Removal of epulis by CO 2 laser.

From analysis of the epulis patient population for 40 years, it could be established that of 1019 lesions, 12.8% relapsed, in 40% of surgical interventions, with the extraction of the tooth involved. For the removal of epulis, we have developed our own method. As a first step, the tumor is excised by CO 2 laser. Thereafter, excochleation and bone decortication are performed, followed, as a third step, by evaporation. In each case, an attempt is made at preserving the teeth. When necessary, radicular treatment and fixation are performed. Postoperatively, minimal edema and pain occurred, and the majority of the patients were able to work on the first postoperative day. Following laser removal of 63 epulides, recurrence was seen in 5 cases (7.9%) without intraoperative tooth extraction. The combined method was applied successfully also in a hemophilic patient. Besides the conventional laser surgical handpiece, an endoscope of own construction was used on surfaces untreatable by direct sight.