RESUMO
Background: As dental lasers are becoming more popular in the branch of oral medicine for its various advantages and applications, this study was carried out to evaluate better mode of obtaining oral biopsies which is a common and inevitable procedure for providing final diagnosis in majority of conditions. Methodology: In this study, a total of 60 patients who required biopsy for final diagnosis of oral mucosal lesions as part of diagnosis in department of Oral Medicine were selected, out of which 30 were subjected to scalpel biopsies and 30 patients were subjected to diode laser biopsies. A 980 nm Zolar plus diode laser was used for the study. Out of 30 patients who were subjected to laser biopsies, 3W continuous mode settings were used for 15 patients and 3W pulsed mode was used for 15 patients. The specimens were sent to Department of Oral Pathology for histopathological evaluation to provide the final diagnosis. The time taken for each patient, volume of local anesthesia, during operative, postoperative pain scale, and co-relation of provisional and final diagnosis was noted for comparison purpose and the pathologist comments, peripheral tissue damage and artifact's for each slide were noted. Results: The study results showed the postoperative pain was comparatively less in diodlaser than scalpel, the lasers were patient friendly as the heammorage was negligible when compared to scalpel and suturing was not required. The pulsed mode in diode laser was advantageous over continuous mode when amount of thermal damage and postoperative pain score was compared. Conclusion: The results showed that oral biopsies can be made better using diode lasers, by having thorough knowledge on the device.
RESUMO
The aim of this report is to present a case showing the treatment of Epulis fissuratum in relation to an ill fitting denture, in a debilitated geriatric patient with a novel technique using liquid nitrogen cryosurgery. Management of geriatric patients can be quite challenging due to the presence of various diseases. Epulis fissuratum associated with an ill fitting denture greatly hinders mastication and produces discomfort and pain to the patient. The liquid nitrogen cryosurgery can be used effectively in its management, due to its excellent haemorrhage control and postoperative healing. A 71-year-old male reported with Epulis fissuratum in the vestibular sulcus, which was associated with an ill- fitting denture. The patient was a known hypertensive and diabetic, presently on anti-coagulant therapy with previous history of myocardial infarction. Liquid nitrogen cryosurgery was used for the treatment of the lesion. During the procedure, nil haemorrhage was achieved and the postoperative healing was satisfactory. Liquid nitrogen cryosurgery hence can be used effectively in debilitated geriatric patients as it has the boon of achieving excellent haemostasis, good healing with minimal postoperative oedema and pain, maintaining an aseptic environment. This novel technique can be effectively used by dentists in the treatment of Epulis fissuratum besides it can also be used in treatment of other oral soft tissue pathologies achieving a plethora of benefits.
