoidal flap, uncovering each implant and allowing apical repositioning and transpositioning of keratinized gingiva to the buccal side. The results obtained were compared with those from other patients operated on by conventional scalpel. The erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser minimized postoperative pain, and the time to prosthetic rehabilitation was also shortened. The esthetic results were far superior, and no complications were recorded.

Treatment of oral mucocele-scalpel versus CO2 laser.

OBJECTIVE: To compare the results obtained after oral mucocele resection with the scalpel versus the CO2 laser, based on the complications and recurrences after surgery. PATIENTS AND METHODS: Of the 68 patients we studied who have mucocele, 38 were resected with a scalpel and the remaining 30 with the CO2 laser (5-7 W). Patient sex and age were documented, along with location of the lesion as well as size, symptoms, duration, etiological factors, type of treatment, complications and recurrences after surgical removal. RESULTS: The sample comprised 40 males and 28 females, aged between 6-65 years. The histological diagnosis was extravasation mucocele in 95% of the cases. The most frequent location was the lower lip (73.5%). The mean lesion diameter was 9 mm, and in most cases no evident etiological factor was recorded. The mean duration of the lesion was 4 months. Among the cases of conventional surgical removal of mucocele, recurrence was recorded in 8.8% of the cases, and 13.2% of the patients suffered postoperative complications--the most frequent being the presence of fibrous scars. There were no complications or relapses after a minimum follow-up of 12 months in the cases subjected to CO2 laser treatment. CONCLUSIONS: Oral mucocele ablation with the CO2 laser offers more predictable results and fewer complications and recurrences than conventional resection with the scalpel.

Salivary gland choristoma in the buccinator muscle: A case report and literature review.

UNLABELLED: Salivary gland choristoma (SGCh) is defined as the presence of normal salivary tissue in an abnormal location. It is a rare entity in oral and maxillofacial region and its ethiology is unknown. The typical presentation of salivary gland heterotopia is an asymptomatic mass that may or may not produce saliva. Some examples of ectopic salivary tissue in the pituitary gland, in the lymph nodes, in the middle ear, in the neck, in the jaw, in the thyroid gland, in the mediastinum and in the rectum have been documented in literature. We report the case of a 61-year-old male presented with a bilateral tumorlike mass in the cheek. The mass was painless, of fibrous consistency and had size change with time. The histological diagnosis was salivary gland choristoma in the buccinator muscle. In this article, we will revise the characteristic of salivary gland heterotopias and we present a report case that has not been described in literature: a bilateral choristoma of salivary gland in the buccinator muscle, which should be included in the differential diagnosis of head and neck masses. KEY WORDS: Choristoma, heterotopias, ectopic tissue, salivary gland, buccinator muscle.

Erbium:YAG laser application in the second phase of implant surgery: a pilot study in 20 patients.

PURPOSE: Conventional implant dentistry implies 2 surgical stages. In this context, pain is often present in the second stage, despite the fact that it is comparatively less aggressive for the patient. The present pilot study proposes application of Erbium:YAG (Er:YAG) laser for second-stage implant surgery. MATERIALS AND METHODS: Twenty patients were studied with a total of 50 implants in which osseointegration was complete. The subjects were divided into 2 groups: a control group (10 patients with 25 implants), subjected to conventional second-stage surgery; and a group of 10 subjects (also with 25 implants) treated with the Er:YAG laser at second-stage implant surgery. RESULTS: The use of Er:YAG laser obviated the need for local anesthesia and minimized postoperative pain and time needed before starting the second stage. With regard to surgical duration, quality of hemostasis, and success in implant treatment, no differences were reported. DISCUSSION: In the second stage of implant surgery, different types of laser have been used, taking advantage of their bacteridal effect; disadvantages arise from inducing damage to the implant surface and adverse thermal effects. CONCLUSION: The advantages afforded by laser treatment include technical simplicity, the possibility of obviating local anesthesia, absence of postoperative pain and edema, and complete tissue healing by day 5, thus facilitating rapid prosthetic rehabilitation. The technique described can be used in all cases except situations where esthetic considerations prevail in anterior areas, or in the event of a lack of keratinized gingiva surrounding the implant.