2.2. Torus Palatinus Er:YAG Laser Removal. A 67-years-old
woman was referred to the Clinic for palatal bone exostosis
removal (Figure 5).
This exostosis covered the anterior region of the palatal
vault without extension to the alveolar process. With thisTP being poorly raised and in the same way large, excision
by slicing or cutting was impossible whatever the technique
used (bur or laser). It was possible to choose between
two techniques: wearing away the TP with surgical burs or
peeling/smoothing it with Er:YAG laser. It was decided to use
Er:YAG laser the following parameters: output power 450 mJ,
frequency 20 to 30 Hz, sapphire tip diameter 1.2 mm, pulse
duration 150 μsec, fluence 39808,91 J/cm2 air-water ratio
5/5, pulse number 12702 corresponding to (30 shots/sec)
421.4 sec that is, a little more than 7 minutes of laser
working time. Local anaesthesia was delivered via infiltration
of articaine 4%. Half thickness flap was easily tipped over
(Figure 6) and the left side smoothed by firing. Same
protocol was used for the right side.
At the end of the surface treatment, a rasp was used to
eliminate the possible remaining bony spicules. The suturewas then made by simple points not too tight. Analgesic
was immediately delivered and prescribed as previously
described and the patient was informed that the signs and
possible symptoms during the postoperative periodmight be
those that are common with this type of surgical procedure.
Moreover, she was informed and recommended to continue
with appropriate hygiene. After one week, sutures were
removed and the wound healed in good conditions (Figure
7).
Due to the mechanism of tissue elimination with Er:YAG
laser (explosive vaporization), it was impossible to take a
sample for histopathological examination.