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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">CO<sub>2</sub> Laser Surgery and Prosthetic Management for the Treatment of Epulis Fissuratum</title><author><name sortKey="De Arruda Paes Junior, Tarcisio Jose" sort="De Arruda Paes Junior, Tarcisio Jose" uniqKey="De Arruda Paes Junior T" first="Tarcisio José" last="De Arruda Paes-Junior">Tarcisio José De Arruda Paes-Junior</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Cavalcanti, Samia Carolina Mota" sort="Cavalcanti, Samia Carolina Mota" uniqKey="Cavalcanti S" first="Sâmia Carolina Mota" last="Cavalcanti">Sâmia Carolina Mota Cavalcanti</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Nascimento, Daniela Fernandes Figueira" sort="Nascimento, Daniela Fernandes Figueira" uniqKey="Nascimento D" first="Daniela Fernandes Figueira" last="Nascimento">Daniela Fernandes Figueira Nascimento</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Saavedra, Guilherme De Siqueira Ferreira Anzaloni" sort="Saavedra, Guilherme De Siqueira Ferreira Anzaloni" uniqKey="Saavedra G" first="Guilherme De Siqueira Ferreira Anzaloni" last="Saavedra">Guilherme De Siqueira Ferreira Anzaloni Saavedra</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Kimpara, Estevao Tomomitsu" sort="Kimpara, Estevao Tomomitsu" uniqKey="Kimpara E" first="Estevão Tomomitsu" last="Kimpara">Estevão Tomomitsu Kimpara</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Borges, Alexandre Luiz Souto" sort="Borges, Alexandre Luiz Souto" uniqKey="Borges A" first="Alexandre Luiz Souto" last="Borges">Alexandre Luiz Souto Borges</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Niccoli Filho, Walter" sort="Niccoli Filho, Walter" uniqKey="Niccoli Filho W" first="Walter" last="Niccoli-Filho">Walter Niccoli-Filho</name><affiliation><nlm:aff id="I2">Department of Biopathology and Diagnosis and Academic Group of Studies and Research with Lasers in Dentistry, São Jose dos Campos Dental School, São Paulo State University, 12245-000 São José dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Komori, Paula Carolina De Paiva" sort="Komori, Paula Carolina De Paiva" uniqKey="Komori P" first="Paula Carolina De Paiva" last="Komori">Paula Carolina De Paiva Komori</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21991461</idno><idno type="pmc">3170081</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3170081</idno><idno type="RBID">PMC:3170081</idno><idno type="doi">10.5402/2011/282361</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">001C78</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001C78</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">CO<sub>2</sub> Laser Surgery and Prosthetic Management for the Treatment of Epulis Fissuratum</title><author><name sortKey="De Arruda Paes Junior, Tarcisio Jose" sort="De Arruda Paes Junior, Tarcisio Jose" uniqKey="De Arruda Paes Junior T" first="Tarcisio José" last="De Arruda Paes-Junior">Tarcisio José De Arruda Paes-Junior</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Cavalcanti, Samia Carolina Mota" sort="Cavalcanti, Samia Carolina Mota" uniqKey="Cavalcanti S" first="Sâmia Carolina Mota" last="Cavalcanti">Sâmia Carolina Mota Cavalcanti</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Nascimento, Daniela Fernandes Figueira" sort="Nascimento, Daniela Fernandes Figueira" uniqKey="Nascimento D" first="Daniela Fernandes Figueira" last="Nascimento">Daniela Fernandes Figueira Nascimento</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Saavedra, Guilherme De Siqueira Ferreira Anzaloni" sort="Saavedra, Guilherme De Siqueira Ferreira Anzaloni" uniqKey="Saavedra G" first="Guilherme De Siqueira Ferreira Anzaloni" last="Saavedra">Guilherme De Siqueira Ferreira Anzaloni Saavedra</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Kimpara, Estevao Tomomitsu" sort="Kimpara, Estevao Tomomitsu" uniqKey="Kimpara E" first="Estevão Tomomitsu" last="Kimpara">Estevão Tomomitsu Kimpara</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Borges, Alexandre Luiz Souto" sort="Borges, Alexandre Luiz Souto" uniqKey="Borges A" first="Alexandre Luiz Souto" last="Borges">Alexandre Luiz Souto Borges</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Niccoli Filho, Walter" sort="Niccoli Filho, Walter" uniqKey="Niccoli Filho W" first="Walter" last="Niccoli-Filho">Walter Niccoli-Filho</name><affiliation><nlm:aff id="I2">Department of Biopathology and Diagnosis and Academic Group of Studies and Research with Lasers in Dentistry, São Jose dos Campos Dental School, São Paulo State University, 12245-000 São José dos Campos, Brazil</nlm:aff></affiliation></author><author><name sortKey="Komori, Paula Carolina De Paiva" sort="Komori, Paula Carolina De Paiva" uniqKey="Komori P" first="Paula Carolina De Paiva" last="Komori">Paula Carolina De Paiva Komori</name><affiliation><nlm:aff id="I1">Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</nlm:aff></affiliation></author></analytic><series><title level="j">ISRN Dentistry</title><idno type="ISSN">2090-4371</idno><idno type="eISSN">2090-438X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The aim of this study was to present a case report of the surgical removal of hyperplasia in the oral cavity, using carbon dioxide (CO<sub>2</sub>) laser radiation and rehabilitation with a complete denture. <italic>Epulis fissuratum</italic> occurs in complete denture patients, because a constant irritative action induces the mucosa to grow under poorly fitting dentures. These lesions must be removed, and to avoid a relapse, new complete dentures should be made to maintain healthy surgical tissues. The clinical sequence presented in this case shows a completely edentulous patient with <italic>epulis fissuratum</italic> on the lower alveolar ridge extending to the vestibular sulcus of the anterior region of mandible. Immediate complete dentures were made prior to the lesion removal with CO<sub>2</sub> laser radiation, providing satisfactory results in oral function and tissue health.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tamarit Borras, M" uniqKey="Tamarit Borras M">M Tamarit Borràs</name></author><author><name sortKey="Delgado Molina, E" uniqKey="Delgado Molina E">E Delgado Molina</name></author><author><name sortKey="Berini Aytes, L" uniqKey="Berini Aytes L">L Berini Aytés</name></author><author><name sortKey="Gay Escoda, C" uniqKey="Gay Escoda C">C Gay Escoda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Blanco, A" uniqKey="Blanco A">A Blanco</name></author><author><name sortKey="Blanco, J" uniqKey="Blanco J">J Blanco</name></author><author><name sortKey="Suarez, M" uniqKey="Suarez M">M Suãrez</name></author><author><name sortKey="Alvarez, N" uniqKey="Alvarez N">N Alvarez</name></author><author><name sortKey="Gandara, Jm" uniqKey="Gandara J">JM Gãndara</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wood, Nk" uniqKey="Wood N">NK Wood</name></author><author><name sortKey="Gouz, Pw" uniqKey="Gouz P">PW Gouz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Frame, Jw" uniqKey="Frame J">JW Frame</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dover, Sf" uniqKey="Dover S">SF Dover</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alamillos Granados, Fj" uniqKey="Alamillos Granados F">FJ Alamillos-Granados</name></author><author><name sortKey="Naval Gias, L" uniqKey="Naval Gias L">L Naval-Gias</name></author><author><name sortKey="Dean Ferrer, A" uniqKey="Dean Ferrer A">A Dean-Ferrer</name></author><author><name sortKey="Del Hoyo, Jra" uniqKey="Del Hoyo J">JRA del Hoyo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Barak, S" uniqKey="Barak S">S Barak</name></author><author><name sortKey="Kaplan, I" uniqKey="Kaplan I">I Kaplan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fisher, Se" uniqKey="Fisher S">SE Fisher</name></author><author><name sortKey="Frame, Jw" uniqKey="Frame J">JW Frame</name></author><author><name sortKey="Browne, Rm" uniqKey="Browne R">RM Browne</name></author><author><name sortKey="Tranter, Rmd" uniqKey="Tranter R">RMD Tranter</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Niccoli Filho, W" uniqKey="Niccoli Filho W">W Niccoli-Filho</name></author><author><name sortKey="Neves, Acc" uniqKey="Neves A">ACC Neves</name></author><author><name sortKey="Penna, Lap" uniqKey="Penna L">LAP Penna</name></author><author><name sortKey="Seraidarian, Pi" uniqKey="Seraidarian P">PI Seraidarian</name></author><author><name sortKey="Riva, R" uniqKey="Riva R">R Riva</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tuffin, Jr" uniqKey="Tuffin J">JR Tuffin</name></author><author><name sortKey="Carruth, Ja" uniqKey="Carruth J">JA Carruth</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schunke, M" uniqKey="Schunke M">M Schünke</name></author><author><name sortKey="Kruss, C" uniqKey="Kruss C">C Krüss</name></author><author><name sortKey="Mecke, H" uniqKey="Mecke H">H Mecke</name></author><author><name sortKey="Werner, Ja" uniqKey="Werner J">JA Werner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Arruda Paes, Tj" uniqKey="De Arruda Paes T">TJ de Arruda Paes</name></author><author><name sortKey="Niccoli Filho, W" uniqKey="Niccoli Filho W">W Niccoli-Filho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kauvar, Anb" uniqKey="Kauvar A">ANB Kauvar</name></author><author><name sortKey="Waldorf, Ha" uniqKey="Waldorf H">HA Waldorf</name></author><author><name sortKey="Geronemus, Rg" uniqKey="Geronemus R">RG Geronemus</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dobry, Mm" uniqKey="Dobry M">MM Dobry</name></author><author><name sortKey="Padilla, Rs" uniqKey="Padilla R">RS Padilla</name></author><author><name sortKey="Pennino, Rp" uniqKey="Pennino R">RP Pennino</name></author><author><name sortKey="Hunt, Wc" uniqKey="Hunt W">WC Hunt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Keng, Sb" uniqKey="Keng S">SB Keng</name></author><author><name sortKey="Loh, Hs" uniqKey="Loh H">HS Loh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Luomanen, M" uniqKey="Luomanen M">M Luomanen</name></author><author><name sortKey="Meurman, Jh" uniqKey="Meurman J">JH Meurman</name></author><author><name sortKey="Lehto, Vp" uniqKey="Lehto V">VP Lehto</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kardos, Tb" uniqKey="Kardos T">TB Kardos</name></author><author><name sortKey="Holt, T" uniqKey="Holt T">T Holt</name></author><author><name sortKey="Ferguson, Mm" uniqKey="Ferguson M">MM Ferguson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Niccoli Filho, W" uniqKey="Niccoli Filho W">W Niccoli-Filho</name></author><author><name sortKey="Murilo Santos, L" uniqKey="Murilo Santos L">L Murilo-Santos</name></author><author><name sortKey="Schubert, M" uniqKey="Schubert M">M Schubert</name></author><author><name sortKey="Morosolli, Ac" uniqKey="Morosolli A">AC Morosolli</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">ISRN Dent</journal-id><journal-id journal-id-type="iso-abbrev">ISRN Dent</journal-id><journal-id journal-id-type="publisher-id">DENTISTRY</journal-id><journal-title-group><journal-title>ISRN Dentistry</journal-title></journal-title-group><issn pub-type="ppub">2090-4371</issn><issn pub-type="epub">2090-438X</issn><publisher><publisher-name>International Scholarly Research Network</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21991461</article-id><article-id pub-id-type="pmc">3170081</article-id><article-id pub-id-type="doi">10.5402/2011/282361</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>CO<sub>2</sub> Laser Surgery and Prosthetic Management for the Treatment of Epulis Fissuratum</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>de Arruda Paes-Junior</surname><given-names>Tarcisio José</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Cavalcanti</surname><given-names>Sâmia Carolina Mota</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nascimento</surname><given-names>Daniela Fernandes Figueira</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Saavedra</surname><given-names>Guilherme de Siqueira Ferreira Anzaloni</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kimpara</surname><given-names>Estevão Tomomitsu</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Borges</surname><given-names>Alexandre Luiz Souto</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Niccoli-Filho</surname><given-names>Walter</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Komori</surname><given-names>Paula Carolina de Paiva</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Dental Materials and Prosthodontics, São Jose dos Campos Dental School, São Paulo State University, São José dos Campos, Avenida Francisco José Longo, 777 Vila Adyana, 12245-000 São Jose dos Campos, Brazil</aff><aff id="I2"><sup>2</sup>Department of Biopathology and Diagnosis and Academic Group of Studies and Research with Lasers in Dentistry, São Jose dos Campos Dental School, São Paulo State University, 12245-000 São José dos Campos, Brazil</aff><author-notes><corresp id="cor1">*Tarcisio José de Arruda Paes-Junior: <email>tarcisio@fosjc.unesp.br</email></corresp><fn fn-type="other"><p>Academic Editor: H. Devlin</p></fn></author-notes><pub-date pub-type="ppub"><year>2011</year></pub-date><pub-date pub-type="epub"><day>28</day><month>11</month><year>2010</year></pub-date><volume>2011</volume><elocation-id>282361</elocation-id><history><date date-type="received"><day>22</day><month>9</month><year>2010</year></date><date date-type="accepted"><day>3</day><month>11</month><year>2010</year></date></history><permissions><copyright-statement>Copyright © 2011 Tarcisio José de Arruda Paes-Junior et al.</copyright-statement><copyright-year>2011</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The aim of this study was to present a case report of the surgical removal of hyperplasia in the oral cavity, using carbon dioxide (CO<sub>2</sub>) laser radiation and rehabilitation with a complete denture. <italic>Epulis fissuratum</italic> occurs in complete denture patients, because a constant irritative action induces the mucosa to grow under poorly fitting dentures. These lesions must be removed, and to avoid a relapse, new complete dentures should be made to maintain healthy surgical tissues. The clinical sequence presented in this case shows a completely edentulous patient with <italic>epulis fissuratum</italic> on the lower alveolar ridge extending to the vestibular sulcus of the anterior region of mandible. Immediate complete dentures were made prior to the lesion removal with CO<sub>2</sub> laser radiation, providing satisfactory results in oral function and tissue health.</p></abstract></article-meta></front><body><sec id="sec1"><title>1. Introduction</title><p>Hyperplasia refers to tissue growth into the oral cavity, located over the alveolar ridges or the soft tissues of the vestibular sulcus. Its etiology is multifactorial, but some irritative factors are more commonly associated, such as periodontal disease, poor oral hygiene, smoking, and poor denture fitting [<xref rid="B1" ref-type="bibr">1</xref>].</p><p>The treatment of this kind of lesion includes elimination of the causing factors and surgical removal of the lesion. If the causal factor persists, the tissue becomes more fibrous over time [<xref rid="B2" ref-type="bibr">2</xref>, <xref rid="B3" ref-type="bibr">3</xref>]. The most common techniques used for removing the hyperplastic lesion are surgical scalpel, electrical scalpel, carbon dioxide laser, Erbium: YAG laser, Neodymium: YAG laser, and diode laser [<xref rid="B1" ref-type="bibr">1</xref>].</p><p>The CO<sub>2</sub> laser is an appropriate option for surgical procedures in soft tissues since it operates at a wavelength of 10.6 n<italic>μ</italic>, which is within the medium range of the electromagnetic infrared spectrum. This wavelength is absorbed by tissues with high water content [<xref rid="B4" ref-type="bibr">4</xref>, <xref rid="B5" ref-type="bibr">5</xref>]. This energy is transformed into heat, causing cell rupture from water boiling [<xref rid="B5" ref-type="bibr">5</xref>]; therefore, tissues with high water content suffer less damage.</p><p>Many advantages of the CO<sub>2</sub> laser include the possibility of minimal bleeding, decreasing edemas, flexibility of the wound healing tissue, reduced postoperative pain, and no need of a conventional suture [<xref rid="B6" ref-type="bibr">6</xref>–<xref rid="B10" ref-type="bibr">10</xref>]. These positive aspects of the use of a CO<sub>2</sub> laser has allowed an improvement in maxillofacial surgeries.</p><p>Despite some disadvantages of CO<sub>2</sub> laser, such as the delay in the initial repair chronology due to heat necrosis [<xref rid="B11" ref-type="bibr">11</xref>, <xref rid="B12" ref-type="bibr">12</xref>], this technique provides suitable repair without scar formation and constitutes an alternative to the conventional incision and suture method.</p></sec><sec id="sec2"><title>2. Case Report</title><p>A sixty-three-year Caucasian old female presented at the Dental Clinic of the University (São Jose dos Campos Dental School—UNESP) looking for dental treatment. The clinical exam showed completely edentulous and presented a hyperplastic lesion over the alveolar ridge extending to the vestibular sulcus in the lower anterior region (Figures <xref ref-type="fig" rid="fig1">1</xref> and <xref ref-type="fig" rid="fig2">2</xref>). According to the patient, two previous surgeries were performed to remove the excess of mucosa, but it relapsed twice. This lesion could impair the retention and stability of a future prosthesis. Considering this clinical situation and the relapse history, the immediate confection of dentures and surgical removal with CO<sub>2</sub> laser radiation was proposed.</p><p>The procedures for the confection of a complete denture consisted of a single impression of the upper and lower arch with an irreversible hydrocolloid to record the ridge and lesion area. Casts were obtained (<xref ref-type="fig" rid="fig3">Figure 3</xref>), and experimental bases (<xref ref-type="fig" rid="fig4">Figure 4</xref>) with wax ridges were made, outlining the lesion area. Compensating curves were registered, and the wax ridges were fixed in centric relation. These casts were then mounted in an arcon semiadjustable articulator. The teeth were mounted following the wax ridges (<xref ref-type="fig" rid="fig5">Figure 5</xref>) and aesthetic approval was received from the patient.</p><p>After an adequate aesthetic result was obtained, the lesion area outlined at the lower cast was removed with a burr (<xref ref-type="fig" rid="fig6">Figure 6</xref>) to the extension of the denture base. This area of the cast was covered with wax (<xref ref-type="fig" rid="fig7">Figure 7</xref>), and both the upper and lower dentures were cured (<xref ref-type="fig" rid="fig8">Figure 8</xref>). Denture manufacture was completed and the surgery proceeded. The lesion removal was made using a carbon dioxide laser (Sharplan 15 F, Israel-FAPESP 97/07645-2), and to carry out the vaporization the CO<sub>2</sub> laser was used in continuous mode with a focused beam with diameter of 4 mm and 8 watt (<xref ref-type="fig" rid="fig9">Figure 9</xref>) the vaporized area was clinically evaluated to verify the absence of bleeding (<xref ref-type="fig" rid="fig10">Figure 10</xref>). Safety glasses, masks, and procedure gloves protected the professionals who participated in the surgery, and vaporization was done under constant aspiration of the plume. </p><p>Dentures were positioned, and the lower denture was immediately rebased with a soft tissue conditioner to stabilize the denture and facilitate wound healing (<xref ref-type="fig" rid="fig11">Figure 11</xref>).</p><p>Postoperative examination was done after seven days and showed satisfactory tissue repair at the surgical area (<xref ref-type="fig" rid="fig12">Figure 12</xref>). The postsurgical exams were done after 7, 14, 21, and 30 days (<xref ref-type="fig" rid="fig13">Figure 13</xref>) of continual wearing of the prosthesis.</p></sec><sec id="sec3"><title>3. Discussion</title><p>The clinical results of the case report presented are in agreement with other studies utilizing CO<sub>2</sub> laser for soft tissues.</p><p>In the current study, the CO<sub>2</sub> laser was used in continuous mode to control the extension of thermal damage using a focused beam to reduce its intensity. Kauvar et al. [<xref rid="B13" ref-type="bibr">13</xref>] histologically demonstrated that the CO<sub>2</sub> laser, in both the pulse and continuous modes, allowed superficial ablation with minimal thermal damage. Some authors, like Dobry et al. [<xref rid="B14" ref-type="bibr">14</xref>], also affirmed that the pulse mode caused less thermal damage, but that a longer actuation time was needed with the tissue.</p><p>The advantages of using a CO<sub>2</sub> laser has been clinically demonstrated in the present study, presenting minimal bleeding during the surgery with no need of sutures while also presenting a good healing response, with minimal wound contraction, less inflammatory reaction, and good re-epithelialization with no scar formation. These conditions were also found in the studies of de Arruda Paes and Niccoli-Filho [<xref rid="B12" ref-type="bibr">12</xref>] and Keng and Loh [<xref rid="B15" ref-type="bibr">15</xref>] who clinically demonstrated that CO<sub>2</sub> laser is ideal for use in these kind of surgeries, bringing comfort and aesthetics to the patient. Luomanen et al. [<xref rid="B16" ref-type="bibr">16</xref>] explained that less wound contraction occurs because the CO<sub>2</sub> laser does not remove the tissue collagen. Kardos et al. [<xref rid="B17" ref-type="bibr">17</xref>] showed that CO<sub>2</sub> laser is effective in vaporizing oral mucosa and achieving haemostasis by vessel coagulation.</p><p>No hemorrhaging episodes or infections occurred during the postoperative exams. These findings are in agreement with Niccoli-Filho et al. [<xref rid="B9" ref-type="bibr">9</xref>] who also demonstrated that good aesthetic and functional characteristics were quickly achieved in an oral surgery using CO<sub>2</sub> laser, enabling an earlier prosthetic rehabilitation. Thus, the CO<sub>2</sub> laser is a useful instrument, which provides control of the surgical field and esthetic and functional results [<xref rid="B18" ref-type="bibr">18</xref>]. The technique presented in this paper was easily executable and allowed a better prediction of the surgery results.</p></sec><sec id="sec4"><title>4. 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Therapy</italic></source><year>2005</year><volume>7</volume><issue>2</issue><fpage>97</fpage><lpage>100</lpage><pub-id pub-id-type="pmid">16537216</pub-id></element-citation></ref></ref-list></back><floats-group><fig id="fig1" position="float"><label>Figure 1</label><caption><p><italic>Epulis fissuratum </italic>over the alveolar ridge extending to the vestibular sulcus in the lower anterior region.</p></caption><graphic xlink:href="DENTISTRY2011-282361.001"></graphic></fig><fig id="fig2" position="float"><label>Figure 2</label><caption><p>Closer view of <italic>Epulis fissuratum. </italic></p></caption><graphic xlink:href="DENTISTRY2011-282361.002"></graphic></fig><fig id="fig3" position="float"><label>Figure 3</label><caption><p>Cast of the lower arch obtained from irreversible hydrocolloid impression.</p></caption><graphic xlink:href="DENTISTRY2011-282361.003"></graphic></fig><fig id="fig4" position="float"><label>Figure 4</label><caption><p>Experimental bases were made outlining the lesion area of the cast.</p></caption><graphic xlink:href="DENTISTRY2011-282361.004"></graphic></fig><fig id="fig5" position="float"><label>Figure 5</label><caption><p>Wax ridges were made over the experimental bases and teeth were mounted following the wax ridges patterns.</p></caption><graphic xlink:href="DENTISTRY2011-282361.005"></graphic></fig><fig id="fig6" position="float"><label>Figure 6</label><caption><p>The lesion area was outlined at the lower cast and removed with a burr to the extension of the denture base.</p></caption><graphic xlink:href="DENTISTRY2011-282361.006"></graphic></fig><fig id="fig7" position="float"><label>Figure 7</label><caption><p>The removed area of the cast correspondent to the lesion was covered with wax.</p></caption><graphic xlink:href="DENTISTRY2011-282361.007"></graphic></fig><fig id="fig8" position="float"><label>Figure 8</label><caption><p>Both the upper and lower dentures were polymerized.</p></caption><graphic xlink:href="DENTISTRY2011-282361.008"></graphic></fig><fig id="fig9" position="float"><label>Figure 9</label><caption><p>Application of the CO<sub>2</sub> laser at the lesion.</p></caption><graphic xlink:href="DENTISTRY2011-282361.009"></graphic></fig><fig id="fig10" position="float"><label>Figure 10</label><caption><p>The aspect of the surgical area after the use of CO<sub>2</sub> laser.</p></caption><graphic xlink:href="DENTISTRY2011-282361.010"></graphic></fig><fig id="fig11" position="float"><label>Figure 11</label><caption><p>The lower denture was rebased with a soft tissue conditioner to allow adequate tissue repair.</p></caption><graphic xlink:href="DENTISTRY2011-282361.011"></graphic></fig><fig id="fig12" position="float"><label>Figure 12</label><caption><p>The aspect of the postsurgical area after 7 days.</p></caption><graphic xlink:href="DENTISTRY2011-282361.012"></graphic></fig><fig id="fig13" position="float"><label>Figure 13</label><caption><p>The aspect of the post surgical area after 30 days.</p></caption><graphic xlink:href="DENTISTRY2011-282361.013"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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