The Use of High-Power Lasers in Oral Surgery

Gáspár, L

doi:10.1089/clm.1994.12.281

Cited by 19 publications

(6 citation statements)

References 12 publications

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“…According to some studies, thermal damage is three to five times deeper after electrocautery than surgical laser 17 18. The surgical technique consists of the administration of a small quantity of anaesthetic (topical anaesthesia is sometimes sufficient) and following the vertical axis of the frenulum until the wound presents a linear shape; the laser is then administered transversely until the wound takes on a rhomboidal shape 13…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the effects of high-level laser and electrocautery in lingual frenectomy surgeries in infants: protocol for a blinded randomised controlled clinical trial

Mazzoni

Navarro²,

Fernandes

et al. 2021

BMJ Open

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IntroductionAnkyloglossia (tongue-tie) is an anomaly characterised by an abnormally short, thick or small lingual frenulum that restricts tongue movements. This condition is considered one of the factors that can interfere with breast feeding by diminishing the ability of the newborn to latch adequately. According to the Brazilian Health Ministry, the prevalence of this anomaly among newborns is 3%–16%. Frenectomy is the most suitable surgical procedure for the treatment of ankyloglossia. The aim of this study is to compare the performance of electrocautery and high-power diode laser as forms of frenectomy.Methods and analysisThe proposed study will be a randomised, controlled, blind clinical trial involving the participation of healthy infants 0–3 months of age with breastfeeding difficulty and a diagnosis of tongue-tie with an indication for lingual frenectomy. The guardians will receive clarifications regarding the procedures and will authorise the participation of the infants by signing a statement of informed consent. A non-blinded researcher will perform the screening and procedures and a blinded researcher will perform the postoperative evaluations. Fifty-six infants will be randomly allocated into two groups (n=28): the electrocautery group or the high-power laser group. The preparation of the patients, asepsis and infection control procedures will rigorously follow biosafety norms. For both groups, patient histories will be taken, clinical evaluations will be performed and a standardised photograph of the lingual frenulum will be taken before surgery. The Bristol Tongue Assessment Tool will be used. We will evaluate pain in the mother during breast feeding before, immediately after, and 15 days after surgery.Ethics and disseminationThis protocol was submitted to the Research Ethics Committee of Nove de Julho University, having been given a favourable opinion (Number: 4387769). Results will be submitted to international peer-reviewed journals and presented at international conferences.Trial registration numberNCT04487418.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the effects of high-level laser and electrocautery in lingual frenectomy surgeries in infants: protocol for a blinded randomised controlled clinical trial

Mazzoni

Navarro²,

Fernandes

et al. 2021

BMJ Open

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“…When compared to other standard treatment procedures such as conventional surgery using scalpels, laser surgery offers a number of advantages. The coagulation of small blood vessels allows for a dry operating field and better visibility [11][12][13][14][15]. Furthermore, it is possible to selectively ablate very thin tissue layers [16].…”

Section: Introductionmentioning

confidence: 99%

Laser induced breakdown spectroscopy for bone and cartilage differentiation - ex vivo study as a prospect for a laser surgery feedback mechanism

Mehari¹,

Rohde²,

Knipfer³

et al. 2014

Biomed. Opt. Express

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Laser surgery enables for very accurate, fast and clean modeling of tissue. The specific and controlled cutting and ablation of tissue, however, remains a central challenge in the field of clinical laser applications. The lack of information on what kind of tissue is being ablated at the bottom of the cut may lead to iatrogenic damage of structures that were meant to be preserved. One such example is the shaping or removal of diseased cartilaginous and bone tissue in the temporomandibular joint (TMJ). Diseases of the TMJ can induce deformation and perforation of the cartilaginous discus articularis, as well as alterations to the cartilaginous surface of the condyle or even the bone itself. This may result in restrictions of movement and pain. The aim of a surgical intervention ranges from specific ablation and shaping of diseased cartilage, bone or synovial tissues to extensive removal of TMJ structures. One approach to differentiate between these tissues is to use Laser Induced Breakdown Spectroscopy (LIBS). The ultimate goal is a LIBS guided feedback control system for surgical laser systems that enables real-time tissue identification for tissue specific ablation. In the presented study, the authors focused on the LIBS based differentiation between cartilage tissue and cortical bone tissue using an ex-vivo pig model. 31(2), 155-156 (1978). 12. M. S. Strong, C. W. Vaughan, G. B. Healy, S. M. Shapshay, and G. J. Jako, "Transoral management of localized carcinoma of the oral cavity using the CO2 laser," Laryngoscope 89(6 Pt 1), 897-905 (1979). 13. J. A. Carruth, "Resection of the tongue with the carbon dioxide laser," J. Laryngol. Otol. 96(6), 529-543 (1982). 14. L. Gáspár, "The use of high-power lasers in oral surgery," J. Clin. Laser Med. Surg. 12(5), 281-285 (1994). 15. M. L. Schoelch, N. Sekandari, J. A. Regezi, and S. Silverman, Jr., "Laser management of oral leukoplakias: a follow-up study of 70 patients," Laryngoscope 109(6), 949-953 (1999). 16. J. A. Carruth, "Lasers in medicine and surgery," J. Med. Eng. Technol. 8(4), 161-167 (1984). 17. M. K. Basu, J. W. Frame, and P. H. Rhys Evans, "Wound healing following partial glossectomy using the CO2 laser, diathermy and scalpel: a histological study in rats," J. Laryngol. Otol. 102(4), 322-327 (1988). 18. M. Luomanen, "A comparative study of healing of laser and scalpel incision wounds in rat oral mucosa," Scand. ©2014 Optical Society of America

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“…This work has demonstrated effectiveness in controlling manifestations related to chronic tonsillitis, according to previous papers, [25][26][27][28][29][30][31]43 referring to the idea of a biochemical, physiological and microbiological rebalancing. Ph measures pre-and post-intervention did not show a statistical difference; however, one positive culture became negative after the intervention.…”

Section: Discussionmentioning

confidence: 98%

“…The fractional CO2 laser technique revealed numerous advantages to the patient and surgeon: it takes around 30 seconds to perform, causes minimum tissue injury with almost no pain, edema or inflammatory reaction, and has no risk of postoperative bleeding, infection or scar contracture. It can be conducted in an outpatient scenario with local anaesthesia 32,43 and can be performed on hypertensive, diabetic and morbidly obese patients without increasing the relative risk. It has proven to be the fastest one, with less intra-and post-procedure morbidity and similar or greater efficacy than other aforementioned.…”

Section: Discussionmentioning

confidence: 99%

Tonsillotomy by a Fractional Carbon Dioxide Laser: A New Technique in the Treatment of Chronic Tonsillitis

et al. 2022

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Introduction: Chronic tonsillitis has a global prevalence, ranging from 5% to 12%. Its clinical manifestations, like recurrent acute tonsillitis, tonsils hypertrophy, caseum and halitosis, can lead adult patients to be submitted to palatine tonsillectomy, surgery that has morbidity and the potential risk of complications, including severe bleeding. This article proposes a new therapy for chronic tonsillitis in adult patients using a fractional carbon dioxide (CO2) laser, which is a fast, minimally invasive procedure capable of removing the need for the traditional tonsillectomy in many patients. The present research aimed to verify the efficacy of tonsillotomy by fractional ablation using the CO2 laser by comparing the number of bacterial infections, tonsils hypertrophy, halitosis and caseum; it is also aimed at analyzing the benefits, risks and complications of the technique. Methods: In this clinical prospective study, 20 patients were subjected to one session of tonsillotomy by fractional ablation and were followed up for a year. The control group was formed by the same patients in the pre-procedure period (one year) without treatment. Statistical analysis: The Wilcoxon paired test, Friedman tests, and multiple non-parametric comparisons were utilized to analyze the data (significance level of 5%). Results: No complications occurred, and the procedure was fast (30 seconds), safe and tolerated well without general anesthesia. After 1 year, there was a total remission of recurrent acute tonsillitis in 95% of the patients, and after 6 months there was a statistically significant improvement in halitosis and caseum, and tonsils size reduction (P<0.05). The level of satisfaction average was 10 after 3 months and 8 after one year. Conclusion: tonsillotomy by fractional ablation using the CO2 laser is a safe, efficient procedure for chronic tonsillitis in adults, and it can be incorporated into daily clinical practice.

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The Use of High-Power Lasers in Oral Surgery

Cited by 19 publications

References 12 publications

Evaluation of the effects of high-level laser and electrocautery in lingual frenectomy surgeries in infants: protocol for a blinded randomised controlled clinical trial

Evaluation of the effects of high-level laser and electrocautery in lingual frenectomy surgeries in infants: protocol for a blinded randomised controlled clinical trial

Laser induced breakdown spectroscopy for bone and cartilage differentiation - ex vivo study as a prospect for a laser surgery feedback mechanism

Tonsillotomy by a Fractional Carbon Dioxide Laser: A New Technique in the Treatment of Chronic Tonsillitis

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