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Kaur G, Sonar PR, Pathak A, Sahu SS. Using Laser Therapy and Topical Ozone as an Effective Intervention to Revolutionize Denture Stomatitis Treatment: A Case Report. Cureus 2024; 16:e62795. [PMID: 39040778 PMCID: PMC11261423 DOI: 10.7759/cureus.62795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
In dentistry, denture stomatitis (DS), a frequent inflammatory illness of the oral mucosa mostly related to denture wearing, is a major concern. DS is a common oral mycotic infection for those who wear partial or total dentures. The most often found species of Candida that may be isolated from both healthy and diseased oral tissues is Candida albicans. DS is associated with uneven denture surfaces, inadequate oral hygiene, or ill-fitting dentures. The diagnosis and management of DS in a 72-year-old male patient is presented in this case study. The patient complained about burning in his palate and having difficulty chewing. Upon clinical examination, erythema and inflammation were seen in the palate region. The history and clinical findings were consistent with DS. The patient was told to completely stop using dentures. Interventions were included in the treatment plan, such as diode laser therapy, topical ozonated oil application, and teaching about denture hygiene. The third day's follow-up visit revealed a progressive healing of the lesions and symptom relief. The lesion fully resolved on the sixth day. This case emphasizes the value of all-encompassing management techniques in treating DS successfully. It also highlights the significance of patient education, good oral hygiene, and focused therapy in producing favorable results.
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Affiliation(s)
- Gunmeek Kaur
- Oral and Maxillofacial Surgery, Luxmi Bai Dental College and Hospital, Patiala, IND
| | - Prasanna R Sonar
- Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Ankita Pathak
- Prosthodontics, Sharad Pawar Dental College and Hospital, Wardha, IND
| | - Sanja S Sahu
- Conservative Dentistry and Endodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (Deemed to be University), Bhubaneshwar, IND
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Vitale MC, Nardi MG, Pellegrini M, Spadari F, Pulicari F, Alcozer R, Minardi M, Sfondrini MF, Bertino K, Scribante A. Impacted Palatal Canines and Diode Laser Surgery: A Case Report. Case Rep Dent 2022; 2022:3973382. [PMID: 36249077 PMCID: PMC9560819 DOI: 10.1155/2022/3973382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/27/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Maxillary canine is the most frequent dental element that could likely remain impacted in the bone structure, with a percentage between 1 and 5%. This study presents a case report using a diode laser for surgical-orthodontics disinclusion of a palatal mucosal impacted permanent left upper canine (2.3) and the simultaneous application of an orthodontic bracket. METHODS After cementation of the trans-palatal bar to the upper first molars with a hook for orthodontic traction, local anaesthesia with articaine was performed, followed by surgical operculectomy using a diode laser (810 nm wavelength, continuous wave mode with a power output of 3 W, and a 0.4 mm diameter optical fiber), and the orthodontic bracket with a passive metal looped ligature was applied. Subsequently, active elastic traction was applied on 2.3 and the upper arch was bonded for the application of a series of orthodontic wires, lace-back, and metal ligatures. A progressive reactivation of the elastic traction and extraction of 6.3 was necessary to translate the canine into the correct arch position. RESULTS Diode laser surgical-orthodontic disinclusion of impacted upper canine was performed successively, resulting in a dry surgical field ideal for orthodontic bracket adhesion. No pain and no swelling have been reported from the patient. The orthodontic treatment allowed the canine to be moved to the correct position in the arch. CONCLUSIONS This case showed that the diode laser is a valid alternative for the surgical-orthodontic disinclusion of an included tooth element.
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Affiliation(s)
- Marina Consuelo Vitale
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Maria Gloria Nardi
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Matteo Pellegrini
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Francesco Spadari
- Maxillo-Facial and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Della Commenda 10, Milan 20122, Italy
| | - Federica Pulicari
- Maxillo-Facial and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via Della Commenda 10, Milan 20122, Italy
| | - Roberto Alcozer
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Martina Minardi
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Maria Francesca Sfondrini
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Karin Bertino
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia 27100, Italy
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Murias I, Grzech-Leśniak K, Murias A, Walicka-Cupryś K, Dominiak M, Golob Deeb J, Matys J. Efficacy of Various Laser Wavelengths in the Surgical Treatment of Ankyloglossia: A Systematic Review. Life (Basel) 2022; 12:life12040558. [PMID: 35455049 PMCID: PMC9031639 DOI: 10.3390/life12040558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022] Open
Abstract
Ankyloglossia, commonly known as tongue-tie, is the most common disorder of tongue morphology characterized by aberrant attachment of the lingual frenum. This study aimed to provide a comprehensive literature review and evaluate the effectiveness of various laser wavelengths in the surgical treatment of patients with ankyloglossia. An electronic screening of PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted on 8 November 2021. The following search terms were used to review the available data on the subject of interest: (ankyloglossia OR tongue tie OR short lingual frenulum OR lingual frenectomy OR lingual frenulectomy OR lingual frenotomy OR lingual frenulotomy) AND laser. The use of lasers in ankyloglossia treatment resulted in shorter procedure time, reduced indications for general anesthesia, reduced administration of postoperative analgesics, fewer sutures or none needed, reduced postoperative bleeding, and improved healing. Despite many advantages, this method has its clinical limitations: it requires the use of expensive equipment; well-trained personnel familiar with lasers; and personal protective equipment for the patient, caregiver, operator, and assistant. The laser procedure does not eliminate the need for myofunctional exercises and work with a speech therapist.
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Affiliation(s)
- Iwona Murias
- EMDOLA, Wroclaw Medical University, 50-425 Wroclaw, Poland;
| | - Kinga Grzech-Leśniak
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (M.D.); (J.M.)
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA;
- Correspondence:
| | - Anna Murias
- Faculty of Medicine, Pavel Jozef Šafárik University, Trieda SNP 1, 040 11 Košice, Slovakia;
| | - Katarzyna Walicka-Cupryś
- Institute of Health Sciences, Faculty of Medicine, University of Rzeszow, 35-959 Rzeszow, Poland;
| | - Marzena Dominiak
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (M.D.); (J.M.)
| | - Janina Golob Deeb
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA;
| | - Jacek Matys
- Laser Laboratory, Oral Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland; (M.D.); (J.M.)
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The Effectiveness of Lasers in Treatment of Oral Mucocele in Pediatric Patients: A Systematic Review. MATERIALS 2022; 15:ma15072452. [PMID: 35407784 PMCID: PMC8999795 DOI: 10.3390/ma15072452] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/10/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023]
Abstract
The mucocele is the most common minor salivary gland associated disease of the oral cavity. It is also considered one of the most common biopsied oral lesions in pediatric patients. In recent years, extensive evidence has been published about the usage of lasers in treating mucoceles in pediatric patients. The aim of the present study was to assess the effectiveness of laser irradiation in the treatment of pediatric mucocele. An electronic search of databases (PubMed, Scopus, Web of Science and Google Scholar) was carried out in order to identify all relevant articles using a combination of the following keywords: "Pediatric", "Oral", "Mucocele", "Dental", "Oral Medicine", "Soft Dental Lasers", "Hard Dental Lasers", and "Lasers," for all case reports, case series, case-control and cohort studies published from 2007 to 2021. After limiting the search results, removing duplicate titles, and eligibility evaluation, 17 papers were enrolled in the study. Out of the total studies included, 10 articles were related to the diode (635 nm, 808 nm, 810 nm, and 980 nm), 5 to CO2 (10,600 nm), 3 to Er, Cr: YSGG (2780 nm), and 1 involving KTP lasers (532 nm). All studies indicated successful clinical results on mucocele excision with better intra- and post-operative indicators. The general characteristics and outcomes were summarized, and the quality of the studies was assessed using CARE guidelines in this systematic review. The reduction or absence of pain and bleeding, hemostasis, reduced operating time, minimal analgesic consumption, and an antibacterial effect were among the advantages of laser irradiation in the included studies. The laser has proven itself to play an effective role in the treatment of oral mucocele in paediatric patients.
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Seyyedi S, Dalirsani Z. Treatment of plaque-like oral lichen planus with CO2 laser. Indian J Dermatol 2021; 66:698-703. [PMID: 35283528 PMCID: PMC8906308 DOI: 10.4103/ijd.ijd_1170_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Oral lichen planus (OLP) is a chronic autoimmune disease, which annoys the patients for several years. It presents with various clinical forms. Although plaque-like form of OLP is usually asymptomatic, it could transform to a malignant lesion. Therefore, treatment considerations are essential to reduce the development of oral cancer. Laser therapy is a newer modality for treatment of plaque-like lesions. Aims: This study aimed to perform laser therapy for plaque-like lesions of OLP. Methods: We described some plaque-like OLP lesions evaporated with CO2 laser. The power of 4–7 watt as continuous wave (CW) and defocused mode was employed for evaporation. The complications and recurrence were evaluated in the follow-up sessions. Results: In some patients, mild keratotic lesions were observed in the follow-up sessions. Most patients were satisfied with treatment process and reported mild burning after treatment. No complication was observed in the patients. Conclusion: CO2 laser could be employed for OLP lesions; however, some degrees of recurrence may occur.
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Recurrent Oral Mucocele Management with Diode Laser. Case Rep Dent 2020; 2020:8855759. [PMID: 33083064 PMCID: PMC7556084 DOI: 10.1155/2020/8855759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/31/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
Background Mucocele is the most common minor salivary glands disease. Its management may present a challenge for dental professionals. The aim of the present clinical case was to describe mucocele treatment with diode laser and its benefits. Case Report. A case of lower lip mucocele in a 10-year-old female patient is reported. A conventional excision surgery was performed. Two months later, the patient reported discomfort and swelling at the same operative site. The lesion had recurred. Thus, mucocele was removed using a diode laser with wavelength of 980 nm, an initiated fiberoptic tip of 300 μm, in continuous mode, and a power setting of 2 Watts. The procedure was rapidly completed with no bleeding. The patient was followed-up after 2 weeks and 6 months. The wound healed without complications: no postoperative discomfort or pain and no infection. There was no recurrence. Conclusion Diode laser is an effective, easy, bloodless, and well-accepted procedure to treat mucocele in pediatric patients.
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Khosraviani F, Ehsani S, Fathi M, Saberi-Demneh A. Therapeutic effect of laser on pediatric oral soft tissue problems: a systematic literature review. Lasers Med Sci 2019; 34:1735-1746. [PMID: 31309364 DOI: 10.1007/s10103-019-02834-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/20/2019] [Indexed: 11/28/2022]
Abstract
In recent years, extensive evidence has been published about usage of laser in oral lesions. The aim of the present study was to review the effectiveness of laser radiation in the treatment of pediatric oral soft tissue problems. The relevant keywords were searched in EBSCO, Medline (via Ovid), PubMed, Scopus, and Web of Science (WOS) databases. Then, eligible case series and controlled clinical trial studies, which published up to the end of 2018, were extracted and scrutinized. In this study, the age range of ≤ 21 years or the average age of ≤ 21 years was considered as the pediatric group. After limiting the search results, removing duplicate titles and eligibility evaluation, 17 papers were enrolled to the study (seven controlled clinical trials and ten case series). Er:YAG (2940 nm), CO2 (10,600 nm), Er,Cr:YSGG (2780 nm), and diode (650, 660, and 975 nm) lasers indicated successful clinical results on mucocele excision, frenectomy, gingival incision and re-contouring, and treatment of vascular malformations. In addition, 660-nm diode laser radiation was an effective adjuvant treatment for halitosis and gingivitis induced by multi-bracket appliances. Reduction or absence of pain and bleeding, suitable homeostasis, reduction of operation time, less analgesic consumption, and antibacterial effect were among the advantages of the laser radiation in the studies. Laser as a main or adjuvant tool can have an effective role in surgical and non-surgical treatments of pediatric oral soft tissue problems. Conducting further randomized controlled trial studies on different soft tissue lesions can contribute to drawing better conclusions.
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Affiliation(s)
| | - Sara Ehsani
- DDS,University of Connecticut, Farmington, USA
| | - Mona Fathi
- MD,Semnan University of Medical Sciences, Semnan, Iran
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Nammour S. Laser-Assisted Tongue-Tie Frenectomy for Orthodontic Purpose: To Suture or Not to Suture? PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:381-382. [PMID: 31180259 DOI: 10.1089/photob.2019.4647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, Liege, Belgium
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Vitale MC, Sfondrini MF, Croci GA, Paulli M, Carbone L, Gandini P, Scribante A. Diode Laser-Assisted Surgical Therapy for Early Treatment of Oral Mucocele in a Newborn Patient: Case Report and Procedures Checklist. Case Rep Dent 2018; 2018:3048429. [PMID: 29854481 PMCID: PMC5941754 DOI: 10.1155/2018/3048429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/28/2018] [Accepted: 03/07/2018] [Indexed: 11/18/2022] Open
Abstract
Mucocele (also known as ranula or salivary gland mucous cyst) of the newborn is a lesion present on the intraoral cavity, with the potential to interfere with respiration and feeding. In the present report, a case of mucocele in a 4-month female patient has been described. As conventional surgery can be followed by several complications such as intraoperative bleeding, difficulties in wound healing, and maintenance of sterility during surgery, in the present case, the use of diode laser has been planned. A topic anesthesia with lidocaine gel was performed. A diode laser (810 nm wavelength, continuous wave mode, power output of 3 watt, and 0.4 mm diameter fiber optic) was set for excising the lesion. The tip was directed at an angle of 10 to 15°, moving around the base of the lesion with a circular motion. The procedure was completed in 3 minutes. The patient was visited with a follow-up of 2 weeks and 4 months after excision. The intraoral wound healed without complications, and no signs of infection or mass recurrence were noted. The histopathological examination confirmed the diagnosis of mucocele. On the basis of the results of the present case report, the use of diode laser can be easily performed also in a noncompliant newborn patient for successful excision of mucocele lesions, and checklist of clinical procedures has been described.
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Affiliation(s)
- Marina Consuelo Vitale
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Giorgio Alberto Croci
- Unit of Anatomic Pathology, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Paulli
- Unit of Anatomic Pathology, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Carbone
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Paola Gandini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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Labial frenectomy with Nd:YAG laser and conventional surgery: a comparative study. Lasers Med Sci 2013; 30:851-6. [PMID: 24146237 DOI: 10.1007/s10103-013-1461-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
Abstract
Labial frenulums are sagittal fibrous folds of oral mucosa with a periosteal insertion that extend from the lips to the alveolar or gingival mucosa. Occasionally, they assume inadequate size or location and may lead to functional and esthetic limitations. The aim of the present study was to compare pre-, trans-, and postsurgical clinical parameters of labial frenectomies performed with conventional surgery and neodymium-doped yttrium aluminum garnet (Nd:YAG) laser. Forty individuals were assessed as a convenience sample and were divided into two groups according to the treatment: group 1 (G1), conventional surgery (n = 22), and G2, Nd:YAG laser surgery (n = 18). Clinical parameters such as frenulum insertion, location, bleeding, surgical time, suturing, preoperative fear, and postoperative discomfort/functional limitations were evaluated. All surgeries were performed by the same operator, and the level of fear, pain, and discomfort related to oral functions were assessed with a visual numeric scale. Most of the frenulums (90%) were classified as papillary or transpapillary insertion. Preoperative fear was similar between groups (p = 0.593). All G2 patients did not require suture (p < 0.001), did not bleed during the procedure (p < 0.001), and had surgical time diminished (p < 0.001). No significant statistical difference regarding pain or oral function could be observed. Three individuals (7.5%) experienced postsurgical complications. Nd:YAG laser frenectomies reduces transoperative bleeding, avoiding the need of suturing, and promotes a significant reduction of surgical time in comparison with conventional surgery. Therefore, further studies are necessary to provide a complete understanding and standardization of the technique as well as the expected clinical results.
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Case series: Laser treatments for soft tissue problems in children. Eur Arch Paediatr Dent 2012; 12:113-7. [DOI: 10.1007/bf03262790] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Boj JR, Poirier C, Hernandez M, Espasa E, Espanya A. Review: Laser soft tissue treatments for paediatric dental patients. Eur Arch Paediatr Dent 2012; 12:100-5. [DOI: 10.1007/bf03262788] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kafas P, Stavrianos C, Jerjes W, Upile T, Vourvachis M, Theodoridis M, Stavrianou I. Upper-lip laser frenectomy without infiltrated anaesthesia in a paediatric patient: a case report. CASES JOURNAL 2009; 2:7138. [PMID: 19829919 PMCID: PMC2740279 DOI: 10.1186/1757-1626-2-7138] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 03/03/2009] [Indexed: 12/02/2022]
Abstract
Labial frenectomy is a common surgical procedure in the field of oral surgery. Labial frenectomy is a procedure usually done for orthodontic reasons. The role of laser surgery in the oral cavity is well established. The use of diode laser frenectomy without infiltrated anaesthesia is currently under investigation. Needle-less oral surgery, without infiltrated anaesthesia, is a novel situation in paediatrics with paramount importance.
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Affiliation(s)
- Panagiotis Kafas
- Department of Oral Surgery, Surgical Implantology and Radiology, School of Dentistry, Aristotle University, Agiou Dimitriou Street,Thessalonica, 541 24, Greece.
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