Aphthous ulcers - Laser Dentistry Forum

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July 18, 2003 at 6:15 am #3398 Reply

ASI
Spectator

Hi Fellow Forum Folks,

The first case is an aphthous ulcer about 4 to 5 days old at the lower labial frenum area. It was treated by the DELight laser 600u 80 degree tip dry at about 10mm away at 10Hz 35mj for about 30 seconds until a dessicated whitish surface appearance was evident. Before and immediate photos. Patient able to put tongue on it right away without any discomfort. A week later, it was completely healed with no complications. Sorry, no post-op photo.

Andrew

July 18, 2003 at 10:53 am #10880 Reply

ASI
Spectator

The second aphthous ulcer case is just short of a week old and treated by the Biolitec 980nm diode laser 600u fibre at 1W CW 10mm away for about 60 seconds until patient felt enough heat and didn’t want to have more for any longer. Pre-op as shown. Again, patient able to touch with tongue right away with no discomfort. No real significant change in appearance evident immediate post-op, hence no photo taken. 10 day post-op photo shows complete healing. Patient still felt some discomfort after lasing for the next few days. Likely could have had lasing a bit longer, I think.

Similar outcome by two different wavelengths. Nothing earth shattering. Just my attempt for a first clinical post.

July 18, 2003 at 3:49 pm #10884 Reply

Kenneth Luk
Spectator

Hi Andrew,

I use 2w cw with saline irrigation for 2min, 360 fiber defocused.

Generally no discomfort from patients.

Ken

July 18, 2003 at 6:59 pm #10877 Reply

vince
Spectator

Nice pics Andrew.

The case with 2 ulcers side to side would have been a cool case to try the 2 wavelengths, one on each and then monitor, compare and contrast.

Regards

July 19, 2003 at 11:36 pm #10889 Reply

Swpmn
Spectator

That’s a cool case. I think the Erbium is better for apthous ulcers due to shallow depth of penetration. More comfortable for patient especially when you can turn the Hz way down as with your DELight.

What camera? Flash system or dental operatory light?

Al

July 20, 2003 at 5:32 am #10881 Reply

ASI
Spectator

Hi Guys,

Thanks for the comments. I will keep your inputs in mind for future treatment.

Nikon Coolpix 4500 with Macro Cool-Light SL-1 was used without dental light.

Andrew

July 21, 2003 at 1:10 pm #10872 Reply

drcam
Spectator

Got my Waterlase today so hope to post some interesting cases soon! I had an apthous ulcer Waterlased and it made it much worse! Not sure of the settings etc but my understanding was that in most peoples hands treated ulcers was usually a piece of cake.

Cheers Cam

July 21, 2003 at 3:30 pm #10885 Reply

Robert Gregg DDS
Spectator

H Cam,

I think we have known for some years that aphthous ulcers (versus HSV-I) are a surface phenomenon that s best treated by lightly altering the surface–not ablating the ulcer.

When I treated an ulcer with Dr. Ron using a pulse Nd:YAG in a defocused mode, it really didn’t do the job. Had we used air to cool and coagulated the surface, we would heve done much better.

Bob

August 15, 2003 at 5:48 am #10876 Reply

kellyjblodgettdmd
Spectator

Andrew – great pics. I have the Coolpix 5000 and the same light. I knew I recognized those 8 mini light bulbs reflecting off of the teeth. Great work.

Kelly

August 20, 2003 at 4:30 am #10879 Reply

ASI
Spectator

Thanks, Kelly. It’s a wonderful system isn’t it?

I also use a HP 7550 Photosmart printer for hard copy print for album presentation.

Andrew

August 20, 2003 at 11:11 pm #10883 Reply

Alfred Wyatt
Spectator

Hi everyone,
When treating surface lesions such as apthous ulcers and oral mucositis, we often use a defocused beam with low wattage until we get a “white surface covering”. If there is not a specific term for this phenomenon,let’s come up with one that fully describes the action the laser performs on the tissue. This way , new laser users will have a better understanding of what they are doing when they treat on of these lesions. Does anyone have any suggestions?

August 22, 2003 at 12:26 am #10886 Reply

Robert Gregg DDS
Spectator

Oh Alfred,

You really know how to be the Straight Man………:biggrin:

How about:

1. Eschar
2. Coag surface
2. Bio-Bandage
3. Schmutz
5. Pool Cheese
6. Calf Slobber (thanks to Rick W.)
7. Wet scab

August 22, 2003 at 2:13 am #10888 Reply

Swpmn
Spectator

Blanched denaturation

Al

August 22, 2003 at 2:33 am #10878 Reply

whitertth
Spectator

I’ve always used the term laser band aid…ez to understand and quite accurate….

September 10, 2003 at 2:13 am #10874 Reply

jetsfan
Spectator

Interesting case this P.M. I had an emergency sent to me by an oncologist/patient.
75y/o female with paraneoplastic pemphigus(not vulgaris). She had painful ulcers throughout her body including her mouth. She is treated with prednisone , which helped, except didn’t help her mouth.Oncologist thought of me. Patient had mouth pain for over 1 month, nothing helped …until today. She had the largest and most numerous oral ulcers that I have ever seen. I lasered as many lesions as I could in 1/2 hour at .25W 9%air 0%water. She got immediate relief. She came in with pain rated 1 on a scale of 1-10 and left with 5.She was so grateful and I was happy to help.
I will try to take photo.s if and when she returns.
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