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Journal of Indian Society of Pedodontics and Preventive Dentistry Official publication of Indian Society of Pedodontics and Preventive Dentistry
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CASE REPORT
Year : 2013  |  Volume : 31  |  Issue : 4  |  Page : 279-281
 

Laser treatment of an oral squamous papilloma in a pediatric patient: A case report


1 Department of Oral and Maxillofacial Surgery, Bülent Ecevit University, Zonguldak, Turkey
2 Department Pedodontics, Faculty of Dentistry, Bülent Ecevit University, Zonguldak, Turkey
3 Department Pathology, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey

Date of Web Publication21-Nov-2013

Correspondence Address:
Levent Demiriz
Bülent Ecevit University, Faculty of Dentistry, Department of Pedodontics, Zonguldak- 67600
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.121833

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   Abstract 

Oral squamous papilloma is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass induced by human papilloma virus (HPV). These oral mucosa lesions are most often asymptomatic and have small progression. Laser assisted surgery is common nowadays with several advantages including successful hemostasis, devoid of sutures, wound sterilization and minimal post-operative pain and edema. The aim of this report is to present the oral squamous papilloma in a pediatric patient and its treatment with soft tissue laser. The lesion was excised with diode laser and the healing was uneventful in follow-up visit after one year. Oral squamous papillomas can be found in child's oral cavity and laser dentistry can be used by dental clinicians to treat these kinds of oral lesions and should be considered as an alternative to conventional surgery.


Keywords: Diode laser, pediatric, squamous -papilloma


How to cite this article:
Misir AF, Demiriz L, Barut F. Laser treatment of an oral squamous papilloma in a pediatric patient: A case report. J Indian Soc Pedod Prev Dent 2013;31:279-81

How to cite this URL:
Misir AF, Demiriz L, Barut F. Laser treatment of an oral squamous papilloma in a pediatric patient: A case report. J Indian Soc Pedod Prev Dent [serial online] 2013 [cited 2019 Jul 22];31:279-81. Available from: http://www.jisppd.com/text.asp?2013/31/4/279/121833



   Introduction Top


Oral squamous papillomas are exophytic lesions caused by human pailloma virus (HPV). They are benign proliferations of the stratified squamous epithelium and this oral mucosa lesion clinicaly seems like soft and white-pink colored. The sites of predilection for localization of the lesions include the tonque, soft palate and uvula, but any surfaces of the oral cavity can be affected. Oral squamous lesions raises concern because of its clinical appearance, which may mimic exophytic carcinoma, verrucous carcinoma or condyloma acuminatum. However, cases usually have a slow progression rather than acute symptoms and these lesions are often asymptomatic and show benign character in pathological examinations. [1],[2],[3]

The use of laser in oral and maxillofacial surgery has been widespread over the last decades with favorable experiences and most of the oral soft tissue surgical procedures are done using lasers. Among the commonly available lasers today, the diode laser is frequently used in dentistry. Bleeding control, visibility and better tissue manipulation are some of the advantages of it. [4],[5] We aimed to present a pediatric case of squamous papilloma treated with diode laser and the post-operational follow-up.


   Case Report Top


A 5-year-old girl was referred with a complaint of soft tisue mass in her hard palate. According to the history, this lesion occured two months ago, however, her parents neglected until they recognized the expansion of the lesion size. Clinical examination showed that there was a pink-coloured lesion extended from the middle line of the hard palate and was approximately 0.7 cm in length [Figure 1]. There was nothing abnormal in her systemic review. The lesion was completely excised from its connection to the hard palate under local anesthesia with diode laser (Picasso Lite, Dentsply, Australia) [Figure 2]. Pathology revealed characteristic findings of a squamous papilloma, including multiple squamous lined papillary fronds containing fibrovascular cores [Figure 3]. A month later, the clinical follow-up showed the complete tissue healing [Figure 4]. One year of follow-up was done and no evidence of recurrence of the lesion was noted [Figure 5].
Figure 1: The clinical photograph of the squamous papilloma in the hard palate

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Figure 2: The surgical specimen which was removed from the oral cavity

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Figure 3: Histopathological appearance of squamous papilloma which is a benign exophytic epithelial lesion (a) A papillary mass composed of hyperplastic squamous epithelium and multiple fi ngerlike projections with fi brovascular core, (b) Dense connective core with benign proliferation of stratifi ed squamous epithelium without cell atypia. [H and E; a; ×100, b; ×200]

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Figure 4: 1 week postoperative view of the hard palate

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Figure 5: 1 year postoperative view of the hard palate

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   Discussion Top


Squamous papillomas are benign mucosal masses commonly induced by HPV-6 and HPV-11. The lesions generally measure less than 1 cm in range and appear as pink to white exophytic granular or cauliflower-like surface alterations. They may be found on the vermilion portion of the lips and any intraoral mucosal site, with a predilection for the hard and soft palate and the uvula. [1],[3],[6],[7] The clinical view and the locations of the lesion in the present case was appropriate to common identifications of oral squamous papilloma. The oral pathology report confirmed the presurgical clinical diagnosis. The lesions are commonly asymptomatic [3] as seen in the present case. Squamous papillomas are traditionally divided into two types: isolated-solitary and multiple-recurring. Although the isolated-solitary type is usually found in an adult's oral cavity, [3] the clinical view of the lesion in the present case was appropriate with the isolated-solitary type. According to this situation, the isolated-solitary type of squamous papilloma may be occured and it should be considered although these lesions is not usually found in child's oral cavity.

Surgical removal is the treatment of choice for these lesions and can be performed with electrocautery, cold-steel excision, laser ablation, cryosurgery, or intralesional injections of interferon. [3],[6] In the present case, surgical excision was applied with diode laser. The laser assisted surgery has several advantages such as excellent hemostasis, high precision in tissue destruction, devoid of sutures, wound sterilization and minimal post-operative pain and edema. [4] Considering these advantages, the diode laser was chosen as an alternative for the removal of the squamous papilloma lesion in the present case. No pain medication was required after excision operation, and wound healing was notable and rapidly achievable. Minimal post-operative pain and rapid wound healing advantages [4] of the laser assisted surgery may provide tolerable procedure for pediatric patients to remove the masses like oral squamous papilloma.


   Conclusions Top


Oral squamous papillomas can be found in child's oral cavity and the clinical diagnosis of these lesions is important. Laser dentistry can be used by dental clinicians to treat these kinds of oral lesions and should be considered as an alternative to conventional surgery.

 
   References Top

1.Carneiro TE, Marinho SA, Verli FD, Mesquita AT, Lima NL, Miranda JL. Oral squamous papilloma: Clinical, histologic and immunohistochemical analyses. J Oral Sci 2009;51:367-72.  Back to cited text no. 1
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2.Khalighi HR, Hamian M, Abbas FM, Farhadi S. Simultaneous existence of giant cell fibroma and squamous papilloma in the oral cavity. IJMS 2011;2:153-6.  Back to cited text no. 2
    
3.Jaju PP, Suvarna PV, Desai RS. Squamous papilloma: Case report and review of literature. Int J Oral Sci 2010;2:222-5.  Back to cited text no. 3
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4.Monteiro LS, Mouzinho J, Azevedo A, Câmara MI, Martins MA, La Fuente JM. Treatment of epulis fissuratum with carbon dioxide laser in a patient with antitthromboticmedicetion. Braz Dent J 2012;23:77-81.  Back to cited text no. 4
    
5.Elanchezhiyan S, Renukadevi R, Vennila K. Comparison of diode laser-assisted surgery and conventional surgery in the management of hereditary ankyloglossia in siblings: A case report with scientific review. Lasers Med Sci 2013;28:7-12.  Back to cited text no. 5
[PUBMED]    
6.Goodstein LA, Khan A, Pinczewski J Young VN. Symptomatic squamous papillomaf the uvula: Report of a case and review of the literature. Case Rep Otolaryngol 2012;2012: 329289.  Back to cited text no. 6
    
7.Boj JR, Hernandez M, Espasa E, Poirier C. Laser treatment of an oral papillomain the pediatric dental office: A case report. Quintessence Int 2007;38:307-12.  Back to cited text no. 7
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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    Abstract
   Introduction
   Case Report
   Discussion
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    References
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