Evaluation of diode laser efficacy in treating benign oral soft tissue masses: A case series

INTRODUCTION AND IMPORTANCE

The diode laser, with a wavelength ranging from 810 to 980 nm, is a modern treatment modality that offers significant advantages in the management of benign oral soft tissue masses. Therefore, this report aimed to assess the efficacy of diode laser application for excisional biopsy of such masses.

CASE PRESENTATION

Three female patients, aged 9, 39, and 45 years, visited the Oral Medicine Clinic with complaints of painless masses in the oral cavity persisting for two to three months. Their intraoral examination showed the presence of pedunculated or sessile exophytic lesions with a smooth surface. The lesions appeared as single, pink to red protrusions located in various sites, including the left buccal mucosa, right lateral border of the tongue, and lower gingiva.

CLINICAL DISCUSSION

Excisional biopsy of the masses was carried out in the patients using the diode laser. The surgical procedures ranged from 10 to 20 min, with minimal intraoperative bleeding and precise cutting, while no pain was reported. Postoperatively, at two weeks and four months follow-up, the intraoral wounds exhibited excellent healing without complications such as pain, bleeding, swelling, scarring, infection, or mass recurrence. The clinical diagnosis of irritational fibroma (two cases) and fibrous epulis were confirmed by histopathological examination.

CONCLUSION

Diode laser emerges as a highly efficacious method for the excisional biopsy of benign oral soft tissue masses, providing intraoperative and postoperative advantages over scalpel surgery.

Correlation of the modified dental anxiety scale value with salivary alpha-amylase in pre-odontectomy patients

Introduction: Odontectomy is a minor surgical procedure that often results in dental anxiety. Dental anxiety can interfere during odontectomy treatment. Dental anxiety can be examined using the Modified Dental Anxiety Scale (MDAS) and through the level of the salivary alpha-amylase enzyme, both of which are dental anxiety biomarkers. The objective of this study was to analyse the correlation between anxiety values with salivary alpha-amylase levels using MDAS as an indicator of anxiety in pre-odontectomy patients. Methods: This study was conducted on 60 research samples of women aged 18-40 years who came to the minor surgery clinic of Department of Oral and Maxillofacial Surgery, Universitas Padjadjaran Dental Hospital, to have odontectomy treatment of maxillary or mandibular third molars impaction, not having systemic and oral diseases, and willing to participate in this study. Patients who met the inclusion criteria then required to sign the research consent statement; afterwards, the MDAS data was taken. The salivary alpha-amylase enzyme data was taken using the Cocoro meter (Nipro, Japan) tip which was kept under the tongue for 30 seconds, then the tip was inserted into the monitor, and the enzyme levels would be counted. The data obtained will be analysed using the Spearman rank correlation test. Results: The results showed that there was a significant relationship (p < 0.01) with a strong positive correlation (r = 0.85). Conclusion: There is a correlation between MDAS value and salivary alpha-amylase enzyme as an indicator of dental anxiety.

Analysis of gene polymorphisms TGFα rs 1058213 to cleft lip cases with or without a non-syndrome sky cleft in Riau Malay Ethnic

Objective: This study aims to determine the role of gene polymorphism TGFα rs 1058213 in cases of cleft lip with or without cleft palate non-syndrome in the Riau Malay tribe.Material and Methods: DNA extraction of venous blood and polymorphism TGFα rs 1058213 was assessed using the Restriction Fragment Length Polymorphism-PCR (RFLP-PCR) working method and followed by sequencing. Genotyping SNP rs1058213 in the TGFα gene was performed by the RFLP-PCR method in control and CLP NS patients. The data was assessed using the test statistic premises T-test difference test.Results: The total sample size included 68 samples consisting of 34 CLP NS samples and 34 control samples. The cases of CLP NS occurred more in men than women, 20 cases (59%) and 14 cases (14%), respectively.Conclusion: There was no significant difference between TGFα rs 1058213 gene polymorphisms in CLP NS and controls in the Riau Malay tribe.

Surgical management of necrotizing fasciitis due to odontogenic infection with sepsis: a case report

Objective:To perform surgical operation on necrotizing fasciitis due to odontegenic infection with sepsis.Methods: In this case an odontogenic infection was accompanied by a large open wound on the face and sepsis. Patient was hospitalized in the Dr.HasanSadikin General Hospital. Management of this patient in the emergency room were administration of appropriate broad-spectrum empiric antibiotic, incision and pus drainage, and extraction of the infected tooth, followed by fluid resuscitation with strict observation. Surgical debridement was then performed.Results:After being treated for 12 days the patient’s condition improved. We planned closure of defects of the facial area, but the patient refused.Conclusion: Necrotizing fasciitis is an uncommon but potentially lethal condition associated with high rates of morbidity and mortality. Early diagnosis coupled with emergent surgical debridement, appropriate broad-spectrum empiric antibiotic treatment, and a multidisciplinary team approach is essential for successful treatment.

Alveolar cleft closure with iliac bone graft: a case report

Objective: The present article is to report a case of a patient with alveolar cleft that was treated with the application of iliac bone graftMethods: A nine year-old girl with maxillary alveolar cleft had labioplasty and palatoplasty. The cleft was closed using iliac bone graft and the result was the canine erupts on the graft site get a better alveolar arch, and no more oronasal fistule. Alveolar cleft can be treated by the use of iliac bone graft.Results: Based on the clinical and radiographic development of the patient, the treatment for overall seemed success with the obtain of maxillary arch continuity, provide bone that is available for permanent canine to erupt, optimal alar base reconstruction, the fistulae was eliminated, provide a better nasal alar cartilage support, get a stabil the maxillary segment for orthodontic treatment, and obtain an ideal alveolar morphology.Conclusion: The timing of alveolar bone grafting usually associated with the state of the developing of dentition. Post operative management is important to get a good result, and to prevent any complications.

Parotid gland tuberculous abscess

Clinically speaking, parotid gland tuberculosis is a rare case. Its diagnostic values are hard to determine as it has clinical similarities with neoplasms. Mistakes during diagnosis happen quite often thus additional layer of examinations are required to be conducted. An 18-year-old woman was referred from a privately-owned hospital with initial diagnosis of infected parotic sinistra tumor. Physical examination discovered a swelling on her sinistra parotid gland and a lump at the colli sinistra region. Ultrasound scan showed benign hypoechoic areas and cystic regions at the left of submandibular muscle which then expanded towards the neck. Results from the PPD5TU (-), BTA 3X (1X positive) and FNAB pointed out an existing a/r parotid and colli sinistra or Tuberculous abscess. The diagnosis of parotid gland tuberculosis is often established after conducting superficial parotidectomy. During this discussion we will present and elaborate a case of parotid gland tuberculous abscess which was diagnosed with PPD5TU, BTA and FNAB. The patient managed to be cured with OAT distribution and no recurrences were recorded afterward. Parotid gland tuberculous abscess is rarely found in clinics. Tuberculosis examination (including PPD5TU and BTA) and FNAB need to be conducted to prevent unnecessary treatment and medical operations.

Congenital double lip pits

Introduction : Lip pits are unusual congenital anomalies affecting the lip, first described by DeMurquay in 1845. Lip pits can encounter aesthetic problem thus the patient ask for surgical overcome. Case Report : A 4-year-old girl patient came with double lower lip pits that present since birth with bilateral cleft lip and palate. The pits made a mucous accumulation occurs during mealtimes and crying, and felt aesthethic discomfort. The surgery was performed by simple excision combined with split-lip advancement technique under general anaesthesia and the excised pits was then analized for histopatological structures. The patient has no aesthetic defect after surgery. Discussion : Congenital lip pits are developmental anomalies that occur as an isolated defect or either in association with other developmental disturbances. It happens due to notching of lip at an early stage of development with fixation of tissues of the base of the notch or from a failure of complete union of embryonic lateral sulci of the lip. Lip pits can be shallow or deep, and may be associated with accessory salivary glands. The treatment is usually surgical excision with removal of entire fistulous tract. Conclusion : Surgical removal of lip pits is commonly for cosmetic purpose. It must be treated wisely because lips are essential part of someones face.

A rare case of massif Adenomatoid Odontogenic Tumor in the anterior region of mandible: Mimicking as dentigerous cyst

Background. Adenomatoid Odontogenic Tumor (AOT) is a rare tumor of epithelial origin. AOT appears in three clinico-topographic variants: follicular, extrafollicular and peripheral. The AOT was predominantly found in the upper jaw, and rarely found in mandible, especially at anterior mandible. AOT is a tumor of odontogenic epithelium having duct like structures, which may be partly cystic, and in some cases the solid lesion may be present only as masses in the wall of a large cyst. The surgical management of this lesion would be enucleation along with removal of associated impacted tooth. The prognosis for both of them is good and recurrences are very rare after complete removal of the lesion. Purpose. It is important to define final diagnose for AOT due to mimicking with DC in clinically and radiographically finding. Biopsy is still obviously necessary to the final diagnosis. Case. 15-year-old female patients reported with chief complain of swelling in anterior mandible. The swelling beginning 4 years ago, gradually progressed, with no history pain, discharge and patient is complaint about loss of sensation around anterior mandible. Aspiration revealed straw colored fluid thinking in the way of DC. The provisional diagnosis of DC was given due to clinical presentation and radiographic imaging. But the biopsy examination showed AOT due to duct-like epithelial cells was being found. Discussion. The case report illustrates characteristic clinical and radiographic features of follicular variant of AOT mimicking a DC at unusual site that is anterior mandible. AOT is thought to arise from odontogenic epithelium and associated with the impacted tooth. Rightfully AOT is a perfect imitator of DC radiographically as well as histopathologically. It usually clinically misdiagnosed as DC as both have a unilocular, well-defined radiolucency surrounding the crown of an impacted tooth. The mass was enucleated, involved teeth were extracted, and titanium plates are used to avoid pathologist fracture. The patient had uneventful postoperative recovery. Follow up of a year has not shown any evidence of recurrence. Conclusion. Follicular type of OAT could confuse us with DC if the support examination just only clinicaly finding and radiographic examination. This case could not be definitively diagnosed on clinical and radiographic features alone. Biopsy was obviously necessary to the final diagnosis.

Treatment of relapse Ameloblastoma after Hemimandibulectomy and Mandibular Reconstruction

Background. Ameloblastoma is a benign odontogenic tumor with an aggressive biological behaviour, and the surgical treatment frequently results in failure for the post operative recurrence. Purpose. The aim of this study was to evaluate the clinical result of the patient with aggressive recurrent ameloblastoma who underwent two times radical surgery to get recurrence free. Case. We report a patient who was diagnosed with ameloblastoma of the mandible 13 years ago and had undertaken operation hemimandibulectomy and mandibular reconstruction. However, recurrence occured and secondary surgical treatment (particularly radical) offers the best chance to the patient. The recurrence of an ameloblastoma mainly displays the ineffectiveness or perhaps lack of success of the main surgical treatment. Conclusion. The method has to be intense as well as radical in order to steer clear of reccurence. For ameloblastoma an ineffectiveness of initial surgical treatment indicates that more radical strategy led to minimum recurrence rate.

The accuracy value of the dentist’s clinical diagnosis in oral lesions performed on biopsy

Introduction: The diagnosis of a pathological disorder can be made in various stages, namely history taking, clinical examination and supporting examination. Clinical diagnosis is a diagnosis obtained from anamnesis and the results of clinical examination. Histopathological diagnosis is a diagnosis obtained from a microscopic examination of tissue. Clinical diagnosis and histopathological examination results may differ. The aim of the study was to obtain the accuracy value of the dentist’s clinical diagnosis by calculating the number of differences between the clinical diagnosis and the results of the histopathological examination of patients who were biopsied in the Department of Oral Surgery of General Hospital Dr. Hasan Sadikin Bandung. Methods: A retrospective descriptive study of cases of pathological abnormalities biopsied in the Department of Oral and Maxillofacial Surgery of General Hospital Dr Hasan Sadikin Bandung. The total number of study samples was 109 medical records of patients with biopsy. Results: The accuracy value of the clinical diagnosis of dentists was 76%, where the difference between the clinical diagnosis and the histopathological examination was 24%. The most common type of disorder with the greatest difference in diagnosis is ameloblastoma followed by papilloma and mucocele. Conclusion: The accuracy value of the clinical diagnosis of dentists in oral lesions performed biopsy is 76%.

Tooth extraction complication and treatments at the Exodontia Clinic of the Oral and Dental Hospital of the Faculty of Dentistry of Universitas Padjadjaran Bandung

The patient’s dental conditions who visited the Exodontia Clinic of the Oral and Dental Hospital of the Faculty of Dentistry of Padjadjaran University, Bandung, were generally in a severe damage stage, causing problems in extraction. This condition, as well as the operator ’s (co-assistant student) that still have limited capability,  may increase the risk of complication. This study was conducted at the Exodontia Clinic of the Oral and Dental Hospital of the Faculty of Dentistry of Padjadjaran University. It is conducted from March 13 to May 13, 2007. It is aimed at finding out the types of tooth extraction complications including the treatments towards the problems. This study was a prospective descriptive using the survey method. The study showed that there were 70 cases (64% ) of complications occurred, namely, 37 cases (6.68%) in the maxilla, and 33 cases (5.96% ) in the mandible. The complications that occurred consisted of root fracture (41 .43%), crown fracture (32.86% ), soft tissue laceration (14 .29%), maxillary sinus perforations (2.86% ), syncope (2.86% ), swelling (2.86% ), and secondary hemorrhage (2.86% ).

The infrared radiation effect to the trismus recovery after odontectomy

Impacted was defined as unerupted teeth, it could some pathological conditions such as pain, swelling, trismus, and should be removed by an operative procedure called odontectomy. Nevertheless, this procedure could cause some complications such as pain, trismus and swelling. Trismus was a jaw restricted movement condition caused by inflammation, swelling and pain. Trismus could be cured by analgetic anti-inflammation medicines, and physiotherapy such as jaw movement exercise, massaging, hot wet application and therapy used infrared light. Infrared light was an electromagnetic radiation with a wavelength between 0.7 μm-1000 μm. It could reduce the inflammation in cell structure, pain and less of side effects. The research was carried out to know the infrared effect to the velocity of trismus recovery. Type of research had been used is quacy experimental in a prospective way, using 15 patients with infrared radiation and 15 patients without infrared radiation. The result of research used t-test with α = 0.05 indicated that there was significant differences velocity of trismus after odontectomy recovery between infrared radiation and without infrared radiation. This study concluded that the velocity of trismus recovery was faster when applied by infrared radiation.