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Gobbo M, Guarda-Nardini L. Laser Forced Dehydration of Benign Vascular Lesions of the Oral Cavity: A Valid Alternative to Surgical Techniques. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:822. [PMID: 38793005 PMCID: PMC11122876 DOI: 10.3390/medicina60050822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Low-flow vascular lesions are commonly encountered in the oral cavity and may require removal due to aesthetic concerns, repeated bleeding or a cluttering sensation. Laser devices represent an excellent aid due to their affinity with blood and to their biostimulating properties and have been substituting traditional excision in selected cases. Materials and Methods: In this study, 30 patients presenting with low-flow oral vascular lesions were included. The lesions were clinically evaluated as follows: lesion's site, reason for treatment, lesion's dimensions, confirmation of positive diascopy via compression with a glass slide and photograph. The lesions were treated with laser forced dehydration (LFD) and then followed-up after 3 weeks, 6 months and 1 year. The laser source was a K-Laser Blu Derma (Eltech, K-Laser S.r.l., Via Castagnole, 20/H, Treviso, Italy). In the case of incomplete healing, a further protocol was performed at the three-week follow-up, and a further follow-up was scheduled for three weeks after. The following aspects were evaluated at each appointment: pain, using a Numeric Rating Scale (NRS) from 0 to 10 (0 = no pain, 10 = worst pain ever); the need to take painkillers (day of intervention and during follow-up); bleeding (yes/no); scar formation. Results: Complete regression was obtained in all patients, with no side effects. Only one patient required a second LFD protocol. NRS was 0 for all patients for the whole duration of the follow-up. None of the patients took painkillers on the day of the intervention and during the follow-up. One patient declared slight bleeding the day of the intervention, which she easily managed at home. One patient showed a small non-retracting and non-painful scar at the three-week follow-up. No recurrences were found after six months and one year. Conclusions: LFD targets endogenous chromophores, minimizing damage to adjacent tissue and limiting side effects. LFD is effective and could be considered a conservative alternative to traditional excision in low-flow lesions.
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Affiliation(s)
- Margherita Gobbo
- Unit of Oral and Maxillofacial Surgery, Ca’ Foncello Hospital, Piazzale Ospedale, 1, 31100 Treviso, Italy;
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Kong YQ, Dong XX, Wu B, Shu P, Li CX, Bao WW, Zheng XW, Liu J, Cheng ML, Yang YQ, Huang XF. A Novel Air-Cooled Nd:YAG Laser for the Treatment of the Venous Lakes of the Lips. Photobiomodul Photomed Laser Surg 2024; 42:230-237. [PMID: 38417045 DOI: 10.1089/photob.2023.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Objective: To evaluate the therapeutic effect of a novel air-cooled Nd:YAG laser in the venous lakes of the lips (VLL). Background: The thermal injury is one of the most important issues during laser therapy for venous lakes. Methods: Six pieces of fresh pork livers were used to provide 30 regions with a diameter of 6 mm for experiment in vitro, among which 15 regions were treated by Nd:YAG laser with air cooling until the tissue turned gray-white, whereas the rest were treated without air cooling as control. The operation time of laser irradiation, the degree of temperature increase, and the depth of coagulation tissue were compared between two groups. Then, 60 VLL patients were selected for Nd:YAG laser treatment with or without air cooling. The operation time of laser irradiation, the degree of temperature increase, the postoperative pain visual analog scale (VAS) score, and the percentage of lesions removed within 1 month were compared. Results: In tissue studies, the treated group showed a longer operation time of laser irradiation (p < 0.01), a lower degree of temperature increase (p < 0.01), and there was no significant statistical difference in the depth of coagulation tissue (p = 0.624). In clinical studies, the treated group showed a longer operation time of laser irradiation (p < 0.01), a lower degree of temperature increase (p < 0.01), and a lower VAS score on the 1st and 2nd day, compared with the control group (p < 0.01). Conclusions: Air cooling during Nd:YAG laser for the treatment of VLL can prolong the surgical time, but lowered tissue temperature and reduced patient pain within 2 days under the premise of ensuring the treatment effect.
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Affiliation(s)
- Ya-Qun Kong
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Xi Dong
- Laboratory of Laser Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Institute of Biomedical Engineering, Tianjin, China
| | - Bin Wu
- Department of Stomatology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Ping Shu
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chang-Xu Li
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei-Wei Bao
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Wan Zheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Juan Liu
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Meng-Lin Cheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yu-Qing Yang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Feng Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Mohsen M, Migliau G, Pergolini D, Romeo U, Palaia G. Accident due to Incorrect Selection of Diode Laser Technique in the Treatment of Oral Venous Malformation. Case Rep Dent 2023; 2023:8817274. [PMID: 38106372 PMCID: PMC10723904 DOI: 10.1155/2023/8817274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/29/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023] Open
Abstract
Venous malformation (VM) originates from a congenital venous network disorder, configuring about 40% of the vascular anomalies that occur in the head and neck region. The usage of diode lasers in the treatment of VM is associated with various advantages, such as short operating time and few postoperative complications. Nevertheless, for larger and deeper VM treatment, it may require more than one session for the complete resolution of the lesion. Laser surgery for oral VM may induce heat accumulation due to excessive irradiation causing adverse events postoperatively, including pain and ulcer formation with scarring. In this clinical case, it was recommended to use the leopard technique (LT) to reduce the lesion size, evaluate the remaining unhealed lesion, and apply different laser techniques to obtain the complete resolution of the lesion.
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Affiliation(s)
- Mohamed Mohsen
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Guido Migliau
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Daniele Pergolini
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Gaspare Palaia
- Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, Rome, Italy
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Comparative Evaluation of Efficacy and Safety of the Diode Laser (980 nm) and Sclerotherapy in the Treatment of Oral Vascular Malformations. Int J Vasc Med 2022; 2022:2785859. [PMID: 36106096 PMCID: PMC9467756 DOI: 10.1155/2022/2785859] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background Vascular malformations are structural abnormalities which are formed by progressively enlarging aberrant and ecstatic vessels without endothelial cell proliferation and composed of the type of vessel involved, i.e., capillary, veins, and arteriovenous. Treatment of vascular malformations may involve many techniques like sclerotherapy, embolization, surgical resection, cryotherapy, laser treatment, or medical therapy. This observational prospective study is aimed at evaluating and comparing the effects and efficacy of diode laser and sclerotherapy in the treatment of oral vascular malformation. Materials and Methods 40 patients presenting with oral vascular malformation were included in the present study. The patients were divided equally (20 in each) into two groups, i.e., the laser group and sclerotherapy group. Sclerotherapy was performed with 3% sodium tetradecyl sulfate while the laser group was treated with diode laser 980 nm with transmucosal thermophotocoagulation. The patients were assessed for the response, remission, and side effects. The results obtained were tabulated and compared with the chi-square test. Results Side effects were found significantly lesser in the laser group compared to the sclerotherapy group (p < 0.05). Statistically significant difference was seen for postoperative pain between two groups. The laser group had mild to moderate pain compared to severe pain in the sclerotherapy group. Recurrence was observed more in the laser group compared to the sclerotherapy group. Conclusions Laser and sclerotherapy with 3% sodium tetradecyl sulfate both are effective in the treatment of vascular malformations. Diode laser seems to be better than sclerotherapy given lesser side effects and comfort to the patients while sclerotherapy seems to be better in respect to recurrences.
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Sarfi D, Adnane S, Haitami S, Ben Yahya I. Diode laser photocoagulation of intraoral (and perioral) venous malformations: Cases series. Int J Surg Case Rep 2021; 88:106436. [PMID: 34710772 PMCID: PMC8577465 DOI: 10.1016/j.ijscr.2021.106436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/24/2022] Open
Abstract
Vascular anomalies are subdivided into vascular tumors (hemangiomas) and vascular malformations. They are frequently located in the head, neck, and oral cavity. They are common complaints reported in patients seeking treatment for aesthetic or functional issues. However, recent advances in the diagnosis and management of these lesions are improving treatment strategies. This review provides both basic and up-to-date knowledge on the most common vascular anomalies encountered by practitioners. Due to the wide variability of treatment options which often generates debate, this paper work aims to provide a comprehensive approach of these lesions based upon current concepts and practical clinical experience. Our article is about 4 patients who had consulted for one or several purplish, elevated, well limited and soft lesion. These lesions was not painful, but worrying for patients. Therapies for VAs continue to generate a dilemma for oral surgeons. Several treatment options were reported, including conventional surgery with or without adjunctive preoperative embolization, and drug therapies, such corticosteroids, intralesional injection of corticosteroids and intralesional injections of sclerosing agents. All of these therapeutic approaches carry a high risk of severe side effects such as scars, pain, and bleeding [7]. Nowadays, advances in the use of lasers have allowed doctors an effective treatment with minimal side effects [9]. All our cases described in this article were done by Pr Haitami, using the 980 nm Diode laser, and a complete healing was observed in about 8 months at the most. The laser is therefore a great help in the management of this type of lesion.
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Affiliation(s)
- Dounia Sarfi
- Oral Surgery, Dental Consultation and Treatment Center, Ibn Rochd University Hospital Center, Casablanca, Morocco, BP: 9157.
| | - Salma Adnane
- Oral Surgery, Dental Consultation and Treatment Center, Ibn Rochd University Hospital Center, Casablanca, Morocco, BP: 9157
| | - Sofia Haitami
- Oral Surgery, Dental Consultation and Treatment Center, Ibn Rochd University Hospital Center, Casablanca, Morocco, BP: 9157
| | - Ihsane Ben Yahya
- Oral Surgery, Dental Consultation and Treatment Center, Ibn Rochd University Hospital Center, Casablanca, Morocco, BP: 9157
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Trafalski M, Kozakiewicz M, Jurczyszyn K. Application of Fractal Dimension and Texture Analysis to Evaluate the Effectiveness of Treatment of a Venous Lake in the Oral Mucosa Using a 980 nm Diode Laser-A Preliminary Study. MATERIALS 2021; 14:ma14154140. [PMID: 34361334 PMCID: PMC8347063 DOI: 10.3390/ma14154140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022]
Abstract
Venous lake (VL) is a common lesion resulting from the enlargement of thin-walled veins surrounded by a thick wall of fibrous tissue. Photocoagulation is becoming one of the basic methods for treating small vascular lesions. The aim of this study was an application of texture analysis (TA) and fractal dimension analysis (FDA) to evaluate VL treatment. Twenty-three VLs were included in the study. We used a 980 nm diode laser, 6 W, 100 ms pulse mode with a 50% duty cycle. The total dose of energy was in a range from 80 J to 600 J. We used the difference of intensity algorithm for FDA and microcontrast and a co-occurrence matrix for TA. A complete therapeutic effect was achieved in 83%, and in 9%, scar formation was observed after three months. No healing was observed in 4%, and there was partial healing in 4%. No differences in FD were observed between the lesions after three months and the healthy mucosa. The fractal dimension and microcontrast of a vascular lesion are mutually coupled. FDA and TA is a useful and objective method of assessing treatment effects for venous lakes. The non-contact mode of the 980 nm diode laser is an effective and safe method for treating a VL.
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Affiliation(s)
- Mateusz Trafalski
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 S. Żeromski Street, 90-549 Lodz, Poland;
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence:
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Abdel-Latif MM, Patil S. Minimal Invasive Surgical Management of Familial Arteriovenous Malformation. Case Rep Dent 2021; 2021:5564470. [PMID: 34221516 PMCID: PMC8211530 DOI: 10.1155/2021/5564470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Familial arteriovenous malformations are exceedingly rare. They are often noted at birth. They can also present during childhood or adolescence. Sclerotherapy has proven to have a favorable outcome. Case Presentation. The present case report describes the treatment of arteriovenous malformations on the tongue, labial mucosa, and vermilion border in siblings treated with boiling saline injections. CONCLUSION Sclerotherapy using boiling saline had shown to effectively treat arteriovenous malformations in the oral region without any significant morbidity.
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Affiliation(s)
- Mokhtar Mamdouh Abdel-Latif
- Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Surgery, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Shankargouda Patil
- Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Sivolella S, Sibillin M, Lupi A, Zanette G, Giraudo C. Diode laser for the treatment of a high flow lip vascular malformation: a case report with four years follow up. Minerva Dent Oral Sci 2021; 71:248-253. [PMID: 33929135 DOI: 10.23736/s2724-6329.21.04486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND About 50% of vascular malformations are located at the head and neck region where they can usually be associated with functional and/or aesthetic limitations. Laser treatment has proven to be effective in treatment of small low-flow vascular malformations but little is known about the use of this therapy for high-flow larger arteriovenous malformations (AVMs). METHODS a congenital high-flow vascular malformation of the upper lip had to be treated because it was causing functional impairment and deformity which were affecting the quality of life. The mainstay of treatment is surgical therapy after embolization of the lesion but the treatment of high-flow lesions is difficult because of the high risk of mortality and morbidity. The lesion was then treated with transmucosal diode laser applications in multiple sessions. RESULTS The lesion progressively reduced in dimension without any sign of recurrence after multiple sessions of transmucosal diode laser applications. The clinical examination and the ultrasound scan performed four years after the last treatment demonstrated that no complications or further recurrence occurred. CONCLUSIONS multiple sessions of diode laser application can be a safe, effective and minimally invasive treatment for oral mucosa vascular malformations, even if characterized by high flow.
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Affiliation(s)
- Stefano Sivolella
- Dentistry Section, Department of Neurosciences, University of Padua, Padua, Italy
| | - Manuel Sibillin
- Dentistry Section, Department of Neurosciences, University of Padua, Padua, Italy -
| | - Amalia Lupi
- Radiology Institute, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Gastone Zanette
- Dentistry Section, Department of Neurosciences, University of Padua, Padua, Italy
| | - Chiara Giraudo
- Radiology Institute, Department of Medicine - DIMED, University of Padua, Padua, Italy
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Palaia G, Renzi F, Pergolini D, Del Vecchio A, Visca P, Tenore G, Romeo U. Histological Ex Vivo Evaluation of the Suitability of a 976 nm Diode Laser in Oral Soft Tissue Biopsies. Int J Dent 2021; 2021:6658268. [PMID: 34007279 PMCID: PMC8100417 DOI: 10.1155/2021/6658268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/24/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Laser-induced thermal effects can preclude a safe histological evaluation of biopsy resection margins. The aim of this study was to evaluate the suitability of a 976 nm diode laser in oral soft tissue biopsies in an ex vivo study. MATERIALS AND METHODS A 976 nm diode laser (Solase®, Lazon Medical Laser, China) has been used in the contact mode, using a 400 μm fiber tip, at different parameters from 4 to 6 W in the continuous wave (CW), with a fluence between 3184 and 4777 J/cm2, and pulsed wave (PW) mode, with a fluence between 318,4 and 477,7 J/cm2, to obtain 30 samples from fresh pig cadaver tongues. All specimens were subdivided into 6 groups (from A to F), and each group consisted of 5 samples. Two sections were obtained from each sample. A histological analysis was performed using an optical microscope at magnifications of 5x and 10x. Statistical analysis was carried out using Kruskal-Wallis and Dunn's tests. RESULTS The results showed that histological readability was optimal in all the samples. The thermal damage was negligible in all groups. The average thermal damage was 208.40 ± 133.81 μm in the epithelial tissue and 330.14 ± 147.45 μm in the connective tissue. The statistical analysis showed no differences between the groups (p > 0.05). CONCLUSION A 976 nm diode laser demonstrated good surgical effectiveness that provoked little peripheral damage in the cut edges and allowed a safe histological diagnosis. Clinical Relevance. In oral pathology, many times, there is fear in using the laser to remove some lesions due to its thermal effect on the tissues close to the lesion. This effect is always present in the use of the laser, but the intent is to minimize this effect to have as little alteration as possible on the surrounding tissues.
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Affiliation(s)
- Gaspare Palaia
- “Sapienza” University of Rome, Department of Oral and Maxillofacial Sciences, Via Caserta 6, Rome 00161, Italy
| | - Federico Renzi
- “Sapienza” University of Rome, Department of Oral and Maxillofacial Sciences, Via Caserta 6, Rome 00161, Italy
| | - Daniele Pergolini
- “Sapienza” University of Rome, Department of Oral and Maxillofacial Sciences, Via Caserta 6, Rome 00161, Italy
| | - Alessandro Del Vecchio
- “Sapienza” University of Rome, Department of Oral and Maxillofacial Sciences, Via Caserta 6, Rome 00161, Italy
| | - Paolo Visca
- Department of Cytology and Cellular Diagnostics, Regina Elena Institute, Via Elio Chianesi 53, Rome 00144, Italy
| | - Gianluca Tenore
- “Sapienza” University of Rome, Department of Oral and Maxillofacial Sciences, Via Caserta 6, Rome 00161, Italy
| | - Umberto Romeo
- “Sapienza” University of Rome, Department of Oral and Maxillofacial Sciences, Via Caserta 6, Rome 00161, Italy
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Jurczyszyn K, Trzeciakowski W, Woźniak Z, Ziółkowski P, Trafalski M. Assessment of Effects of Laser Light Combining Three Wavelengths (450, 520 and 640 nm) on Temperature Increase and Depth of Tissue Lesions in an Ex Vivo Study. MATERIALS 2020; 13:ma13235340. [PMID: 33255836 PMCID: PMC7728334 DOI: 10.3390/ma13235340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/30/2022]
Abstract
Background: Lasers are widely used in medicine in soft and hard tissue surgeries and biostimulation. Studies found in literature typically compare the effects of single-wavelength lasers on tissues or cell cultures. In our study, we used a diode laser capable of emitting three components of visible light (640 nm, red; 520 nm, green; 450 nm, blue) and combining them in a single beam. The aim of the study was to assess the effects of laser radiation in the visible spectrum on tissue in vitro, depending on the wavelength and pulse width. Methods: All irradiations were performed using the same output power (1.5 W). We used various duty cycles: 10, 50, 80 and 100% with 100 Hz frequency. Maximum superficial temperature, rate of temperature increase and lesion depth were investigated. Results: Maximum superficial temperature was observed for 450 + 520 nm irradiation (100% duty cycle). The highest rate of increase of temperature was noted for 450 + 520 nm (100% duty cycle). Maximum lesion depth was observed in case of three-wavelength irradiation (450 + 520 + 640 nm) for 100, 80 and 50% duty cycles. Conclusions: The synergistic effect of two-wavelength (450 + 520 nm) irradiation was observed in case of maximum temperature measurement. The deepest depth of lesion was noted after three-wavelength irradiation (450 + 520 + 640 nm).
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Affiliation(s)
- Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, 50-425 Wroclaw, Poland;
- Correspondence:
| | - Witold Trzeciakowski
- Institute of High Pressure Physics, Polish Academy of Sciences, 01-142 Warsaw, Poland;
| | - Zdzisław Woźniak
- Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (Z.W.); (P.Z.)
| | - Piotr Ziółkowski
- Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (Z.W.); (P.Z.)
| | - Mateusz Trafalski
- Department of Dental Surgery, Wroclaw Medical University, 50-425 Wroclaw, Poland;
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Evaluation of sclerotherapy of benign oral vascular lesions with monoethanolamine oleate. Clin Oral Investig 2020; 25:1767-1774. [PMID: 32748074 DOI: 10.1007/s00784-020-03479-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the efficacy of sclerotherapy with monoethanolamine oleate (MEO) in a series of cases of benign oral vascular lesions (BOVL). MATERIAL AND METHODS Clinical records and images were retrieved (2015-2019), and data regarding age, gender, location, size, symptomatology, treatment and outcomes of patients were collected. All patients were diagnosed according to the classification of International Society for the Study of Vascular Anomalies and received the same treatment protocol (MEO 0.05 g/mL). The collected data were submitted to descriptive analysis and Pearson's chi-square test (p ≤ 0.05). RESULTS Thirty-seven patients were treated. Most were female (70.3%) aged 9 to 88 years (median, 57.5 ± 17.4 years). Lower lip (54.1%) was the most affected site followed by buccal mucosa (16.2%). Thirty-two lesions were asymptomatic and 35.1% showed ≤ 0.5 cm in size. In 48.6% of the patients, only one application of MEO was performed. Complete regression occurred in 62.2% of cases, whereas 27% showed partial regression. One patient showed hypersensitivity during treatment. There was no significant difference between clinical outcome and age, anatomic site, size, and number of applications of MEO. CONCLUSIONS Sclerotherapy with MEO is an acceptable and affordable treatment and can provide satisfactory results in BOVL, especially where other treatment options could compromise the esthetic aspects. CLINICAL RELEVANCE As it is a non-invasive therapy leading, in most cases, to adequate clinical results, safety, and tolerability, sclerotherapy with MEO can be considered an effective treatment for BOVL.
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Dell'Olio F, De Falco D, Di Nanna S, Casorelli A, Favia G. Diode Laser Photocoagulation of Oral Venous Malformations in Patients on Anticoagulant Therapy Without Drug Discontinuation. Cureus 2020; 12:e7340. [PMID: 32313781 PMCID: PMC7164702 DOI: 10.7759/cureus.7340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The diode laser is widely used for the treatment of venous malformations of the oral cavity nowadays. Anticoagulant therapy is usually modified or suspended in patients needing oral surgery, especially for vascular lesion treatment. We report a case series of venous malformations in patients on anticoagulant therapy treated by diode laser photocoagulation without drug discontinuation.
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Affiliation(s)
- Fabio Dell'Olio
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, ITA
| | | | - Simona Di Nanna
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, ITA
| | - Assunta Casorelli
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, ITA
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13
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Limongelli L, Tempesta A, De Caro A, Maiorano E, Angelelli G, Capodiferro S, Favia G. Diode Laser Photocoagulation of Intraoral and Perioral Venous Malformations After Tridimensional Staging by High Definition Ultrasonography. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:722-728. [PMID: 31560255 DOI: 10.1089/photob.2019.4635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Luisa Limongelli
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Angela Tempesta
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Alessio De Caro
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Giuseppe Angelelli
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
| | - Gianfranco Favia
- Department of Interdisciplinary Medicine, Università degli Studi di Bari Aldo Moro, Bari, Italy
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Haas OL, Scolari N, da Silva Meirelles L, Favoretto AX, de Oliveira RB. Sialolith removal in the submandibular region using surgical diode laser: report of two cases and literature review. Oral Maxillofac Surg 2018; 22:105-111. [PMID: 29356906 DOI: 10.1007/s10006-018-0674-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/09/2018] [Indexed: 06/07/2023]
Abstract
PURPOSE Sialolithiasis is defined as the presence of one or more calcified structures within the duct of a major or minor salivary gland. It occurs as a result of deposition of calcium salts around an accumulation of organic debris in the duct lumen. The main signs and symptoms are edema and bacterial infection with abscess formation. METHODS This study aimed to report two cases of submandibular sialolithiasis treated surgically with diode laser and conduct a review of the literature by means of a systematic search. In the two cases, the calculi were located in the distal part of the submandibular duct and could be palpated intraorally. Surgery was performed in an outpatient setting under local anesthesia. A linear incision was made in the floor of the mouth, in the region of the opening of Wharton's duct, to expose and remove the calculi. Laser cutting was performed using a diode laser module coupled to a 400-μm optical fiber emitting at a wavelength of 980 nm (infrared), 2.5 W output power, and in continuous pulse mode. RESULTS The use of diode laser is a safe and minimally invasive option for this type of procedure. CONCLUSION Offering advantages such as enhanced coagulation properties and high-quality incision, absence of bleeding, low risk of nerve damage, and few comorbidities.
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Affiliation(s)
- Orion Luiz Haas
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Neimar Scolari
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Lucas da Silva Meirelles
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil.
| | - André Xavier Favoretto
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Rogério Belle de Oliveira
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
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Bargiela-Pérez P, González-Merchan J, Díaz-Sanchez R, Serrera-Figallo MA, Volland G, Joergens M, Gutiérrez-Perez JL, Torres-Lagares D. Prospective study of the 532 nm laser (KTP) versus diode laser 980 nm in the resection of hyperplastic lesions of the oral cavity. Med Oral Patol Oral Cir Bucal 2018; 23:e78-e85. [PMID: 29274158 PMCID: PMC5822545 DOI: 10.4317/medoral.21812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 11/14/2017] [Indexed: 12/28/2022] Open
Abstract
Background The aim of this study is to evaluate the resection of hyperplastic lesions on the buccal mucosa comparing the 532nm laser (KTP), versus diode 980nm laser, considering pain, scarring, inflammation and drug consumption that occurred postoperatively with each lasers. Material and Methods A prospective study of consecutive series of 20 patients in two groups that presents hyperplastic lesions on the buccal mucosa. The choice of the KTP laser or diode 980nm laser for the surgery was made randomly. The power used was 1.5W in both groups in a continuous wave mode with a 320 μm optical fiber. Parameters of pain, scarring, inflammation and consumption of drugs were recorded by a Numerical Rating Scale and evaluated postoperatively. These recordings were made the day of the surgery, 24 hours after, 14 and 28 days after. Results Pain and inflammation was light - moderate. The consumption of paracetamol was somewhat higher in the diode 980nm laser versus the KTP laser after 24 hours, although data was not statistically significant; significant differences were found after 28 days in regards to pain (p = 0.023) and inflammation (p = 0.023), but always in the absence parameter so we find no pain in both lasers. Scarring in the two types of laser showed no differences along the visits, with not detected scar retractable. Conclusions Although there is a slight histological difference regarding the KTP laser in the oral soft tissues for clinical use, both wavelengths are very suitable for excision of oral fibroma. Key words:Laser surgery, Laser therapy, oral surgery, soft tissue, 980 nm diode laser, 532 nm KTP laser.
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Affiliation(s)
- P Bargiela-Pérez
- Dental School - University of Seville C/ Avicena s/n 41009 Sevilla, SPAIN,
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Bacci C, Sacchetto L, Zanette G, Sivolella S. Diode laser to treat small oral vascular malformations: A prospective case series study. Lasers Surg Med 2017; 50:111-116. [PMID: 28906568 DOI: 10.1002/lsm.22737] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The current work examined a consecutive series of patients presenting vascular malformations (VMs) and venous lakes (VLs) of the lip and oral mucosa who were treated with transmucosal diode laser applications and assessed over a 1 year period. STUDY DESIGN AND METHODS Fifty-nine patients (31 males and 28 females) presenting low-flow VMs or VLs of the oral cavity were treated transmucosally using a diode laser (with an 830 nm operating wavelength and 1.6 W output power) with a 320 µm diameter flexible fiber. All the lesions were assessed 7 days, 30 days, and 1 year after the laser treatment, and the lesion reduction percentage was scored on a one to five scale. The patients were also asked to assess their pain perception daily during the 7 days following the treatment using a visual analog scale (VAS). RESULTS There were no procedure-related intra- or post-operative complications; only modest pain intensity was reported. Thirty days after the treatment, lesion reduction was described as excellent or good in 52 cases; it was fair or poor in 7. Six patients (F:M ratio 2:4) required a second diode laser application. At the 1 year follow-up, volume reduction was complete in 48 out of 59 patients; there were five recurrences (F:M ratio 3:2). No relevant gender-related differences were noted. CONCLUSION The use of diode laser application to treat small oral VMs and VLs was associated to shorter operating times and fewer postoperative complications with respect to the scapel surgery approach. More than one session may nevertheless be required if the anomaly is larger than 10 mm. Lasers Surg. Med. 50:111-116, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Christian Bacci
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
| | - Luca Sacchetto
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
| | - Gastone Zanette
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
| | - Stefano Sivolella
- Department of Neurosciences, Dentistry Section, University of Padova, Via Giustiniani 2, 35131 Padova, Italy
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Favia G, Tempesta A, Limongelli L, Suppressa P, Sabbà C, Maiorano E. Diode laser treatment and clinical management of multiple oral lesions in patients with hereditary haemorrhagic telangiectasia. Br J Oral Maxillofac Surg 2016; 54:379-83. [DOI: 10.1016/j.bjoms.2015.08.260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 08/18/2015] [Indexed: 01/02/2023]
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PHACES syndrome: Diode laser photocoagulation of intraoral hemangiomas in six young patients. Int J Surg Case Rep 2015; 11:124-128. [PMID: 25974260 PMCID: PMC4446671 DOI: 10.1016/j.ijscr.2015.03.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/23/2015] [Accepted: 03/24/2015] [Indexed: 11/21/2022] Open
Abstract
This study well defines the oral clinical aspects of PHACES oral hemangiomas, poorly noticed in current English literature, and their laser therapy. Diode laser photocoagulation techniques have been proved to be very effective and minimally invasive surgical treatment for IH in syndromic patient considering the presence of numerous lesions and the necessity of several interventions. This study shows the two main laser technique used for the treatment of oral hemangiomas highlighting the differences between these ones and their main recommendations.
Introduction The acronym PHACES describes the association of posterior fossa malformations, facial hemangiomas, arterial anomalies (cardiovascular or cerebrovascular), coarctation of the aorta and cardiac defects, eye abnormalities, and sternal or ventral defects. In this study we report on 6 patients affected by the PHACES syndrome and showing 34 intraoral hemangiomas (IH), treated by diode laser photocoagulation (DLP). Case presentation IH appeared as red-bluish soft masses, smooth or lobulated, from a few millimetre to several centimetres in size, covered by intact mucosa and blanching on pressure. IHs were treated by DLP with 320 μm fibres at a wavelength of 800 ± 10 nm. The diode laser techniques applied were: Transmucosal DLP (DLTP), a no-contact technique in which laser energy is delivered by a flexible optic quartz fiber, which is kept 2–3 mm apart from the lesion, and Intralesional DLP (DLIP), in which the fibre is introduced into the lesion through a transmucosal access. DLTP was used for 20 flat, superficial IHs and, after a variable number of laser sessions (average = 3) depending on the size of the lesion, 65% completely regressed, while in the remaining 35% shrinkage of the lesion was achieved with minor and few complications. The remaining 14 deep/multi-lobulated IHs were treated by DLIP, resulting in complete regression of 79% of them. Conclusions DLP techniques are an effective and minimally invasive procedure for IH in patients with PHACES, in consideration of the multiple lesions to treat, of the necessity of multiple interventions and the higher compliance of the patients.
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Jasper J, Camilotti RS, Pagnoncelli RM, Poli VD, da Silveira Gerzson A, Gavin Zakszeski AM. Treatment of lip hemangioma using forced dehydration with induced photocoagulation via diode laser: report of three cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:e89-94. [PMID: 25577591 DOI: 10.1016/j.oooo.2014.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 01/15/2014] [Accepted: 03/10/2014] [Indexed: 12/21/2022]
Abstract
Several vascular lesions are related to the lip area. There is no universally accepted protocol for the treatment of hemangiomas and vascular malformations. In the oral cavity, high-power lasers represent an excellent therapeutic option for this type of lesion. Their coagulative properties allow for the performance of procedures without the risk of bleeding, which promotes a better healing pattern and a differentiated postoperative appearance. This study describes three cases of lip hemangioma treated with forced dehydration with induced photocoagulation (FDIP) via diode laser. All the reported cases were followed up until complete healing of the operated area had total remission of lesions, with no complications or adverse effects. The findings of the present study suggest that FDIP is effective and useful in the treatment of hemangiomas in the oral cavity. Laser treatment of these lesions prevents their recurrence and is well tolerated by patients.
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Affiliation(s)
- Juliana Jasper
- Post-graduate student, Oral and Maxillofacial Surgery Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Renata Stifelman Camilotti
- Post-graduate student, Oral and Maxillofacial Surgery Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rogério Miranda Pagnoncelli
- Titular professor and Laser Center Coordinator, Oral and Maxillofacial Surgery Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vladimir Dourado Poli
- Associate professor, Oral and Maxillofacial Surgery Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alexandre da Silveira Gerzson
- PhD student, Oral and Maxillofacial Surgery Department, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ana Maria Gavin Zakszeski
- Undergraduate student, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Asai T, Suzuki H, Takeuchi J, Komori T. Effectiveness of photocoagulation using an Nd:YAG laser for the treatment of vascular malformations in the oral region. Photomed Laser Surg 2014; 32:75-80. [PMID: 24392965 DOI: 10.1089/pho.2013.3594] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this study is to make a clinical evaluation of vascular malformations in the oral region treated by photocoagulation with an Nd:YAG laser, to determine its effectiveness. BACKGROUND DATA The Nd:YAG laser, with a wavelength of 1064 nm in the near-infrared part of the electromagnetic spectrum, has unique characteristics, such as absorption by oxygenated hemoglobin, negligible absorption by water, and a deep depth of penetration, all of which are ideal for performing the photocoagulation of vascular malformations. METHODS The subjects were 67 patients (69 cases) with vascular malformations in the oral region who visited our hospital from 2004 to 2011, and were treated by photocoagulation using an Nd:YAG laser. They consisted of 23 male patients and 44 female patients, ranging from 7 to 89 years of age. Lesion size was classified for convenience into two groups (<15 mm or ≥ 15 mm) for clinical analysis and evaluation. The lesions were located at sites including the lip, tongue, buccal mucosa, gingiva, mouth floor, and soft palate, and ranged in size from 3 to 42 mm along the major axis. Fifty patients (74.6%) were treated on an outpatient basis, whereas 17 patients (25.4%) were treated in the hospital. All patients were treated using an Nd:YAG laser at an output of 8-15 W under local anesthesia. RESULTS No patient developed serious complications from this treatment. However, it was necessary to irradiate the laser beam two or more times in cases of deep-seated lesions. CONCLUSIONS We were able to obtain satisfactory results without clinical complications, using only external irradiation. These results suggest that the Nd:YAG laser is effective for the treatment of vascular malformations in the oral region.
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Affiliation(s)
- Tomoko Asai
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine , Chuo-ku, Kobe, Japan
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Gianfranco G, Eloisa F, Vito C, Raffaele G, Gianluca T, Umberto R. Color-Doppler ultrasound in the diagnosis of oral vascular anomalies. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:1-5. [PMID: 24678469 PMCID: PMC3938866 DOI: 10.4103/1947-2714.125852] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In last few years, thanks to laser technology with minimally invasive approach, there was a growing need for treatment of oral vascular malformations inside the dental offices. Generally, the diagnosis of oral vascular malformations is based on clinical history, clinical examination and imaging exams. In the present paper, we review, researching by PubMed, the technical aspects, clinical indications, potentialities and limitations of color-Doppler ultrasound in the work-up of oral vascular malformations. Different imaging modalities are encountered for the diagnosis and follow-up of these lesions such as computed tomography, magnetic resonance imaging, color-Doppler ultrasound and angiography. To date, color-Doppler ultrasound is considered the first-line imaging approach since it provides a non-invasive, cost effective, real time evaluation of oral vascular anomalies. It provides both morphological and vascular information, which are useful to determine the best therapeutic options. Ultrasonography, for these reasons, could be considered as a valuable diagnostic tool in the preliminary assessment of oral vascular anomalies.
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Affiliation(s)
- Gaimari Gianfranco
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
| | - Fioravanti Eloisa
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
| | - Cantisani Vito
- Department of Radiology, University “La Sapienza”, Rome, Italy
| | | | - Tenore Gianluca
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
| | - Romeo Umberto
- Department of Dentistry and Oral Surgery, University “La Sapienza”, Rome, Italy
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