Photomed Laser Surg. 2009 Oct 27. [Epub ahead of print]
The Association of Low and High Laser Treatments on Self-Inflicted Lip Injury: A Case Report.
Santos MT, de Souza Merli LA, Guare RO, Ferreira MC.
1 Universidade Cruzeiro do Sul , São Paulo, Brazil .
Objective: Report a clinical case of surgical lip lesion removal owing to self-injury in a 9-year-old male quadriplegic, spastic cerebral palsy (CP) patient using low and high lasers in association. Background: Various management methods for oral trauma have been suggested, depending on the severity, frequency, and cause of injury, including medication, behavioral techniques, and oral appliances or dental extractions. Methods: Initially, low-level laser therapy (LLLT) was used on the injured labial tissue measuring 2.2 cm externally and 3.4 cm in the internal mucosal, followed by surgical removal using a CO(2) laser. After 30 days, a significant reduction in injury to the oral tissues was observed, and the region presented normal color and good healing conditions. Conclusion: The association of different laser therapies to remove and heal a lip lesion owing to self-injurious behavior was effective and promoted improvement in the patient’s quality of life by establishing painless mastication.
Braz Dent J. 2004;15 Spec No:SI29-33.
Efficiency of laser therapy applied in labial traumatism of patients with spastic cerebral palsy.
Moreira LA, Santos MT, Campos VF, Genovese WJ.
Laser Disciplines in Dentistry, Implantodontics and Integrated Dentistry Clinic, University of Cruzeiro do Sul (UNICSUL), São Paulo, SP, Brazil. firstname.lastname@example.org
The aim of this study was to report the effectiveness of laser therapy applied to traumatic labial injury of patients with spastic cerebral palsy. We report two cases of patients with internal mucosa and lower lip traumatism caused by oral reflex automatism with spastic tonic bite and lower lip interposition. One patient presented extensive lower lip ulceration, loss of tissue, crusty and hemorrhagic areas, with increasing pain and spasticity. The other patient presented local congestion signs, extremely enlarged tissue growth and increased labial volume. Laser therapy was applied to all injured areas, with a low-potency diode InGaAlP laser [685 nm Quasar (Dentoflex), 190 J/ cm2, with a 24-h interval between the first and second administration, and a 7-day interval between the two subsequent ones. At first re-evaluation, 24 h later, there was a striking reduction in inflammation, a decrease in vascular congestion, and a reduction of the ulcerated area with spasticity and pain reduction. At the 14-day re-evaluation, significant clinical differences in the advanced healing process were seen. Low-intensity laser showed to be effective in traumatic soft tissue treatment in cerebral palsy patients by accelerating the healing process, reducing secondary contamination, promoting analgesia; thus, it can be an important tool in the treatment of these patients.