The effect of CO2 laser treatment on soft tissue following post-operational radiotherapy
(extract from vol. 2 of the "Assistant")

Mr X
A patient of Dr. S (Paris) for both the Neoplasic treatment, and the movable prosthesis, as well as the necessary implantation of the same. Taken in charge by Dr. Le Neveu Yves, in 1997, for treatment of the fixed prosthesis, by CO2 Laser (5 watts), this was followed in 1998-99, by a further treatment with the CO2 Laser (15 watts), in order to clean the channel of the left hand implantation around the head of the magnet linking with the movable Prosthesis. (See the January X-ray).

The 4 Implanted Magnets, support the complete movable prosthesis : but the opening is obstructed. Consequently, as the use of a scalpel is forbidden on irradiated tissue, the only non-toxic treatment possible, was the CO2 Laser.
4899
T = 0    48 99
Detail of the prosthesis

Blockage of the canal causes :

Pain and Inflammation of the cheekbone, which impedes the removal and replacement of the Prosthesis, which must be worn permanently. Hygiene is good for this case.
The success of laser treatment :

19.3.97 :
5 W continuous. No adverse sensibility. Gum tissue was irradiated in 1990.
26.5.98 :
SP Laser 5 W
25.8.98 :
SP Laser 5 W
12.5.99 :
15 W continuous, under light anaesthetic.
Detail of the prosthesis :

Showing the magnetic section at the extremity of the base support that is introduced directly into the mandibular channel or attached to the pocket of the mucous membrane.

PROGRESSIVE CLEANING OF THE ACCESS CHANNEL TO THE LEFT HAND MAGNETIC IMPLANT
18.8.99 - Slight relapse
complimentary treatment super pulse 5 watts no anaesthetic
T = 0

In this case the use of the Laser rests superficial because the retractation of scar tissue is above normal.


August 1999 :
The satisfactory condition of the channel, allows the normal replacement of the Prosthesis, without difficulty, during insertion.
Curent treatment :
Instead of waiting for the orifice to heal naturally, a monthly series of appointments was envisaged, for observation and systematic cleaning against the possibility of further by soft tissue invasion.
Observation :
The intensity of 5 watts continuous without pain in 1997 could no longer be supported by the patient, because the zone treated by the CO2 Laser, appears to have recovered a certain amount of sensitivity.

CONCLUSIONS : 1997 - 1998 - 1999
The overall results, are highly satisfactory, and the orifice, which would otherwise have had to remain blocked, due to the non acceptance of traditional means, was successfully treated by the new Laser Technique. This new protocol, permitting the elimination of tissue by CO2 Laser, allows the cleaning of the implantation channel, followed by a perfect cicatrisation, no matter how many other operations are carried out in the same area.
Dr Y. Le Neveu

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