PMC9453113_01
Clinical appearance.. A. The erythematous pedunculated mass at tooth no. 36 and tooth no. 37.. B. Tooth no. 37 was displaced from the normal position.
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The mass was soft consistency with no bleeding and no pus ( Figure 1A). Tooth no. 37 exhibited buccal displacement, as shown in Figure 1B. Tooth no. 36 and tooth no. 37 exhibited second-degree and third-degree mobility, respectively.
Radiographic examination.. The periapical radiograph demonstrating alveolar bone loss at tooth no. 36 and tooth no. 37.
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Pathohistological investigation.. Histopathology section showing endothelial cell proliferation and distribution throughout the lesion, which are the characteristics of a pyogenic granuloma.. A. At x10 magnification and B. At x40 magnification.
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The interstitial-intralesional laser technique.. A. The optical fiber was inserted into the lesion, beginning at the base of the lesion and then progressing to the top. The optical fiber was placed tangentially to the tooth and root surface.. B. After a single treatment with interstitial-intralesional laser therapy on four areas.
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The lesion was firstly treated by interstitial-intralesional laser therapy under local anesthesia using a 980 nm diode laser at 3 W continuous-wave with a 200-micron optical fiber, as shown in Figure 4A and B.
Photobiomodulation using a 635 nm diode laser via an 8 mm optical fiber.
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This treatment was then immediately followed by treatment with using a 635 nm diode laser via an 8 mm optical fiber at 100 mW, continuous wave and 4 J/cm 2 with non contact mode to the lesion at the buccal and lingual sites for 1 session per area to achieve photobiomodulation ( Figure 5).
The clinical outcomes after interstitial-intralesional laser therapy.. A. 2 weeks after the first therapy.. B. 2 weeks after the second therapy.. C. 3 weeks after the third therapy.
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The remission of the pyogenic granuloma was observed, as shown in Figure 6A, B and C.
The LANAP procedure.. A. The 980 nm diode laser was used for dilating the gingival sulcus.. B. Scaling and root planning with hand instruments.. C. The 980 nm diode laser was used for ablating the long junctional epithelium and granulation tissue in the gingival sulcus.. D. Toluidine blue was injected as a photosensitizer into the gingival sulcus.. E. The gingival sulcus was irradiated with a 635 nm diode laser via a 200-micron flexible tip to initiate photosensitizer.
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Step 1: After supragingival scaling with an ultrasonic scaler, a 980 nm diode laser at 0.7 W and continuous wave was delivered via a 200-micron optical fiber into the gingival sulcus ( Figure 7A). Then, it was followed by scaling and root planning ( Figure 7B).
The clinical outcomes after LANAP procedure.. A, B and C. Intraoral features after LANAP showing the normal appearance of the gingivae of the lower left molars and the repositioning of the teeth to their previous location and occlusion.. D. Periapical radiograph of tooth no. 36 and tooth no. 37 showing an increase in periapical radiopaque characteristics in the previous defect.
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The periapical radiograph showed improvement through the indication of bone formation at the periapical areas of tooth no. 36 and tooth no. 37, as shown in Figure 8.