EIJMRMS ISSN: 2750-8587
VOLUME04 ISSUE06
106
THE STUDY OF THE USE OF AN ERBIUM LASER FOR SURGICAL TREATMENT OF ROOT
CYSTS OF THE JAWS
Tashmuhammedova Shaxnoza
Samarkand State Medical University, Uzbekistan
Sadriyev Nizom Najmiddinovich
Samarkand State Medical University, Uzbekistan
AB O U T ART I CL E
Key words:
root perforation, omission,
inhomogeneous filling, excessive intake of
material.
Received:
20.06.2024
Accepted
: 25.06.2024
Published
: 30.06.2024
Abstract:
The problem of surgical treatment of
patients with odontogenic root cysts (periodontal
ligament) remains relevant to this day. This is due
to the high frequency of this disease. Periodontal
root cysts account for about 86% of all
odontogenic cysts and 7-15% of all diseases of the
maxillofacial region. In addition, the urgency of
the problem of treating patients with odontogenic
jaw cysts is due to the possible development of
complications of surgical treatment (cystectomy
or cystotomy) using cutting or rotating tools:
damage to neighboring anatomical structures,
infection, suture divergence and disease
recurrence - all this leads to long-term treatment
[1-6 ]. Despite the extensive arsenal of surgical
methods and medications used to treat patients
with this disease, this problem is not considered
to be completely solved.
INTRODUCTION
The difficulty of diagnosing and treating this condition is partly due to its proximity to anatomically
significant objects. This inflammatory cyst arises from a cystic granuloma. Cyst growth does not occur
due to epithelial proliferation, but as a result of increased intraluminal pressure. Thus, the volume of
the cyst increases with the resorption and restructuring of the surrounding bone tissue; in 40% of cases,
the cause of the development of a radial cyst is caries-affected teeth; in 60% of cases, the cyst develops
VOLUME04 ISSUE06
https://doi.org/10.55640/eijmrms-04-06-17
Pages: 106-113
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
AND MANAGEMENT STUDIES
ISSN: 2750-8587
VOLUME04 ISSUE06
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as a complication of endodontic treatment; in 60% of cases, the cyst is the result of a pulp infection. In
some cases, necrotic pulp is squeezed out of the root apex with the subsequent development of
periodontitis or pulp traumatization, especially when removing tartar under anesthesia [7, 8].
According to radiation studies, complications of endodontic treatment include root perforation,
omission, inhomogeneous filling, excessive intake of material into the periodontal ligament and
insufficient sealing of the oral cavity or crown area [8-10]. The main methods of surgical treatment,
depending on the size of the jaw crest cyst, are cystotomy and cystectomy. In some cases, surgical
treatment may be complicated by secondary infection, relapses and the formation of fistulas due to
residual bacterial colonies in a complex branched system of lateral, triangular and root canals with
additional anastomoses. The use of modern high-intensity lasers reduces the likelihood of these
undesirable effects of treatment. Dental Er:YAG lasers with a wavelength of 2940 nm are capable of
producing intense short pulses and are characterized by the ability to automatically adjust operating
parameters (energy, duration, frequency and pulse shape) depending on the nature of the procedure
by selecting them on the monitor. The energy of the laser light wave is focused into space in the form of
a very narrow beam with high directivity, monochromaticity and continuous or short-pulse energy
transfer. The focused laser beam acts as a very sharp and aseptic cutting tool, allowing operations to be
performed without direct contact with tissues, with pronounced hemostasis and anesthesia. The
erbium laser beam is capable of cutting both soft and hard tissues. Laser irradiation of tissues occurs
without pressure and friction and is not accompanied by vibration. Ablation (evaporation) occurs in
tissues affected by laser radiation as a result of thermomechanical processes. The chromophore of an
erbium laser is water, a substance capable of absorbing laser light energy and converting it into thermal
energy. It is water that evaporates from the tissue during laser irradiation. The process of ablation
(tissue cutting) occurs only when a certain energy density (ablation threshold) is exceeded. This
threshold is approximately 3.3 J/cm2 for enamel, 2.8 J/cm2 for dentin, 1.3 J/cm2 for bone and 0.8 J/cm2
for skin. In subablation zones (below the ablation threshold), only heating and drying of tissues occurs
[2, 5, 11, 12]. In this regard, it is of interest to study the effectiveness of laser cystectomy using an Er:YAG
laser. In this case, an erbium laser should be used to resect the tip of the root, remove the remnants of
the shell and sterilize the walls of the resulting bone defect. In case of large cysts, it is advisable to fill
the postoperative defect with bone-forming material (1). This contributes to the formation of high-
quality bone regeneration products and stimulates the activity of cellular factors of local immunity [3].
The purpose of this study was to study the effectiveness of surgical treatment of patients with jaw root
cysts using an Eg:YAG laser.
MATERIALS AND METHODS
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
AND MANAGEMENT STUDIES
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Examination and surgical treatment of patients with root cysts of the jaws of various localization (n=55;
33 women and 22 men, age 21-62 years) were performed. Of these, 19 mandibular and 36 maxillary;
heterogeneous osteogenic material "Osteodent" was used to replace the formed bone defects in 22
patients; 29 patients underwent traditional cystectomy, 16 of them with the use of "Osteodent"; 26
patients underwent Er:YAG laser laser cystectomy using an Er:YAG laser, 16 of them also used
Osteodent. The erbium Er:YAG laser (DECA Smart 2940D plu, Italy) is characterized by a wavelength of
2940 nm, an energy of 50-500 MJ and a pulse frequency of 10-30 Hz. The pulse duration is 230-700
microseconds (see Fig. 1). Laser cystectomy is based on traditional cystectomy methods. Using an
erbium laser with an energy of 100 MJ and a pulse frequency of 10 Hz, a vertical incision is made at the
location of the cyst or inside the bone, with a trapezoidal arcuate incision in the area of the transitional
fold. Then, at an energy of 150 MJ, a pulse frequency of 10 Hz, in the mode of ultrashort pulses (short
pulse - 230 microseconds), the cyst expanded to its diameter, and the bone molar expanded or the bone
was perforated in the projection of the cyst. For resection of the root part of the cyst, the energy was
increased to 200 MJ, and the pulse frequency was increased to 20 Hz. Sterilization of the wall surface of
the formed postoperative bone defect was performed using a defocused laser beam (fiber at a distance
of 1.5 cm from the wall surface) with an energy of 100 MJ and a pulse frequency of 10 Hz. Then the laser
was irradiated on the ablated surface of the root with energy for 15 seconds.
RESULTS AND DISCUSSION
The use of a high-intensity erbium laser has increased the effectiveness of treatment of patients with
root cysts of the jaws. Clinical research data revealed a significant difference in performance depending
on the method of surgical treatment. The results showed a pronounced postoperative pain syndrome
requiring the use of analgesics in all patients who underwent traditional cyst removal. Moreover, the
pain persisted for up to 4-5 days after surgery, while using laser technology, less intense pain, which
did not require the use of analgesics, was observed for 1-1.5 days. This may be due to the fact that the
laser energy is absorbed by the cellular fluid, and not by the nerve endings, therefore, when using a
laser, there is no stress effect on nerve cells. In addition, when using a laser, tissues are less injured.
With a conventional cystectomy, collateral edema of soft tissues was observed for 3-5 days, with the
use of an Er:YAG laser, collateral edema was less pronounced and was detected within 2-3 days. This is
probably due to the short duration, accuracy and selectivity of laser irradiation, the absence of
intraoperative pressure on tissues, friction and vibration, as well as minimal traumatization of
surrounding tissues. The healing process of laser wounds is not accompanied by neutrophil infiltration,
which is characteristic of "scalpel wounds" with traditional methods. With conventional cystectomy,
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
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epithelialization was observed on day 7-8, whereas with surgical laser surgery - on day 5-6, and the
sutures could be removed faster (Fig. 3). It is noteworthy that 19 patients were treated for single or
double recurrences of radial cysts. Relapses and fistula formation were not observed for 1-2 years after
laser removal of cysts. The data of the radiation method studies conducted 1, 3 and 6 months after
surgery determined the activation of bone regeneration processes in postoperative defects in patients
after laser cystectomy. When bone beams filled the entire cavity of the bone defect after laser surgery,
only a small number of beams were observed in patients after traditional cystectomy. 12 months after
laser cystectomy, the osteogenic process was completed in all patients. With traditional treatment, bone
formation was slow in more than half of the patients, and alternation of young and mature bone tissue
was observed. Besides, there was less mature bone. Radiation studies have revealed the specifics of
bone tissue restoration in postoperative defects after laser treatment. Early formation of the cortical
layer along the periphery of the defect was observed, followed by restoration from the periphery to the
center. In the case of the usual restoration of a bone defect after cystectomy, there was a uniform delay
in bone restoration through a soft-tissue corn along the entire length of the defect. The data obtained
are consistent with experimental studies of bone regeneration in rabbits using irradiation methods.
Thus, according to microfocus radiography, the authors revealed the same specifics of healing of laser
defects applied to the mandibular angle of rabbits with an erbium laser [13]. In short, an analysis of
clinical research methods has shown that the use of erbium:YAG laser helps to reduce pain reactions,
postoperative edema and epithelialization time. These irradiation techniques determined that the
formation of dense bone regenerate in the postoperative period occurred faster than with traditional
treatment.
CONCLUSIONS
Analysis of the results of clinical and X-ray studies has shown that the consistent use of erbium and
neodymium lasers in the surgical treatment of excision of the mandibular root cyst effectively reduces
intraoperative tissue injury, shortens treatment time, reduces the risk of infection of the periodontal
ligament from the canal system and contributes to the prevention of disease recurrence, thus the results
of this study showed that it can be used for
REFERENCE
1.
Абдуллаева П. Р., Ахмедов А. А. СПОСОБ ЛЕЧЕНИЯ ИШЕМИЧЕСКИХ СОСТОЯНИЙ
ЗРИТЕЛЬНОГО НЕРВА И СЕТЧАТКИ (ЛИТЕРАТУРНЫЙ ОБЗОР): Medical science
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
AND MANAGEMENT STUDIES
ISSN: 2750-8587
VOLUME04 ISSUE06
110
//Ethiopian International Journal of Multidisciplinary Research.
–
2023.
–
Т. 10. –
№. 09.
–
С. 18
-23.
2.
Ризаев Ж. А., Ахмедов
А. А. ОСНОВЫ СТОМАТОЛОГИЧЕСКОЙ ПОМОЩИ В
РЕСПУБЛИКЕ УЗБЕКИСТАН НА ОСНОВЕ РАЗВИТИЯ ОБЩЕЙ ВРАЧЕБНОЙ
ПРАКТИКИ
//ЖУРНАЛ
СТОМАТОЛОГИИ
И
КРАНИОФАЦИАЛЬНЫХ
ИССЛЕДОВАНИЙ. –
2023.
–
Т. 4. –
№. 3.
3.
Абдуллаева Н. И., Ахмедов А. А. ОСТЕО
-
ИММУНОЛОГИЧЕСКИЙ СТАТУС ПАЦИЕНТОВ
С ЗАБОЛЕВАНИЙ ПАРОДОНТА В ПОДРОСТКОВОМ И МОЛОДОМ ВОЗРАСТЕ //TA'LIM
VA RIVOJLANISH TAHLILI ONLAYN ILMIY JURNALI.
–
2023.
–
Т. 3. –
№. 11. –
С. 143
-149.
4.
Ахмедов А. А. Иммунологические аспекты патогенеза гингивита и пародонтита
//IQRO.
–
2023.
–
Т. 3. –
№. 2. –
С. 121
-123.
5.
Ризаев Ж. А., Ахмедов А. А. GROWTH AND DEVELOPMENT OF GENERAL MEDICAL
PRACTICE IN THE REPUBLIC OF UZBEKISTAN TO IMPROVE DENTAL CARE //ЖУРНАЛ
СТОМАТОЛОГИИ И КРАНИОФАЦИАЛЬНЫХ ИССЛЕДОВАНИЙ. –
2023.
–
Т. 4. –
№
. 3.
6.
Ахмедов А. А., Нарзиева Н. DENTAL PROSTHETICS ON IMPLANTS AND THEIR
FEATURES //American Journal of Pedagogical and Educational Research.
–
2023.
–
Т. 16.
–
С. 132
-135.
7.
Astanovich A. D. A. et al. The State of Periodontal Tissues in Athletes Engaged in Cyclic
Sports //Annals of the Romanian Society for Cell Biology.
–
2021.
–
С. 235
-241.
8.
Alimjanovich R. J., Astanovich A. A. СОВЕРШЕНТСВОВАНИЕ СТОМАТОЛОГИЧЕСКОЙ
ПОМОЩИ В УЗБЕКИСТАНЕ С ИСПОЛЬЗОВАНИЕМ КОНЦЕПТУАЛЬНОГО ПОДХОДА
ДЛЯ УЛУЧШЕНИЕ ЕЕ КАЧЕСТВА
//JOURNAL OF BIOMEDICINE AND PRACTICE.
–
2023.
–
Т. 8. –
№. 4.
9.
Yusufboy S., Qobilovna B. Z. STUDYING THE PROPERTIES OF EQUIA VERSUS AMALGAM
//European International Journal of Multidisciplinary Research and Management
Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 61
-65.
10.
Shaximardonova E. S., Kobilovna B. Z. RED LICHEN PLANUS OF THE ORAL MUCOSA AND
ITS CLINICAL ANALYSIS OF A PATIENT WITH, ASSOCIATED WITH THE EPSTEIN
—
BARR
VIRUS //European International Journal of Multidisciplinary Research and Management
Studies.
–
2024.
–
Т. 4. –
№. 01. –
С. 272
-279.
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
AND MANAGEMENT STUDIES
ISSN: 2750-8587
VOLUME04 ISSUE06
111
11.
Ортикова Н. Х., Ризаев Ж. А., Мелибаев Б. А. ПСИХОЛОГИЧЕСКИЕ АСПЕКТЫ
ПОСТРОЕНИЯ СТОМАТОЛОГИЧЕСКОГО ПРИЕМА ПАЦИЕНТОВ ДЕТСКОГО
ВОЗРАСТА //EDITOR COORDINATOR. –
2021.
–
С. 554.
12.
Ортикова Н. Тенденция эффективности профилактических мероприятий путем
коррекции психологического стресса у детей на стоматологическом приёме
//Общество и инновации. –
2022.
–
Т. 3. –
№. 6. –
С. 181
-189.
13.
Sevinch E., Zarafruz B. ETIOLOGICAL TREATMENT FEATURES INFLAMMATORY
PERIODONTAL DISEASE //European International Journal of Multidisciplinary Research
and Management Studies.
–
2024.
–
Т. 4. –
№. 03. –
С. 241
-246.
14.
Yusufboy S., Qobilovna B. Z. SOCIAL AND DENTAL SURVEY OF PATIENTS TECHNOLOGY
OF OLDER AGE GROUPS SUFFERING WITH ACUTE LEUKEMIA //European International
Journal of Multidisciplinary Research and Management Studies.
–
2024.
–
Т. 4. –
№. 05. –
С. 352
-356.
15.
Yusufboy S., Qobilovna B. Z. FEATURES OF THE STRUCTURE OF COPD IN ELDERLY
PATIENTS //European International Journal of Multidisciplinary Research and
Management Studies.
–
2024.
–
Т. 4. –
№. 05. –
С. 363
-368..
16.
Yusufboy S., Qobilovna B. Z. STUDY OF CHANGES IN THE ORAL CAVITY IN ENDOCRINE
DISEASES //European International Journal of Multidisciplinary Research and
Management Studies.
–
2024.
–
Т. 4. –
№. 05. –
С. 357
-362.
17.
Yusufboy S., Qobilovna B. Z. SMARTBURS II
–
A REVIEW OF THE ADVANTAGES OF SMART
BOR //European International Journal of Multidisciplinary Research and Management
Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 56
-60..
18.
Fakhriddin C., Shokhruh S., Nilufar I. ENDOKANAL PIN-KONSTRUKSIYALARNI
ISHLATISHDA ASORATLAR VA XATOLAR TAHLILI //JOURNAL OF BIOMEDICINE AND
PRACTICE.
–
2022.
–
Т. 7. –
№. 1.
19.
Shoxrux S., Shoxrux I., Faxriddin C. PREVENTION AND TREATMENT OF ORAL
INFECTIONS IN DENTURE WEARERS //International Journal of Early Childhood Special
Education.
–
2022.
–
Т. 14. –
№. 4.
20.
Xusanovich C. F. COMPLETE REMOVABLE PROSTHESIS SUPPORTED BY IMPLANTS
//European International Journal of Multidisciplinary Research and Management
Studies.
–
2023.
–
Т. 3. –
№. 11. –
С. 127
-133.
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
AND MANAGEMENT STUDIES
ISSN: 2750-8587
VOLUME04 ISSUE06
112
21.
Xusanovich C. F. et al. PROSTHETICS A COMPLETE REMOVABLE PROSTHESIS BASED ON
IMPLANTS //European International Journal of Multidisciplinary Research and
Management Studies.
–
2023.
–
Т. 3. –
№. 11. –
С. 122
-126.
22.
Yusufboy S., Qobilovna B. Z. STUDY THE EFFECT OF HYGIENIC CARE ON THE MICROBIAL
LANDSCAPE OF THE ORAL CAVITY IN PATIENTS USING COMBINED SPLINTING
STRUCTURES WITH MODERATE PERIODONTITIS //European International Journal of
Multidisciplinary Research and Management Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 50
-55.
23.
Khusanovich K. B. R. C. F. TYPES AND APPLICATIONS OF DENTAL COMPLIMENTS
//Journal of Modern Educational Achievements.
–
2023.
–
Т. 5. –
№. 5. –
С. 95
-99.
24.
Zarnigor J. MAIN ROLE OF HYGIENIC EDUCATION IN THE SYSTEM PRIMARY
PREVENTION OF DENTAL DISEASES OF PATIENT //European International Journal of
Multidisciplinary Research and Management Studies.
–
2023.
–
Т. 3. –
№. 11. –
С. 157
-
163.
25.
Qizi J. Z. B. METHODS OF OPTIMIZATION OF TREATMENT OF PERIODONTAL DISEASES
USING NEW TECHNOLOGIES //European International Journal of Multidisciplinary
Research and Management Studies.
–
2023.
–
Т. 3. –
№. 10. –
С. 234
-241.
26.
Sevinch E., Qobilovna B. Z. A STUDY ON THE MORPHOFUNCTIONAL STATE OF ORAL
ORGAN TISSUES DURING THE USE OF NON-REMOVABLE ORTHODONTIC STRUCTURES
//European International Journal of Multidisciplinary Research and Management
Studies.
–
2024.
–
Т. 4. –
№. 03. –
С. 247
-253..
27.
Shaxnoza T., Qobilovna B. Z. COMPREHENSIVE TREATMENT OF PERIODONTAL
DISEASES USING LOW-INTENSITY MAGNETIC LASER RADIATION //European
International Journal of Multidisciplinary Research and Management Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 137
-144.
28.
Nigora N., Kobilovna B. Z. EARLY SIGNS AND RISK FACTORS FOR THE DEVELOPMENT
OF THE ARTICULAR FORM OF TRANSVERSAL OCCLUSION ANOMALY //European
International Journal of Multidisciplinary Research and Management Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 93
-98.
29.
Ulug’bek X., Kobilovna B. Z. STUDY OF
COMPOSITE MATERIAL SAMPLES0 //European
International Journal of Multidisciplinary Research and Management Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 115
-119.
EUROPEAN INTERNATIONAL JOURNAL OF MULTIDISCIPLINARY RESEARCH
AND MANAGEMENT STUDIES
ISSN: 2750-8587
VOLUME04 ISSUE06
113
30.
Shaxnoza T., Qobilovna B. Z. STUDYING THE PROPERTIES OF AN AESTHETIC ELASTIC
DENTURE //European International Journal of Multidisciplinary Research and
Management Studies.
–
2024.
–
Т. 4. –
№. 02. –
С. 46
-49.
