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laser – international magazine of laser dentistry No.4, 2015

case report I techniquesonlyareperformedinareasthatpreviously hadbiopsyspecimenstakenorwhenaclinicaldiagno- sis has been made properly. Cryosurgery disadvan- tagesincludeunpredictabledegreeofswelling,lackof precision for depth and freezing area, and high de- pendenceontheoperator’sskillandexperience.How- ever, advantages of cryosurgery include absence of pain, low risk of infection and no need of suture re- moval.12,15 _Case report A65-year-oldfemalepatientwithsoremouthsen- sation, who had worn her dentures for six years con- tinuously without removing it during sleep, was re- ferredfortreatment. Medicalhistory Theanamnesisofthepatientrevealednosystemic medical problems, no allergic reactions, no medica- ment or drugs and no history of past surgical proce- dures so that the patient had no need for a referral to amedicalconsultant. Dentalhistory Oral and maxillofacial examination of the patient revealednoT.M.J.ormyofascialdisturbances. Clinicalfindings Oldandill-fittingdentures,resorbedalveolarridge and a diffuse erythematous lesion of the palate were observed(Fig.1). X-rayexamination X-ray examination showed no abnormal destruc- tiveeffects. Clinicaldiagnosis Thecasewasclinicallydiagnosedasdenturestom- atitistypeIIaccordingtotheNyotonclassification,and wedecidedtotreatitbydiodelaser. Laserparameters The laser had a wavelength of 980 nm, 400 µm fi- bre,1.2Woutputpower,continuesmodeandinitiated fibre. Treatmentdeliverysequence After filling out the consent form, the surgery area was anaesthetised by infiltration method with 2% li- docainewithEpi1:100,000,1.8ml.Afterwards,thefol- lowingtreatmentstepswereexecuted: −Defining of the controlled area and the proper plac- ingofthelaserwarningsignstosecuretheoperating room. −Checking of the safety for patient's eye glasses, pa- tient'sguardianeyeprotectionandtheassistanteye protection. −Set up of the laser and test of proper laser operation (fibre cleaving, control of the laser output, aiming beamcontrol,spotsizeestimation,initiationofthefi- brewithadarkarticulationpaperandtest-fireofthe laser),usingminimumpowerandsetting. −Checking the patient's information (examination sheetandX-ray,consentform,etc.). Thelesionvaporization Removal of the superficial contaminated epithelial surfaces was performed with contact and scanning modeincombinationandthelesionwasvaporized.Dur- ing the treatment, high volume suction was used to evacuatethevaporplumeandobjectionableodorsatthe siteofoperation.Duringtheentireprocedure,thelaser- tissueinteractionwasrespectedinordertopreventany unsuitablereactionsinthesurroundingtissue.Removal of carbonized tissue was done by a micro-applicator brushsuckedin3%hydrogenperoxidesolution. Postproceduraleducation Thepatientwasadvisedtokeeptheareacleanand toavoidfoodandliquidsthatmaycausepainorirrita- tion to the sensitive tissue, but can use over-the- counteranalgesicsasneeded. Finalresult Excellent laser vaporization of the contaminated layerwasobservedwithnobleeding,nocarbonization andnochar(Fig.2).Thepatientdidnotexperienceany discomfortandwassatisfied. Follow-up The first visit after laser treatment was one day af- tertheprocedure(Fig.3).Thepatientrevisitedafterfive Fig. 4_Five day after treatment. Fig. 5_One week after treatment. Fig. 6_Two weeks after treatment. I 11laser4_2015 Fig. 4 Fig. 6Fig. 5

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