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rev port estomatol med dent cir maxilofac . 2020;61(2):72-78 77

was still possible to observe discrete edema. One week later, second phase of surgery, she reported mild pain (2, 3), and
there was an immature scar with regions of coloration similar paracetamol 500 mg was taken every 8 hours in the first two
to the normal mucosa (Figure 14). The wound cavity was irreg- days. On the third day, there was no pain, only complaint of
ular, covered by granulation tissue. In the second week (11 -14 aesthetic and functional discomfort.
days), the reabsorption of damaged tissue particles was com- We observed that, within three days of surgery, no areas of
plete (Figure 15). For 21 to 30 days, a clear and whitish scar carbonized tissue were visible. The lesions were well delimited,
remained along the surgical site (Figure 16), and after 3 months with possible necrotic material covering the wound. On the
the scar was almost imperceptible (Figure 17). first seven days post -surgery, inflammation was evident and,
at 14 days, the inflammatory process had already diminished,
and all surgical wounds showed tissue repair with the forma-
Discussion and Conclusions tion of an immature scar. As observed previously, all surgical
wounds were re -epithelialized between three and four weeks
We chose the diode laser for this treatment due to its easy post -surgery. At 3 months post -surgery, the lip had a normal
handling for cutting and coagulation procedures. The novelty mucosa -like appearance with no apparent scar. Some studies
8
of this case is the use of fiber tips that are easily attached to suggest the scarce number of myofibroblasts during healing
the handpiece with no cladding plastic. Also, we used a wave- as a possible explanation for the minimal degree of contrac-
length of 980 nm, as it offers a 10 -times higher water absorp- tion of the wound after laser irradiation. 20-22 In contrast, after
tion than the 810 -nm one, presenting better cutting proper- a conventional surgical excision, myofibroblasts occur in large
9
ties. As it passes through the tissue, the laser beam generates quantities.
heat and coagulates the tissue to a depth of about 7 to 10 mm, The excision of vascular lesions with diode laser provides
occurring selective photothermolysis. 10 better control of hemorrhage and reduced surgical time. The
In this clinical case, the patient had a marked aesthetic, absence of sutures provides a more comfortable postoperative
anatomical, and functional impairment of the perioral anato- period, with less impairment of function. The wounds were
my. There was also the risk of possible local trauma and sub- fully reepithelialized in approximately 21 to 30 postoperative
sequent bleeding. The patient had visited several health pro- days. Postoperative pain was minimal or nonexistent.
fessionals looking to solve the lip problem that affected her
aesthetics and compromised socialization. She had not ob-
tained positive answers, and the justification was always that Ethical disclosures
classic surgery could leave irreversible scars and cause exten-
sive hemorrhage. Protection of human and animal subjects. The authors
Hemangiomas and vascular malformations have the ap- declare that the procedures followed were in accordance with
pearance of blood -filled blisters or reddish, bluish, or purplish the regulations of the relevant clinical research ethics com-
spots. 11,12 In cases where there is increased blood flow veloci- mittee and with those of the Code of Ethics of the World Med-
ty, they are pulsatile, have a higher temperature than adjacent ical Association (Declaration of Helsinki).

tissues, and tend to increase – up to several centimeters – with
decubitus position, crying, coughing, vomiting, or hyperten- Confidentiality of data. The authors declare that they have
followed the protocols of their work center on access to patient
1,5
sion. In this case, there was no history of spontaneous bleed- data and for its publication.
ing. The diagnosis can be made based on the clinical aspect
and using a diascopy and puncture maneuver, which, if the Right to privacy and informed consent. The authors have
lesion is arterial, causes retraction of the plunger of the sy- obtained the written informed consent of the patients or sub-
ringe. 1,5 The present case agrees with reports by Neville et al. 1 jects mentioned in the article. The corresponding author is in
that capillary hemangiomas originate from trauma. Histolog- possession of this document.
ically, the hemangioma presents as a proliferation of large
numbers of small blood vessels coated by a single layer of en-
dothelial cells and separated by septa of connective tissue. 13 Conflict of interest
In our case, the histology was compatible with capillary
hemangioma. The authors have no conflicts of interest to declare.
According to several authors, 14-17 laser excision is the first
option among several alternative techniques in the treatment
of these lesions. In a study to evaluate the efficacy of treatment references
of oral hemangiomas with diode laser -induced photocoagula-
tion, the authors suggested that lesions larger than 2.5 cm 1. Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia Oral &
should be treated in two sessions. 14 Maxilofacial. 2nd ed. Rio de Janeiro: Guanabara Koogan; 2004.
Our results were similar to those of other authors 8,18,19 who p.540 -5.
evaluated and compared the degree of postoperative pain, dis- 2. Shafer W, Hine M, Levy B. Tratado de Patologia Bucal. 4 ed. Rio
de Janeiro: Guanabara Koogan; 1987. p.141 -2.
comfort, and functional complications of patients submitted 3. Fernandes DT, Elias RA, Santos -Silva AR, Vargas PA, Lopes
to oral soft -tissue laser treatments. On the first three postop- MA. Benign oral vascular lesions treated by sclerotherapy
erative days after the first phase, the patient reported no pain with ethanolamine oleate: A retrospective study of 43
or mild pain (0, 1) without the need for analgesic. After the patients. Med Oral Patol Oral Cir Bucal. 2018;23:e180 -7.