scholarly journals Comparison between Scalpel and Laser technique for gingival depigmentation-A Split mouth study.

Author(s):  
Lashika Tambe ◽  
Rajesh Gaikwad ◽  
Chitra Patil ◽  
Shrutika B. Borade

INTRODUCTION An esthetic smile is a perfect balance between hard and soft tissues of the mouth. Gingiva plays an important role in the esthetic appearance of an individual. Gingival pigmentation is considered to be unaesthetic by patients, and it may have a psychological impact on them. Gingival depigmentation is a periodontal plastic surgery procedure, and variety of depigmentation techniques have been described in the literature. The aim of this study was to compare the efficacy of diode laser and scalpel in gingival depigmentation procedure. MATERIAL AND METHOD A total of 12 patients with age range between 20 -40 years were selected in the randamized, split mouth study. The maxillary arch was divided into two segments: 1.Segment I- right first premolar to right central incisors. 2.Segment II- left first premolar to left central incisors. These two segments were randomly assigned to surgical scalpel and diode laser techniques modalities. The research included the following clinical evaluation parameters at baseline and 3 months: Dummet Oral Pigmentation Index (DOPI) by Dummet and Gupta (1964)and VAS for pain. RESULTS There is clinically no significant difference between the Dummet Oral Pigmentation Index (DOPI)and Visual analogue scale for pain between Laser and Scalpel for gingival depigmentation. CONCLUSION Therefore, within the limitation of this study it can be concluded that scalpel technique is still considered the gold standard treatment for gingival depigmentation. KEY WORDS- diode laser, Visual analogue scale (VAS), Dummet Oral Pigmentation Index (DOPI).

2009 ◽  
Vol 16 (4) ◽  
pp. 233-236 ◽  
Author(s):  
MSM Mark ◽  
TTS Au ◽  
YF Choi ◽  
TW Wong

Objectives To determine whether the minimum clinically significant difference (MCSD) in visual analogue scale (VAS) pain score varies with age, gender, education level and cause of pain (trauma versus non-trauma) in Chinese patients. Methods This was a prospective descriptive study of local Chinese patients 15 years of age or older who presented with pain to the accident & emergency department. On presentation, patients were asked to indicate their current pain severity with a single mark through a standard 100–mm visual analogue scale. Then they would be offered an analgesic for pain-relief. After 30–45 minutes, the patients were asked to give a verbal categorical rating of their pain as ‘a lot better’, ‘a little better’, ‘much the same’, ‘a little worse’, or ‘much worse’ and to mark the level of pain on a VAS of the same type as used previously. The MCSD in VAS pain score was defined as the mean difference between the current and preceding scores when the subject reported ‘a little worse’ or ‘a little better’ in pain. Data were compared based on gender, age, education level, and traumatic versus non-traumatic causes of pain. Results 186 patients were enrolled in the study, yielding 77 evaluable comparisons where pain was rated as ‘a little better’ or ‘a little worse’. Overall, the MCSD in VAS pain score in the group was 17 mm (95%CI 13.6 mm to 20.6 mm). There were statistically significant differences between the MCSD in VAS pain score between genders and causes of pain (trauma versus non-trauma). Conclusions The MCSD in VAS pain scores was found to be 17 mm. There was significant differences in MCSD in VAS pain score in different genders and between trauma and non-trauma cases.


2009 ◽  
Vol 42 (02) ◽  
pp. 199-203
Author(s):  
A. O. Ademuyiwa ◽  
O. A. Sowande ◽  
O. Adejuyigbe ◽  
U. E. Usang ◽  
T. I. B. Bakare ◽  
...  

ABSTRACT Aim: To evaluate the cosmetic appearance of herniotomy wound scars closed using either the tissue glue or subcuticular suturing technique. Materials and Methods: Prospective randomised control study; randomisation into tissue glue and suturing groups. Ethical clearance obtained. Cosmetic outcome were based on visual analogue scale by parents and Hollander wound evaluation scale by a Plastic Surgeon blinded to the wound closure method. Results: Fifty one wounds were evaluated, 26 in the tissue glue group and 25 in the suturing group. Parents’ evaluation using Visual Analogue scale (VAS) showed that in the suturing group, 17 parents (68%) gave a VAS of 8cm while six parents (24%) gave a score of 7cm. Two parents (8%) gave a score of 9cm. In the tissue glue group, 22 parents (84.6%) scored the scar of their children as 8 or 9cm on the VAS while four parents (15.4%) gave a score of 7cm. The median VAS was 8cm for both groups with a range of 7 to 9cm. The Chi- square test showed that the parents preferred tissue glue compared with subcuticular suturing (X2 = 7.90, P < 0.05). The Hollander Wound Evaluation Scale (HWES) used by Plastic Surgeon showed 21 herniotomy wounds (84%) had a score of 6 in the suturing group while four wounds (16%) had a score of 5. In the tissue glue group, 19 wounds (73%) had a score of 6, six wounds (23.1%) had a score of 5 and a patient (3.8%) had a score of 4. The median score is 6 for both groups. There was no statistically significant difference between both groups (X2 = 1.481, P = 0.393). Conclusion: This study has shown that the cosmetic outcome of wound closure using the tissue glue technique and subcuticular suturing technique are similar.


Author(s):  
Erika Michele dos Santos Araújo ◽  
Bárbara Fávero Araújo Lima ◽  
Júlia Gomes Lúcio de Araújo ◽  
Fernanda Cristina Nogueira Rodrigues ◽  
Stella Ferreira do Amaral ◽  
...  

Objective: This case report proposes a treatment for dentin hypersensitivity (DH) using photobiomodulation (PBT) with low power diode laser. Methods and Results: Male patient, 28 years old, reporting “dental sensitivity,” diagnosed by anamnesis and intraoral examination, with non-carious cervical lesions (NCCL) and DH on teeth 15 to 25, with different pain intensities, measured with visual analogue scale (VAS). For DH treatment, a PBT was proposed, with 808nm, 100mW, 20s and 2J of energy, applied during 3 sessions, with one-week interval and reevaluation after 30 days. After the first session, the patient reported improvement of sensitivity in all teeth, except for 15, that remained sensitive even during the reevaluation. Conclusion: PBT was effective in DH treatment, with desensitization being observed for 30 days in 90% of treated teeth.


2019 ◽  
Vol 10 (1) ◽  
pp. 13-18
Author(s):  
Shivjot Chhina ◽  
Abhishek Gakhar ◽  
Stuti Gupta ◽  
Shradha ss ◽  
Ejya Sharma ◽  
...  

Oral melanin pigmentation is a ubiquitous presentation in the oral cavity. It could be a cause of psychological distress to many subjects due to aesthetic reasons. Aims and Objectives: This study attempts to compare the laser and scalpel depigmentation techniques. It also includes a comparison related to the Visual Analog Scale, patient comfort, healing response and time taken for the procedure and recurrence of pigmentation. Materials and Methods: A total of 10 patients were included in the study. A split-mouth approach comparing the scalpel technique with that of the diode laser technique was planned. Results and Conclusion: The results of the present study revealed that both laser and scalpel techniques are equally effective for depigmentation, yielding aesthetic results.


2019 ◽  
Vol 10 (2) ◽  
pp. 131-138
Author(s):  
Leila Jokar ◽  
Mojtaba Bayani ◽  
Hamid Hamidi ◽  
Mohammad Keivan ◽  
Saranaz Azari-Marhabi

Introduction: Gingival hyperpigmentation is excessive deposition of melanin pigments in the epithelium of gingiva which affects facial esthetics. Various surgical methods for gingival depigmentation have been used to treat the darkened color of pigmented gingiva. This study compared the use of 940 nm diode laser and liquid nitrogen cryosurgery in the treatment of gingival physiologic hyperpigmentation in terms of gingival depigmentation, postoperative pain, healing duration, pigmentation recurrence, and patients’ satisfaction. Methods: Fifteen systemically healthy patients (11 females and 4 males; 17-35 years of age) with bilateral gingival physiologic hyperpigmentation were enrolled in this split-mouth randomized study. Maxillary anterior labial gingiva of each patient was divided into left and right halves, and each half was randomly depigmented by either laser or cryosurgery. Patients were given questionnaires to evaluate the procedures and were followed up in 3, 7, 10, 17 and 21 days postoperatively for the assessment of gingival healing and 1, 3, 6 and 12 months after the treatments to detect any sign of pigmentation recurrence. Results: The severity of post-op pain measured by visual analogue scale (VAS) was mild to average and showed no significant difference between the 2 modalities (P>0.05). There was no considerable swelling or hemorrhage after the treatment procedures and the healing duration was significantly shorter in laser (P<0.05). The degree of pigmentation in all gingival sites treated by laser reached and remained at zero until the last follow up (1 year) and reached zero in 9 out of 15 cryosurgerytreated sites. All patients were completely satisfied with the laser, and 9 out of 15 were completely satisfied with cryosurgery. No pigmentation recurrence was observed during any follow-up periods. Conclusion: Removal of gingival physiologic hyperpigmentation by laser therapy and cryotherapy was effective and safe. The efficiency of the laser was better than cryotherapy.


2019 ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  

Abstract Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: A prospective cohort study was carried out, and only women who underwent cesarean deliveries under spinal anesthesia were included. Postoperative patient-controlled intravenous analgesia was performed for all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen, and the pump was programmed as 2.0 mL/h background infusion, and loading dose of 1 mL with a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using visual analogue scale, and inadequate analgesia was defined as visual analogue scale ≥40 during the postoperative 48 hours. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: From January to May 2017, a total of 168 patients (67 primipara and 101 multipara) were included. The relative risk for multipara to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primipara. In patients under 30 years old, inadequate analgesia on visceral pain in the multipara was higher than that on the primipara (RR, 3.56 [1.05 to 12.04], P=0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). No difference was found in PCIA consumption between two groups. (111.1 ± 36.0mL vs. 110.9 ± 37.3mL, P=0.979) Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (62.2%vs.37.7%, P=0.011). Conclusions: Multipara who underwent first repeat cesarean section have lower risk to experience inadequate analgesia on incision pain during the first 48 hours after surgery compared to primipara. While multipara under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  

Abstract Background The differences in post-operative pain are unclear between the primiparas who underwent a primary cesarean section and multiparas who underwent their first repeat cesarean section. The study aimed to explore the possible differences in postoperative pain between primiparas and multiparas. Methods A prospective cohort study was performed only including women who underwent cesarean deliveries under spinal anesthesia. Postoperative patient-controlled intravenous analgesia (PCIA) was administered to all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen; the pump was programmed as 2.0 mL/h background infusion with a loading dose of 1 mL and a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using the visual analogue scale, and inadequate analgesia was defined as a visual analogue scale score ≥ 40 during 48 h post-operation. Additionally, the patients’ pain statuses in postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results From January to May 2017, a total of 168 patients (67 primiparas and 101 multiparas) were included. The relative risk for multiparas to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primiparas. In patients aged < 30 years, inadequate analgesia on visceral pain was higher in multiparas than in primiparas (RR, 3.56 [1.05 to 12.04], P = 0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multiparas and primiparas (33.7% vs. 40.2%, P = 0.381). No difference was found in PCIA use between the two groups (111.1 ± 36.0 mL vs. 110.9 ± 37.3 mL, P = 0.979). In addition, a significantly higher incidence of pain was noted 4 weeks post-surgery in primiparas than that in multiparas (62.2% vs. 37.7%, P = 0.011). Conclusion Multiparas who underwent their first repeat cesarean section have a lower for inadequate analgesia on incision pain during the first 48 h after surgery than primiparas. Multiparas aged under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain. Trail Registration ClinicalTrial.gov: NCT03009955, Date registered: December 30, 2016.


2016 ◽  
Vol 31 (7) ◽  
pp. 463-470 ◽  
Author(s):  
Carina EG van Zandvoort ◽  
Irwin M Toonder ◽  
Irma AJ Stoopendaal ◽  
Cees HA Wittens

Objectives To determine whether audio and visual distraction can affect the pain perception of a patient undergoing endovenous thermal ablation under tumescent anesthesia. Methods Patients underwent an endovenous thermal ablation procedure and were randomized into two groups: non-distraction (AVD−) and with distraction (AVD+). Visual analogue scale pain score and hospital anxiety depression scale scores were used to measure outcome. The recruited patients were asked to submit an anticipated visual analogue scale pain score prior to treatment as well as the actual experienced post-operative visual analogue scale pain score. Results There was no significant difference between the AVD− and AVD+ groups post-operative pain score 2.85 (SD 1.7) versus 2.60 (SD 2.3), p = 0.68. Pain score in women with distraction (AVD+) decreased from 3.81 to 2.42. The pain score in men with distraction (AVD+) increases from 1.88 to 2.82. In the AVD− group, a significant difference was found between men and women ( p = 0.014). Disregarding gender, a significant difference was found between the anticipated pain score and the actual pain score in both the AVD− group ( p = 0.009) and AVD+ group ( p = 0.021). There was a correlation between depression and the pain score, which was not seen between pain and anxiety score. Conclusion The results suggested that audiovisual distraction has no influence on the visual analogue scale pain score during endovenous thermal ablation under tumescent anesthesia. Despite this, patients appreciate and evaluate audio and visual distraction as pleasant to extremely pleasant when applied.


2015 ◽  
Vol 20 (2) ◽  
pp. 107-111 ◽  
Author(s):  
Bekir Serdar Unlu ◽  
Mehmet Yilmazer ◽  
Gulengul Koken ◽  
Dagistan Tolga Arioz ◽  
Ebru Unlu ◽  
...  

BACKGROUND: Hysterosalpingography (HSG) is the most commonly used method for evaluating the anatomy and patency of the uterine cavity and fallopian tubes, and is an important tool in the evaluation of infertility. The most frequent side effect is the pain associated with the procedure.OBJECTIVES: To evaluate four analgesic methods to determine the most useful method for reducing discomfort associated with HSG.METHODS: In the present prospective study, 75 patients undergoing HSG for evaluation of infertility were randomly assigned to four groups: 550 mg of a nonsteroidal anti-inflammatory drug (NSAID) (group 1); 550 mg NSAID + paracervical block (group 2); 550 mg NSAID + paracervical analgesic cream (group 3); or 550 mg NSAID + intrauterine analgesic instillation (group 4). A visual analogue scale was used to assess the pain perception at five predefined steps.RESULTS: Instillation of the liquids used for HSG was found to be the most painful step of HSG, and this step was where the only significant difference among groups was observed. When comparing visual analogue scale scores, group 2 and group 3 reported significantly less pain than the other groups. Group 1 reported significantly higher mean ( ± SD) scores (7.2 ± 1.6) compared with groups 2 and 3 (4.7 ± 2.5 and 3.8 ± 2.4, respectively) (P<0.001). In addition, group 2 reported significantly less pain than group 4 (4.7 ± 2.5 versus 6.7 ± 1.8, respectively) (P<0.02).CONCLUSIONS: For effective pain relief during HSG, in addition to 550 mg NSAID, local application of lidocaine cream to the posterior fornix of the cervix uteri and paracervical lidocaine injection into the cervix uteri appear to be the most effective methods.


2016 ◽  
Vol 9 (3) ◽  
pp. 296 ◽  
Author(s):  
Reddy Nagati Raghavendra ◽  
M. Ragul ◽  
Al-Qahtani Nabeeh ◽  
K. S. Ravi ◽  
S. Tikare ◽  
...  

<p>Excessive gingival pigmentation is a major aesthetic concern in modern society, though it is not a medical problem they consider it as a negative attribute. Patients with gingival hyperpigmentation usually complain and request cosmetic therapy, particularly if the pigmentation is visible during speaking and smiling. Various depigmentation methods, including burr abrasion, cryosurgery, electro-surgery, split thickness flap excision and surgical scraping techniques have been used with varying degrees of success. Recently, lasers have been used to ablate cells containing and producing the melanin pigment. The present study was undertaken to compare the clinical effectiveness and patient comfort of surgical scrapping and diode laser technique used for gingival depigmentation for a follow up period of 6 months.20 subjects participated in this split mouth study. The clinical evaluation parameters included Extent and Intensity of gingival hyperpigmentation, post-operative gingival bleeding and pain. On follow up examination at 6<sup>th</sup> month there was no statistical difference in repigmentation extent and intensity between diode laser and surgical scraping techniques. The mean pain scores for treated sites with diode laser were significantly lower than surgical scrapping technique at 24 hours (t-value=2.430, p-value=0.02). The postoperative gingival bleeding at end of procedure was significantly lower with diode laser than surgical scrapping technique (p-value=&lt;0.0001). There was no statistical difference in postoperative re-pigmentation and clinical efficacy among the subjects between surgical scraping and diode laser technique at 6<sup>th</sup> month follow up. Diode laser technique provides better haemostasis and good visibility at the surgical site. The post-operative patient comfort is better at the surgical sites treated with diode laser than surgical scrapping method. Hence, both the techniques are used for depigmentation procedures depending on the severity and gingival biotype and patient acceptance.</p>


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