Introduction Whether or not laser use provides any meaningful benefit at immediate implant and ridge preservation sites remains an open question in periodontics. However, various lasers have been used in conjunction with tooth extraction and immediate implant placement. Evidence supporting adjunctive laser irradiation at immediate implant and ridge preservation sites is mostly limited to preclinical studies and a small number of case reports. Case Series Adjunctive neodymium‒doped: yttrium, aluminum, garnet (Nd:YAG) laser irradiation was used at six immediate implant sites and five ridge preservation sites. Three immediate implants were in maxillary incisor positions and three were in premolar positions, two maxillary and one mandibular. All cases exhibited favorable healing and satisfactory clinical outcomes. Conclusions Nd:YAG laser energy application with 650‐µs pulse duration consistently supported rapid clot formation and graft containment at immediate implant and ridge preservation sites. Histologic analyses and controlled clinical trials comparing ridge preservation and immediate implant procedures with and without laser use are needed. Because cellular responses and clinical outcomes may be exquisitely sensitive to irradiation parameters, studies should report materials and methods in detail.
Type of Case: A 32‐year‐old female presents missing tooth #5 and requesting replacement with a dental implant. She has an unremarkable medical history. The tooth #5 site is a healed ridge with adequate bone to support an implant without additional augmentation. Clinical Approach #1 (CMR and TMJ): This approach involves routine implant surgery with placement of a healing abutment. Preoperative management includes 2 g amoxicillin 1 hour prior to the procedure and postoperative pain medication. The rationale for use of an antibiotic is to decrease the risk of infection and implant failure and to reduce peri‐implant inflammation during early healing. The desired effect of the antibiotic is to minimize or eliminate the negative effects of bacteria in the wound site and on the implant surface during healing. This clinical approach is recommended to protect the investment of resources and time by the patient and dental team for optimal treatment outcomes. Clinical Approach #2 (AWB, BGC, and KJE): This approach involves routine implant surgery with placement of a healing abutment. Postoperative management includes pain medications without antibiotic use. The rationale for avoidance of antibiotics is to eliminate risk of an adverse drug reaction such as urticaria, anaphylaxis, or gastrointestinal disturbances. Because the evidence justifying antibiotic coverage is considered to be weak, clinicians are advised to consider withholding antibiotic prescriptions for routine implant placement as a means of risk mitigation for the patient and public health in general.
Premalignant lesions over buccal mucosa are very common in India, some of these lesions require excision leaving behind defects and various techniques can be used in reconstruction of these defects. Small palatal defect, oroantral fistulas have been successfully closed by buccal pad of fat flap. Aim of this study was to evaluate reconstruction of defects after excision of premalignant lesion over buccal mucosa using buccal pad of fat. 20 patients were selected for this study who presented with different premalignant lesions like erythroplakia, proliferative verrucous leukoplakia, chronic hyperplastic candidiasis, Oral submucous fibrosis over buccal mucosa in Dr. DY Patil medical college surgery unit 4 and 7. Excision of lesion followed by reconstruction with buccal pad of fat was done. Patients were followed up every 14 days for 14 weeks, and was evaluated for epithelisation of flap and post-operative complications like infection and flap necrosis and also the functionality of the flap. In this study we have observed complete epithelisation of the flap in most of our patients. Dehiscence of the wound was observed in 3 of the patients with large defects (>4×5 cm). No postoperative morbidity was in postoperative patients. Buccal pad of fat is an excellent technique for reconstruction of small defects of buccal mucosa. It is a reliable and a fast method which has easy accessibility less complications and minimal morbidity.
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