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Materials (Basel, Switzerland) Mar 2022The 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... (Review)
Review
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 CO (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.
PubMed: 35407784
DOI: 10.3390/ma15072452 -
Medicina Oral, Patologia Oral Y Cirugia... Nov 2023There are different surgical techniques to remove Oral mucoceles, including conventional surgery with scalpel, removal of the lesion with CO2 laser, and micro... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There are different surgical techniques to remove Oral mucoceles, including conventional surgery with scalpel, removal of the lesion with CO2 laser, and micro marsupialization. The present systematic review was conducted with the aim of comparing the recurrence rate of different surgical techniques for treatment of the oral mucoceles.
MATERIAL AND METHODS
An electronic search for randomized controlled trials published in English until September 2022 related to different surgical methods for the treatment of oral mucocele was performed in Medline/PubMed, Web of Science, Scopus, Embase and Cochrane databases. A random-effects meta-analysis was conducted to compare the recurrence rate of different techniques.
RESULTS
Among 1204 papers initially identified, after the removal of duplicate articles and screening of the titles and abstracts, fourteen full-text articles were reviewed. Seven articles comparing the recurrence rate of oral mucocele in different surgical techniques were found. Seven studies were included in qualitative studies, and five articles were included in the meta-analysis. The risk of mucocele recurrence in the micro-marsupialization technique was 1.30 times that of the surgical excision with scalpel technique, which was not statistically significant. The risk of mucocele recurrence in the CO2 Laser Vaporization technique was 0.60 times that of the Surgical Excision with Scalpel technique, which was not statistically significant.
CONCLUSIONS
The results of this systematic review showed that there is no significant difference between the recurrence rate of surgical excision, CO2 laser and marsupialization techniques for the treatment of oral mucoceles. Although more randomized clinical trials are needed for definitive results.
Topics: Humans; Mucocele; Neoplasm Recurrence, Local; Mouth Diseases; Surgical Instruments; Laser Therapy
PubMed: 37330953
DOI: 10.4317/medoral.26015 -
The Journal of Evidence-based Dental... Jun 2023Oral mucoceles could be managed with minimally invasive therapy (MIT) or conventional surgery, and both modalities reportedly possess advantages and demerits. This... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Oral mucoceles could be managed with minimally invasive therapy (MIT) or conventional surgery, and both modalities reportedly possess advantages and demerits. This review aims to investigate and compare the postoperative disease recurrence and complications of these interventions with each other.
METHODS
Relevant studies were searched in 5 databases (PubMed, Embase, Scopus, Web of Science and Cochrane Library) from inception to December 17, 2022. The pooled relative risks (RRs) with 95% confidence intervals (CIs) of disease recurrence, overall complications, nerve injury and bleeding/hematoma in MIT vs conventional surgery were calculated in meta-analysis. Trial Sequential Analysis (TSA) was performed to confirm our conclusions and assess the need for future trials.
RESULTS
Six studies (1 randomized controlled trial and 5 cohort studies) were included for systematic review and meta-analysis. The results showed no significant difference in recurrence between MIT and conventional surgery (RR=0.80; 95% CI, 0.39-1.64; P = .54; I=17%), and the results of the subgroup analysis were consistent. The incidence of the overall complications (RR=0.15; 95% CI, 0.05-0.47; P = .001; I=0%) and nerve injury (RR=0.22; 95% CI, 0.06-0.82; P = .02; I=0%) was significantly lower in MIT than in conventional surgery, but the incidence of bleeding/hematoma presented no significant difference (RR=0.34; 95% CI, 0.06-2.07; P = .24; I=0%). The results of TSA suggested that the conclusion of MIT significantly reducing the risk of overall complications was stable; and additional clinical trials were need in the future for confirming the conclusions regarding disease recurrence, nerve injury and bleeding/hematoma.
CONCLUSIONS
For mucoceles in the oral cavity, MIT is less likely to induce complications (i.e., nerve injury) compared with surgical removal, and the control of disease recurrence is comparable to that of conventional surgery. Therefore, the application of MIT for mucoceles could be a promising alternative to conventional surgery when the latter is not applicable.
Topics: Humans; Mucocele; Neoplasm Recurrence, Local; Hematoma
PubMed: 37201978
DOI: 10.1016/j.jebdp.2023.101841 -
Journal of Oral Pathology & Medicine :... Jan 2021Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to...
BACKGROUND
Intravascular papillary endothelial hyperplasia is an unusual vascular lesion characterized by the proliferation of endothelial cells. The aim of this study was to determine the frequency and general features of this lesion.
METHODS
Biopsy records of three oral pathology services were reviewed for intravascular papillary endothelial hyperplasia cases from 1959 to 2020. In addition, a systematic review of case reports and case series was carried out in eight electronic databases.
RESULTS
Of the 65 205 retrieved cases, 20 (0.03%) were diagnosed as intravascular papillary endothelial hyperplasia. Mean patient age was 46.55 years, and females (12 cases/60%) were more affected. The lower lip (9 cases/47.36%) was the most commonly affected site, and the lesions were generally asymptomatic (7 cases/63.63%). Clinically, 90% of the lesions presented (18 cases) as a nodule, with a mean size of 1.13 cm. The clinical diagnostic hypotheses most frequently raised were mucocele (6 cases/37.50%) and hemangioma (5 cases/31.25%). An excisional biopsy was chosen in all cases for treatment. Forty-nine studies of the systematic review were included, yielding 105 cases. The literature showed similarity in all variables.
CONCLUSION
Despite the uncommon frequency, clinicians and oral pathologists should familiarize themselves with the similarities between intravascular papillary endothelial hyperplasia and some other lesions in terms of clinical and histological features.
Topics: Diagnosis, Differential; Endothelial Cells; Endothelium, Vascular; Female; Hemangioendothelioma; Humans; Hyperplasia; Middle Aged; Mouth Mucosa
PubMed: 33188642
DOI: 10.1111/jop.13127 -
The Journal of Craniofacial Surgery 2020To describe the osteoplastic approach and to perform a systematic review of the indications and outcomes of the osteoplastic flap procedure for frontal sinus surgeries...
OBJECTIVE
To describe the osteoplastic approach and to perform a systematic review of the indications and outcomes of the osteoplastic flap procedure for frontal sinus surgeries with or without obliteration.
DATA SOURCES
PubMed, Medline, Google Scholar, and Cochrane databases.
REVIEW METHODS
All published studies in the English language on the osteoplastic flap with or without obliteration were identified from 1905 to 2018. All studies with <20 patients were excluded. The number of patients, technique, indications, follow-up period, symptom relief, revision rates, and complications were recorded and analyzed.
RESULTS
A systematic review yielded 25 series containing 1374 patients for analysis. Indications for surgery included chronic frontal sinusitis, mucoceles, fractures or traumas, osteomas, neoplasms, and cerebrospinal fluid leak. The mean follow-up period ranged from 12.8 to 144 months. The percentage of patients needing revisions for frontal sinus disease was 6.2%. There was a high rate of symptomatic improvement (85.0%) and a low rate of major complications (0.7%). However, minor complications occurred in 19.4% of patients.
CONCLUSION
The osteoplastic flap with or without obliteration has many indications. In an era where endoscopic technique provides excellent access to the frontal sinuses, external approaches remain a useful adjunct, and/or salvage technique. In experienced hands, the osteoplastic flap can yield excellent long-term clinical results, with low rates of complications. Regardless of the surgical approach, long-term follow-up is necessary due to the recurrent nature of frontal sinus disease.
Topics: Humans; Paranasal Sinus Diseases; Plastic Surgery Procedures; Surgical Flaps; Treatment Outcome
PubMed: 33136864
DOI: 10.1097/SCS.0000000000006717 -
Journal of Lasers in Medical Sciences 2023Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues.... (Review)
Review
Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues. The carbon dioxide (CO2) laser was one of the first soft tissue removal lasers. Because of the strong affinity of the CO2 laser to water, it is best used for removing, vaporizing, and coagulating these tissues. In minor oral surgery, CO2 laser therapy has shown advantages. Therefore, this study examined the CO2 laser use in minor oral soft tissue surgery. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in this study. A question for research encompassing the inclusion criteria for the participants, intervention, comparison, outcome, and study design (PICOS) was formulated. The search queries were entered into the PubMed/Medline, Scopus, and Embase databases. Consideration was given to publications published between January 1, 2018 and March 15, 2023. The research included 37 studies after narrowing search results, eliminating duplicate titles, and conducting an eligibility review (three animal studies, seven case reports, three case series, and twenty-four clinical studies). CO2 lasers alone or in combination with other therapies successfully treated oral potentially malignant disorders (OPMDs), oral tumors, oral fibrous-epithelial lesions, gingival melanin hyperpigmentation, pyogenic granuloma, socket preservation, mucocele, high labial frenulum attachment, and so on. CO2 lasers reduced intra- and postoperative complications and adverse effects, improved postoperative functional results, ablated tissues with precision, and minimized disease recurrence and malignant transformation. Our study found that the CO2 laser in oral minor surgeries is successful, but further randomized clinical trials and multicenter studies are recommended to compare CO2 laser surgery to other treatments.
PubMed: 38028885
DOI: 10.34172/jlms.2023.44 -
Annals of Plastic Surgery Oct 2023Frontal sinus obliteration is a possible terminus for the management of chronic sinusitis, frontal bone trauma, cancer extirpation, or mucocele. The mucosa of the sinus... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Frontal sinus obliteration is a possible terminus for the management of chronic sinusitis, frontal bone trauma, cancer extirpation, or mucocele. The mucosa of the sinus is stripped and space obliterated with either autogenic, allopathic, or synthetic materials. This study aimed to compare the outcomes of autologous fat and hydroxyapatite cement (HAC) for frontal sinus obliteration.
METHODS
A multidatabase systematic review was conducted to collect outcomes on frontal sinus obliterations with either autologous fat or HAC. Outcomes collected included infection of the frontal sinus or obliteration material, mucocele formation, skin infection at the operative site, hematoma or seroma, cosmetic defect, donor site infection, and need for revision procedure. Prevalence of outcomes was analyzed through meta-analysis of proportions.
RESULTS
Twenty studies were ultimately included in the meta-analysis. Sixteen studies reported outcomes for 667 patients obliterated with autologous fat, and 7 studies reported outcomes for 100 patients obliterated with HAC. Prevalence of infection of the frontal sinus or obliteration material, mucocele formation, skin infection at the operative site, hematoma or seroma, and cosmetic defect did not differ statistically between the cohorts. Donor site infection secondary to fat harvesting for fat obliteration had a prevalence of <0.01. Revision rate was 0.04 (95% confidence interval, 0.01-0.8) for fat obliteration and 0.10 (95% confidence interval, 0.00-0.33) for HAC obliteration.
CONCLUSIONS
No statistically significant differences in the studied outcomes were detected between obliterations with autologous fat and HAC, suggesting that either is equally suitable and may be up to the surgeon's preference.
Topics: Humans; Frontal Sinus; Mucocele; Seroma; Hydroxyapatites
PubMed: 37556560
DOI: 10.1097/SAP.0000000000003581 -
International Journal of Pediatric... Nov 2020The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest...
INTRODUCTION
The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest increase has been in neonates. For parents considering frenotomy for their breastfeeding newborn, there is controversy surrounding the evaluation of tongue-tie and the benefit of a frenotomy. Complications from tongue-tie procedures are thought to be low, though it is not well reported nor studied.
OBJECTIVES
The aim of this study is to describe a case of a sublingual mucocele after laser frenotomy in a neonate with tongue-tie and to investigate major complications reported after tongue-tie release in pediatric patients through a systematic review of the literature.
CASE REPORT
We present a 6-week-old female who underwent a laser frenotomy procedure performed by a dentist who presented with a new cyst under her tongue.
MATERIAL AND METHODS
A systematic literature search of articles published from 1965 to April 2020 was conducted in Ovid MEDLINE(R), Ovid EMBASE, and Scopus. Citations were uploaded into a systematic review software program (DistillerSR, Ottawa, ON, Canada), followed by full text screening.
RESULTS
47 major complications were reported in 34 patients, including our patient. Most of the cases were located in the United States and Europe. The most frequent indications for the procedure were breastfeeding problems (n = 18) and speech impediment (n = 4). The procedure was performed by dentists (n = 6), lactation consultants (n = 5), and otolaryngologists (n = 4). The bulk of the major complications after frenotomy included poor feeding (n = 7), hypovolemic shock (n = 4), apnea (n = 4), acute airway obstruction (n = 4), and Ludwig angina (n = 2).
CONCLUSIONS
Reporting of complications after frenotomy is lacking. Risks to neonates may be different than risks to older children and adults. Practitioners across different specialties should be monitoring and studying this more rigorously to better guide patients and families on the risks and benefits of this procedure.
Topics: Airway Obstruction; Ankyloglossia; Apnea; Female; Humans; Infant; Lingual Frenum; Postoperative Complications; Ranula; Shock
PubMed: 32927351
DOI: 10.1016/j.ijporl.2020.110356 -
Lasers in Medical Science Dec 2019In 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...
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), CO (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.
Topics: Child; Humans; Laser Therapy; Lasers, Semiconductor; Mouth; Publication Bias; Risk; Treatment Outcome
PubMed: 31309364
DOI: 10.1007/s10103-019-02834-0