PDF(Pubmed)
Abstract：
Peripheral giant cell granuloma (PGCG) is a non-neoplastic, tumour-like reactive lesion that exclusively involves the gingiva and/or the alveolar crest. The surgical approach with a scalpel has been the golden standard of treatment for PGCG, but the scientific literature reports a high rate of lesion recurrence. Hence, this unique case report aimed to evaluate the efficacy of λ 10,600 nm high-level laser therapy (HLLT) in eradicating persistent, aggressive, and recurrent PGCG that failed to respond to standard surgical treatment. A fit and healthy thirty-four-year-old Caucasian male presented with a two-month history of recurrent episodes of an oral mucosal lesion involving the buccal and lingual interdental papillae between the lower right second premolar (LR5) and lower right first molar (LR6), which was surgically excised with a scalpel three times previously. A λ 10,600 nm-induced HLLT was chosen as a treatment modality at a lower peak power of 1.62 W, measured with a power metre, emitted in gated emission mode (50% duty cycle), whereby the average output power reaching the target tissue was 0.81 W. The spot size was 0.8 mm. Ninety seconds was the total treatment duration, and the total energy density was 7934.78 J/cm2. Patient self-reporting outcomes revealed minimal to no post-operative complications. Initial healing was observed on the 4th day of the post-laser treatment, and a complete healing occurred at two-weeks post-operatively. The histological analysis revealed PGCG. This unique case report study demonstrated the efficacy of λ 10,600 nm-induced HLLT and its superiority to eradicate persistent aggressive PGCG over the standard surgical approach with minimal to no post-operative complications, accelerating wound healing beyond the physiological healing time associated with no evidence of PGCG recurrence at the six-month follow-up timepoint. Based on the significant findings of this unique study and the results of our previous clinical studies, we can confirm the validity and effectiveness of our standardised λ 10,600 nm laser dosimetry-induced HLLT and treatment protocol in achieving optimal outcomes. Randomised controlled clinical trials with large data comparing λ 10,600 nm with our dosimetry protocol to the standard surgical treatment modality at long follow-up timepoints are warranted.
摘要：
外周巨细胞肉芽肿（PGCG）是一种非肿瘤性，肿瘤样反应性病变，仅涉及牙龈和/或肺泡c。手术刀的手术方法一直是PGCG治疗的金标准，但科学文献报道的病变复发率很高。因此，这个独特的病例报告旨在评估λ10,600nm高水平激光治疗（HLLT）在根除持续性，侵略性,和对标准手术治疗无效的复发性PGCG。一名健康健康的34岁白种人男性，有两个月的口腔粘膜病变复发史，涉及右下第二前磨牙（LR5）和右下第一磨牙（LR6）之间的口腔和舌侧牙间乳头，之前用手术刀手术切除了三次。选择λ10,600nm诱导的HLLT作为1.62W的较低峰值功率的治疗模式，用功率计测量，在门控发射模式下发射(50%占空比)，由此到达目标组织的平均输出功率为0.81W。斑点尺寸为0.8mm。90秒是总的治疗时间，总能量密度为7934.78J/cm2。患者自我报告结果显示，术后并发症很少或没有。在激光治疗后的第4天观察到初始愈合，术后2周完全愈合.组织学分析显示PGCG。这项独特的病例报告研究证明了λ10,600nm诱导的HLLT的疗效及其在根除持续性侵袭性PGCG方面优于标准手术方法，且术后并发症最少甚至没有。在6个月的随访时间点，加速伤口愈合超过生理愈合时间，没有PGCG复发的证据。基于这项独特研究的重要发现和我们以前的临床研究结果，我们可以确认我们的标准化λ10,600nm激光剂量测定诱导的HLLT和治疗方案在实现最佳结果方面的有效性和有效性。有必要进行随机对照临床试验，并在长期随访时间点将λ10,600nm与我们的剂量测定方案与标准手术治疗方式进行比较。
