810nm半导体牙科激光治疗口腔颌面部良性病变35例分析

Treatment of oral and maxillofacial benign lesions in 35 cases with 810nm wavelength diode dental laser system:A preliminary report

目的：尝试应用810nm半导体牙科激光治疗口腔颌面部良性病变,并与传统CO_2激光外科进行比较。方法：自2005年8月至10月,应用810nm半导体牙科激光治疗口腔颌面部良性病变35例。采用电脑编程预设外科激光手术模式,激光治疗平均参数为2～6．6J/cm^2,脉宽30～60ms,400μm直径光纤专用刀柄,光纤为接触式。治疗病种包括黏液腺囊肿4例、乳头状瘤3例、微囊型淋巴管或(和)静脉畸形5例、白斑8例、舌系带附丽过长4例、牙龈增生11例。采用2%利多卡因局部麻醉后,实施激光切除手术。随访3～4个月,随访率100%。结果：本组35例显示,810nm半导体激光手术总有效率为100%,治疗后近期无复发。结论：810nm半导体牙科激光具有良好的水中切割功效,接触式纤细光纤切割较为精准,周围组织热损伤较小,是口腔颌面部激光手术的先进工具,其远期疗效有待进一步观察。

PURPOSE： A novel dental laser system （810nm wavelength diode dental laser made in Germany） was tried to treat oral and maxillofacial benign lesions and the efficacy was compared with the conventional CO2 laser. METHODS： From August to October 2005, diode dental laser system with 810nm wavelength was tried to treat oral and maxillofacial benign lesions in our department, including mucocele, papilloma, microcystic lymphatic malformation and/or venous malformations, oral leukoplakia, abnormal attachment of lingual frenulum and gingival hyperplasia. The treatment was under programmable laser surgery mode. The average frequency used was 2-6.6J/cm^2,the pulse duration was 30ms to 60ms with contact optic fiber 400μm in diameter. The treatment was performed under infiltration or block anesthesia with 2% lidocaine. All the patients were followed up for 3 to 4 months, and the short term resuhs were assessed. RESULTS： All the 35 lesions were cured after diode dental laser surgery, with an overall short term efficacy of 100%. All the surgical wounds healed primarily. No recurrence was found during follow up periods. CONCLUSION： It is found that diode dental laser system （810nm in wavelength） has higher cutting efficacy and greater accuracy under water, while minor thermal damage to the surrounding tissues, especially when contact optical fiber is chosen. It is an advanced tool for oral and maxillofacial surgery, but the long-term results remain to be investigated. Supported by Shanghai Leading Academic Discipline Project （Grant No.Y0203）.