Gingival enlargement (GE) can result from gingival inflammation, fibrous overgrowth, or a combination of both factors. Various etiological factors contribute to GE, including low-grade trauma, iatrogenic causes, drug-induced effects, systemic diseases, plaque accumulation, hormonal influences, vitamin deficiencies, genetic predispositions, and idiopathic reasons. Effective treatment in clinical practice hinges on accurately diagnosing the underlying cause. Among these, plaque-induced inflammation is the most common, driven by the accumulation of plaque and calculus. One challenge in maintaining oral hygiene is orthodontic treatment, which can impact speech, chewing, aesthetics, and psychological well-being. In this case report, a 21-year-old female patient developed GE associated with orthodontic appliance use. To address this, excess gingival tissue was surgically removed under local anesthesia using gingivectomy and gingivoplasty procedures, and the excised tissue was sent for histopathological examination. Following the surgery, a periodontal dressing (GC Coe Pack™) was applied to protect the tissue and aid in healing. The case underscores that enlarged gingival tissue, covering nearly half of the dental crowns, led to plaque accumulation and aesthetic concerns. Post-procedure, achieving a proper gingival contour eliminated suprabony pockets and enhanced the aesthetic appearance. The patient showed positive outcomes with no remaining suprabony pockets, resulting in a natural gingival contour, improved aesthetics, and reduced plaque retention. Surgical gingivectomy and gingivoplasty proved to be successful interventions in this case.

Frenum morphology is of pivotal concern while treating patients who desire improved aesthetics and for treating patients with midline diastemas, as it may lead to failure or relapse of orthodontic treatment. Frenum, a thick band of muscle fiber, may present with abnormalities in the shape, size, form, number, and thickness, which may cause gingival recession along with poor oral health. Frenectomy is adopted as the plan of action while treating abnormal frenum cases by resecting the frenum attachment to provide closure of the spacing between the upper anterior teeth, as in the case of midline diastema. Various forms and techniques of frenectomy have been adopted according to the type of frenum attachment and aesthetic concerns of the patients. Amidst the various treatment options available, conventional frenectomy using a scalpel has emerged as a viable solution for treating patients. The surgeons value and praise its exceptional precision and ease of use, and the patients prefer it for its affordability; hence, a functional and aesthetic outcome is achieved via this treatment. This report provides a comprehensive overview of a case of conventional frenectomy with a one-week follow-up.

Cricothyroidotomy remains one of the reliable methods for securing the airway when all other methods fail. A broken surgical blade lodged in the neck which stemmed from this procedure is almost unheard of. The objective of this case report is to highlight the challenges in managing foreign bodies in the neck due to iatrogenic causes and the utilization of imaging studies to locate the foreign bodies. We present a case of a 50-year-old lady who was in a \'Can\'t Intubate, Can\'t Oxygenate\' situation and underwent a cricothyroidotomy but complicated with two fragments of surgical blades were broken and lodged in the neck.

A mucocele is a benign cystic lesion containing clear fluid within a thin capsule, typically resulting from the disruption of minor salivary glands and leakage into surrounding tissues, most commonly on the lower lip. These lesions often arise due to traumatic injuries such as lip-sucking, biting, or trauma from orthodontic appliances. This study compares different surgical methods for mucocele removal in pediatric patients through three distinct cases. This study includes three pediatric cases of mucocele removal using different surgical methods. Case 1 involved a nine-year-old girl with a traumatic bite on the lower lip, treated with a traditional approach using a scalpel. The surgical excision resulted in adequate healing with no recurrence after six months. Case 2 described a 12-year-old boy with a lip-biting habit, who presented with a swelling on the lower left lip. He underwent diode laser treatment, which facilitated faster healing, minimal discomfort, and no scarring after 30 days. Case 3 involved a 14-year-old boy, also with a lip-biting habit, who had swelling on the lower left lip. Electrocautery was used for his treatment, resulting in minimal bleeding, effective healing after 21 days, and no recurrence at the six-month follow-up. These cases demonstrate the efficacy of different treatment modalities for mucocele removal in pediatric patients. Evaluations of pain, bleeding, and swelling indicated that minimally invasive methods like the diode laser offer significant benefits in patient comfort and recovery. These findings highlight the potential of minimally invasive techniques to enhance the management of mucoceles in pediatric patients, underscoring the need for further research to determine the long-term efficacy of various treatment modalities.

We aimed to compare surgical time, bleeding level, patient pain level, healing period, scar tissue, relapse of the initial process and complications in patients with nasopharyngeal oncological masses undergoing surgery using a scalpel blade versus a CO2 surgical laser. This is a clinical prospective study comprising surgical work in the nasopharynx area. A sample of 12 inpatients dogs (N = 12) of both genders underwent a surgical excision of nasopharyngeal masses with a scalpel blade (GS n = 6) and CO2 surgical laser (GL n = 6). An Aesculigth CO2 surgical laser-Vetscalpel® model with a superpulse mode, 12 W of power, and a multi-focus pen was used. Statistically significant differences were registered for a p-value of < 0.05. Variations were noted between both groups (GS and GL) concerning surgery time (p = 0.038), first meal time (p = 0.013), pain level (p = 0.003), and healing time (p = 0.014), with the GL group presenting lower values. GL exhibited only one relapse case, with the elapsed time being more than double that of the GS group. Surgical and healing times were shorter in the GL group, and pain levels were lower, with the GL group also demonstrating less scar tissue than the GS group, along with a lower relapse rate. Nasopharynx surgical exposure with precision via the soft palate using the CO2 laser has facilitated successful treatment of regional masses without discomfort and complications, compared to conventional blade scalpel procedures.

BACKGROUND: Abdominoplasty, an emerging surgical procedure worldwide, associated with complications, as seroma, infection, and hematoma. This systematic review and meta-analysis compare the outcomes of abdominoplasty procedures performed using a scalpel versus a diathermocoagulation device (diathermy monopolar electrocautery), aiming to find a safer approach with fewer complications.
METHODS: We conducted a systematic search in November 2023 using PubMed, Ovid Medline, and Ovid Chocrane databases. The methodological index for nonrandomized studies and the Revised Cochrane Risk of Bias assessment tools were used to assess risk of bias for observational studies and randomized controlled trials, respectively. The data were analyzed using RevMan software.
RESULTS: Six articles (1135 patients) were included, 521 patients were operated using a scalpel and 614 using electrocautery. Our analysis suggests that both seroma and drain output were seen more among the electrocautery group, with an odds ratio (OR) of 0.62 (95% CI [0.39, 0.97], p = 0.04) and - 103.63 (95% CI [- 205.67, - 1.59], p = 0.05), respectively. It is important to note the high heterogeneity seen among the studies discussing the total drain output. Additionally, we did not find any statistical significance between both techniques in terms of the rate of hematoma, wound infection, operation time, and hospital stay length.
CONCLUSIONS: When comparing the use of scalpel and electrocautery dissection in abdominoplasty, higher rates of seroma and total drain output are significantly associated with electrocautery dissection.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

BACKGROUND: Robot-assisted total joint arthroplasty (robotic-TJA) has become more widespread over the last 20 years due to higher patient satisfaction and reduced complications. However, robotic TJA may have longer operative times and increased operating room traffic, which are known risk factors for contamination events. Contamination of surgical instruments may be contact- or airborne-related with documented scalpel blade contamination rates up to 9%. The robot arm is a novel instrument that comes in and out of the surgical field, so our objective was to assess whether the robot arm is a source of contamination when used in robotic TJA compared to other surgical instruments.
METHODS: This was a prospective, single-institution, single-surgeon pilot study involving 103 robotic TJAs. The robot arm was swabbed prior to incision and after closure. Pre- and postoperative control swabs were also collected from the suction tip and scalpel blade. Swabs were incubated for 24 hours on tryptic soy agar followed by inspection for growth of any contaminating bacteria.
RESULTS: A contamination event was detected in 10 cases (10%). The scalpel blade was the most common site of contamination (8%) followed by the robot arm (2%) and suction tip (0%).
CONCLUSIONS: Robotic TJA is contaminated with bacteria at a rate around 10%. Although the robot arm is an additional source of potential contamination, the robot arm accrues bacterial contamination infrequently compared to the scalpel blade.
CONCLUSIONS: Contamination of the robot arm during robotic TJA is minimal when compared to contamination of the scalpel blade.

In modern surgical practice, the focus extends beyond simply making and closing incisions. We aim to investigate the various complex aspects that redefine the criteria for achieving effective surgical outcomes. This narrative combines current knowledge, integrating practical experiences and academic viewpoints to comprehend the changing field of surgical care thoroughly. The tapestry explores the detailed aspects of surgical safety, examining the most recent progress in protocols, technology, and team dynamics that strive to reduce procedural risks. Examining precision in surgery, this narrative goes beyond conventional limits to explore the incorporation of advanced technologies, such as robotics and navigational systems. The complex interplay between the surgeon\'s proficiency and these technology aids is crucial in attaining unparalleled accuracy and favorable patient results. The focal point of this investigation is the patient\'s well-being, encompassing postoperative care, rehabilitation, and long-term health. Actual accounts from surgical procedures highlight the significant influence of comprehensive patient-centered methods, emphasizing the crucial need for empathy, communication, and individualized care plans in promoting healing and adaptability. As we explore this complex situation, the combination of real-life stories and academic discussions creates a clear and detailed image of a surgical environment that goes far beyond the boundaries of the operating room. \"Beyond the Scalpel\" seeks to engage practitioners, scholars, and stakeholders in a conversation that redefines the criteria for surgical success. It aims to establish a new benchmark that combines safety, precision, and patient well-being, ultimately shaping the future of surgical practice.

Every person expresses their blissful moments through a smile. The elegance of the smile depends majorly on the colour of the gingiva. One of the factors that determines the colour of the gingiva is the amount of melanin pigment in the gingival epithelium. The intensity of melanin pigmentation differs from one person to another, and it is prevalent among all ethnicities. Most people are aesthetically concerned and widely prefer pink gingiva, leading to a demand for gingival depigmentation. There are various suggested treatment modalities for gingival depigmentation, like scalpel, electrosurgery, LASER, cryosurgery, etc. However, the recurrence of pigmentation is common in the depigmentation procedure. The current study attempts to determine the post-operative healing of gingival tissues following split-thickness epithelial excision with and without topical application of Vitamin C (ascorbic acid).

The peripheral cemento-ossifying fibroma (PCOF) lesion primarily affects females in their second decade of living. These lesions are more frequently associated with the gingival margin, the anterior surface of the molars, and the maxilla. On clinical examination, PCOF typically appears as a well-differentiated, slowly expanding gingival mass in the interdental papilla region that is less than 2 cm in size. The surface may seem ulcerated, the base may be sessile or sometimes pedunculated, and the colour is either the same as the gingiva or reddish. The histological examination, which identifies cellular connective tissue and the focal presence of bone or calcifications, provides the basis for the final diagnosis. Treatment modalities for the PCOF include surgical excision of the lesion. A 38-year-old female reported slow-growing swelling associated with the maxillary anterior region. Removal of the lesion is done by using a scalpel, and histopathological examination revealed the peripheral type of cemento-ossifying fibroma. This case report demonstrates the management of PCOF lesions with the conventional scalpel approach with the help of proper clinical examination, radiological findings, and histopathological examination, which reveals favourable outcomes in the patient regarding esthetics and improves mastication-related issues and speech.