Minimally Invasive Treatment with a 980nm Diode Laser in Lingual Hemangioma

Laser use continues to expand into the medical and dental fields, and patients are increasingly seeking out such treatment because it is perceived as less invasive and less traumatic than traditional methods. Laser surgical treatments have also shown fewer postoperative complications and faster, uneventful healing when compared to traditional surgical techniques.

While not common in the oral cavity, hemangiomas can occur in the lips, tongue, buccal mucosa, and palate. Their appearance can vary from a round, bluish-red, raised lesion, to a pedunculated, irregular shaped mass. Most hemangiomas of the oral cavity are classified as capillary hemangiomas, which are formed by small capillaries surrounded by a layer of endothelial cells in a connective-tissue stroma. Hemangiomas can become quite large, are unsightly, and can bleed if traumatized. Some can affect swallowing, speech, or breathing, though most do not. Past treatment modalities for oral hemangiomas usually involved medication (eg, systemic steroid treatment), sclerotherapy, embolization, x-ray therapy, or excisional surgery. These treatment methods carry several unwanted side effects, including bleeding, risk of infection, and systemic complications, and all of which can lead patients to avoid treatment.

However, the diode laser can greatly increased the patient’s acceptance of treatment and overall perception of care. The actual treatment for lingual hemangioma consisted of using a 980nm diode laser (LunDent, Lunray) with an adjustable pain therapy handpiece capable of creating laser energy spot with different size. After both the patient and the doctor wear the laser protective glasses, the handpiece set at a spot size of 15 mm and power output set at 4.0 W continuous wave. Then, the pain therapy handpiece slowly moved over the lesion while emitting laser energy for two 3-minute intervals, with a 30-second interval between the actual laser treatments. Total laser time on tissue is 6 minutes and no local anesthetic need during the procedure. Postoperatively, patients will only receive postoperative care instruction, including nonprescription NSAIDs, warm salt-water rinses, and a soft diet. The patient does not develop any adverse conditions such as swelling, fever, signs of infection, or  difficulty swallowing or breathing. 

Within dentistry, diode lasers have become common for use as soft-tissue surgical devices. As these tools are used more frequently, their functions and utility continue to expand in the dental clinic. Besides soft-tissue surgical applications, some diode lasers can also be used for teeth whitening, biostimulation, reduction of gingival inflammation as an adjunct in the management of periodontal disease, temporomandibular joint treatment, and laser treatment of vascular lesions. Diode lasers also have a high affinity for hemoglobin, which makes them suitable for the treatment of vascular malformations and pigmented lesions. The diode laser treatment results in no bleeding, fewer postoperative symptoms, and a safer approach to treating these types of lesions and providing relief to the patient.