Rolando Crippa

Treatment of hemangioma of the head and neck with diode laser and forced dehydration with induced photocoagulation.

OBJECTIVE The aim of this study was to investigate the efficacy of treating oral hemangiomas using forced dehydration with induced photocoagulation (FDIP) via diode laser. METHODS One-hundred sixty patients were treated between 1999 and 2006 (76 men, 46%; 84 women, 54%). In 136 cases we used FDIP to treat hemangioma, and in 24 cases complete surgical excision was performed. One-hundred thirty-four lesions had a surface area <2 x 2 cm2, whereas only two had large lesions measuring 2.5 x 2 cm2. RESULTS In 136 patients with hemangiomas treated with FDIP, 134 cases (98.53%) showed complete remission, one case (0.735%) did not show complete remission, and one case (0.735%) displayed tumor growth. There were no adverse effects and all patients were carefully followed-up until complete healing was documented, along with any complications. CONCLUSIONS Our findings suggest that FDIP is a useful and effective treatment for benign oral vascular lesions. FDIP treatment of these oral lesions is clinically significant because it provides effective management, avoids recurrence, and shortens healing time. We believe that the use of this method by medical and dental specialists should be supported.

Apicoectomies with the erbium laser: a complementary technique for retrograde endodontic treatment.

OBJECTIVE The purpose of this study was to evaluate the efficacy of erbium lasers for retrograde endodontic treatment, in terms of clinical outcome and therapeutic success. BACKGROUND DATA Apicoectomy with retrograde filling is a well-established surgical procedure to treat teeth affected by persistent periapical lesions. The apical root end is generally removed with burs, and the adjacent periapical tissue curetted, or alternatively treated with ultrasound or laser. METHODS Between 2000 and 2010, 65 apicoectomies were performed on necrotic teeth that presented apical lesions (29 men, 36 women). The lasers used in the study were the erbium:yttrium-aluminum-garnet (Er:YAG) laser, wavelength 2940 nm, and the erbium,chromium-doped:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser, wavelength 2780 nm. RESULTS Of the 65 teeth in the study, failure only occurred in 9 CASES, MANIFESTING AFTER DIFFERENT TIMES. THE REMAINING PATIENTS, 86.15%, experienced no complications, and their treatment followed a positive course. CONCLUSIONS Laser-assisted surgery increases the range of therapeutic approaches in the sphere of retrograde endodontic treatment. The results of this study show that the erbium laser, used for apicoectomy, results in a high success rate with considerable benefit in terms of clinical outcome and therapeutic success.

Sialolithiasis of the Submandibular Salivary Gland Treated with the 810- to 830-nm Diode Laser

OBJECTIVE Surgical management of salivary gland diseases has always been challenging because it carries a considerable risk of nerve damage. This study evaluates an innovative ambulatory laser-aided technique that may be an alternative to traditional treatment, and presents our 5-y experience of salivary gland excision. MATERIALS AND METHODS Twenty-five submandibular salivary gland excisions were performed with an 810- to 830-nm diode laser. The diagnosis was sialolithiasis with stones in the salivary gland duct above the glandular hilum. A 320-microm flexible delivery fiber was used in continuous wave mode at 2.5 W power. The procedure consisted of locating the stone, isolating the duct from the surrounding tissues, introducing a button probe, ductal incision above the stone, sialolithotomy, and checking duct patency. RESULTS The overall success rate was 92%. The largest stone removed was 4.5 cm in size. In 1 patient (4%), an additional undetected stone was diagnosed by endoscopy after removal of the stone from the duct, and in 1 patient (4%), synechiae formed in the duct during healing and duct patency had to be restored with a probe. We had no cases of transient palsy or paresis of the mandibular branch of the facial or lingual nerves. CONCLUSION Use of the 810-nm laser is safe for this type of surgical procedure, carries a low complication rate, and is a valid alternative to traditional surgery. It is indicated as the procedure of choice in cases of stones located in the duct above the kink leading into the mylohyoid muscle, and above the glandular hilum.

Pyoderma gangrenosum with severe cutaneous and oral involvement

ejd.2013.1968 Auteur(s) : Angelo V. Marzano1 angelovalerio.marzano@policlinico.mi.it, Silvia Alberti-Violetti1, Rolando Crippa2, Francesca Angiero3, Gianluca Tadini1, Carlo Crosti1 1 U.O. Dermatologia, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy; 2 U.O. Patologia Orale e Laserterapia, Istituto Stomatologico Italiano, Milan, Italy; 3 Department of Surgical Sciences and Integrated Diagnostic, University of Genoa, Genoa, Italy Pyoderma gangrenosum [...]

Neurofibromas of the Oral Cavity: Clinical Aspects, Treatment, and Outcome

OBJECTIVE This study aimed to evaluate the efficacy of diode laser for the surgical treatment of neurofibromas (NF), in terms of clinical outcome and therapeutic success. BACKGROUND DATA The NF is a benign tumor of the peripheral nerve sheath, characterized by the proliferation of Schwann cells, perineural cells, and endoneural fibroblasts. NF may occur as a solitary lesion, or as part of a generalized neurofibromatosis syndrome; much more rarely it occurs in the form of multiple neurofibromas with no associated syndrome. Two distinct variants of neurofibromatosis have been described: types I and II. METHODS Ten cases are reported (6 women and 4 men, age range 43-70 years) with smooth, painful, or painless lesions of the oral mucosa. Lesions were completely excised using a diode laser at 980 nm wavelength, average power 2.0 W, in continuous wave mode, with 320 μm optical fibers, for 45 sec average time. RESULTS Complete healing occurred within 20 days. There were no adverse effects; patients were carefully followed up and there have been no recurrences after an interval of 3 months to 3 years. CONCLUSIONS The results of this diode laser treatment of NF demonstrate good effectiveness of this novel therapy, which may replace conventional surgical procedures.

Dental Abnormalities in Pituitary Dwarfism: A Case Report and Review of the Literature

Hypopituitarism is a disorder caused by a reduced level of trophic hormones that may be consequent on different destructive processes. The clinical manifestations depend on the type of hormone involved. A deficiency of growth hormone (GH) in children causes the lack of growth known as pituitary dwarfism. The case is reported of a patient with pituitary dwarfism, multiple dental anomalies, functional prosthetic problems, and a revision of the literature. She was subjected to prosthetic rehabilitation without surgical intervention, using zirconium substructures, thus eliminating the potential complications that may require trauma surgery. The therapeutic approach adopted led to excellent results and restored an aesthetic smile.