Fibrolipoma of the lip treated by diode laser surgery: a case report

Twelve-Year Follow-Up of Laser Frenectomy during Early Mixed Dentition

Median maxillary labial frenum (MMLF) is one of the oral freni, found on the inner side of the centre of the upper lip. Maxillary midline diastema (MMD) is commonly associated with highly attached frenum, and frenectomy during early mixed dentition is controversial. A 6-year-old boy came with a chief complaint of unpleasant spacing between the two upper front teeth. A median maxillary high attached labial frenum with midline spacing of 5 mm was diagnosed. A consensus was made with the child's father to remove the frenum by laser. Diode laser frenectomy was done, and subsequent follow-up for 12 years revealed no relapse and complete closure of the diastema. Frenectomy during early mixed dentition could be a suitable option for the closure of midline diastema.

Laser-Assisted Gingivectomy to Treat Gummy Smile

Excessive gingival display (EGD) is the extensive exposure of the gingiva during a smile. It is a common concern among patients, which may compromise the esthetic outcome of the dental treatment. Dental lasers demonstrate several advantages for soft tissue dental surgery compared with conventional surgical methods related to their technical characteristics. Owing to the excellent coagulation, especially of the surgical lasers, reduced to no need of anesthesia or suturing and faster healing, they demonstrate optimal clinical results. Nevertheless, good knowledge of laser-tissue interaction is required to obtain the best predictable results without gingival recession or bone tissue damage.

Diode Laser Photocoagulation of Intraoral and Perioral Venous Malformations After Tridimensional Staging by High Definition Ultrasonography

Objective: To determine optimal settings for use of diode lasers to treat vascular malformations in the head and neck. Background: Diode lasers are generally accepted as effective tools to treat vascular malformations in the head and neck, yet there are no standardized treatment protocols for this treatment approach. Settings for these lasers, in addition to laser type and size and lesion depth are important variables for designing appropriate treatments for vascular malformations. Materials and methods: Vascular venous malformations (VeMs) were classified into five groups according to high-definition ultrasound measurements of superficial dimensions (<1, 1-3, and >3 cm) and lesion extension depth (≤5, and >5 mm). Using a 800 ± 10 nm diode laser for surgical procedures, we treated lesions by two different approaches: trans-mucous/cutaneous photocoagulation (8 and 12 W pulsed wave for cutaneous and mucosal lesions, respectively) and intralesional photocoagulation using a laser set to 13 W in the pulsed wave modality to treat both cutaneous and mucosal lesions. Results: We treated 158 vascular VeMs. According to preoperative staging, there were 52 lesions in Group A (superficial dimension <1 cm), 28 in Group B₁ (superficial dimension from 1 to 3 cm, extension depth ≤5 mm), 16 in Group B₂ (superficial dimension from 1 to 3 cm, extension depth >5 mm), 42 in Group C₁ (superficial dimension >3 cm, extension depth ≤5 mm), and 12 in Group C₂ (superficial dimension >3 cm, extension depth >5 mm). All Group A lesions showed complete healing after a single laser treatment, whereas 7%, 10%, 12%, and 16% of lesions classified in Groups B₁, B₂, C₁, and C₂, respectively, required further treatments. Conclusions: The laser settings defined in this study were associated with a reduced number of laser applications needed for effective treatment of vascular VeMs. Moreover, the cooling of irradiated tissues, together with prolonged application of a topical regenerative gel, provided good treatment acceptability, reduced the number of postoperative complications, and promoted faster healing of covering tissues.

A girl with a giant fibrolipoma in her thoracic cavity: a rare case report

Background

Fibrolipoma is an uncommon subtype of lipoma. On the basis of the results of a survey of the PubMed database, only approximately a dozen cases in children have been described in which the histological diagnosis of fibrolipoma has been confirmed. In children, fibrolipomas have been reported in the eyelids, ears, lips, nasopharynx, mouth, and other locations but not in the thoracic cavity. We present the case of a 15-year-old girl with a giant fibrolipoma in the left side of her thoracic cavity.

Case presentation

A 15-year-old Chinese girl presented with chest tightness and exercise-induced shortness of breath of 4 months’ duration. Computed tomography revealed a giant mixed-density space-occupying lesion in the left side of her thoracic cavity, originating possibly from the pleura. Radiological findings were inconclusive and failed to exclude malignant mesenchymal tumor. After excluding malignant tumor with two needle biopsies and identifying the tumor’s feeding blood vessels by computed tomography angiography examination, our treatment plan was, first, embolization of the tumor’s blood vessels by digital subtraction angiography and, second, to remove the tumor by thoracotomy.

Conclusions

Thoracic fibrolipoma in children is rare; its treatment is complete resection of the tumor. Pathological examination of the removed tissue is the gold standard for diagnosis. Early computed tomography and magnetic resonance imaging examinations are helpful to determine the extent and nature of the tumor and to reduce damage of the surrounding organs. Preoperative examination of tumor markers, ultrasound-guided biopsy, and preoperative digital subtraction angiography tumor vascular embolization are important preoperative preparations to ensure surgical resection.

Effective management of focal reactive gingival overgrowths by diode laser: A review and report of two cases

Background

Focal reactive gingival overgrowths (FRGO) are a common observation in a clinical dental practice that may occur in response to external and internal chronic stimuli in form of fibrous connective tissue lesions in the oral mucosa. Gingiva is the most commonly involved site of oral reactive lesions. For the confirmed diagnosis of FRGO not only clinical, but the histopathological presentation of the lesion plays a vital role. Various surgical treatment modalities like a scalpel, cryosurgery, electrosurgery, and lasers have been applied in the management of FRGO. The laser is new treatment modality being employed for treatment of FRGO.

Case report

The purpose of this paper is to attempt short review on FRGO with the management of FRGO using diode laser. Here, we present effective management of peripheral giant cell granuloma and peripheral ossifying fibroma using diode laser. The follow-up of 01year showed no recurrence in both the cases.

Conclusions

Diode soft tissue laser has added advantages like a bloodless surgical field, reduced bacteremia, minimal intra and postoperative discomfort over conventional modalities. Thus it is highly effective in the surgical management of FRGO.

Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances

Background

Patients with class II malocclusion generally seek orthodontic treatment for esthetic concern. Various myo-functionl appliances can be used for the treatment of skeletal as well as the dental malocclusion in a growing patient. Among various functional appliances, twin block appliance is most commonly used due to better patient compliances. It redirects the mandibular growth to correct the maxillomandibular relationship, enhancing facial esthet ics. This article presents a modified design of the twin block appliance which is less bulky, more esthetic, can be used concurrently with fixed orthodontic appliance, and is easily accepted by uncooperative patients.

Case summary

An 11-year-old-boy, who presented himself with a skeletal class II malocclusion, was treated with simultaneous use of fixed twin block along with fixed orthodontic appliance to correct both the skeletal and dental malocclusion. The twin block design was modified to have a better compatibility with the fixed orthodontic appliance.

How to cite this article: Pattanaik S, Puvvula N, Mohammad N. Accelerating Treatment of Skeletal Class II Malocclusion using Fixed Twin Block Appliances. Int J Clin Pediatr Dent 2018;11(2):146-150.

A Case of Painless Excision

Soft tissue lesions of the oral cavity are seen in children at the dental office. This case report aims to showcase the ability of laser to treat recurrent soft tissue lesions in the oral cavity in a painless manner. This painless procedure provides relief to the child and parent who suffer from anxiety toward dental treatment.

How to cite this article: Suyash IA, Bhatia R. A Case of Painless Excision. Int J Clin Pediatr Dent 2018;11(2):135-140.

Customized Hybrid Bluegrass Appliance: An Innovative Technique

Oral habits in the form of thumb sucking and tongue thrusting are commonly learned patterns of behavior seen in preschool children and they are associated with anxiety, fear, hunger, oral pressure, and sleep. Chronic practice can cause dentoalveolar, perioral problems, and atypical root resorption (ARR) of anterior primary teeth. The ARR is provoked by the thumb sucking habit, and leads to early loss of anterior primary teeth. The early loss of anterior tooth may result in speech and masticatory problems, and psychological disturbance to the child. Hence, pediatric dentists play a crucial role in giving necessary information to parents and guardians. Starting from counseling to appliance therapy, various treatment modalities have been reported in the literature. One of them is bluegrass appliance; it is a nonpunitive habit reminder therapy. The present case report describes a customized hybrid bluegrass appliance designed to eliminate thumb sucking and tongue thrusting habit, and to perform as an esthetic functional space maintainer. How to cite this article: Mohammad Z, Bagalkotkar A, Mishra A, Veerala G. Customized Hybrid Bluegrass Appliance: An Innovative Technique. Int J Clin Pediatr Dent 2018;11(2):141-145.

Pre-emptive Intracoronal Radiolucency in First Permanent Molar

Pre-eruptive intracoronal radiolucency (PECR) is characterized by the existence of a radiographic radiolucent area inside the coronal dentin prior to dental eruption. It is a rare clinical entity of unknown etiology, usually asymptomatic and diagnosed through routine radiographs. The aim of this article is to report the treatment of a PECR in an 8-year-old girl. Surgical procedure to expose the crown was conducted; upon tooth eruption, the radiolucent lesion was accessed and the tooth was restored. The case has an 18-month follow-up and emphasis on aspects linked to diagnosis and clinical approach was discussed. How to cite this article: Ilha MC, Kramer PF, Ferreira SH, Ruschel HC. Pre-eruptive Intracoronal Radiolucency in First Permanent Molar. Int J Clin Pediatr Dent 2018;11(2):151-154.

Palisaded Encapsulated (Solitary Circumscribed) Neuroma of the Buccal Mucosa: a Rare Case

The rarity of oral soft tissue spindle cell tumors combined with overlapping microscopic patterns can make challenges in their diagnosis and treatment. Oral cavity palisaded encapsulated neuroma is an uncommon lesion which occurs often on the hard palate. It is essential for oral pathologists to be familiar with its histopathology of this lesion is essential since many lesions are probably diagnosed microscopically as neurofibroma or schwannoma. Here, we report a case of oral palisaded encapsulated (solitary circumscribed) neuroma in an unusual site.

Fibrolipoma on upper eyelid in child

An 18-months-old male infant presented with a rapidly growing tumor on the right upper eyelid. Orbital computed tomography (CT) revealed a large, well-circumscribed mass with low density signal in the right upper eyelid. Magnetic resonance images (MRI) showed a lesion of mixed T1-signal intensity and high signal intensity in T2-weighted images. The tumor was treated by simple anterior orbitotomy with excisional biopsy, and the diagnosis of fibrolipoma was made by histopathologic examination. There was no evidence of tumor at the four-year follow-up. Fibrolipoma is one of the rare variant of the lipoma and only four cases have been reported in the orbit including the present case. Except for this case all other cases were reported in adults.

"Rare or Underdiagnosed?" - Solitary Circumscribed Neuroma of the Lip

Solitary circumscribed neuroma, also known as palisaded encapsulated neuroma is a benign neural tissue tumour. This is usually an asymptomatic and often misdiagnosed pathology in the head and neck region. Lip lesions have a broad differential diagnosis. Clinician's awareness and accurate diagnosis are vital for their appropriate management. Here, we present a case report of solitary circumscribed neuroma of the lip, with a one year follow-up.

Diode laser for excisional biopsy of peripheral ossifying fibroma

Peripheral Ossifying Fibroma is one of the commonest occurring reactive lesions on gingiva. It is associated with local irritational factors and often interferes with speech, mastication and maintenance of oral hygiene, in addition to being aesthetically unpleasant. It is usually treated with surgical excision using scalpel and removal of irritational factors, often resulting in mucogingival defect. Other modalities such as radiosurgery and electrocautery have also been used for its management, but they cause changes in microarchitecture of biopsy specimen, altering the histologic picture for true diagnosis. We are presenting a case of excisional biopsy of this lesion in an adult female using a diode laser with excellent post-operative results, without affecting microarchitecture of biopsy specimen. The patient is being followed for last 1 year and no sign of recurrence has been found. A diode laser may offer a good alternative modality for management of such cases.

Fibrolipoma of the nasal septum; report of the first case

Background/Objective

Fibrolipomas are a rare subtype of lipomas and very rare in the oral and maxillofacial region. Lipomas affecting the central nervous system are even more infrequent occurring with a frequency of 0.1%.

Study design, methods

Case report.

Case presentation

This report includes a patient who had a nasal septal fibrolipoma and an accompanying corpus callosum lipoma.

Conclusions

To our knowledge, this is the first reported nasal septal fibrolipoma case in the literature. The diagnostic and surgical features of this case and the unity of septal fibrolipoma and intracranial lipomas are discussed.

Using the diode laser in the lower labial frenum removal

Using the diode laser in the lower labial frenum removal.

OBJECTIVE

The aim of this study is to assess the advantages of the use of diode laser to removal inferior labial frenum.

METHODS

The treatment with the diode laser was proposed to a female patient of 32 years old in good general health having an abnormal inferior labial frenum that causes retracting of the gingival margin. The incision was carried out with diode laser at a wavelength of 940 nm and was removed the frenum mucosa and the deep tissue constitute of connective fiber and muscle fiber. Before the surgery wasn't used the local anesthetic and after the cutting wasn't necessary the use of suture.

RESULTS

The wound had a good healing without scar. The patient didn't have pain and bleeding during the healing and she didn't report complications. It wasn't necessary the use of antibiotic and anti-inflammatory.

CONCLUSIONS

The use of lasers has proved effective in the removal of labial frenum because it offers several advantages for the patient than traditional surgery.

Submuscular fibrolipoma of the forehead

Fibrolipoma is a rare variant of lipoma with a mixture of fibrous connective tissue. Clinically, it presents as an asymptomatic, slowly growing mass with a smooth, firm, or soft consistency. Although fibrolipoma can occur in any part of the body, in the head region it mainly occurs in the oral cavity and sometimes in the lip, parotid gland, nose, and cheek. We present the first case of a 65-year-old man with a submuscular fibrolipoma of the forehead that showed no evidence of recurrence after excision.

Oral fibrolipoma-a rare histological entity: report of 3 cases and review of literature

Lipomas are rare benign soft tissue mesenchymal neoplasms in the oral cavity, representing 1% of all benign oral tumors. Fibrolipoma (FL), an uncommon, histological variant of the classic lipoma, mostly affects the buccal mucosa. Very few cases of FL have been reported in the English literature. To the best of our knowledge a review of the English literature showed 33 cases of FL affecting the oral cavity.The diagnosis and differentiation of FL with clinically similar lesions such as fibroma, mucocele and pleomorphic adenoma are very essential for a correct treatment plan and complete follow-up. Due to the rarity of oral cavity fibrolipoma reports, three cases and a review of literature is presented here.

980 nm diode lasers in oral and facial practice: current state of the science and art

AIM

To evaluate the safety and efficacy of a 980 nm diode laser for the treatment of benign facial pigmented and vascular lesions, and in oral surgery.

MATERIALS AND METHODS

20 patients were treated with a 980 nm diode laser. Oral surgery: 5 patients (5 upper and lower frenulectomy). Fluence levels were 5-15 J/cm(2); pulse lengths were 20-60 ms; spot size was 1 mm. Vascular lesions: 10 patients (5 small angiomas, 5 telangiectases). Fluences were 6-10 J/cm(2); pulse lengths were 10-50 ms; spot size was 2 mm. In all cases the areas surrounding the lesions were cooled. Pigmented lesions: 5 patients (5 keratoses). All the lesions were evaluated by dermatoscopy before the treatment. Fluence levels were 7-15 J/cm(2); pulse lengths were 20-50 ms; spot size was 1 mm. All the patients were followed at 1, 4 and 8 weeks after the procedure.

RESULTS

Healing in oral surgery was within 10 days. The melanoses healed completely within four weeks. All the vascular lesions healed after 15 days without any residual scarring.

CONCLUSIONS

The end results for the use of the 980 nm diode laser in oral and facial surgery appears to be justified on the grounds of efficacy and safety of the device, and good degree of acceptance by the patients, without compromising their health and function.

Upper-lip laser frenectomy without infiltrated anaesthesia in a paediatric patient: a case report

Labial frenectomy is a common surgical procedure in the field of oral surgery. Labial frenectomy is a procedure usually done for orthodontic reasons. The role of laser surgery in the oral cavity is well established. The use of diode laser frenectomy without infiltrated anaesthesia is currently under investigation. Needle-less oral surgery, without infiltrated anaesthesia, is a novel situation in paediatrics with paramount importance.