Diode laser in the excision of intraoral fibroma: A safe tool for minimally invasive dentistry

Abstract

T he traumatic fibroma is a commonly seen intraoral overgrowth that occurs following tissue injury. Most common etiological factors include plaque, calculus, overhanging restorations, habits such as lip biting, and injury from the broken teeth [1,2]. They occur more frequently in the third and fourth decades with twice the frequency of occurrence in women as compared to men [1,3]. The most common site of occurrence is buccal mucosa along the plane of occlusion. Other sites include mandibular labial mucosa, gingiva, tongue, and palate [1,3]. Clinically, they appear as a sessile or pedunculated mass. The lesion may appear pale or similar to the surrounding mucosa. The outer surface may appear smooth and whitish due to hyperkeratosis or may be ulcerated due to repetitive trauma. The lesion is usually asymptomatic and does not have any risk of malignancy [4,5]. The recurrence rate is very low and it occurs due to incomplete elimination of the etiological factors [5].The conventional treatment modality includes surgical excision using scalpel blades, electrocautery, and cryosurgery. These methods, however, have many disadvantages such as excessive bleeding, need of suturing, scarring in the region of excision, postsurgical pain, swelling, and delayed wound healing [6,7]. To overcome these difficulties, the "Diode Laser" has emerged as a minimally invasive tool. Lasers have been used in dentistry since 1999 [8]. The diode laser is a solid-state semiconductor consisting of Gallium, Arsenide, Aluminium, and Indium. It has been found to be superior to conventional surgical methods in terms of ease of handling, pain control, less chairside time, and low cost. This case series highlights the benefits of using a diode laser as a minimally invasive tool for excision of intraoral fibromas. CASE SERIES Case 1A 21-year-old male patient reported to the department of periodontology with a chief complaint of growth on the left side of the tip of the tongue. The past medical and dental histories were not relevant. On examination, the patient's blood pressure was 120/90 mm Hg, pulse rate was 60/min, respiratory rate was 18/min, and the patient was afebrile with a temperature of 37.8°C. The solitary growth was seen approximately 4 months ago. It was initially small in size but had increased gradually to the present size (5 mm × 5 mm). The growth was firm, non-tender, and palepink with an intact surface and sessile base (Fig. 1a). The local lymph nodes were not palpable. Based on the clinical findings, a diagnosis of fibroma was made.

Surgical Treatment of Oral Fibrous Hyperplasia with Diode Laser: An Integrative Review

“…Of these, 10 were eliminated after applying the inclusion and exclusion criteria. Finally, 12 studies (Al- Magro et al, 2013;Pai Jagadish et al, 2014;Bakhtiari et al, 2015;Amaral et al, 2017;Perales-Garza Ret al, 2017;Andriola et al, 2018;One & Uchôa, 2018;Mancera et al, 2019;Otaibi & Al-Mohaya, 2020;Dhande et al, 2021;Sawai et al, 2021;Costa et al, 2022) were included in the data extraction. Figure 1 provides a summary of the selection process.…”

“…Of the 12 studies examined, 8 are case reports (Magro et al, 2013;Bakhtiari et al, 2015;Perales-Garza Ret al, 2017;Andriola et al, 2018;One & Uchôa, 2018;Mancera et al, 2019;Dhande et al, 2021;Costa, 2022) and 4 are case series (Al-Pai Jagadish et al, 2014;Amaral et al, 2017;Otaibi & Al-Mohaya, 2020;Sawai et al, 2021). The studies were published from 2013 to 2022, with 5 Brazilian studies (Magro et al, 2013;Amaral et al, 2017;Andriola et al, 2018;One & Uchôa, 2018;Costa, 2022), 3 Indians (Pai Jagadish et al, 2014;Dhande et al, 2021;Sawai et al, 2021), 1 Iranian (Bakhtiari et al, 2015), 1 Mexican (Perales-Garza Ret al, 2017), 1 German (Mancera et al, 2019), and 1 Saudi (Al-Otaibi & Al-Mohaya, 2020). The total sample comprised 64 patients, predominantly female (68.75 %, n=44) and mean age of 47.1 (±16.1) years.…”