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Cureus Apr 2024Background Gingival pigmentation (GP), characterized by the presence of melanin in the gingival tissues, is a common aesthetic concern in dental practice. While it poses...
Background Gingival pigmentation (GP), characterized by the presence of melanin in the gingival tissues, is a common aesthetic concern in dental practice. While it poses no inherent health risks, the visible discoloration may cause psychological distress for individuals seeking optimal dental aesthetics. Understanding the efficacy of various methods is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival depigmentation (GD). Aim The objective of the study was to compare the effectiveness of scalpel and microneedling (MN) with ascorbic acid in the treatment of GD. Materials and methods Sixteen patients who had a complaint of GP were included in the study, of whom eight were allocated for depigmentation with a scalpel, and the other eight patients were treated with the MN technique with ascorbic acid. Postoperative wound healing scores were evaluated on the first and seventh days, respectively. The intensity of depigmentation was assessed at baseline, in the first month, and at the end of the third month, respectively. Results The mean Dummett-Gupta Oral Pigmentation Index (DOPI) score at baseline was 2.65±0.16 and 2.61±0.17 in the surgical and microneedling groups with ascorbic acid, respectively. The mean DOPI score at the end of the third month was 1.67±0.39 and 0.87±0.17 in the scalpel and MN with ascorbic acid groups, respectively. There was a statistically significant difference between the scalpel and MN with ascorbic acid groups at the end of the first and third months, respectively, where MN with ascorbic acid showed aesthetically pleasing outcomes. Patients treated with the scalpel technique showed incomplete healing and ulceration on the first and seventh days after the procedure when compared to the MN technique with ascorbic acid. The healing index scores were statistically significant in the MN with ascorbic acid group. Conclusion The MN technique with ascorbic acid is a successful technique for treating GD. It showed aesthetically gratifying outcomes when compared to the conventional surgical technique.
PubMed: 38752063
DOI: 10.7759/cureus.58285 -
Biomedica : Revista Del Instituto... Sep 2023Introduction. Over time, efforts have been invested in the design of new instruments that overcome the disadvantages of the gold standard instrument in surgery, the...
Introduction. Over time, efforts have been invested in the design of new instruments that overcome the disadvantages of the gold standard instrument in surgery, the scalpel. As a result, electronic equipment has emerged such as the electric scalpel and laser devices. The available evidence on these instruments suggests that the tissue response is related to each instrument’s physical and biological cutting principles. Objective. To compare the histological changes in gingiva samples associated with surgical cutting performed with a 940 nm diode laser, a 2780 nm erbium, chromium: yttriumscandium-gallium-garnet (Er,Cr:YSGG) laser, and an electric scalpel, by presenting a series of cases. Case presentation. We present three cases of healthy patients undergoing cosmetic surgery. The clinical examination revealed exposure of a keratinized gingiva band greater than 4 mm, normal color and texture in gingival tissue, with a firm consistency and no bleeding on periodontal probing. Gingivectomy was indicated with the following protocols: Diode laser of 940 nm at 1 W, in continuous mode; Er,Cr:YSGG laser of 2780 nm at 2.5 W, 75 Hz, H mode, air 20, water 40, gold tip MT4); and electric scalpel in cutting mode at power level four. Gingival tissue samples were taken and stored in 10% formaldehyde for histological analysis. Conclusion. All the evaluated cutting instruments generated histological changes produced by the thermal effect, the main ones being collagen coagulation and carbonization. The depth of thermal damage caused by the 2780 nm Er,Cr:YSGG laser was much lesser than that induced by the electric scalpel and the 940 nm diode laser.
Topics: Humans; Gingivectomy; Artifacts; Lasers, Solid-State; Lasers, Semiconductor
PubMed: 37871565
DOI: 10.7705/biomedica.6930 -
Clinical Oral Investigations Nov 2023This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.
OBJECTIVE
This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.
MATERIALS AND METHODS
Twenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points.
RESULTS
At 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups.
CONCLUSION
While diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures.
CLINICAL RELEVANCE
Gingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.
Topics: Humans; Lasers, Semiconductor; Gingival Diseases; Lasers, Solid-State; Esthetics, Dental; Hemorrhage; Hyperpigmentation; Pain
PubMed: 37878070
DOI: 10.1007/s00784-023-05310-w -
Nigerian Journal of Clinical Practice Sep 2023Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed...
BACKGROUND
Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed macroscopic and microscopic observations.
AIMS
This study aimed to clinically and histologically evaluate palatal wound healing in rats by secondary intention after excision using a steel scalpel, diode laser, and radiofrequency.
MATERIALS AND METHODS
An excision was made in the edentulous anterior maxilla of 42 4-month-old male Wistar rats weighing 289-428 g. Part of the connective tissue was left in the surgical area to observe the dynamics of secondary intention wound healing. Three experimental groups were established: the steel scalpel, an 810-nm diode laser at a power output of 1.5 W in continuous mode, and a monopolar radiofrequency in a fully rectified waveform at 15 W. Clinical and histological analyses were performed on days 2, 4, and 7. Hemostasis, changes in body weight, defect size, epithelial gap, and inflammatory infiltration were evaluated.
RESULTS
The epithelial gap closed completely in all groups on day 7. Bleeding occurred significantly more in the scalpel group (P < 0.001). No significant changes were observed in body weight between the groups. Macroscopically, the mean wound area decreased over time in all groups. Wound healing was significantly slower in the laser group on day 2 and in the radiofrequency group on days 4 and 7 (P < 0.001). Microscopically, the laser created the cleanest wound area, with minimal inflammatory infiltration and no thermal injury. More damage occurred in the connective tissue of the radiofrequency group. Wound healing was observed on day 7 in all groups.
CONCLUSIONS
Palatal wound healing with secondary intention yielded different outcomes in a rat model when different techniques were used. However, almost complete healing was observed in all wounds, which highlights the importance of the soft tissue left in the surgical area. Wound healing in periodontal soft tissue procedures is not compromised by different techniques, as long as the clinician has sufficient knowledge and experience.
Topics: Male; Rats; Animals; Lasers, Semiconductor; Steel; Laser Therapy; Rats, Wistar; Wound Healing; Body Weight
PubMed: 37794538
DOI: 10.4103/njcp.njcp_578_22 -
Obstetrics & Gynecology Science Nov 2023To show how endoCUT mode can be safely managed with cervical conization.
OBJECTIVE
To show how endoCUT mode can be safely managed with cervical conization.
METHODS
Demonstration of the technique and explanation of endoCUT and soft coagulation mode with narrated video footage. Cervical conization is a therapeutic and diagnostic procedure performed for the diagnosis of cervical intraepithelial lesions and cervical cancer. Specific.
METHODS
include cold scalpel, ultrasonically activated device and laser, and loop electrosurgical excision procedure (LEEP), which involves transpiration and partial excision. The endoCUT mode and soft coagulation in VIO3® (ERBE, Tübingen, Germany) were used to perform cervical conical resection safely and at low cost. The endoCUT mode was originally developed for polypectomy in gastrointestinal endoscopy, where no counter traction can be applied.
RESULTS
The endoCUT mode approach to cervical conization with several key strategies to minimize blood loss and ensure safety: 1) incisions can be made in close contact; 2) resection can be performed with minimal contact with the lesion; 3) control of bleeding from the resected transection by soft coagulation; and 4) low running cost of endoCUT mode.
CONCLUSION
Conventionally, cervical conical resection has been performed by using a device capable of making a close incision (cold scalpel, ultrasonically activated device and laser, and LEEP etc.), but there have been issues with bleeding control and cost. Here, we present a new technique using the endoCUT mode and several strategies for safe and effective resection.
PubMed: 37381884
DOI: 10.5468/ogs.23066 -
Cureus Oct 2023An oral fibroma is a benign scar-like reaction frequently resulting from chronic mouth irritation. It is also called an oral polyp, fibrous nodule, localised intraoral...
An oral fibroma is a benign scar-like reaction frequently resulting from chronic mouth irritation. It is also called an oral polyp, fibrous nodule, localised intraoral fibrous hyperplasia, and traumatic fibroma. Chronic irritation from things like biting one's lips or cheek, orthodontic treatments, rubbing against a hard tooth, or wearing dentures or other dental prostheses is frequently the cause. It is often the same colour as the surrounding mouth lining, but occasionally, it can be paler or appear darker if it has bled. Trauma can cause the surface to become rough and scaly or ulcerated. It is primarily dome-shaped and similar to a pedunculated polyp. A traumatic fibroma most frequently occurs on the inside of the cheek. The inside of the lower lip, the gingiva, and the sides of the tongue are other frequent locations. The given case series reported traumatic fibroma associated with anterior teeth and buccal mucosa treated with a conventional scalpel and diode laser techniques, respectively. Diagnosing and treating the aetiology and educating the patient about the same is essential in fibroma cases. The clinical features of both claims and mere aetiology confirmed the diagnosis. The sole option available when therapy is needed is a surgical fibroma excision. Surgical excision is the most popular method for treating oral or traumatic fibromas. Two ways are available for the surgical removal of an oral fibroma: with a scalpel or using a diode laser. Both case presentations demonstrate that surgical excision with a scalpel and diode laser was discovered to be a simple, efficient, and affordable method for treating traumatic fibroma in this report, which presents two traumatic fibromas with different locations with varying aetiology. Traumatic fibromas reported here were in the aesthetic zones, which need to be treated as they can cause traumatic occlusion and difficulty chewing and speech. The patients reviewed for the next three months revealed complete satisfactory healing and no recurrence in both cases.
PubMed: 38021932
DOI: 10.7759/cureus.47810 -
Skin Research and Technology : Official... Jan 2024Acne scars present a complex challenge in dermatology and cosmetics, despite advancements in technological interventions such as fractional lasers, microneedling, and...
BACKGROUND
Acne scars present a complex challenge in dermatology and cosmetics, despite advancements in technological interventions such as fractional lasers, microneedling, and surgical procedures. Effective treatment remains elusive for many individuals.
OBJECTIVE
This study aims to evaluate the efficacy of rotational fractional resection using 1 mm diameter rotating scalpels as a primary treatment for icepick and boxcar scars on the cheeks and glabella region.
METHODS
Three patients with acne scars underwent a single treatment session of rotational fractional resection. Evaluation occurred at the 2-month post-treatment mark to assess improvements in scar appearance and potential skin-related side effects.
RESULTS
Following the treatment, significant improvements were observed in the targeted acne scars. Notable enhancements were noted without major skin-related adverse effects, except for minor suture marks.
CONCLUSION
The outcomes of this study underscore the potential of rotational fractional resection as an innovative and effective approach in treating acne scars. This single-session cosmetic procedure shows promise in yielding lasting and quantifiable results, offering a hopeful solution for individuals seeking comprehensive acne scar treatment.
Topics: Humans; Cicatrix; Acne Vulgaris; Skin; Treatment Outcome
PubMed: 38174806
DOI: 10.1111/srt.13545 -
Revista Espanola de Enfermedades... Jan 2024A pilot, multicenter and randomised study on the treatment of Barrett´s esophagus with electro conventional scalpel versus argon plasma coagulation in 36 patients...
A pilot, multicenter and randomised study on the treatment of Barrett´s esophagus with electro conventional scalpel versus argon plasma coagulation in 36 patients consecutives. The disappearance of gastric mucosa was achieved in 83% of cases. Not serious adverse effects.
PubMed: 38258761
DOI: 10.17235/reed.2024.10201/2023 -
The Journal of Craniofacial Surgery Jan 2024Inflammation after surgical incisions is related to the degree of tissue damage. Healing with low inflammation is desirable, especially in patients with compromised...
Inflammation after surgical incisions is related to the degree of tissue damage. Healing with low inflammation is desirable, especially in patients with compromised healing potential. This experimental study was conducted to assess the degree of inflammatory reaction and scar formation from incisions made by an ultra-polished scalpel (UPS). Two paravertebral incisions were made with a conventional scalpel (CS) and a UPS in 18 individual rats with diabetes. The fibrotic tissue (scar) area and expression levels of collagen, transforming growth factor, and matrix metalloproteinases were quantified on postoperative days 3, 7, and 30. The scar widths and areas were significantly lower in the UPS group than in the CS group. The scar widths were 64.3 ± 14.7 µm and 86.8 ± 12.1 µm in the UPS and CS groups, respectively (P = 0.03). The scar areas were 11,398 ± 1595 µm2 in the UPS group and 17,433 ± 3487 µm2 in the CS group (P = 0.014). The UPS group had less inflammation on day 3, less transforming growth factor synthesis on days 3 and 7, lower levels of matrix metalloproteinases, and less collagen synthesis on day 7 than did the CS group. The UPS achieved less local inflammation by reducing the local tissue damage in diabetic rat models, enabling better healing, and resulting in less scar formation. The UPS warrants further clinical study as it may bring beneficial outcomes for patients with impaired healing capability and patients who seek to reduce scarring.
PubMed: 38270441
DOI: 10.1097/SCS.0000000000009955