The aim of the present work is to perform a comparative investigation between traditional surgery with CO2 and electrosurgery and Nd:Yag laser treatment for surgical excision of patients affected by Sturge-Weber Syndrome.

The Authors divided six patients affected by SWS into two groups A and B (three patients per group). All patients presented with a massive gingival hypertrophy on both jaws in the anterior and posterior sectors.

All patients took barbiturates and anticonvulsants after the occurrence of seizures. Only two patients presented with macroglossia and were included in two different groups. Spontaneous bleeding of hypertrophic tissues affected all patients admitted to surgery.

The patients belonging to group A underwent CO2 laser treatment and electrosurgery. The patients belonging to group B underwent Nd:Yag laser treatment. The treatment of patients belonging to group B offered advantages in performing surgery, better control of hemorrhagic diathesis but, in the assessment of a 4 year follow-up, we noticed a reduced onset of relapse in patients treated with neodymium laser, compared to patients treated with CO2 laser treatment and electrosurgery who had a relapse already two years later.
SWS is a rare congenital disorder that belongs to a group of neuroectodermal development anomalies. The odontostomatologic manifestations are gingival hyperplasia caused by poor oral hygiene, by anticonvulsant drug therapy and by alterations to the peripheral circle.
The surgical protocol applied to group A involved electrosurgery for excision of the gingival masses, that was able to reduce bleeding. The surgical protocol used in patients of group B involved locoregional infiltrations of anesthetic with a subsequent excision of hypertrophic tissues by Nd:Yag laser.

This procedure ensured greater accuracy and rapidity, significantly reducing the risk of intraoperative and postoperative bleeding, and a better visibility of the operative field. Besides a reduced tissue trauma, there was also a reduced postoperative edema, followed by an almost silent clinical symptomatology.

The Authors could also notice a faster reepithelization, without evident cicatricial retractions and with good aesthetic and functional results. The four-year follow-up revealed the presence of relapse already two years after surgery for the first group of patients, while the most significant clinical outcome was that patients treated with neodymium laser had no relapse.

F. Inchingolo 1-4, V. Picciariello1, M. Tatullo 2, M. Marrelli 4 , R. Mingrone 4, A.M. Inchingolo 3, A. Palladino 1, F. Scandale 4, A.L. Valenzano 2, A.D. Inchingolo1, G. Dipalma1-4
Department of Odontostomatology and Surgery, University of Bari, Bari, Italy
Private Doctor in Dental Sciences
Department of Odontostomatology and Surgery, University of Milano, Milano, Italy
Department of Maxillofacial Surgery, Calabrodental Srl, Crotone, Italy