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ePaper created 2017-01-04, 09:21:41 | version 1.38.0
19 4 2016 laser case report | Case 3: Photocoagulation for surgical site after surgical removal of impacted tooth by 790 diode laser A 19 year-old woman with no systemic disease pre- sented with a lower right third molar partial bony im- paction. This needed to be removed by surgical ex- traction. The standard procedure including flap operation,osteotomyandtoothsectionwasconducted under local anaesthesia; 2 % mepivacaine with 1:100,000 epinephrine. After the tooth was delivered, therewasbleedinginthebonysocket(Fig.11).A790 nm diodelaserat0.3 Wwasusedtoirradiatethesocketand woundedareafor30 secpercycle,foratotaloftwoep- isodes.Aninitialbloodclotwasfound(Fig.12). Clinical results There was no active bleeding, but an immediate haemostasis in the surgical removal area, which was differentcomparedtoourexperiencesofusingstan- dard technique. Also the healing in a week was fa- vourable (Figs. 13a & b). Patient satisfaction The patient seem to be satisfied with immediate haemostasis after the operation. Case 4: Photocoagulation for bony socket and soft tissue haemostasis after surgical removal of soft tissue impaction by 808 nm diode laser A 26 year-old woman with no systemic disease had achiefcompliantofalowerrightthirdmolarsofttissue impaction.Thesurgicalremovalwasrequiredfortreat- ment.Thestandardprocedureincludingflapoperation ostectomyandtoothsectionwasconductedunderlo- cal anesthesia; 2 % mepivacaine with 1:100,000 epi- nephrine. After the tooth was delivered, there was bleeding in the bony socket (Fig. 14). An 808 nm diode laser at 0.5 W was used to irradiate the socket and woundedareafor5 secpercycleandatotaloffourep- isodes. The initial blood clot with some carbonisation was found (Fig. 15). Clinical results There was no active bleeding and an immediate haemostasis in the surgical removal area, which was different from our experiences of using standard technique. Patient satisfaction The patient seem to be satisfied that there was no bleeding after the operation. Discussion Although the CO2 laser was commonly used in the surgicalremovalofintraorallesionsduetothelimita- tion of lateral damage, which made specimen avail- ableforhistopathologicalinvestigationtogetherwith the ability of sealing of vessels up to 500 micron in diameter,7-9 we experienced insufficient tissue coag- ulationatthelateralborderofthetongueincase1.In this case, we used the LED photocoagulation in order to avoid photoablation and carbonisation effect. The benefits of using lasers in oral surgical proce- dures were clinically significant to both the dental surgeons and the patients. All techniques and wave- Fig. 12 Fig. 13a Fig. 11 Fig. 11: After surgical removal of the lower right third molar impaction, it was oozing via the bony socket. Fig. 12: Initial blood clot formation without oozing was found immediately after post-photocoagulation using a 790 nm diode laser. Figs. 13a & b: One week after operation, there was no complication. Surgical wound healing was observed. Fig. 13b 42016