In vitro study of the soft tissue effects of microsecond-pulsed CO2laser parameters during soft tissue incision and sulcular debridement

Efficacy and Safety of Carbon Dioxide Laser System in the Treatment of Scalp Sebaceous Adenoma With the Use of a New Scanner Unit

Sebaceous adenoma (SA) is a rare solitary tumor that preferentially affects the forehead and scalp. The objective of this case report was to determine the efficacy and safety of a 10,600-nm carbon dioxide (CO2) laser device in the treatment of large scalp SA, using a new scanning system which allows to speed up the removal of the lesion. A 65-year-old male with SA on the scalp area underwent one session with the CO2 laser system. For this procedure, a new scanner system with 7-inch or 4-inch focal handpieces were used. A local anesthesia with lidocaine was performed before laser treatment. Some possible side effects such as dyschromia, burning sensation, bleeding and mild to moderate post-treatment erythema, itching, crusting, and edema, were checked. In order to monitor the effectiveness of the treatment, clinical photos that documented the patient lesion were captured before treatment and at 1 month of follow-up. The clinical and aesthetic results observed after laser procedure were excellent, with a complete remission of patient's scalp SA lesion at 4 weeks' follow-up. Patient satisfaction was very high, and no side effects were observed. This laser system technology allows for precise, effective, and targeted action on the lesions treated while simultaneously protecting the surrounding areas, ensuring the best possible re-epithelialization.

Periodontal and peri-implant wound healing following laser therapy

Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.

Highlights of thirty-year experience of CO2 laser use at the Florence (Italy) department of dermatology

The CO₂ laser has been used extensively in dermatological surgery over the past 30 years and is now recognised as the gold standard for soft tissue vaporization. Considering that the continuous wave CO₂ laser delivery system and the newer “superpulsed” and scanned CO₂ systems have progressively changed our practice and patient satisfaction, a long range documentation can be useful. Our experience has demonstrated that the use of CO₂ laser involves a reduced healing time, an infrequent need for anaesthesia, reduced thermal damage, less bleeding, less inflammation, the possibility of intra-operative histologic and/or cytologic examination, and easy access to anatomically difficult areas. Immediate side effects have been pain, erythema, edema, typically see with older methods, using higher power. The percentage of after-treatment keloids and hypertrophic scars observed was very low (~1%) especially upon the usage of lower parameters. The recurrence of viral lesions (condylomas and warts) have been not more frequent than those due to other techniques. Tumor recurrence is minor compared with radiotherapy or surgery. This method is a valid alternative to surgery and/or diathermocoagulation for microsurgery of soft tissues. Our results are at times not consistent with those published in the literature, stressing the concept that multicentric studies that harmonization methodology and the patient selection are vital.