scholarly journals Comparison of Diode Laser and Conventional Method in Treatment of Gingival Melanin Hyperpigmentation

Author(s):  
Revan Birke Koca-Ünsal ◽  
Gökhan Kasnak ◽  
Erhan FIRATLI

Purpose: The goal of this study is to compare the scalpel and diode laser methods for treating gingival hyperpigmentation in terms of postoperative discomfort and wound healing. Materials & Methods: Sixteen systemically healthy individuals diagnosed with light or moderate gingival hyperpigmentation were enrolled for this study. Patients were randomly assigned to one of two treatment groups: scalpel or laser. Dummett’s oral pigmentation index was recorded at baseline. Early wound healing and post-operative discomfort were evaluated on the 7th day by using the VAS form. Comparisons between the groups were tested using the Mann-Whitney U test and P-value < 0.05 was considered significant. Results: Total epithelization was observed in the laser group, whereas the epithelization was incomplete in the scalpel group at the end of the observation period. The pain perception on the first two days after the surgery was significantly higher in the scalpel group than in the laser group. (p=0,002 and p=0,038, respectively). No significant differences were found between the fourth- and seventh-day when surgical techniques were compared regarding pain perception (p>0,05). Similarly, pain perceptions of female and male individuals showed no significant difference (p>0,05). Conclusion: In the treatment of gingival hyperpigmentation, both surgical techniques were clinically successful. Although the treatment process was long, according to the results of our study, the laser technique is superior to the scalpel method in terms of patient comfort. The choice of the method may vary depending on the available equipment and the clinician’s preference or request of the patient.

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>


2021 ◽  
Author(s):  
Ameer A. Alaqeedy ◽  
Rasheed Ali Rashid ◽  
Raid M. Al-Ani

Abstract Introduction: The study aimed to compare the 2 procedures of tonsillectomy (coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications. Materials and Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Data concerning the age, gender, indications for tonsillectomy, operative time, the amount of the blood loss, post-tonsillectomy pain by VAS scores, and other complications were recorded for each patient. Results: Out of 62 participants, there were 34 (54.8%) females. The majority were from the age group ≤18 years (n=54, 87.1%). The operative time and amount of the intraoperative blood loss were significantly lower in the coblation than a diode laser tonsillectomy. However, the postoperative pain scores in the diode laser were a statistically significant difference less than the coblation group at the periods 3 hours, 8 hours, 24 hours, and 7 days (P-value<0.05). While there was no statistically significant difference between the two groups at 2 weeks postoperative period (P-value=0.392). No primary or secondary postoperative bleeding in all patients. Conclusion: coblation was better than diode laser because of shorter operative time and less intraoperative blood loss. However, the diode laser technique had lesser postoperative pain at the postoperative periods 3 hours, 8 hours, 24 hours, and 7 days than coblation.


1986 ◽  
Vol 95 (2) ◽  
pp. 210-212 ◽  
Author(s):  
Charles M. Stiernberg ◽  
R. Mark Williams ◽  
James A. Hokanson

Recent clinical studies have shown that adjuvant chemotherapy may improve response rates to treatment for advanced head and neck carcinomas. Given preoperatively, some chemotherapeutic agents adversely affect wound heallng. The specific purpose of this study was to evaluate the Influence of cisplatin on wound healing when it is given preoperatively. Forty-four Swiss outbred mice were divided into control and treatment groups. One week before surgery, the treatment group received cisplatin (2 mg/ kg body weight) by subcutaneous injections on 2 consecutive days. Each control animal was given an equal volume of normal saline. A 1.5 cm transverse incision was made in each animal, and wounds were closed with surgical staples. The mean woundbreaking strength was determined for a minimum of 5 treatment and 5 control mice on postoperative days 6, 10, 13, and 16. Serum creatinine, blood cell counts, and changes in weight were also monitored. Results showed wound strength on postoperative day 10 to be significantly reduced in mice treated with cisplatin (P < 0.05). There was no significant difference for wound strength on any other days and all other variables were simllar between both groups. In conclusion, cisplatin has an adverse effect on wound healing, the peak of which probably occurs during the proliferative stage of wound healing. Further studies are needed to determine the optimal time for surgery after preoperative chemotherapy. All new chemotherapeutic agents, particularly those being considered in a preoperative regimen, should be tested in this manner.


2018 ◽  
Vol 12 (5) ◽  
pp. 509-514 ◽  
Author(s):  
M. Troy ◽  
B. Shore ◽  
P. Miller ◽  
S. Mahan ◽  
D. Hedequist ◽  
...  

Purpose To compare two common surgical techniques of epiphysiodesis: drill/curettage epiphysiodesis (PDED) versus cross screw epiphysiodesis (PETS). The hypothesis is that the two techniques have similar efficacy but demonstrate differences in length of hospital stay (LOS), time to return to activity and complication rates. Methods A retrospective review of growing children and adolescents less than 18 years old who required an epiphysiodesis with leg-length discrepancy (LLD) of 2 cm to 6 cm with minimum two years of follow-up was conducted. Characteristics including age at surgery, gender, epiphysiodesis location, side, operative time, LOS and hardware removal were compared across treatment groups. LLD, expected growth remaining (EGR) and bone age were determined preoperatively and at most-recent visit. The correction ratio (change in EGR) was calculated along with a 95% confidence interval (CI) to assess if correction in leg length was achieved. Results A total of 115 patients underwent epiphysiodesis in the femur (53%), tibia (24%) or a combination (24%). The cohort was 47% male, with a mean age of 12.6 years (7.7 to 17.7) at surgery. Median follow-up was 3.7 years (2.0 to 12.7). In all, 23 patients underwent PETS and 92 patients had PDED. Both treatment groups achieved expected LLD correction. There was no significant difference in median operative time, complication rates or LOS. PETS patients returned to activity at a mean 1.4 months (interquartile range (IQR) 0.7 to 2.1) while PDED patients returned at a mean 2.4 months (IQR 1.7 to 3) (p < 0.001). Conclusion Effectiveness in achieving expected correction, LOS and operative time are similar between screw and drill/curettage epiphysiodesis. Patients undergoing PETS demonstrated a faster return to baseline activity than patients with PDED. Level of Evidence: III


2018 ◽  
Vol 1 (2) ◽  
pp. 1-17
Author(s):  
Fahcreza ◽  
Elsa Iskandar ◽  
Rachmat Hidayat ◽  
Petty Purwanita ◽  
Anang Tribowo ◽  
...  

Abstract Background: Chemical trauma to the cornea is an emergency condition of the eye that requires early diagnosis and good treatment. Alkaline have ability to saponify fatty acids in cells and cell membranes which can make penetration into the stroma and destroy proteoglycans and collagen in cells. Aloe vera (AV) contains several active substances that are reported to have anti-inflammatory, immunomodulatory, and wound healing effects. AV has been reported to accelerate the healing process of corneal epithelial defects by increasing fibroblast proliferation, collagen production and growth factor production. This study aims to determine the difference between the effect of aloe vera extract with a concentration of 10%, 20%, 40% and BSS on the healing of extensive corneal lesions in white wistar rats alkaline trauma models. Method: This study was an experimental study with a pre and posttest only with control group design in vivo approach to 30 Wistar white rats which were divided into 5 treatment groups for 3 days. Comparative analysis of effectiveness using the ANNOVA test or the Kruskal Wallis test and continued by the post hoc test. Results: Based on the one way ANOVA test there was a statistically significant difference in effectiveness between the five treatment groups on the percentage of corneal wound healing area and TGF-β expression with an assessment of p = 0,000 each. The administration of alloevera (AV) concentration of 20% had a significant difference in percentage of healing of corneal lesions and TGF-β expression compared with other treatment groups with p = 0,000 each. Large differences in the area of corneal lesions in the 40% AV group were -0.45 in the BBS group, 0.146 in the 10% AV group, 0.493 in the 20% AV group. The difference in the AV group 10% was 0.30 in the BBS group, -064 in the AV group 20%, and -0.14 in the AV group 40%. However, TGFβ expression in the normal control group that did not receive treatment was 54.94 (53.21-56-12). TGFβ levels in the BSS group were 10.44, the 10% aloe vera group was 25.43, 47.99 for the 20% aloe vera group and 37.95 for the 40% aloe vera group. Conclusion: There is a difference between the effect of aloe vera extract with concentrations of 10%, 20%, 40% and BSS on the extensive healing of corneal lesions in white wistar rats with alkaline chemical trauma models.


e-GIGI ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Lidia A. Kewo ◽  
Damajanty H.C. Pangemanan ◽  
Aurelia Supit

Abstract: To date, there are lots of documentations about the adverse effects of smoking on the oral cavity. Albeit, smoking is still considered as a casual thing in our community. Chemicals contained in the cigarette smoke can irritate the gums and soft tissues of the mouth, thus inhibiting wound healing after tooth extraction. This study was aimed to determine the difference in post-extraction dental wound healing between smokers and non-smokers. This was a comparative analytical study with a cross sectional design. Samples were obtained by using total sampling method. Subjects consisted of 16 smokers and 16 non-smokers that fulfilled the study eligibility criteria. Their oral cavities were examined to check the signs of inflammation (calor, dolor, rubor, tumor, and functio laesa). The results showed that there was a difference in post-extraction wound healing in inflammatory phase between smokers and non-smokers. As many as 9.4% of smoker patients and 34.4% of non-smoker patients recovered at 7 days post extraction. The Mann Whitney U test showed a p-value of 0.005. In conclusion, there was a significant difference in post-extraction wound healing between smokers and non-smokers.Keywords: smokers, non-smokers tooth extraction, wound healing Abstrak: Kebiasaan merokok bukan merupakan hal asing di masyarakat walaupun banyak dokumentasi mengenai akibat buruk dari merokok terhadap rongga mulut. Bahan kimia yang terdapat dalam asap rokok dapat mengiritasi gusi dan jaringan lunak mulut sehingga menghambat penyembuhan luka pasca ekstraksi gigi. Penelitian ini bertujuan untuk mengetahui perbedaan penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan bukan perokok. Jenis penelitian ialah analitik komparatif dengan desain potong lintang. Pengambilan sampel menggunakan total sampling yang memenuhi kriteria penelitian. Terdapat sebanyak 16 orang perokok dan 16 orang bukan perokok sebagai subyek penelitian. Pemeriksaan rongga mulut dilakukan untuk melihat tanda-tanda inflamasi (kalor, dolor, rubor, tumor, dan fungsio laesa). Hasil penelitian menunjukkan terdapat perbedaan penyembuhan luka 7 hari pasca ekstraksi gigi pada fase inflamasi antara pasien perokok dengan yang bukan perokok; sebanyak 9,4% pasien perokok dan 34,4% pasien bukan perokok yang sudah sembuh. Hasil uji Mann Whitney U mendapatkan nilai p=0,005. Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan yang bukan perokokKata kunci: perokok, bukan perokok, ekstraksi gigi, penyembuhan luka


2020 ◽  
Vol 11 (2) ◽  
pp. 126-134
Author(s):  
Narges Naghsh ◽  
Mahdi Kachuie ◽  
Marzie Kachuie ◽  
Reza Birang

Introduction: Dentin hypersensitivity is a common oral problem that occurs as a short and sharp pain. There are many techniques to treat this condition, the latest of which is laser treatment. The aim of this study was to evaluate the effect of two types of low-power diode lasers (660 nm and 810 nm) on dentin hypersensitivity in order to achieve an acceptable clinical application by adjusting the effective parameters. Methods: In this randomized, double-blind clinical trial, sensitive teeth of 7 patients were divided into three groups with a randomized matching method: group I, treated with 660-nm diode laser irradiation, group II, treated with diode laser 810-nm, and group III, the control group. Irradiation parameters for 660-nm and 810-nm diode lasers were the power of 30 mW and 100 mW respectively, in contact and continuous modes, perpendicular to the tooth surface with a sweeping motion. Treatments were carried out in four sessions at weekly intervals. The data obtained were analyzed with SPSS 22, using one-way repeated measures ANOVA and the LSD (least significant difference) test. The significance level was considered as P≤0.05. Results: There were no significant differences in visual analogue scale (VAS) score changes between the two laser groups after the intervention in the first, second and third weeks compared to the baseline (P>0.05). These changes in the fourth week were significantly higher in the 810-nm laser group compared to the 660-nm laser group (P=0.04), and in the 660-nm laser group, they were more than the control group (P=0.02). The mean VAS scores at 1-week, 1-month and 2-month postoperative intervals were significantly lower in the 810-nm laser group than in the 660-nm laser group, and in the 660-nm laser group, they were less than the control group (P<0.001). Conclusion: The use of 660-nm and 810-nm diode lasers with the power of 30 and 100 mW respectively for 120 seconds was effective in reducing pain in patients with dentin hypersensitivity. However, the effect of the 810-nm laser on reducing the dentin hypersensitivity was more long-lasting than that of the 660-nm laser.


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 35 (11) ◽  
pp. 1153-1161 ◽  
Author(s):  
Jatinder Grewal ◽  
Anna-Liisa Sutt ◽  
George Cornmell ◽  
Kiran Shekar ◽  
John Fraser

Purpose: Patients supported with extracorporeal membrane oxygenation (ECMO) have been reported to have increased sedation requirements. Tracheostomies are performed in intensive care to facilitate longer term mechanical ventilation, reduce sedation, improve patient comfort, secretion clearance, and ability to speak and swallow. We aimed to investigate the safety of tracheostomy (TT) placement on ECMO, its impact on fluid intake, and the use of sedative, analgesic, and vasoactive drugs. Methods: Prospective data were collated for all ECMO patients over a 5.5-year period. Data included the cumulative dose of sedatives and analgesics, fluid balance, inotrope and vasopressor requirements, and number of packed red cell (PRC) units transfused. Data were analyzed to determine the differences in the aforementioned between 5 days pre-TT and post-TT insertion. Results: Thirty-one (22.1%) of 140 patients underwent TT while on ECMO in the study period. Inotrope and vasopressor use was significantly less in the post-TT period compared to pre-TT dose ( P value = .01). This was in the setting of Sequential Organ Failure Assessment scores the day before TT placement being significantly greater than those on days 2, 3, and 4. There was a trend toward reduction in analgesic usage in the post-TT period. No major complications of TT were reported. There was no significant difference ( P value = .46) in the amount of PRC used post-TT. Conclusions: These data indicate that TT may result in a reduction in vasopressor and inotropic requirement. Data do not suggest increased major bleeding with placement of TT in patients on ECMO. The potential risk and benefits of inserting a TT in ECMO patients need further validation in prospective clinical studies.


2017 ◽  
Vol 5 (1) ◽  
pp. 281
Author(s):  
Amandeep Singh ◽  
Gurdhian Singh ◽  
Darsshan Singh Sidhu ◽  
Mohit Bhalla

Background: An abscess is a common surgical condition. Abscesses may occur anywhere in the body. Surgical treatment of subcutaneous and soft tissue abscesses includes percutaneous aspiration, incision and drainage without primary closure, incision and drainage with primary closure with drain. The present study was planned to compare conventional method of incision and drainage with incision and drainage with primary closure in cases of acute -abscesses.Methods: A total of 100 patients with acute abscesses were included in the study and randomized into 2 groups with 50 patients in each group. The present study was carried out to compare the conventional method of incision and drainage with incision and drainage with primary closure of the wounds in acute abscesses with regards to wound healing, post- operative pain, duration of hospital stays and recurrence rates.Results: Wound healing was significantly faster in incision and drainage with primary closure (9.18±0.941days) as compared to conventional method of incision and drainage (16.66±1.944 days) [p <0.05]. Mean hospital stay with convention method of incision and drainage was 7.12±0.718 days and with primary closure was 4.0±0.728days (p <0.05). Mean VAS was significantly less in primary closure as compared with conventional method. Decreasing trend in VAS was observed on day 3, day 5 and day 7 (p value 0.000). Recurrence rate of an abscess was seen in 5 cases in conventional method and 2 cases in primary closure (p >0.05).Conclusions: Author have observed a significant difference noted in time taken for wound healing, postoperative pain, hospital stay and recurrence rate between two groups.


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