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ePaper created 2017-06-15, 09:14:00 | version 1.38.0
| case report Treatment of black hairy tongue Authors: Prof. Georgi T. Tomov, Michail Batilas & Pavlos Spyrantis, Bulgaria Black hairy tongue (BHT) is a benign medical con- dition characterised by elongated fi liform papillae with typical appearance of the dorsum of the tongue.1 Its prevalence varies ranging from 0.6 to 11.3 per cent.2–4 Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, xerostomia, and antibiotics use.5,6 Complications of BHT (burning mouth syndrome, halitosis, dysgeusia) respond poorly to conventional therapy.1,7 The treatment of BHT involves the identifi - cation and discontinuation of the offending agent, modifi cations of chronic predisposing factors, pa- tient’s reassurance to the benign nature of the con- dition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. The use of antimicrobial therapies, topical triam- cinolone acetonide, gentian violet, salicylic acid, vita- min B complex, thymol, and topical or oral retino - ids, as well as keratinolytics (podophyllin), topical 30 per cent urea solution, and trichloroacetic acid have been reported in the literature, although poten- tial side effects from local irritation and possible sys- temic absorption are important factors to consider.1,7 In the available literature, lasers are not reported as therapeutic modality for the treatment of BHT. Fig. 1: Appearance of patient’s tongue on initial presentation. Fig. 2a: The “chisel” tip is positioned parallel to the dorsal plane in order to cut the papillae without damaging the tongue. Fig. 2b: Visible borderline between ablated and no ablated area. Fig. 1 The aim of this article is to report about a new ap- proach applied in the treatment of BHT, using a com- bination of laser ablation with Er:YAG laser and tolu- idine blue-mediated photodynamic therapy (PDT) with diode laser. Case report A 37-year-old female patient complained about an abnormal appearance of her tongue of seven months duration. The patient noted a bad taste in her mouth. Shortly before the oral complaint onset she was pre- scribed antibiotics for sinusitis. Additionally, the pa- Fig. 2a Fig. 2b 14 laser 2 2017