Juvenile Hyaline Fibromatosis: Impact of Periodontal Care on Quality of Life and a Patient Perspective.

Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive inherited condition presenting early in life and characterized by the accumulation of hyaline-like tissue in the skin as well as various organs. Gingival overgrowth is a significant oral manifestation. This paper highlights how early and essential periodontal intervention may be necessary to improve mastication and subsequent weight gain, and to eliminate pain and improve the patient's quality of life. Here we highlight the key features of this condition and demonstrate how appropriate surgical management can have a significant impact on a patient's wellbeing. CPD/CLINICAL RELEVANCE: Juvenile hyaline fibromatosis has a significant impact on patient wellbeing and it is therefore important that clinicians are able to recognize the condition and ensure that patients receive appropriate care and management.

Young patients' perception on different surgical management of the disto-oclusal gingival operculum in second mandibular molars.

AIM: This baseline study aims to find out the young patients' perception on different surgical management of the disto-oclusal gingival operculum in second mandibular molars:the conventional technique and the laser assisted one. MATERIAL AND METHODS: The current study included a batch of 20 patients who needed surgical bilateral removal of the disto-oclusal operculum in second mandibular molars order for them to receive conservative treatment. Each patient benefited of two different surgical techniques (laser assisted and conventional). Patients' perception towards these procedures was evaluated with a simple questionnaire. RESULTS: The questionnaires were evaluated by a specialized team and the results were illustrated in the specific charts. On one hand the conventional technique wasn't perceived as very comfortable and on the other hand the laser assisted technique was very well perceived by the patients. CONCLUSIONS: The overall perception of young patients towards laser assisted periodontal surgery was very high and this is a means of reducing operating time and anxiety caused by the surgery itself.

Young patients' perception on different surgical management of the disto-occlusal gingival operculum in second mandibular molars.

AIM: This baseline study aims to find out the young patients' perception on different surgical management of the disto-oclusal gingival operculum in second mandibular molars: the conventional technique and the laser assisted one. MATERIAL AND METHODS: The current study included a batch of 20 patients who needed surgical bilateral removal of the disto-oclusal operculum in second mandibular molars order for them to receive conservative treatment. Each patient benefited of two different surgical techniques (laser assisted and conventional). Patients' perception towards these procedures was evaluated with a simple questionnaire. RESULTS: The questionnaires were evaluated by a specialized team and the results were illustrated in the specific charts. On one hand the conventional technique wasn't perceived as very comfortable and on the other hand the laser assisted technique was very well perceived by the patients. CONCLUSIONS: The overall perception of young patients towards laser assisted periodontal surgery was very high and this is a means of reducing operating time and anxiety caused by the surgery itself.

Comparison of surgical stripping; erbium-doped:yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study.

BACKGROUND: Gingival melanin depigmentation procedures are commonly associated with recurrence of pigmentation, which starts with migration of melanocytes from the adjacent free gingiva. The extent and rate of recurrence varies according to the treatment modalities used and duration of follow-up. The aim of this study is to compare the surgical stripping; carbon dioxide (CO2); and erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser techniques for gingival depigmentation and to evaluate their effect on histologic changes in melanocyte activity and clinical repigmentation. METHODS: In this study, 140 sites from 35 patients with bilateral melanin hyperpigmentation were treated with surgical stripping (two sites per patient), "epithelial-peel" (CO2 laser, 2 to 4 W, continuous wave),and "brushstroke" (Er:YAG laser, 180 mJ, 10 Hz, long pulse) techniques. Surgical microscope monitoring was performed intraoperatively. Patient preference and perception of pain, change in Dummett oral pigmentation index (DOPI), Hedin index, and change in area of pigmentation from baseline to 6 months postoperatively were recorded. Twenty samples each from the three treatment modalities were selected for histologic analysis using hematoxylin and eosin and dihydroxyphenylalanine oxidase special stains. RESULTS: At the 6-month postoperative visit, 15 of 70 (21.4%) and three of 20 (15%) of the surgical-treated; 10 of 35 (28.6%) and six of 20 (30%) of the Er:YAG-laser-treated; and eight of 35 (22.8%) and four of 20 (20%) of the CO2-laser-treated sites showed clinical and histologic repigmentation, respectively. Paired t test, analysis of variance, and χ(2) tests were used for statistical analyses. P values for comparison of microscopic evaluation, change in DOPI, Hedin index, and area of pigmentation were 0.001, which were statistically significant. Comparison for patient preference and pain indices gave statistically significant values for Er:YAG laser depigmentation (P = 0.001). CONCLUSIONS: Clinical repigmentation after gingival depigmentation is an outcome of histologic changes in the melanocyte activity and density of the melanin pigments. Surgical stripping for gingival depigmentation remains the gold standard; however, Er:YAG laser and CO2 lasers can be effectively used but with distinct differences.

Sensation information, self-instruction and responses to dental surgery.

The interaction effects of presurgery anxiety and two intervention strategies upon adjustment during dental surgery were examined. Patients undergoing gingivectomy (N = 113) were randomly assigned to one of four information groups: sensation, self-instruction, combined sensation and self-instruction, or control; and separated according to level of trait and state anxiety. Results showed an interaction effect between the information conditions and state anxiety (p less than .05). Compared with the control group, high state anxiety subjects reported less tension (p less than .05) and distress (p less than .05) after receiving sensation information; less tension (p less than .005) after receiving self-instruction information; and increased positive self-statements (p less than .05) with the combined information. Low-state anxiety subjects showed negative treatment effects; sensation information alone (p less than .001) or combined with self-instruction (p less than .01) reduced the number of reported positive self-statements.