Please activate JavaScript!
Please install Adobe Flash Player, click here for download

laser - international magazine of laser dentistry No. 2, 2017

| case report Fig. 4: Toluidine blue-mediated photodynamic therapy (PDT) with diode laser. Fig. 5: Appearance of patient’s tongue after six months of therapy. Fig. 4 Fig. 5 posed combined laser therapy include mechanical removal of the papillae by ablation with Er:YAG laser and consequent local photodynamic therapy. Photo- dynamic therapy (PDT) has been investigated as a po- tential antimicrobial therapy and an alternative tool against some infectious diseases in the oral cavity.9 The toluidine blue photosensitiser used in this study is absorbed well by the aiming beam of 635 nm. Similarly to methylene blue, toluidine blue has a low antiseptic effect. Conclusion There are many possible causes of BHT. It is import- ant for the clinician to take an accurate and detailed history in order to determine the most likely causal agents. The treatment should be individualised, based on the clinician’s assessment of the aetiologic agents. This case demonstrated a successful resolu- tion of the condition using combined laser therapy. This new modality offers possibilities for both re- moval of the papillae by ablation and consequent local photodynamic therapy with pronounced anti- fungal effect._ accumulation of keratinised layers so the elongated papillae secondarily collect fungi and bacteria. Our patient was also positive for Candida albicans that is easily harboured in this retentive niche. For these reasons, the therapy effectiveness depends on the ability to remove the hyperkeratinised layer for a better antifungal therapy. In the available literature, many treatment modal- ities exist, which generally means that the existing methods are ineffective.1,7 The efficacy of tongue scraping is also questionable. The benefits of the pro- contact Author details Prof. Georgi T. Tomov DDS, MS, PhD Associate Professor and Chair of the Department of Oral Pathology, Faculty of Dental Medicine Medical University of Plovdiv, Bulgaria dr.g.tomov@gmail.com Kurz & bündig Die schwarze Haarzunge (engl. black hairy tongue; BHT) ist eine harmlose Erkrankung, die gekennzeichnet ist durch eine Verlängerung der Papillae filiformes, mit einem haarigen und dunklen Belag auf dem Zungenrücken.1 Die Prävalenz zur Entwicklung von BHT liegt zwischen 0,6 und 11,3 Prozent.2–4 Begünstigt wird die Erkrankung durch Faktoren wie Rauchen, übermäßiger Kaffeekonsum, schlechte Mundhygiene sowie die Einnahme von Antibiotika.5,6 Bei der Therapie geht es vor allem darum, die krank machenden Erreger zu beseitigen. Ein neuer Ansatz in der Be- handlung von BHT ist dabei die Kombination aus Laserablation mit dem Er:YAG-Laser und Toluidinblau-vermittelter photodynamischer Therapie (PDT) mit dem Diodenlaser. Im Falle einer 37-jährigen, weiblichen Patientin konnte die schwarze Haarzunge durch einerseits Beseitigung der Papillen mittels Laserablation und andererseits konsequent lokaler photodynamischer Therapie mit stark antimykotischer Wirkung erfolgreich behandelt werden. Literature 16 laser 2 2017

Pages Overview