Excision of oral mucocele by different wavelength lasers.

Background: Mucocele is a common benign neoplasm of oral soft tissues and the most common after fibroma. It generally occurs in the lower lip and its treatment includes excision of cyst and the responsible salivary gland, in order to prevent recurrences. Aims: To evaluate the capability of three different lasers in performing the excision of labial mucocele with two different techniques. Materials and Methods: In the presented cases, excision was performed using two different techniques (circumferential incision technique and mucosal preservation technique) and three different laser wavelengths (Er,Cr:YSGG 2780 nm, diode 808 nm, and KTP 532 nm). Results: All the tested lasers, regardless of wavelength, showed many advantages (bloodless surgical field, no postoperative pain, relative speed, and easy execution). The most useful surgical technique depends on clinical features of the lesion. Conclusion: Tested lasers, with both techniques, are helpful in the management of labial mucocele.

O uso do laser de CO2 no tratamento de coristoma sebáceo na cavidade oral: relato de caso / Treatment of sebaceous choristoma of the oral cavity with CO2 laser: a case report

O objetivo deste estudo foi relatar nossa experiência com a aplicação oral de laser CO2 na excisão de lesão em tecido mole. O coristoma é o termo que define uma massa de células normais que se assemelham a um tumor ou um tecido que se desenvolve em local atípico. Os aspectos clínico e histológico do coristoma oral pode variar: há relatos de coristomas sebáceos, cartilaginosos, ósseos e gástricos. O coristoma sebáceo, também denominado grânulo de Fordyce, é uma característica comum da mucosa oral que normalmente não requer biópsia ou excisão e cujo diagnóstico é essencialmente clínico. Neste relato descrevemos um caso de coristoma sebáceo do arco palatal, removido devido ao desconforto causado ao paciente. Após obter a autorização do paciente, foi realizado o tratamento cirúrgico, que consistiu de uma sessão de laser CO2 (Opus 20, Lumenis, EUA). potência 2W e feixe de luz 2 mm, modo pulsado. O paciente relatou um mínimo edema pós-cirúrgico, ausência de dor e completa reepitelização após duas semanas. Concluímos que o laser CO2 ainda é um comprimento de onda útil, na prática da cirurgia oral, devido à alta absorção pela água e hemoglobina, bem como sua atuação favorável no processo de cicatrização.

The aim of this study was to report our experience on the oral application of CO2 laser for the excision of soft tissues lesions. Choristoma is the term indicating a tumor-like mass of normal cells or tissue that develops in an abnormal location. The clinical and histological aspect of the oral choristoma can vary: there are reported cases of sebaceous, cartilaginous, osseous and gastric choristoma. Sebaceous choristoma, also defined as Fordyce's spot or granule, is a common feature of oral mucosa for which biopsy or excision is normally not required and diagnosis is essentially clinical. In this report we describe a case of sebaceous choristoma of the palatal arch removed because of the patient discomfort. We used for the surgical treatment, after informed consent informed was obtained, a C02 laser (Opus 20, Lumenis - USA) using an output power of 2 Watts with a spot size of 2 mm in surgery pulsed mode in one session. The patient reported a minimal post-surgical oedema without pain and the complete reepithelization was obtained 2 weeks later. C02 laser is still a useful wavelength in the oral surgery practice due to its high absorption in water and haemoglobin (bloodless field) as well as its healing process ability.