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Register a new userThe use of Cryosurgery with Liquid Nitrogen in the management of Physiological Gingival Melanin Pigmentation
استخدام الجراحة القرية بالآزوت السائل في تدبير التصبغ اللثوي الميلانيني الفيزيولوجي
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Tishreen University ورقة بحثية
Publication date
2016
fields
Dentistry
and research's language is
العربية
Created by
Shamra Editor
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تهدف الدراسة إلى تقييم فعالية استخدام الجراحة القرّيّة بالآزوت السائل في علاج المشكلة التجميلية الناجمة عن التصبغ اللثوي الميلانيني. تألفت عينة البحث من 20 مريض راجعو قسم طب الفم في كلية طب الأسنان ممن يعانون من تصبغ لثوي ميلانيني فيزيولوجي في الفترة بين 1 تشرين الثاني 2013 و1 نيسان 2016، تضمنت المراقبة السريرية أخذ صور ضوئية للمرضى قبل و بعد 3 أشهر، و 6 أشهر، و سنة من تطبيق الإجراء، و استخدم مشعر التصبغ اللثوي لـ Dummett لقياس مقدار التصبغ، و استخدم اختبار T-student للعينات المقترنة في تحليل البيانات. تم تطبيق العلاج على اللثة المصطبغة مع الحد الأدنى من الإنزعاج للمريض و كان الشفاء التالي خالٍ من المضاعفات و غير مؤلم. أظهر التحليل الإحصائي للبيانات وجود فرق معنوي بين مقدار التصبغ قبل و بعد التطبيق. بالنتيجة يمكن اعتبار تقنية الجراحة القرّيّة باستخدام الآزوت السائل طريقة فعالة و آمنة لإزالة التصبغ اللثوي الميلانيني.
The aim of the study was to assesst the effect of cryosurgery by means of liquid Nitrogen LN to manage the aesthetic problem caused by gingival melanin Pigmentation (GMP). The study is composed of 20 patients who attended the department of oral medicine at Tishreen University, Lattakia- Syria. Their chief complaint was GMP between November 1st 2013 and April 1st 2016. The clinical observation included caputuring photographs pre-procedure and 3 months, 6 months and a year post-procedure. Dummett Oral Pigmentation Index (DOPI) was used as a reference to indicate the colour of the pigmented areas degrees, and statistical analysis was performed by T-student test for paired samples. Ablation of hyperpigmented gingiva was accomplished with minimal discomfort and post-procedure healing was uneventful and with no post-pain. Such statistical study revealed a significant difference between pre- and post-procedure measurements of pigmented areas. In conclusion, the application of cryosurgery using LN appears to be an effective and safe method for elimination of GMP.
References used
CICEK, Y. The normal and pathological pigmentation of oral mucous membrane: A review. J Contemp Dent Pract, 2003,4:76–86
DUMMETT.C.O. Oral pigmentation: First symposium of oral pigmentation. J Periodontol. 1960;31:356
DUMMETT.C.O; BARENS, G. Pigmentation of the oral tissues: A review of literature. J Periodontol. 1967;38:369–78
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copic trans-nasal repair and failure rates.
Materials & Methods: Retrospective study of 34 cases (first main group) of meningeal nasal fistula admitted to Al Moassate university hospital between 5.2004 - 5.2009 in addition to three cases in which the fistula had occurred during an endoscopic sinus surgery (second secondary group).
Results: In the first group the main presenting complain was persistent or intermittent clear watery rhinorrhea in 30 patients (88.23%), history of repeated Meningitis in 4 patients (11.76%) and rhinorrhea and one episode of meningitis in one patients (2.94%).A history of head trauma was detected in 20 patients (58.82%), nasal surgery in 4 patients (11.76%), where no history of head trauma or nasal surgery was found in 10 patients (29.41%). The fistula situated in the roof of the ethmoid sinus in 28 patients (79.41%), roof or lateral wall of sphenoid sinus in 4 patients(11.76%), and in the roof of both ethmoid and sphenoid sinuses in tow patients(5.88%). The fistula was closed by endoscopic trans-nasal approach with fascia latta in 31 patients (83.78%), fascia of rectus abdominalis in one patient and with the mucoperostium of contra-lateral inferior turbinate in 5 patients (13.51%). Follow-up was for 12-43 months. Recurrence has occurred in 10 patients (27.02%) in a form of recurrence of watery rhinorrhea or recurrence of meningitis or both of them. Second endoscopic trans-nasal intervention had done in 8 of
them, second recurrence occurred in 3 patients. Thus the overall success rate was (91.42%).
Conclusion: Endoscopic trans-nasal approach is an effective way to repair the meningeal nasal fistulas with low morbidity and mortality rate in comparison with the traditional open neurosurgery approach.
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