scholarly journals Clinical Effectiveness of Gingival Depigmentation Using Conventional Surgical Scrapping and Diode Laser Technique: A Quasi Experimental Study

2016 ◽  
Vol 9 (3) ◽  
pp. 296 ◽  
Author(s):  
Reddy Nagati Raghavendra ◽  
M. Ragul ◽  
Al-Qahtani Nabeeh ◽  
K. S. Ravi ◽  
S. Tikare ◽  
...  
Keyword(s):  
Diode Laser ◽  
Statistical Difference ◽  
Clinical Effectiveness ◽  
Patient Comfort ◽  
Patient Acceptance ◽  
P Value ◽  
Laser Technique ◽  
Gingival Bleeding ◽  
Gingival Depigmentation

<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>

scholarly journals Assessment of Clinical Outcomes and Patient Response to Gingival Depigmentation by Scalpel Surgical Stripping and Diode Laser: A Randomized Split-Mouth Study

2019 ◽  
Vol 10 (1) ◽  
pp. 13-18
Author(s):  
Shivjot Chhina ◽  
Abhishek Gakhar ◽  
Stuti Gupta ◽  
Shradha ss ◽  
Ejya Sharma ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Oral Cavity ◽  
Diode Laser ◽  
Patient Comfort ◽  
Laser Technique ◽  
Analog Scale ◽  
Patient Response ◽  
Melanin Pigmentation ◽  
Aesthetic Results ◽  
Gingival Depigmentation

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.

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

2021 ◽  
Author(s):  
Revan Birke Koca-Ünsal ◽  
Gökhan Kasnak ◽  
Erhan FIRATLI
Keyword(s):  
Wound Healing ◽  
Diode Laser ◽  
Pain Perception ◽  
Surgical Techniques ◽  
Patient Comfort ◽  
P Value ◽  
Laser Technique ◽  
Treatment Groups ◽  
Significant Difference ◽  
Laser Group

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.

scholarly journals A Comparison of 940 nm Diode Laser and Cryosurgery With Liquid Nitrogen in the Treatment of Gingival Physiologic Hyperpigmentation Using Split Mouth Technique: 12 Months Follow Up

2019 ◽  
Vol 10 (2) ◽  
pp. 131-138
Author(s):  
Leila Jokar ◽  
Mojtaba Bayani ◽  
Hamid Hamidi ◽  
Mohammad Keivan ◽  
Saranaz Azari-Marhabi
Keyword(s):  
Liquid Nitrogen ◽  
Diode Laser ◽  
Randomized Study ◽  
Facial Esthetics ◽  
Surgical Methods ◽  
Significant Difference ◽  
Treatment Procedures ◽  
Gingival Depigmentation ◽  
Better Than

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.

Interface pressures with compression systems: relevance to clinical practice

2019 ◽  
Vol 24 (Sup10) ◽  
pp. S32-S35
Author(s):  
Jeanette Muldoon
Keyword(s):  
Clinical Practice ◽  
Clinical Effectiveness ◽  
Patient Comfort ◽  
Patient Acceptance ◽  
Related Factors ◽  
Treatment Regimens ◽  
Correct Application ◽  
The Right ◽  
Instructions For Use ◽  
Interface Pressures

Interface pressures with compression depend on many factors relating to the science of measurement and intrinsic, patient-related factors, including limb size and tissue texture. While it is important for manufacturers of compression devices to measure pressures, it may not always be relevant to clinical practice where application methods and oedematous limbs may affect final pressures. Accurate performance of any compression system relies on the use of the right technology for the right condition and patient lifestyle. Correct application following training and in accordance with instructions for use may be adapted according to individual patient comfort and needs, including mobility, tissue texture and the stage of management. In order to provide treatment regimens that are safe, effective and well tolerated by patients, as well as being easy to apply and demonstrate sound economic practice, science needs to meet clinical practice. Patient reporting is an important for successful treatment, matching clinical effectiveness with patient acceptance during reassessment and monitoring.

scholarly journals Comparative Study between Modified Transverse and Hayman Suture Regarding the Efficacy and Purperium Complications in Thi-Qar

2021 ◽  
pp. 22-33
Author(s):  
Aseel Mosa Jabber
Keyword(s):  
Statistical Difference ◽  
Post Partum ◽  
High Rate ◽  
P Value ◽  
Post Partum Hemorrhage ◽  
Significant Statistical Difference ◽  
Surgeon Experience ◽  
Compression Suture ◽  
Uncontrolled Hemorrhage

Background: Main causes of death post-partum is the uncontrolled hemorrhage, that managed by different modalities, whereuterine compression suture had different efficacies as a main interventional tools of sever postpartum hemorrhage. Aim: comparing different sutures types (modified transverse and Hayman suture) regarding their efficacy through its impact and in determining the final outcome and complications of post-partum hemorrhage. Materials and methods: A prospective comparative analytical study including 122 females , who underwent delivery between march 2017and December 2019, all of them followed for , 1 week, 6,weeks 6 months. Were the samples collected from Bent-Al-Huda teaching hospital and Al-Rehman private hospital-Thi-Qar, 2 groups of study; 1st one (52) underwent modified B-lynch suturing (Hyman suturing) while the 2nd group(70) underwent transverse sutures of modified Ouahba suture, written consent had taken from all patients, SPSS version 24 used for analysis. Results: Among 122 delivered women suffer from primary post-partum hemorrhage, 52 (42.63%) were sutured by Hayman suture, and 70 (57.37%)were sutured by transverse suturing,There was significant statistical difference between the types of intervention and blood loss P value <0.05. There was significant statistical difference between the types of intervention and complication development (p value=0.0001). There was no significant independent predictors or determinant for the complication development except the type of intervention. Only follow-up period and complication were truly to be correlated with type of intervention, the other variable were confounders Conclusion: Even though the hemostasis had been achieved in both maneuver with excellent success rate, the transvers suture carrying high rate of persistent pain but the Hayman suture carry higher rate of serious complication such hysterectomy and intestinal obstruction. several factors determine the choosing of the suture type such as site, severity and cause of bleeding and the surgeon experience.

Comparative Evaluation of Gingival Depigmentation by Diode Laser and Cryosurgery Using Tetrafluoroethane: 18-Month Follow-Up

2012 ◽  
Vol 2 (3) ◽  
pp. 129-134 ◽  
Author(s):  
Vishal Singh ◽  
Subraya Bhat Giliyar ◽  
Santhosh Kumar ◽  
Mahalinga Bhat
Keyword(s):  
Diode Laser ◽  
Comparative Evaluation ◽  
Gingival Depigmentation

scholarly journals AB1305-HPR IS BETTER AND SAFER TOFACITINIB AS A FIRST LINE OF TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS? – A COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1943.2-1943
Author(s):  
O. Valencia ◽  
M. Cabrera ◽  
F. Rodriguez ◽  
P. Santos-Moreno
Keyword(s):  
Adverse Events ◽  
Disease Activity ◽  
Statistical Difference ◽  
Extended Release ◽  
The Other ◽  
P Value ◽  
Second Line ◽  
First Line ◽  
Extended Release Tablet

Background:Tofacitinib is the first oral Janus Kinasa inhibitor approved for the treatment of rheumatoid arthritis (RA); and although it is approved both after conventional treatment and after biological therapy, it is not well known its real-life effectiveness in both cases and if it is preferable to use it after cDMARDs or biologics.Objectives:We compare the effectiveness and safety of Tofacitinib in patients with RA analyzing if better and safer Tofacitinib after cDMARDs or biologics.Methods:A retrospective analysis of a real-world cohort of patients with RA, who were treated with Tofacitinib in last 3 years, as first line of treatment (T1) after failure with cDMARDS and second line of treatment after biologic drug failure (T2). The therapy was considered effective with the change from moderate-high disease activity to low disease activity or remission measured by DAS28, in those who met criteria of high adherence, without change or addition of other conventional DMARDs, without new dose or increase of dose of oral glucocorticoids. A logistic model of regression was performed to evaluate de differences between T1 and T2, using as covariates sex, age, comorbidities, time of disease evolution, adverse events and other causes of discontinuation. Medication survival time and the main causes of suspension were measured. Mixed model regression and least-squared means were used to estimate the baseline changes and a Kaplan-Meyer survival analysis to estimate time to remission and drug survival.Results:105 patients with RA were included (median age: 56.1 ± 11.7 years; 80.9% female, median disease duration 11.48 ± 10.1 years); 43% (45/105) of patients with positive rheumatoid factor and 73% (77/105) positive anti-citrulline antibodies. Regarding treatment 51% (54/105) used Tofacitinib as 1T, after failure to cDMARDs; on the other hand, Tofacitinib was used as 2T, after failure to biologics in 49% (51/105) of patients. DAS28 levels were reduced at 8, 16 and 24 weeks with statistical difference (p value 0.004, <0.0001, and <0.001, respectively). HAQ-DI also reported reduction but without statistical difference. The use of Tofacitinib was more effective after failure to cDMARDs (p value 0.014) and patients with more than 3 years of disease (p value 0.04), a statistically better response. Also, corticoids use, positive RF, extended release tablet of tofacitinib reported better changes of DAS28 but without statistical significance. Patients with high disease activity treated with Tofacitinib 1T decreased from 30% at baseline to 19% at the last follow-up; patients in 2T way were in moderate activity of the disease in 57% at baseline and went to 37% in the last follow-up. There was an increase in patients who achieved remission in both groups, but higher in 1T where they went from 9% to 41%, while in 2T they went from 22% to 33% (p < 0.05). The survival rate of the medication was 1.7 years in 1T and 2.1 in 2T; in terms of time to remission, the use of Tofacitinib monotherapy presented statistical difference (p value <0.001). The main cause of suspension of treatment was therapeutic failure 12% (13/105), 9% in 1T (5/54) and 16% (8/51) in 2T (p <0.005). 6% of patients (6/105) presented suspension due to the occurrence of adverse events, 4% (2/54) in 1T and 8% (4/51) in 2T (p <0.005).Conclusion:In patients with RA, the use of Tofacitinib as the first line of treatment (after failure to cDMARDs) is better in effectiveness and safer in comparison with its use as a second line of treatment (after biologics), with significant differences in the rates of therapeutic failure and occurrence of adverse events/reactions. On the other hand, concomitant corticoids use, positive RF, extended release tablet of Tofacitinib seem to increase the effectiveness of Tofacitinib in terms of DAS28 and HAQ-DI.Disclosure of Interests:Omaira Valencia: None declared, Michael Cabrera: None declared, Fernando Rodriguez: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.

scholarly journals Coblation Versus Diode Laser Tonsillectomy: A Comparative Study

2021 ◽  
Author(s):  
Ameer A. Alaqeedy ◽  
Rasheed Ali Rashid ◽  
Raid M. Al-Ani
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Comparative Study ◽  
Diode Laser ◽  
Operative Time ◽  
Postoperative Bleeding ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Laser Technique ◽  
Significant Difference

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.

scholarly journals Gingival Depigmentation Using Diode 980 nm and Erbium-YAG 2940 nm Lasers: A Split-Mouth Clinical Comparative Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Zaid Kamel Jnaid Harb ◽  
Walid El-Sayed ◽  
Jumma Alkhabuli
Keyword(s):  
Wound Healing ◽  
Diode Laser ◽  
Er:Yag Laser ◽  
Pain Patient ◽  
Laser Technique ◽  
Melanin Pigmentation ◽  
Yag Laser ◽  
Anterior Teeth ◽  
The Right ◽  
Gingival Depigmentation

Aim of the Study. This study aimed to compare the effectiveness of diode laser (980 nm) and erbium-YAG laser (2940 nm) for gum depigmentation. Background. Gingival hyperpigmentation, “black gum,” refers to black discrete single or multiple pigments on the gingiva. Several factors may play a role in gingival hyperpigmentation ranging from physiologic pigmentation to manifestations of systemic diseases. Several techniques have been used for gingival depigmentation to lighten its color. Methods. Fifteen patients exhibiting nonsmoking melanin hyperpigmentation, with the mean age of 28.6 ± 7.8 years, were recruited. The facial gingiva of the anterior teeth and premolars of each jaw was divided into two halves. The right or left side of each jaw quadrant randomly received either diode laser operating at 980 nm wavelength or erbium-YAG laser at 2940 nm. Parameters such as degree of gingival depigmentation, bleeding, pain, patient satisfaction, and wound healing were assessed and compared between the two techniques. The subjects were followed up to six months for melanin pigmentation recurrence. Results. Both techniques were efficient for gingival depigmentation. Nevertheless, bleeding during surgery was statistically higher for Er:YAG laser technique as compared to diode laser. Wound healing showed statistically nonsignificant differences between the two lasers, although Er:YAG seems to give better outcomes than the diode. The patients were satisfied with both laser techniques during and after gingival depigmentation. However, the pain score was higher for Er:YAG laser than for diode laser. Conclusion. This study demonstrated that both lasers’ techniques are efficient for gingival depigmentation. However, diode laser seems to show less painful experience and relatively better bleeding control.

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