BACKGROUND The goal of periodontal disease treatment is to completely remove bacteria and promote wound healing.The erbium-doped yttrium aluminum garnet(Er:YAG)laser is commonly used to treat periodontal disease.Advan...BACKGROUND The goal of periodontal disease treatment is to completely remove bacteria and promote wound healing.The erbium-doped yttrium aluminum garnet(Er:YAG)laser is commonly used to treat periodontal disease.Advanced platelet-rich fibrin+(A-PRF+)secrets growth factors that accelerates soft-and hard-tissue regeneration and wound healing.Herein I present 2 cases of patients with oral diseases treated with a combination of Er:YAG laser and A-PRF+.CASE SUMMARY Case 1 was a female with pocket depth bone loss over 8 mm and infection of tooth 31 and 41,and severe advanced periodontitis with grade III mobility.Case 2 was a male with tooth 22 root end apical swelling and infection and alveolar bony defects.Clinical outcomes were recorded at 6 and 36 mo.In case 1,the Er:YAG laser was used to perform open flap debridement(100 mJ/pulse,15 Hz)and remove calculus and granulation tissue(50 mJ/pulse,30 Hz).In case 2 the laser was used to create a semilunar full thickness flap incision(80 mJ/pulse,20 Hz)and eliminate the pathogen(100 mJ/pulse,15 Hz).In both patients,A-PRF+mixed with bone was used to fill bone defects,and A-PRF+autologous membranes were used to cover tension-free primary flaps.There was no recurrent infection at 36 mo,and tissue regeneration and would healing occurred.CONCLUSION Debridement with an Er:YAG laser followed by treatment with A-PRF+is effective for the treatment periodontal diseases with bone defects.展开更多
BACKGROUND Bouveret syndrome,also known as gallstone ileus,is a rare form of gastric outlet obstruction accounting for 1%-3%of cases.This condition is most often reported in females.The diagnosis can be challenging an...BACKGROUND Bouveret syndrome,also known as gallstone ileus,is a rare form of gastric outlet obstruction accounting for 1%-3%of cases.This condition is most often reported in females.The diagnosis can be challenging and is often missed due to atypical presentations,which occasionally mimic gastric outlet obstruction symptoms such as nausea,vomiting,loss of appetite and hematemesis.The symptoms vary with stone size.Larger stones are managed with a surgical approach,but this carries increased morbidity and mortality.Over the past decade,the endoscopic approach has emerged as an alternative mode of treatment,but it is generally unsuccessful in the management of larger-sized stones.A literature review revealed cases of successful endoscopic treatment requiring multiple sessions for stone sizes measuring up to about 4.5 cm.Here we present a unique case of an elderly patient with Bouveret syndrome with a 5 cm stone mimicking a gastric mass and causing gastric outlet obstruction,who was successfully managed in a single session using a complete endoscopic approach with laser lithotripsy.CASE SUMMARY An 85-year-old female patient presented with 1-month history of intermittent abdominal pain,vomiting,decreased appetite and weight loss.An abdominal computed tomography showed a 4.5 cm×4.7 cm partially calcified mass at the gastric pylorus causing gastric outlet obstruction.Endoscopy showed an ulcerated fistulous opening and a large 5 cm impacted gallstone in the duodenal bulb.Endoscopic nets and baskets were used in an attempt to remove the stone,but this approach was unsuccessful.Given her advanced age,poor physical condition and underlying comorbidities,she was deemed to be high-risk for surgery.Thus,a minimally invasive approach using endoscopic laser lithotripsy was attempted and successfully treated the stone.Post-procedure,the patient experienced complete resolution of her symptoms with no complications and was able to tolerate her diet.She was subsequently discharged home at 48 h,with an uneventful recovery.CONCLUSION展开更多
文摘BACKGROUND The goal of periodontal disease treatment is to completely remove bacteria and promote wound healing.The erbium-doped yttrium aluminum garnet(Er:YAG)laser is commonly used to treat periodontal disease.Advanced platelet-rich fibrin+(A-PRF+)secrets growth factors that accelerates soft-and hard-tissue regeneration and wound healing.Herein I present 2 cases of patients with oral diseases treated with a combination of Er:YAG laser and A-PRF+.CASE SUMMARY Case 1 was a female with pocket depth bone loss over 8 mm and infection of tooth 31 and 41,and severe advanced periodontitis with grade III mobility.Case 2 was a male with tooth 22 root end apical swelling and infection and alveolar bony defects.Clinical outcomes were recorded at 6 and 36 mo.In case 1,the Er:YAG laser was used to perform open flap debridement(100 mJ/pulse,15 Hz)and remove calculus and granulation tissue(50 mJ/pulse,30 Hz).In case 2 the laser was used to create a semilunar full thickness flap incision(80 mJ/pulse,20 Hz)and eliminate the pathogen(100 mJ/pulse,15 Hz).In both patients,A-PRF+mixed with bone was used to fill bone defects,and A-PRF+autologous membranes were used to cover tension-free primary flaps.There was no recurrent infection at 36 mo,and tissue regeneration and would healing occurred.CONCLUSION Debridement with an Er:YAG laser followed by treatment with A-PRF+is effective for the treatment periodontal diseases with bone defects.
文摘BACKGROUND Bouveret syndrome,also known as gallstone ileus,is a rare form of gastric outlet obstruction accounting for 1%-3%of cases.This condition is most often reported in females.The diagnosis can be challenging and is often missed due to atypical presentations,which occasionally mimic gastric outlet obstruction symptoms such as nausea,vomiting,loss of appetite and hematemesis.The symptoms vary with stone size.Larger stones are managed with a surgical approach,but this carries increased morbidity and mortality.Over the past decade,the endoscopic approach has emerged as an alternative mode of treatment,but it is generally unsuccessful in the management of larger-sized stones.A literature review revealed cases of successful endoscopic treatment requiring multiple sessions for stone sizes measuring up to about 4.5 cm.Here we present a unique case of an elderly patient with Bouveret syndrome with a 5 cm stone mimicking a gastric mass and causing gastric outlet obstruction,who was successfully managed in a single session using a complete endoscopic approach with laser lithotripsy.CASE SUMMARY An 85-year-old female patient presented with 1-month history of intermittent abdominal pain,vomiting,decreased appetite and weight loss.An abdominal computed tomography showed a 4.5 cm×4.7 cm partially calcified mass at the gastric pylorus causing gastric outlet obstruction.Endoscopy showed an ulcerated fistulous opening and a large 5 cm impacted gallstone in the duodenal bulb.Endoscopic nets and baskets were used in an attempt to remove the stone,but this approach was unsuccessful.Given her advanced age,poor physical condition and underlying comorbidities,she was deemed to be high-risk for surgery.Thus,a minimally invasive approach using endoscopic laser lithotripsy was attempted and successfully treated the stone.Post-procedure,the patient experienced complete resolution of her symptoms with no complications and was able to tolerate her diet.She was subsequently discharged home at 48 h,with an uneventful recovery.CONCLUSION
