Case report
A 70 years old female patient presented with lingual torus in the right side of the lower arch, which required implant placement in that region. Patient did not have any problem with tori but insisted on removal of the same. Swelling was situated in the lingual cortical plate extending from 42 to 45 region measuring about 1.4 cm x 1.1 cm x 0.8 cm. A thorough medical and dental history was completed along with a clinical examination, preoperative diagnostic casts and a panoramic radiograph. Using panoramic radiographs to evaluate bone height, it was determined that 3 endosseous implants could be used to support the desired posterior fixed restoration. Surgery was planned out to facilitate ease of placement and favorable prognosis of implant supported fixed restoration in that area.
The surgical procedure was planned by Implant placement and excision of tori in the same sitting. After aseptic preparation the area local anesthesia was administered, crestal incision (Fig 1) was given and torus was exposed with careful elevation of mucoperiosteum using periosteal elevator (Fig 2). To begin the sectioning and removal of the tori with the Er,Cr:YSGG laser device, the settings were adjusted to 3.5 W, 40% water, 20% air, and 20 Hz. Excision of tori was carried out using Er,Cr:YSGG laser, mz 6 tip at the base of the lesion ( Fig 3) with
approximately 1.0 mm from the tissue while sectioning the tori. Fig 4 showing excised torus. Implants were placed in 34, 36 and 37 region. Sutures were placed (Fig 5). After the procedure, the surgical site exhibited no edema, minimal bleeding, and no other adverse effects from the laser surgery. Postoperative instructions included: soft diet, salt water rinses and a prescription of paracetamol 500 mg thrice daily for three days. Patient was recalled for checkup on first post operative day and there was no swelling in the region. Post operative phase was uneventful and suture removal was done after 7 days. The patient was recalled again at 2 weeks and the healing appeared clinically complete.
