Treatment of Oral Granulation Tissue with the Flashlamp Pulsed Dye Laser

Meffert, Jeffrey J.; Cagna, David R.; Meffert, Roland M.

doi:10.1111/j.1524-4725.1998.tb04261.x

Cited by 23 publications

(17 citation statements)

References 14 publications

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“…22,26 Other treatment protocols have also been proposed such as cryotherapy, chemical and electric cauterization, and the use of Nd:YAG (neodymium:yttriumaluminum-garnet) laser and carbon dioxide laser. 27 Meffert et al 28 used the flash lamp pulsed-dye laser on granulation tissue around a dental implant.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of a Pyogenic Granuloma in Relation to a Dental Implant

Dojcinovic¹,

Richter²,

Lombardi³

2010

Journal of Oral and Maxillofacial Surgery

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Pyogenic granuloma is an inflammatory vascular hyperplasia often occurring in the oral cavity. It appears in response to various stimuli such as low-grade local irritation, trauma, or female steroid hormones. A 32-year-old man sought care for a tender and bleeding lesion of the left posterior maxillary gingiva. The intraoral examination showed an exophytic ulcerated nodule measuring 1.0 cm, related to a dental implant placed in the upper left second premolar position. Radiographic examination showed an oversized healing cap. A provisional diagnosis of reactive inflammatory hyperplasia was made, and the lesion was excised and submitted for histologic examination. On microscopy, the surgical specimen showed an ulcerated nodule consisting of a delicate connective tissue stroma containing numerous blood vessels with plump endothelial cells, intermingled with abundant polymorphonuclear lymphocytes. A diagnosis of pyogenic granuloma associated with a dental implant was made. In this case it was the result of an inappropriate choice of a healing cap, thus allowing an accumulation of dental plaque and sustained chronic inflammation of the peri-implant tissue. A conservative excision and replacement of the healing cap were sufficient for definitive treatment.

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Section: Discussionmentioning

confidence: 99%

Occurrence of a Pyogenic Granuloma in Relation to a Dental Implant

Dojcinovic¹,

Richter²,

Lombardi³

2010

Journal of Oral and Maxillofacial Surgery

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“…84 A flash lamp pulsed dye laser have been used also in removing the lesion. 85 Cryosurgery is another technique of conservative surgery has been used in removal the pyogenic granuloma. 86 Using electrocautery can offer less bleeding from the operative field.…”

Section: Discussionmentioning

confidence: 99%

Recurrent pyogenic granuloma: an update

Al-Shiaty

Ottoman

2015

Int J Sci Rep

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Background: Given the fierce controversy about the nature of pyogenic granulomas, starting with its unfitting name and ending up with its ideal treatment modality, this paper tries to numerically identify some predisposing factors of recurrence.Methods: The literature was initially reviewed and a total of twenty recurrent cases of pyogenic granuloma were contrasted, on one hand, to their initial appearance. On the other hand, all are contrasted to a similar number of normal mucosa using three histochemical stains: Alcian blue, periodic acid-Schiff and Masson’s trichrome.Results: For all recurrent lesions, all specimens showed myxoid structure histologically even if their initial appearance had possessed a sparse myxoid structure. The age of recurrence has been correlated to the histochemical findings. For the Alcian Blue stain (AB), the value of t-test was 3.808840. The pertaining value of P was 0.000593. The result was significant at P ≤0.05. For the PAS stain, the value of t-test was 3.640327. The value of P was 0.000871. The result was significant at P ≤0.05. In Masson’s trichrome staining, the value of t-test was 3.100816. The value of P was 0.002942. The result was significant at P ≤0.05. Accordingly, all stains showed significant difference in fibrous content in the initial and recurrent lesions. Conversely, the count of both endothelial vessels and inflammatory infiltrates in the recurrent lesions were significantly lower than the primary precursors.Conclusions: Given that collagen fibers are continually degraded and resynthesized while proteolytic degradation occur outside the cells through the activity of enzymes called matrix metalloproteinases (MMPs), it is suggested that MMPs -positively expressed by PAS reactions- account for the spacing of the fibrous stroma, allowing for reshaping the three dimensional structure of the connective tissue. Myxoid structures are certainly promoting recurrence either via excessive secretion of hyaluronic acids or unknown mechanisms. The undisputed fact is the presence of myxoid structures in all our reported recurrent cases. Both inflammatory cascade and endothelial proliferation have no vital role in the recurrence according to our morphometric results. Finally, PAS stain should give more details in examining PGs than the other recruited counterparts.Keywords: Recurrent pyogenic granuloma, PAS stain, Myxoid structures, Etiopathogensis

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“…8,38 The effectiveness of the flash lamp pulsed dye laser for the treatment of cutaneous PG have been reported by numerous authors for decades. [26][27][28][29] Meffert et al 30 used the flash lamp pulsed dye laser to treat a resolute intraoral mass of granulation tissue, and deduced that a series of treatments with the pulsed dye laser worked well on this lesion. Powell et al 31 reported one of the first uses of Nd:YAG laser for excision of PG, and noticed decreased risk of bleeding in comparison to other methods along with superior coagulation characteristics; which were the reasons why they chose Nd:YAG laser.…”

Section: Discussionmentioning

confidence: 99%

“…3,13,36 PG is most commonly treated by surgical excision; but many other treatment modalities, including various types of laser, have also been successfully used. 2,3,8,9,[27][28][29][30][32][33][34]37 Laser surgery offers more benefits compared to conventional treatment modalities such as reduced bleeding, instant sterilization, reduced bacteremia, less need for sutures and/or post-surgical dressing, decreased pain and edema during and after the procedure, less wound contraction and minimal scar tissue formation, faster healing process and increased patients acceptance. 8,38 The effectiveness of the flash lamp pulsed dye laser for the treatment of cutaneous PG have been reported by numerous authors for decades.…”

Section: Discussionmentioning

confidence: 99%

“…During the excision, irritant agents such as dental plaque, calculus, foreign bodies, defective restoration and source of trauma should be eliminated. 9,11 Otherwise electric cauterization, 18 cryosurgery, 19,20 sodium tetradecyl sulfate sclerotherapy, 21,22 monoethanolamine oleate ligation, absolute ethanol injection, 23 cauterization with silver nitrate, 24 intralesional steroids, 25 flash lamp pulsed dye laser, [26][27][28][29][30] neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, 8,31 carbon dioxide (CO 2 ) laser, 32 erbium-doped yttrium aluminum garnet (Er:YAG) laser 9 and diode laser 2,3,33,34 have also been used by various clinicians to eliminate the lesion. Although PG does not show infiltrative tendency or malignant transformation potential, the recurrence rate after simple excision is comparatively high (about 16%); thus in some cases re-excision is required.…”

Section: Introductionmentioning

confidence: 99%

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Management of a Recurrent Pyogenic Granuloma of the Hard Palate with Diode Laser: A Case Report

Erbaşar¹,

Şengüven

Gültekin

et al. 2016

J Lasers Med Sci

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IntroductionPyogenic granuloma (PG) is a prevalent, benign mucocutaneous lesion exhibited by an exuberant tissue, caused by a local irritation or trauma.1-3 It was first described in English literature by Hullihen 4 in 1844; but the term 'pyogenic granuloma' or 'granuloma pyogenicum' was presented by Hartzell 5 in 1904. However, the term 'pyogenic granuloma' can be a misnomer because the lesion neither causes pus formation nor it represents a true granuloma, histologically. Some researchers use the term "lobular capillary hemangioma" which is histologically a more accurate term for this lesion. 2,6,7 Clinically, PG appears as a sessile or pedunculated exophytic mass with smooth or lobulated surface that may easily bleed or ulcerate, and covered by yellow fibrinous membrane. The color of the lesion depends on the vascularity of the growth, so it can be red, purple or pink. 1,3,[8][9][10] In the 75% of all cases, gingiva is the most affected site by PG. Aside from the gingiva it is also encountered on the lips, tongue, buccal mucosa and the hard palate. The maxillary gingiva is more commonly affected than the mandibular one and the anterior region more than the posterior. Also the lesions are more frequently on the buccal side of the gingiva than the lingual side. 6,10,11 The lesion usually develops slowly, without pain and asymptomatically. But in some cases it may develops fast, reaches its full size and remains stable. The size ranges from a few millimeters to several centimeters but it rarely Gazi University, School of Dentistry, Department of Oral Surgery, Ankara, Turkey Abstract Introduction: Pyogenic granuloma (PG) is a prevalent inflammatory hyperplasia of skin and oral mucosa which is often caused by constant low-grade local irritation, traumatic injury or hormonal factors. In many cases, gingival irritation and inflammation due to poor oral hygiene are precipitating factors. Oral PG occurs predominantly on the gingiva, but it is also encountered on the lips, tongue, buccal mucosa and rarely on the hard palate. Although surgical excision is the first choice of treatment, many other treatment modalities could be counted such as cryosurgery, sodium tetradecyl sulfate sclerotherapy, intralesional steroids, flash lamp pulsed dye laser, neodymium-doped yttrium aluminium garnet (Nd:YAG) laser, carbon dioxide (CO2) laser, erbium-doped yttrium aluminum garnet (Er:YAG) lasers and diode laser have been suggested. After surgical excision recurrence occurs up to 16% of these lesions. It is believed that recurrence ensues as a result of incomplete excision, failure to eliminate etiologic factors or repeated trauma. Case Report: A 50-year-old female was referred to the Department of Oral Surgery, Gazi University, School of Dentistry, complaining of a swelling and growth on the right side of the hard palate for four months. Patient reported a similar growth in the same area about two years earlier, which had turned out to be a PG by histopathology. The treatment plan included surgical excision of the lesion using diode ...

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Treatment of Oral Granulation Tissue with the Flashlamp Pulsed Dye Laser

Abstract: The PDL may have utility in this oral condition, providing a new venue for cooperation between dentists and dermatologists.

Cited by 23 publications

References 14 publications

Occurrence of a Pyogenic Granuloma in Relation to a Dental Implant

Occurrence of a Pyogenic Granuloma in Relation to a Dental Implant

Recurrent pyogenic granuloma: an update

Management of a Recurrent Pyogenic Granuloma of the Hard Palate with Diode Laser: A Case Report

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