Tori excision

[DrAnil]

Discussion
First laser was introduced in 1960 by Theodore Maiman. It is clear that in the practice of oral and maxillofacial surgery, lasers have become an important tool in armamentarium to treat cosmetic and pathologic entities.
Different approaches and tools are available for removal of mandibular tori including the osteotome and mallet, rotatory instruments with different rotation conditions, saws and microsaws, ultrasound and piezoelectric tools, and laser systems. Many patients are reluctant to be subjected to the use of an osteotome and mallet while awake, especially if repeated blows are required to separate the torus or exostosis from the bone. Mechanical drills and saws have been used efficiently to cut bone. Despite improvements in technology, metallic cutting instruments result in deposition of debris on bone, heating vibrations, noise and discomfort. Surgical burs induce an increase in the focal temperature of regions undergoing bone osteotomy, resulting in necrosis and irreversible modifications in the structure and physical properties of the bone tissue. Many studies have shown the
importance of tissue cooling to decrease thermal damage.5 Numerous studies have demonstrated that the Erbium laser cuts bone precisely, with minimal thermal damage of 5 to 30 µm.
In the present case, patient was comfortable during intraoperative period and postoperative period was uneventful. The laser has demonstrated significant advantages over other modalities for intraoral surgical procedures. With adequate training and experience, one can use this tool for efficient, bloodless and less invasive surgery.
The surgical field is cleaner, with less blood to obscure the surgeon’s field of vision. Laser technology has certain advantages, such as accuracy of the incision and absence of vibration and manual pressure during use. The laser has also been shown to have bactericidal effects in the wound.

Conclusion
Lasers have clinical advantages such as bacterial reduction at the surgical sites and increased comfort levels. Laser in surgical removal of exostosis appears to be justified on the grounds of reduced surgical time with more efficient cutting compared to micromotor and much better acceptance by the patients.