One day Laser Seminar

The Oral soft tissue lesions could be divided in surface and exophytic lesions. The surface lesions of oral mucosa consist of lesions that involve the epithelium and/or superficial connective tissue; generally, they don’t exceed 2-3 mm in thickness. Clinically, surface lesions are flat or slightly thickened and white, pigmented or with vesicular-ulcerated-erythematous. On the other side, the exophytic oral lesions are characterized as pathologic growths projecting above the normal contours of the oral mucosa. There are several underlying mechanisms responsible for oral exophytic lesions such as hypertrophy, hyperplasia, neoplasia, and pooling of the fluid. Both superficial and exophytic lesions are sometimes difficult to deal with clinically. The Author through the clinical presentations of several cases describe the advantages and the limit to approach them with different laser wavelengths.

Osteonecrosis of the jaws (ONJ) is an uncommon but severe bone disease, can be related to various medicaments including bisphosphonates, antiangiogenic and antiresorptive medicaments such as Denosumab, human mono-clonal antibody to the receptor activator of nuclear factor-kB ligand. For this reason, the term ONJ was currently replaced by Medication Related Osteonecrosis of the jaws (MRONJ). The rise in number in the latest years can be explained with many patients treated with all these drugs, assumed for osteometabolic (i.e osteoporosis, osteogenesis imperfecta) or neoplastic diseases (multiple myeloma, metastatic breast, prostate and renal cancer). The onset mechanism of MRONJ is not entirely understood, probably different mechanisms are involved, such as inhibition of the osteoclasts differentiation and function, decrease of the angiogenesis and inflammation/infection of the jaw bones. The Author, through the presentations of some clinical cases, describes the diagnostic and clinical aspects of MRONJ and explains how is possible to prevent or to manage the MRONJ

The modern Medicine is still dominated by expensive and artificial pharmaceuticals and sophisticated technologies that, even if helpful in many pathologic conditions, have led to a growing emergence of resistant bacteria and patient’s hypersensitivity. Despite more than 50 years have passed since the first studies about the biological and therapeutic properties of light were announced, the diffusion of this totally natural way of treatment is still limited to few researchers and to even less clinical practitioners. Recent studies have shown both in vitro and in vivo the potentialities of therapeutic lasers and their beneficial effects in the treatment of many pathologies even though many questions remain controversial, especially about dosages and therapeutic protocols. The low energy laser light penetrates the mucosa, without releasing heat or determining structural changes in the tissues and it is absorbed directly by the mitochondria, the intracellular chromophores, or by the membrane proteins, influencing their permeability. The irradiation enhances the vital processes of the cells, mainly by the increase of production of ATP, the cellular fuel, with an effect that is called photobiomodulation (PBM). This effect is strictly dose dependent in the same way of the common drugs, but without any negative side effect. The PBM has anti-inflammatory and analgesic action, reduces local edema and improves the peripheral microcirculation via the production of Nitric Oxide by the cells; it also stimulates the proliferation of many cell types as fibroblasts, osteoblasts, neurons and collagen fibers, improving the tissue healing processes; the PBM induces at last the vitality and the effectiveness of the immunologic processes so enhancing the defensive reactions of the organism. All these properties can be easily applied in the daily dental practice determining a considerable improvement of the results of many common treatments in a biological way and without any adverse side effect. All these considerations and the advantages of the PBM in dentistry are reported and analyzed by the Author with a wide scientific support while the all clinical benefits are demonstrated by the presentation of several cases that were positively managed and resolved through the principia of the PBM.