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Marco Meleti
Department of Biomedical, Biotechnological and Translational Sciences–Center of Oral Pathology and Laser Surgery, University of Parma, Via Gramsci, Parma 14-43100
Dentistry

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Recurrent p16-Positive Human Papillomavirus (HPV) Associated Oral Lesions Treated with a Diode Laser: A Case Report Pezzi, Margherita Eleonora; Passerini, Pietro; Frontera, Marco; Vescovi, Paolo; Meleti, Marco
Journal of Dentistry Indonesia Vol. 26, No. 2
Publisher : UI Scholars Hub

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Human papilloma virus (HPV) family include approximately 150 known subtypes of viruses that can infect humans and other animals. Among these, HPV-16 is known for its association with oral squamous cell carcinoma (OSCC), particularly within the oropharynx. HPV 16 genotype can be found in a variety of oral lesions, its presence being frequently observed in papillomas. Treatment of oral papillomas can sometimes be challenging as HPVs tend to shed to different oral sites, causing multifocal lesions. Moreover, HPV-related lesions tend to recur if incompletely removed. Several light-amplification by stimulated emission of radiation (laser) wavelenghts are currently used in dentistry as surgical tools both on soft and hard tissues. Among these diode laser is one of the most used. Advantages of laser surgery include, among others, good precision, optimal hemostasis, possible biostimulative and antibacterial effects and a reduced post-operative discomfort. Here we report the case of a 26-year old man with multiple, recurrent p-16 positive papillomatous lesions, which was successfully treated through diode laser (445 nm) surgery.
Absorption Capability of a 645-nm Diode Laser on Swine Soft Tissue Samples: a Preliminary Study in an Ex-Vivo Model Ghidini, Giulia; Vescovi, Paolo; Meleti, Marco; Giacomo, Setti; Alessandro, Sala; Roberto, Sala
Journal of Dentistry Indonesia Vol. 26, No. 2
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Most published articles have highlighted several positive effects of low-level laser therapy on tissues; however, to our knowledge, no studies have investigated the depth to which a light beam penetrates cell layers of an irradiated tissue. To date, it is unclear if the laser reaches cells and how many of the cells can be reached in the tissues underlying the oral mucosa. This is of paramount importance as the effect of a laser at a particular depth (e.g., the periosteum and/or bone) should be measurable and predictable to some extent Objectives: The present preliminary ex vivo study aimed to assess the possible interaction between complex biological systems and laser light through the irradiation of different soft tissue samples. Methods: A 645-nm wavelength diode laser was used for evaluation. Owing to known similarities with human tissues, swine tissue samples harvested from the mandibular oral mucosa were used. One sample of periosteum (0.45-mm thick), two mucosal samples (0.5- and 1-mm thick), and three samples, including both the mucosa and periosteum (1-, 1.3-, and 1.65-mm thick), were used as target soft tissues. Measurements were recorded with a power meter located under the irradiated tissues. Results: The mean absorption values for the 0.5-mm mucosa sample; 0.45-mm periosteum sample; 1-, 1.3-, and 1.65-mm mucosal and periosteum samples; and 1-mm mucosal sample were as follows: 70.64 ± 20.14 mW; 90.75 ± 42.87 mW; 93.40 ± 18.68 mW, 101.93 ± 13.60 mW, and 102.80 ± 18.54 mW; and 111.40 ± 13.22 mW, respectively. Conclusion: The red-light laser with a 645-nm wavelength can reach cells in each layer of the measured tissues.
An Auto-fluorescence Guided Surgical Approach Performed with Er:YAG Laser and Nd:YAG Low Level Laser Therapy for Medication-related Osteonecrosis of the Jaw Giovannacci,, Ilaria; Meleti, Marco; Bonanini, Mauro; Vescovi, Paolo
Journal of Dentistry Indonesia Vol. 22, No. 2
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Medication-Related Osteonecrosis of the Jaw (MRONJ) therapy remains an unresolved problem. The proposed conservative and surgical treatment regimens are associated to contradictory success rates. Surgical approach with Er:YAG laser is associated to significant better results compared to medical treatment and traditional surgical approaches. Objective: To describe a new surgical approach that couples the advantages of the Er:YAG laser and the usefulness of the AF in highlighting surgical margins. One of the difficulties encountered during surgical removal of a MRONJ is the precise individuation of necrotic bone margins. Case Report: A case of Stage III mandibular osteonecrosis treated with a new surgical approach is presented. The aim is to describe an auto-fluorescence (AF) guided surgical approach performed with Er:YAG laser and Nd:YAG Low Level Laser Therapy (LLLT). After one month of follow-up, the complete mucosal healing was evident and symptoms was unobserved. Such a technique allowed a highly accurate and minimally invasive approach through the selective ablation of the non-/hypofluorescent areas. Conclusion: Taking into account the advantages of laser therapy and the possible effectiveness of the AF in highlighting surgical margins, this approach would probably achieve excellent outcomes.
Pain and Health-Related Quality of Life After Oral Soft Tissue Surgical Intervention: The Advantages of the Nd:YAG Laser Giovannacci, Ilaria; Vescovi, Paolo; Mergoni, Giovanni; Fornaini, Carlo; Bonanini, Mauro; Meleti, Marco
Journal of Dentistry Indonesia Vol. 21, No. 2
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The new technology such as the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser has been used for oral soft tissue surgery. Previous study shown that laser surgery resulted in lower morbidity and complication rates. Objective: This study aims to evaluate the differences in the post-operative course associated to the use of Nd:YAG laser and to cold blade after oral soft tissue surgery. Methods: One-hundred and eighteen comparable surgical interventions were evaluated. Group 1 (G1) included 77 interventions performed with Nd:YAG laser; group 2 (G2) 41 with cold blade. Acute post-operative pain was evaluated with visual analogue scale (VAS), numeric rating scale (NRS) and verbal rating scale-6 (VRS-6) on the same day of surgery, and at 1, 3 and 7 days after surgery.The HRQoL was evaluated on day 7 using a 0-45 score range questionnaire. Data were analyzed using the software STATA 12 (StataCorp LP, College Station, Texas, USA). Results: No statistically significant differences could be highlighted in VAS and NRS scores. The VRS-6 scores resulted statistically significant at days 1 and 3. At day 1, 47.14% of patients in G1 and 13.16% in G2 had no pain; at day 3, 62.86% in G1 and 21.05% in G2 had no pain. The HRQoL in G1 was statistically higher than G2. Conclusion: The better HRQoL and the lower post-operative pain observed in laser-treated patients may be associated to the possible bio-modulating effect of the laser.
Co-Authors Alessandro, Sala Carlo Fornaini Frontera, Marco Ghidini, Giulia Giacomo, Setti Giovannacci,, Ilaria Giovanni Mergoni Ilaria Giovannacci Mauro Bonanini Paolo Vescovi Passerini, Pietro Pezzi, Margherita Eleonora Roberto, Sala