RESUMO
AIM: The aim of this study was to review the craniofacial growth impairment and different malfunctions associated with short lingual frenum and to assess the validity of lingual frenum surgery based on minimally invasive laser release with a myofunctional approach. MATERIALS AND METHODS: Thirty patients, children and adolescents whose ages ranged from 8 years to 18 years, diagnosed with a short lingual frenum and concomitant orthodontic problems and/or presence of associated muscular or postural problems, were treated in this study. Pre-operative tongue assessment was performed following morphological and functional criteria, consisting of measurement of the free tongue, and of visual assessment of tongue protrusion out of the mouth and elevation to the incisive palatal papilla. Postural evaluation was assessed in frontal and lateral view. Laser surgery was completed with local anaesthesia, using Erbium YAG laser (2940 nm, LightWalker, AT-Fotona, Ljubljana, Slovenia) equipped with sapphire conical tip (600 micron), with energy ranging from 120 to 160 mJ, at 15 Hz frequency, and varying the adjustable pulse duration from 300 µs to 600 µs. RESULTS: Significant improvement was noted in 29 of 30 patients comparing preoperative scores to both three-week and two-month post-op scores. Postural improvement was found in 18 of 30 patients, indicating the multifactorial involvement of different causes for correct body posture. CONCLUSION: This study confirmed the validity of Erbium:YAG laser surgery as an effective technique in children and adolescents to release a short lingual frenum. The functional approach of the procedure performed with the Erbium:YAG laser, and the concomitant myofunctional therapy demonstrated to be simple and safe in children, and adolescents. Because of the multifactorial causes involved in correct body posture, an adequate osteopathic therapy is important to successfully complete the full body rehabilitation.
Assuntos
Terapia a Laser , Lasers de Estado Sólido , Doenças da Língua , Adolescente , Criança , Humanos , Lactente , Freio Lingual/cirurgia , Língua , Doenças da Língua/cirurgiaRESUMO
AIM: This study aimed to determine the impact of laser surgical tongue-tie, lip-tie, buccal tie release on breastfeeding and Gastroesophageal Reflux Disease (GERD) in a prospective cohort study conducted from June 2019 to June 2020 in a private general dental practice. MATERIALS AND METHODS: Preoperative, one-week and one-month postoperative surveys were completed, consisting of Visual Analogue Scale (VAS) for nipple pain severity, Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), and the Revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R). All study participants were breastfeeding dyads (0-12 weeks of age) with untreated ankyloglossia and/or tethered maxillary/buccal frena. The laser surgery was completed using 2 different near- infrared diode lasers with 300µm diameter fibre: a 980 nm wavelength diode laser (Lasotronix Smart Pro, Piaseczno Poland) was used at 4.0 W, gated with 100 µs t/on and 100 µs t/off, and a 1470 nm wavelength diode laser (Pioon S1, Wuhan Pioon Tech Co Ltd., Wuhan, China), used at 3.5W, gated with 50 ms t/on and 50 ms t/off. RESULTS: Statistically significant improvement was noted in VAS, I-GERQ-R and BSES-SF comparing preoperative scores to both one-week and one-month scores. The study had 132 breastfeeding dyads enrolled. Posterior tongue-tie was noted in 71% of this cohort. CONCLUSION: This study confirms the need for functional assessment of tongue and lip movement for this significantly affected cohort. Laser surgical release (frenotomy) of tongue-tie, lip-tie, buccal-tie resulted in significant improvement in breastfeeding outcomes. These improvements (VAS, I-GERQ-R and BSES-SF) in breastfeeding outcomes were found for cohorts of the classically recognised anterior tongue-tie and the less obvious (without functional assessment) submucosal tongue-tie were found.
Assuntos
Anquiloglossia , Refluxo Gastroesofágico , Adolescente , Anquiloglossia/cirurgia , Aleitamento Materno , Criança , China , Feminino , Refluxo Gastroesofágico/cirurgia , Humanos , Lactente , Freio Lingual/cirurgia , Polônia , Estudos ProspectivosRESUMO
AIM: Anomalous maxillary median labial frenum may be associated with undesired effects such as persistence of diastema between anterior teeth or traction of marginal gingiva. The aim of this study was to propose a surgical frenum repositioning technique that is minimally invasive, safe, easy, reproducible, and predictable. Another objective of the study was to identify clinical scenarios that could have indication for labial frenectomy associated with early orthodontic therapy, so as to justify early frenum repositioning in children. A retrospective assessment of clinical outcomes of this technique is described. MATERIALS AND METHODS: A total of 20 frenectomies were performed on children aged 8 to 10 years. Frenectomies were performed with Er:YAG laser set at 150mJ 2.25-3.0W and 15-20 pulse per second, with water spray. Recall visits were done at 7, 21 and 90 days and 1, 2, 3 and 4 years. RESULTS: At post-operative visits, all patients reported no post-operative pain or minimal discomfort. None experienced post-operative bleeding at a distance of few hours. All patients reported that the procedure was well tolerated and "acceptable". No recurrences occurred 4 years after frenectomy. CONCLUSION: The Er:YAG laser used in this study allowed considerable reduction of the operating time, reducing the amount of local anaesthetic used as well as avoiding surgical sutures. The surgical design and technique also minimised post-operative discomfort and complications resulting in stable healing overtime, making the procedure fully accepted by children.
Assuntos
Freio Labial/cirurgia , Terapia a Laser/métodos , Criança , Estética Dentária , Feminino , Humanos , Lasers de Estado Sólido , Masculino , Estudos Retrospectivos , CicatrizaçãoRESUMO
AIM: Erbium lasers can provide effective and minimally invasive caries removal in children. The bonding phase remains a critic step as well as the choice of material. Glass ionomers exhibits lower bonding properties in laser irradiated teeth compared to the conventional method or to composite and resin modified glass ionomer. Laser can also provide effective decontamination and coagulation effects in vital and non vital pulp therapy of primary teeth, improving and simplifying the cleaning and disinfecting steps.
Assuntos
Descontaminação/métodos , Colagem Dentária/métodos , Assistência Odontológica para Crianças/métodos , Cárie Dentária/radioterapia , Terapia a Laser/métodos , Coagulação Sanguínea/efeitos da radiação , Criança , Resinas Compostas/química , Cimentos de Ionômeros de Vidro/química , Humanos , Lasers de Estado Sólido , Dente DecíduoRESUMO
AIM: Knowledge of the physical characteristics of different laser lights and optical and thermal properties of oral tissues is very important to understand the interaction of dental lasers with biological tissues. Choosing the correct dental laser is crucial to match specific wavelengths with target chromophores of different tissues; this affinity makes laser irradiation selective and therefore minimally invasive. Various types of lasers are used in dentistry, offering a viable alternative to low and high-speed handpieces and surgical blades, and also minimising fear and discomfort of the patient. Lasers can provide innovative and minimally invasive therapies in different branches of dentistry including preventive and restorative dentistry, traumatic injury treatments and surgical procedures. Laser has also biostimulating and anti-inflammatory effects, as well as analgesic effect.
Assuntos
Terapia a Laser/métodos , Odontopediatria/métodos , HumanosRESUMO
AIM: Lasers can provide effective soft tissues applications in children. All the wavelengths produce incision and vaporisation of oral tissues, together with a high bactericidal effect. The haemosthatic effect varys according to the wavelength used, and the choice of a visibile, near, medium or far infrared laser allows a better interaction with specific targets, gingiva, mucosa, frenum, or oral pathology.
Assuntos
Assistência Odontológica para Crianças , Terapia a Laser/métodos , Doenças da Boca/cirurgia , Mucosa Bucal/cirurgia , Criança , HumanosRESUMO
AIM: Human Severe Combined Immunodeficiency (SCID) is a prenatal disorder of T lymphocyte development that depends on the expression of numerous genes. Juvenile myelomonocytic leukemia (JMML), previously known as juvenile chronic myeloid leukemia (JCML), is a rare, myelodysplastic/myeloproliferative disease typically presenting in early childhood. CASE REPORTS: Two cases are described of immunodeficiency disorders, both treated with chemotherapeutic drugs (Busulfan plus cyclophosphamide) before bone marrow transplantation. After treatment, these two different cases showed several similar oral lesions: microdontia, root alterations, numerous tooth ageneses, incomplete calcification, enamel hypoplasia, premature apexification and hypodontia. Both subjects underwent dental and orthodontic treatment. The first phase comprised orthopaedic treatment using a removable appliance (Interim-G®) followed by rapid palatal expansion; in the second phase patients underwent tooth extraction and were treated using fixed appliances for 19 and 26 months, respectively (mean 2 years) to obtain final alignment and maximum intercuspation. In the third and final phase, reconstruction of malformed teeth was completed, and implant-supported protheses were applied. CONCLUSION: The difficulties of managing and treating these diseases are discussed, with particular focus on tooth anomalies and malocclusion disorders. Collaboration between dentist and paediatrician in dealing with patients with a variety of oral lesions and tooth anomalies is important in order to prevent any other possible tooth lesions and ensure correct jaw development.
Assuntos
Antineoplásicos Alquilantes/efeitos adversos , Transplante de Medula Óssea/efeitos adversos , Leucemia Mielomonocítica Juvenil/complicações , Imunodeficiência Combinada Severa/complicações , Anormalidades Dentárias/etiologia , Adolescente , Bussulfano/efeitos adversos , Criança , Ciclofosfamida/efeitos adversos , Humanos , Leucemia Mielomonocítica Juvenil/terapia , Masculino , Má Oclusão/etiologia , Melfalan/efeitos adversos , Imunodeficiência Combinada Severa/terapiaRESUMO
AIM: When ankyloglossia is relatively severe and generates mechanical limitations and functional challenges, surgical reduction of the frenum is indicated. MATERIALS AND METHODS: Laser technique is an innovative, safe and effective therapy for frenectomy in both children and adolescents. Erbium:YAG laser (2940nm) can be useful for paediatric dentist: 1.5W at 20pps is a commonly used average power to easily, safely and quickly cut the frenum. RESULTS: Usually after laser frenectomy, the postoperative symptoms and relapse are absent. CONCLUSION: Early intervention is advisable to reduce the onset of alterations correlated to the ankyloglossia. A multidisciplinary approach to the problem is advisable, in collaboration with orthodontist, physiotherapist and speech therapist, to better resolve the problem.
Assuntos
Terapia a Laser/métodos , Freio Lingual/cirurgia , Adolescente , Criança , Transtornos de Deglutição/etiologia , Humanos , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Freio Lingual/anormalidades , Lordose/etiologia , Má Oclusão/etiologia , Equipe de Assistência ao Paciente , Postura , Distúrbios da Fala/etiologia , Doenças da Língua/etiologiaRESUMO
BACKGROUND: The idea of substituting a drill with a laser light, has led to its introduction in dentistry. Besides being more accepted to patients, in paediatric dentistry the laser has demonstrated safety compared with rotating instruments. REVIEW: A review of the past 20 years of the dental literature concerning laser use in dentistry, including paediatric dentistry was completed. The findings of that review are presented. TECHNIQUES: The various types of lasers and their uses for caries detection, tooth sealing and caries removal are described. RESULTS: Laser caries detection demonstrated a good reproducibility, reliability and predictability to monitor the caries process over time. Erbium lasers have been found to be efficient for caries removal, tooth cleaning and decontamination. CONCLUSION: The laser erbium technology represents a safe device to effectively and selectively remove carious tissues from decayed teeth. For children, all the recognized advantages of this technique play a decisive role in the successful day-to-day treatment of dental caries.
Assuntos
Restauração Dentária Permanente/métodos , Terapia a Laser , Adolescente , Criança , Assistência Odontológica para Crianças , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Humanos , Terapia a Laser/métodos , Lasers , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa IntensidadeRESUMO
BACKGROUND: Dental trauma in children is a frequent and often complex clinical event in which laser-assisted therapy, particularly using erbium lasers, can offer new treatment possibilities, improving the outcomes and reducing the associated complications. REVIEW: In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. Laser anaesthesia is another interesting and challenging area. CONCLUSION: Given the paucity of data on laser-assisted dental trauma therapy in the international literature and the absence of well-structured guidelines, this is an area ripe for scientific research.
Assuntos
Terapia a Laser/métodos , Terapia com Luz de Baixa Intensidade/métodos , Traumatismos Dentários/terapia , Analgésicos/uso terapêutico , Anestesia Dentária/métodos , Anti-Inflamatórios/uso terapêutico , Criança , Humanos , Lasers de Estado Sólido/uso terapêutico , Periodonto/lesões , Fraturas dos Dentes/terapiaRESUMO
AIM: Modern technology has perfected a new instrument that has become almost indispensable in modern dentistry, in accordance with the philosophy of minimally invasive therapy: the laser. The aim of this work is to evaluate the effectiveness and efficacy of laser technology to solve mucogingival problems associated with orthodontic treatment. Some laser wavelengths work both on hard and soft tissues (2780 nm, 2940 nm), other lasers, such as the 810 nm diode, have a very good surgical and haemostatic action on soft tissues and an important analgesic and biostimulating effect that can help the healing of both TMJ painful symptoms as well as the pain following active orthodontic treatment. Several cases connected to orthodontic therapy are presented. MATERIALS AND METHODS: Different laser systems (diode laser at 810 nm; Er,Cr:YSGG laser at 2780 nm; Erbium:YAG laser at 2940 nm) were used, both for soft tissue surgery and enamel etching, and for biostimulating effect. These wavelengths were used with different parameters for each case, according to international current studies in view of minimally invasive therapy. RESULTS: The cases reported showed very quick and good healing of the laser treated tissues. These treatments, necessary for the orthodontic therapy or for its completion, become extremely simple, safe and rapid and the orthodontic specialist can perform them himself. CONCLUSION: The laser technique is very effective in many operative and surgical procedures during orthodontic therapy. Further studies are however necessary to set the treatment protocols in orthodontic biostimulation.
Assuntos
Terapia a Laser , Ortodontia Corretiva , Adolescente , Criança , Dente Canino/cirurgia , Feminino , Seguimentos , Humanos , Freio Labial/cirurgia , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Freio Lingual/anormalidades , Freio Lingual/cirurgia , Terapia com Luz de Baixa Intensidade , Masculino , Mandíbula/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos , Técnicas de Movimentação Dentária/instrumentação , Dente Impactado/cirurgiaRESUMO
AIM: The goal of paediatric dentistry is to provide preventive education to parents and patients as well as interception and therapy of dental diseases in a minimally invasive way using a stress-free approach. Different laser wavelengths are used for different applications following these minimally invasive concepts: argon, KTP, diode, Nd:YAG, and CO2 lasers are used for soft tissue applications and the erbium family is used for both soft and hard tissue procedures. This paper offers a revision and a discussion of the international literature, showing also some clinical procedures. related to these scientific studies. Soft tissues laser applications in Pediatric Dentistry include application in oral surgery as well as in periodontics and orthodontics. Laser applications on hard tissues include caries prevention and detection and application for sealing of pits and fissures. Also application for cavity preparation, carious removal and pulp therapy are discussed.
Assuntos
Odontologia Baseada em Evidências , Terapia a Laser , Doenças da Boca/cirurgia , Doenças Dentárias/cirurgia , Criança , Humanos , Lasers , Terapia com Luz de Baixa Intensidade , Doenças da Boca/radioterapia , Odontopediatria , Doenças Dentárias/radioterapiaRESUMO
AIM: This study aimed to evaluate the laser therapy efficacy in paediatric dentistry, considering the subjective tolerance and acceptance of therapy in children needing both dental and soft tissue treatments. METHODS: A group of 50 patients from 6 to 12 years of age, needing both hard and soft tissue therapy was selected and treated, without anesthesia, with an Er,Cr:YSGG laser 2780 nm and an Er:YAG laser 2940 nm for a total of 100 treatments performed; before and after the treatment the patients experience was tested with Wong-Baker modified facial image scale. RESULTS: The study showed a good percentage of acceptance and tolerance of both laser treatments: a success rate of 90 % for hard tissues and 63% for soft tissues was obtained; for the total 100 treatments the acceptance was of 75%. CONCLUSION: The Erbium lasers are very effective in paediatric dentistry and are good treatment options.
Assuntos
Assistência Odontológica para Crianças , Terapia a Laser , Lasers de Estado Sólido/uso terapêutico , Aceitação pelo Paciente de Cuidados de Saúde , Atitude Frente a Saúde , Criança , Comportamento Infantil , Assistência Odontológica para Crianças/psicologia , Cárie Dentária/terapia , Preparo da Cavidade Dentária/métodos , Gengivectomia/métodos , Humanos , Freio Labial/cirurgia , Freio Lingual/cirurgia , Dor/prevenção & controle , Dor/psicologia , Dente Decíduo/patologiaRESUMO
BACKGROUND: Epulis is a benign tumour located in the area of the alveolar bone, periodontal ligament and marginal gingiva. A clinical case of Epulis, treated using an Er,Cr:YSGG laser in our Paediatric Dentistry division of the PTV Hospital, University of Rome Tor Vergata, is described. CASE REPORT: A pink, sessile, broad-based lesion, elastic in consistency, was detected on the maxillary vestibular gum above the lateral right incisor. The lesion was removed with Er,Cr:YSGG laser (2780 nm) without anaesthetic infiltration, power ranged from 1,5 to 2,0 Watts at 20 Hz repetition rate under 20%-15% air-water spray. The histopathological examination confirmed the diagnosis of fibrous epulis. The immediate postoperative course was excellent, with no pain or need for anti-inflammatory or analgesic drugs. Wound healing was good after 1 week, and was completed after 1 month. The patient was followed up for 3-6 months, and checked again after 1 and 2 years to assess possible relapse. The Er,Cr:YSGG laser has several treatment advantages, fundamental in Paediatric Dentistry: it requires only topical anaesthesia, it has a high clinical safety, there is a short treatment time, no surgical sutures are required; no complications were encountered during or immediately following laser surgery, all resulting in excellent patient cooperation.
Assuntos
Doenças da Gengiva/cirurgia , Lasers de Estado Sólido/uso terapêutico , Criança , Doenças da Gengiva/patologia , Humanos , Masculino , Maxila/patologia , Maxila/cirurgia , Resultado do Tratamento , CicatrizaçãoRESUMO
AIM: Pulp capping represents the boundary between conservative and endodontic therapy. The importance of this technique, which considerably improves the prognosis of the tooth, justifies the quest for new techniques and technologies: the most recent literature reports more predictable results (approximately 90%) with cappings performed using laser of different wavelengths, compared to traditional procedures, which report a success rate of approximately 60%. The purpose of this work is to assess the efficiency of laser technology combined with the use of a self-hardening calcium hydroxide base in pulp capping procedures performed on decayed permanent teeth. MATERIALS AND METHODS: This study was carried out on 34 patients, aged between 11 and 18 years (average 14,5) who needed pulp cappings for deep caries affecting permanent teeth (8 front and 26 back). They were divided into three groups based on the operative protocol employed: traditional technique, laser-assisted technique using Er,Cr:YSGG lasers (2780 nm) and laser assisted technique using Erbium:YAG lasers (2940 nm); all patients were asked to return for follow-up visits (anamnesis, vitality testing and intraoral x-ray) scheduled at 1, 3, 6, 12 months, 2 and 4 years; other 30 cases on adult patients (19 to 40 years, average 27,1), treated with the same methods, were used as control group. RESULTS: Traditional technique group showed a success of 63% (adult control group 50%); Er,Cr:YSGG laser-assisted technique showed a success rate of 80% (adult control group 80%); Erbium:YAG lasers laser-assisted technique showed a success rate of 75% (adult control group 70%). All age groups had good success rates with the pulp capping technique, regardless of the technique used. CONCLUSION: Laser technology proved effective in improving the prognosis of pulp capping procedures on teeth affected by deep caries pathology.