Treatment of epulis fissuratum with CO2 laser and prosthetic rehabilitation in patients with vesiculobullous disease.

OBJECTIVE

The purpose of this article is the clinical presentation of the treatment of epulis fissuratum with CO(2) laser and prosthetic rehabilitation of three patients with vesiculobullous diseases (VBDs).

BACKGROUND

Oral problems such as blister formation with minimal trauma are usually encountered in the VBDs. With repeated cycles of blistering and healing, oral hygiene is usually compromised, which leads to rapid breakdown of the dentition. Prosthetic rehabilitation includes complete, partial, and implant-supported dentures; however, ill-fitting dentures can cause inflammatory fibrous hyperplasia. Clinical application of CO(2) laser has been recommended to treat benign oral lesions such as epulis fissuratum and fibroma.

METHODS

The treatment plan consisted of excision of fibrous tissues, controlling dental plaque, and prosthetic rehabilitation. The excision of fibrous tissue was performed with CO(2) laser, and the wounds formed by laser were left open to secondary epithelization. The dental plaque and calculus deposits were cleaned with ultrasonic scalers and a well-formed acrylic denture for maxilla and mandible were fabricated after a month.

RESULTS

There was no recurrent fibrous tissue formation at 1 year follow-up. However, plaque accumulation control was unsatisfactory and the patients were therefore urged to undergo a regular 6-month preventive dental prophylaxis regimen and denture re-evaluation.

CONCLUSIONS

The CO(2) laser may be a useful instrument in the treatment of soft tissue pathologies in VBDs patients due to minimal damage to surrounding tissue. Use of complete or partial dentures has been considered a practical, economic, and nonsurgical treatment option for patients who have been diagnosed with VBDs.