ABSTRACT
BACKGROUND: Gingival hyperpigmentation is a major concern for a significant number of patients, as a relevant aesthetic or cosmetic need. Oral melanin pigmentation is considered to be multifactorial and could be related to physiological or even pathological reasons and can be the consequence of a variety of local or systemic factors. This pigmentation varies individually across races or age groups and is without any gender predilection. Evidence gleaned from literature is presented from case-control studies and from the authors' own research work in prospective, split-mouth, double-blinded, clinical trials comparing treatment modalities in effecting depigmentation. METHODS: A systematic review of published articles, using suitable assay criteria, was carried out to formulate a consensus on laser-assisted modalities. A total of 295 published sources were subject to critical analysis and resulted in six papers that were subject to data scrutiny. Additionally, evidence is presented on clinical protocols and treatment outcomes. RESULTS: Analysis of randomized clinical studies identified the use of two laser wavelength groups-near infrared diode and erbium group of mid-infrared lasers. Several areas of analysis were examined, and inconsistent degrees of significance were obtained to establish which laser group was optimal and if they were any better than scalpel depigmentation. CONCLUSION: A definitive conclusion is wanting as studies with scientific and standardized protocols of evaluation are yet to provide a take on comparative assessments between different techniques of depigmentation.
ABSTRACT
BACKGROUND AND AIMS: An out-patient surgical procedure in the paediatric age group is a tough task for a surgeon, more so when compounded with mentally challenging conditions like cerebral palsy. Every step involved, either administration of local anaesthesia or handling sharp surgical instruments around the face or achieving haemostasis, can be a challenge, with compromise on patient safety. Neither undue restraint nor general anaesthesia is advisable, considering the magnitude of the procedure. In such cases, a safe, rapid and effective technique that can be comfortably performed under topical anaesthesia without use of sharp instruments or needles would be an ideal option. The purpose of this paper is to highlight one such situation, where an intra-oral soft tissue tumor was safely and effectively ablated using diode laser, under topical anaesthesia in a child with cerebral palsy concurrent with Worster Drought syndrome. RESULTS: Topical anaesthesia provided adequate conditions to ablate the tumor. A bloodless field was achieved, with no need for sutures. The procedure was completed in less than half the time required for a conventional approach. Postoperative follow-up of 3 months showed complete healing with no recurrence. CONCLUSIONS: Portable diode lasers are an effective tool for minor oral surgical procedures in paediatric population especially, children who are mentally challenged.
