Aggressive osseous commitment result by keratocyst odontogenic tumour: case report, radiographic and clinical standpoints.

Keratocystic odontogenic tumour (KCOT) previously known as odontogenic keratocyst was recently classified as a benign lesion characterized by an infiltrating pattern, local aggressiveness with the propensity to recurrence. It is thought to arise from the dental lamina. Pain is usually not associated with KCOT until swelling occurs, and it commonly affects the posterior mandible. Multiple KCOT are associated with nevoid basal cell carcinoma syndrome. This study reports an aggressive case of KCOT with destruction of the osseous tissue of the mandible, accentuated face asymmetry, dysphagia and dysphonia. It was managed with a defined protocol which entailed diagnosis, treatment with enucleation along with peripheral ostectomy and rehabilitation. A long-term follow-up schedule was provided to the patient to observe the recurrence behaviour of this cyst. In postoperative phase, no complication was noticed regarding wound healing and recurrence.

CO(2) Laser Surgery and Prosthetic Management for the Treatment of Epulis Fissuratum.

The aim of this study was to present a case report of the surgical removal of hyperplasia in the oral cavity, using carbon dioxide (CO(2)) laser radiation and rehabilitation with a complete denture. Epulis fissuratum occurs in complete denture patients, because a constant irritative action induces the mucosa to grow under poorly fitting dentures. These lesions must be removed, and to avoid a relapse, new complete dentures should be made to maintain healthy surgical tissues. The clinical sequence presented in this case shows a completely edentulous patient with epulis fissuratum on the lower alveolar ridge extending to the vestibular sulcus of the anterior region of mandible. Immediate complete dentures were made prior to the lesion removal with CO(2) laser radiation, providing satisfactory results in oral function and tissue health.

Healing process after surgical treatment with scalpel, electrocautery and laser radiation: histomorphologic and histomorphometric analysis.

The aim of this study was to evaluate and compare the healing process after surgical treatment of chemically induced lesions in the lateral edge of tongue of hamsters performed with scalpel, electrocautery, carbon dioxide (CO(2)) laser radiation or neodymium:yttrium-aluminum-garnet (Nd:YAG) laser radiation. Eighty hamsters of both sexes were used and examined at postoperative days 7, 14, 21 and 28 by histological and histomorphometric analysis of the skeletal muscle fibers. In the histological analysis it was observed that the dynamics of the healing process was faster in the group treated by scalpel than in the other groups. The histomorphometric observation of the skeletal muscle fibers was submitted to one-way analysis of variance (ANOVA) and Tukey's multiple comparison test, with a level of significance set at P < 0.05, which showed that the amount of skeletal muscle fiber formed had significantly increased in the group treated by scalpel in comparison with that in the groups treated by electrocautery (P < 0.01), CO(2) laser irradiation (P < 0.001) and Nd:YAG laser irradiation (P < 0.01) on the 14th postoperative day. A gradual increase in skeletal muscle fibers formed during the healing process was observed in all groups. When the laser irradiated groups were compared, it was possible to conclude that tissue organization and vascularization were faster and more intense in the Nd:YAG laser irradiated group than in the CO(2) laser irradiated group.

Surgical treatment of earlobe keloid with CO2 laser radiation: case report and clinical standpoints.

Keloids are considered to be benign hyperproliferative growths of dense fibrous tissue and overabundant deposition of disorganized, thick, hyalinized collagen that result from an abnormal tissue response to cutaneous injury. Keloids do not have a specific cause, although genetic predisposition is heavily implicated. We present a case report of a patient with an earlobe keloid that was treated with carbon dioxide laser radiation (CO(2)) with an 0.8-mm focus, 7 W, a power density of 2.5 W/cm(2), in a continuous mode. The patient was seen for follow-up 6 months later. An intact hole for placement of an earring was observed with a very good esthetic and functional result.

Homogenous amniotic membrane as a biological dressing for oral mucositis in rats: histomorphometric analysis.

OBJECTIVE: Oral mucositis is a frequent and significant side effect of chemotherapy and/or radiation therapy. The purpose of this study was to evaluate the effects of the homogenous amniotic membrane (HAM) as a biological dressing for oral mucositis induced by 5-fluorouracil (5-FU) in the labial fornix region of inferior incisors in rats. METHODS: Sixty rats were divided into three groups: control (50% acetic acid), 5-FU (50% acetic acid and 5-fluorouracil-induced oral mucositis) and 5-FU+HAM (50% acetic acid and 5-fluorouracil-induced oral mucositis, and treated with HAM). Histological analyses were done 3, 7, 14 and 21 days after applying the acetic acid. RESULTS: HAM showed not only no signs of rejection as well as an excellent tissue adherence to the ulcerated surface. Histomorphometric analysis indicated a lower quantity of inflammatory cells in the 5-FU+HAM group in all periods when compared to the other groups and there was a statistically significant difference in the 3- and 7-day periods (P<0.001). CONCLUSIONS: The results of this study suggest that HAM was biocompatible with great adhesive power to the ulcerated surface, accelerated the healing process and exhibited anti-inflammatory activity. Further studies should be done to investigate the potential benefits of this material in clinical trials. HAM could lead to improved results as a biological dressing in treatment and management of oral mucositis in patients submitted to chemotherapy and/or radiation therapy.

Surgical treatment of erythroleukoplakia in lower lip with carbon dioxide laser radiation.

Erythroplakia is considered to represent a premalignant condition and is felt to be at high risk to progress to oral cancer development. When the lesion presents with red and white mucosal alterations concomitantly, the term erythroleukoplakia is used. However, in erythroleukoplakia lesions, the red or erythroplakia areas have been shown to be most likely to demonstrate dysplastic changes compared to the white hyperkeratotic areas. We present a case of patient with erythroleukoplakia involving the lower lip that was treating with carbon dioxide laser radiation (CO2) with 0.8 mm focus, 5 W, power density of 2.5 W/cm2 in continuous. After the surgery, the vaporized surface was protected with a fibrinolisine + chloramphenicol cream. To date, after 6 months, there has been no clinically evident recurrence on the vermilion area. The functional and esthetic results observed were judged to be excellent.

Estudo clínico comparativo entre cirurgia convencional e / Clinical Comparative Study Between Conventional Surgery And Co2 Laser Radiation In Treatment Of Mucoceles

O objetivo deste estudo foi avaliar o aspecto clínico entre o tratamento cirúrgico convencional e a laser de dióxido de car-bono (CO2) em fenômeno de retenção de muco (FRM). Foram constituídos dois grupos de pacientes, num total de vinte e quatro. Grupo I (biópsia convencional) com nove pacientes adultos, tratados através de cirurgia do tipo biópsia excisional. Grupo II (radiação laser) com quinze pacientes adultos tratados através de vaporização a laser, em modo contínuo, foco de 0,6mm de diâmetro, 2 Watts de potência, Densidade de potência (=Intensidade) de 256 W/cm2, fluência de 0,077 J/cm2. Os dados obtidos foram analisados estatisticamente pelos métodos de Teste de Permutação Exata, Teste Exato de Fisher e análise percentual. As cirurgias em lesões do tipo FRM tratados com laser de CO2 apresentaram melhores resultados do que àquelas realizadas através de cirurgia convencional. Os pacientes submetidos à vaporização com laser de CO2 apre-sentaram ausência de hemorragia e/ou diminuição da dor e edema, assim como a desnecessidade de sutura. Comparada ao método convencional, a cirurgia com laser de CO2 requer menor tempo de trabalho constituindo uma excelente vantagem. Entretanto, o aspecto clínico final das biópsias nos dois grupos não apresentou diferenças significativas.

Effects of copper vapor laser radiation on the root canal wall of human teeth: a scanning electron microscope study.

OBJECTIVE: The aim of this study is to analyze the effects of copper vapor laser radiation on the radicular wall of human teeth. MATERIALS AND METHODS: Immediately after the crowns of 10 human uniradicular teeth were cut along the cement-enamel junction, a chemical-surgical preparation of the radicular canals was completed. Then the roots were longitudinally sectioned to allow for irradiation of the surfaces of the dentin walls of the root canals. The hemi-roots were separated into two groups: one (control) with five hemi-roots that were not irradiated, and another (experimental) with 15 hemi-roots divided into three subgroups that were submitted to the following exposure times: 0.02, 0.05, and 0.1 s. A opper vapor laser (510.6 nm) with a total average power of 6.5 W in green emission, frequency of 16.000 Hz, and pulse duration of 30 ns was used. RESULTS: The results obtained by scanning electron microscope analysis showed the appearance of a cavity in the region of laser beam impact, with melting, recrystallization, and cracking on the edges of the dentin of the cavity due to heat diffusion. CONCLUSIONS: We determined that the copper vapor laser produces significant morphologic changes in the radicular wall of human teeth when using the parameters in this study. However, further research should be done to establish parameters that are compatible with dental structure in order to eliminate thermal damages.

Treatment of developmental defect of upper lip with carbon dioxide laser radiation (CO2): first surgical time.

With the exception of the cleft lip, developmental defects (DD) of the lip are rare. The upper lip originates from the ectomesenchyme and is formed by the merging of the nasal medial and lateral processes with the maxillary process. Disturbances during this formation period can cause DD with functional and/or esthetic repercussions. We present a case of DD of the upper lip in a patient with a history of progressive growth of the left lateral portion of the upper lip that occurred from the time of birth until the age of 22 years. Clinical examination revealed hypertrophy of the area from the left philtral columns to the left commissure of the lip, extending the portion of the surface mucosa creating a flaccid and asymptomatic tissue mass. All other buccal structures appeared to be within normal limits and without any evidence of defects or deformities. In the surgical planning we decided to carry out corrective surgery in two phases. The first phase accomplished a conservative excision of the total abnormal labial tissue mass with a CO2 laser radiation (5 W in continuous mode, bunch diameter Phi = 0.6 mm with a power density of 768 W/cm2 and fluency of 0.231 J/cm2) being careful to preserve the vermilion portion of the lip. Postsurgical clinical evaluations were done every three days until the skin sutures were removed and then every seven days until two months post surgery. While the entire mass of excessive tissue could not be completely removed, the removal of the excessive mucosal tissue produced a very good outcome relative to lip function, with a good esthetic result without scarring, and good tissue mobility. The results showed that the CO2 laser is an extremely useful instrument that can provide excellent control of the surgical field and allow for healing that produces excellent functional and esthetic results.

Effects of copper vapor laser irradiation (lambda = 510.6 nm) on the enamel and dentine of human teeth: an ultra-structural morphologic study.

OBJECTIVE: A morphological and ultra-structural study of copper vapor laser (lambda = 510.6 nm) effects on enamel and dentine was performed to show the effects of this radiation. METHODS: A total of 15 human molars were cut in half; 15 pieces were separated for irradiation on enamel and 15 for dentine. These two groups were further divided into five experimental groups, including a control group, comprised of three half-sections each, irradiated by a CVL laser with a power of 7 W, a repetition rate of 15,000 pulses/sec and exposed at 500, 600, and 800 msec and 1 sec irradiation times with a 5-sec interval between irradiations. RESULTS: In an ultra-structural SEM exam, we observed that on the enamel surfaces irradiated for 1 sec there was morphological alteration that consisted of catering, flaking, and melting on the surfaces. There was no alteration for the other exposure times. On the dentine teeth irradiated for 1 sec, we observed an evident ultra-structural alteration of melted tissue and loss of morphological characteristics. In the dentine group irradiated by 800 msec, we observed ablation and a partial loss of morphological characteristics. In the dentine groups irradiated by 500 and 600 msec, no alteration was observed. CONCLUSIONS: The results showed that irradiation with CVL promoted morphologic changes in the enamel as well as in the dentine and demonstrated a need for future studies in order to establish a safe protocol for further use in the odontological practice.

Estudo comparativo entre cirurgia convencional e a laser de dióxido de carbono (CO2) na orientaçäo da reparaçäo do nervo facial: estudo histológico em ratos / Comparative study between conventional surgery and carbon dioxide laser (CO2) in the orientation of the reparation of the facial nerve: histological study in rats

As lesöes do nervo facial, causadas por traumas, iatrogenias, ou por princípio oncológico, säo complicaçöes extremamente desagradáveis, e comportam conseqüências severas, visto que, näo raramente, chegam a interfirir na identidade facial dos pacientes acometidos. Portanto, tentativas de reestabelecimento da funçäo do nervo facial, há longa data säo publicados na literatura. É sabido que uma das condiçöes mais importantes, para a regeneraçäo da funçäo do nervo facial, é uma adequada coaptaçäo da bainha de mielina nas extremidades lesadas do nervo. O atual estudo, teve por objetivo avaliar, histologicamente, a orientaçäo da regeneraçäo do ramo bucal, do nervo facial lesado, em ratos após a aproximaçäo dos cotos e aplicaçäo da radiaçäo laser, e compara-la com a simples aproximaçäo. Para tanto foi seccionado o ramo bucal do nervo facial em 24 ratos, que foram divididos em dois grupos. No grupo I foi realizado a simples aproximaçäo das extremidades lesadas, e no grupo II, além da aproximaçäo, foi aplicado a radiaçäo laser de CO2 com 2 watts de potência. Os resultados nos levaram a concluir que a utilizaçäo da radiaçäo laser de CO2 resultou numa melhor orientaçäo da regeneraçäo nervosa, e que, a longo prazo, a utilizaçäo da radiaçäo laser, näo prejudicou a reparaçäo dos outros tecidos biológicos envolvidos no processo

Efeitos da radiaçäo laser de dióxido de carbono em tecido ósseo: estudo macroscópico em ratos / Effect of carbon dioxide laser radiation on osseous tissue: macroscopic study in rats

O laser de dióxido de carbono (CO²), pelas suas propriedades intrínsecas, tem se tornado um instrumento cirúrgico importante; entre estas podemos citar: hemostasia, reduçäo do edema e da dor pós-operatória e esterilizaçäo do campo cirúrgico. Seu uso em tecido ósseo para realizaçäo de osteotomias ainda é questionável, principalmente devido à possibilidade de iatrogenias causadas pelo aumento da temperatura tecidual, bem como destes efeitos na área paraincisional. O propósito deste estudo foi proporcionar a confecçäo de um plano piloto visando analisar macroscopicamente os efeitos da radiaçäo laser de CO² em tíbia de rato a fim de estabelecerem-se parâmetros de segurança quanto a potência. Foram utilizados 12 ratos. Após anestesia, os ossos foram submetidos a radiaçäo com potência de 1, 3 e 5 watts. Os animais foram sacrificados nos tempos imediatamente após, 3, 7 e 14 dias após a irradiaçäo, visando à remoçäo do osso tratado. Os espécimes obtidos foram observados através de lupa estereoscópica com aumentos de 14, 25 e 40 vezes e fotografados para posterior análise. Os resultados permitiram concluir que a potência de 1 watt proporciona uma melhor qualidade de resposta à reparaçäo e que as potências de 3 e 5 watts provocaram o atraso na cronologia de reparo

Homogeneous implant in rat tibias of matrix preserved in 98 percent glycerin: histomorphologic study / Implante homógeno de matriz óssea preservada em glicerina a 98 por cento em lojas cirúrgicas preparadas em tíbias de ratos: estudo histomorfológico

Entre os meios químicos de preservação de tecidos, a glicerina tem oferecido bons resultados conservando a integridade celular mesmo provocando a desidratação tecidual. Tendo em vista as propriedades osteoindutoras da matriz óssea e a boa qualidade da glicerina como meio de preservação dos tecidos, foi realizado o implante de matriz óssea em tíbia de ratos. Foram utilizados vinte e quatro ratos e, em cada animal foram realizadas duas cavidades. Numa das cavidades foi implantada a matriz óssea preservada em glicerina a 98 por cento e na outra, a matriz óssea sem preservação. Seis animais foram sacrificados aos 10, 20, 30 e 60 dias após o implante. As peças obtidas após o processamento histológico de rotina foram coradas em hematotoxilina e eosina e tricrômico de Masson. Os resultados obtidos mostram que a matriz preservada em glicerina sofre reabsorção mais rápida e substituição por tecido ósseo neoformado

Efeitos da radiação laser de dióxido de carbono (CO2) na mucosa de revestimento bucal: estudo histológico em ratos / Effects of carbon dioxide laser (CO2) in oral mucosa: histologic study in rats

Este trabalho avaliou histologicamente a reparação da mucosa bucal de 45 ratos brancos Wistar, frente à radiação laser de CO2 com diferentes potências. Os animais foram, aleatoriamente, divididos em três grupos de 15 ratos cada, irradiados com potências de 2,7 e 10 watts, por 0,5 segundo, modo simples, com foco de 0,8 mm, sendo sacrificados imediatamente após irradiação e, após três e sete dias. As peças seguiram técnica histológica de rotina para parafina, e coloração hematoxilina/eosina (H.E.). Os resultados imediatos mostraram em todos os grupos necrose por coagulação, atingindo o tecido muscular com maior profundidade no grupo III; aos três dias foi evidenciada no grupo I (2 watts) área lesada revestida com epitélio pavimentoso de fina espessura, no grupo II (7 watts) área de tecido de granulação atingindo a camada muscular e no grupo III (10 watts) extensa área de tecido de granulação atingindo camadas mais profundas do plano muscular; aos sete dias foi observada no grupo I, camada contínua de epitélio pavimentoso queratinizado recobrindo a área irradiada, no grupo II camada uniforme de epitélio pavimentoso com área de tecido de granulação e no grupo III, epitélio queratinizado com presença de tecido de granulação em pequena área. Os resultados permitiram concluir que: o grupo de animais irradiado com 2 watts de potência (Grupo I) não apresentou diferenças e/ou atraso significantes na cronologia de reparação tecidual e aqueles irradiados com 7 e 10 watts (Grupos II e III) mostraram comprometimento na cronologia de reparação quando comparados ao Grupo I

Estudo clínico comparativo entre reparo após sutura convencional e incisão à laser de dióxido de carbono (CO2) com diferentes potências / Comparative study between wound healing after conventional suture and CO2 laser incision with different power

No presente estudo analisamos clinicamente as diferenças de respostas entre incisão à bisturi e à laser de CO2 na reparação tecidual, em pele de ratos. No Grupo Controle a incisão foi realizada com bisturi convencional seguida de sutura simples. Nos grupos tratados, a incisão foi realizada com laser CO2, variando-se as potências utilizadas (5, 10, 15 e 20 W respectivamente). Os animais foram fotografados imediatamente após a cirurgia e com 3, 7. 14 e 21 dias. Notamos que nos grupos tratados com laser de CO2 houve ausência de sangramento, proporcionando melhor visualização do campo operatório e menor intensidade de inflamação e/ou edema pós-operatório. Nas potências de 15 e 20 W ocorreram áreas de carbonização ao longo das regiões incisadas, bastante evidentes, provocando um retardo na reparação, quando comparadas à incisão convencional. Já com as potências de 5 e 10 W, a reparação teve um padrão similar ao do grupo controle

Vestibuloplastia em maxila com laser de dióxido de carbono (CO2): relato de um caso / Vestibuloplasty in maxilla with carbon dioxide laser (CO2): a case report

Inúmeras têm sido as técnicas cirúrgicas com o intuito de melhorar os rebordos alveolares visando uma perfeita adaptaçäo de próteses totais. As técnicas empregadas podem levar a complicaçöes pós-operatórias do tipo edema, dor, dificuldade de deglutiçäo e de movimentos, hemorragia e/ou infeccçöes. Com o advento do laser de dióxido de carbono (CO2), esta cirurgia melhorou em muito, pois este tipo de irradiaçäo promove a remoçäo de mucosa sem sangramento nem necessidade de sutura, além de pós-operatório com um mínimo de dor e edema. Apresentamos um caso de vestibuloplastia extensa em maxila, realizada com laser de CO2, que näo apresentou nenhum tipo de complicaçäo pós-operatória, além de proporcionar ao paciente imediato retorno estético e funcional, por meio de reembasamento imediato com material do tipo resiliente

Efeitos da radiaçäo laser do tipo hélio-neônio verde (550 NM) no processo de reparo em feridas de extraçäo dental: estudo histológico em ratos / The effect of green helium-neon laser on the healing of extraction wounds: histological study in rats

Foi feito um estudo histológico sobre os efeitos da radiaçäo laser do tipo hélio-neônio verde (550 nm) no processo de reparo em feridas de extraçäo dental em ratos. Os resultados sugerem que este tipo de tratamento näo trouxe benefícios significantes sobre este processo. A proliferaçäo de fibroblastos e a formaçäo de tecido osteóide näo foram mais proeminentes no grupo irradiado

Processo de reparo em feridas de extraçäo dental após implante de colágeno esponjoso: estudo histomorfológico / Healing process of dental extraction wounds after spongeous collagen implantation: hystomorphologic study

Para possibilitar uma avaliaçäo histomorfológica do processo de reparo em feridas de extraçäo após implante de colágeno espanjoso, foram empregados 40 ratos machos com peso entre 200 e 300 gramas. Esses animais foram divididos em 2 grupos de 20 com os seguintes procedimentos experimentais. No grupo I (controle) após a extraçäo do incisivo superior direito, a mucosa foi suturada. No grupo II (com implante) após a extraçäo do mesmo dente, cada alvéolo recebeu um fragmento de colágeno esponjoso e, a seguir, a mucosa foi suturada. Decorridos 4, 10, 21 e 40 dias após o ato cirúrgico, 5 animais de cada grupo foram sacrificados e as peças obtidas após processamento laboratorial de rotina, foram incluídas em parafina para possibilitar a microtomia. Os cortes obtidos foram corados em hematoxilina e eosina para estudo histomorfológico. De acordo com os resultados obtidos pode-se concluir que o colágeno esponjoso constitui uma das opçöes para o tratamento local de hemorragias capilares após a exodontia. Ocasiona reaçäo inflamatória nos primeiros dias e é reabsorvido rapidamente pelo organismo além de permitir a neoformaçäo conjuntiva nas proximidades

Familiar multiple neurofibromatosis: report of case

The study presents a case of neurofibromatosis familiar involving a 4-year-old boy and his family. The lesions that characterize this syndrome are: neurofibromas distributed over the entire body, associated to "café-au-lait" spots. This occurs due to genetic disorder and it is an autossomal dominant trait. The growth of the refered process was showed asymptomatically in the left side of the patient's face. They also had exophthalmia, expansion of the upper and lower maxilla in the same side and "café-au-lait" spots. His father also had these spots and multiple neurofibromas without sympton. According to the history, clinical and radiographic aspects it was diagnosed that familiar multiple neurofibromatosis (von Recklinghausen's disease) must be followed, as the neurofibroma might suffer malignant degeneration.