Oral Hemangiomas

Clinical Explanation: 
Infantile hemangiomas are benign vascular neoplasms that have a
characteristic clinical course marked by early proliferation and followed by spontaneous
involution. During the proliferative phase in the neonatal period or early infancy, rapidly
dividing endothelial cell proliferation is responsible for the enlargement of these lesions.

Related Key-words: 
periapical abscess,diode laser,200um bare fiber

Medical device: 
CHEESE 7W 980nm (output power 1.5w-2w,CW )

Accessories:
400um bare fiber,dental surgery handpiece with tips

Operation procedure:
Treatment was carried out in an outpatient setting solely using a topical anesthetic
EMLA cream (lidocaine 2.5% and prilocaine 2.5%) for at least one hour under occlusion
before treatment. For intra-oral portions of the lesions, topical anesthesia was applied
before field-block local anesthesia injection, in a circular manner surrounding the lesion.

1.Cases were managed using CHEESE 7W with wavelength of 980nm,CW,1.5W-2W,
400um bare fiber, the spot size was 10mm. The laser spot was adjusted to include 1-
2mm of the normal skin or mucous membrane beside the edge of the lesion within the
active beam field to be sure that the outer edge of the lesion was radiated.

2.The laser was coupled to chilled air-cooling apparatus during radiation of skin lesions,
but for the oral portion of the lesion,air cooling was not used because the forced cold air
flow can causes breathing difficulty in some patients.Compression was done from inside
the oral cavity to the outside during irradiation of the outer cutaneous side and from the
outside to inside during irradiation of the mucous membrane portion of the lesion.

Result:
Results were considered excellent when there was complete resolution without any skin
changes (no color or textural changes) and no recurrence of the lesion after follow-up.

Advantage:
Laser photocoagulation has been successful in the majority of patients, with minimal
morbidity damage to the surrounding tissue. As the CHEESE dental diode laser is a
deep photocoagulating laser, one that targets tissue protein, epidermal changes - and
sometimes scarring - may result after treatment; thus, to minimize the cryogen cooling of
the skin, application should aim to protect the epidermis and papillary dermis while
achieving deep tissue photocoagulation during diode laser irradiation.