.

1

1.
2.



3.

2

( 1)
1.


()

2.


3.

4.

Planning

Reflecting Acting

Observing

Retrospective Cohort
Study
- 50
-

- -
-
2554 2554
-





n of one design


-
2

-
(Qualitative Study)
( In Depth Interview)

4
 2554
8 3 5 50-84
-
20-30

MP3

5





20

6

01 54

-
- ASA II Organic mentle disorder
- Mucocele
mild redden mucosa mild firm consistency

mucocele CO2 laser

2 fibrous formation
7
reactive hyperplasia of healing wound parafunctional halait
diode laser

2
traumatic glossitis
parafunctional habit 2 1.5 mm.

diode laser 5 Watt CW 2
mild redden area mild mucosa parafunction habit

parafunction habit

mucocele CO 2 laser
fibrous formation parafunction habit

7
 diode laser

8
 02 79


lichen planus erosive type bilateral submucous fibrosis
fluocinolone gel 2
submucous fibrosis folic acid, fluconazole
2

-
- ASA II
mild atrophic
mucosa
firm consistency burning
mouth syndrome sevene xerostomia and oral submucous fibrosis

diode laser/ O.5W/ 2 J/point

3 2 folic acid

folic acid
2

9
 03 51


4
#34-36 2
2

irritative fibroma Kenalog in orabase 2 , Difflam
mouthwash 2 Z-bec 1 1

(erythematous area) 3x3 mm. left posterior lateral
border of tongue #27 OD sharp edge of marginal leakage amalgam filling
irritative glossitis due to #27 defective restoration
#27 OD 1

8x8 mm.

- 4
- ASA I
redden of tongue mucosa at left posterior lateral
border, 8x8 mm. in diameter, no lymph node palpable Irritative glossitis

diode laser 1 Watt/CW 1

2 ( 6 mm.)

10
 04 60
.

3

3

- ASA II 10
Zertex


0.06
Xerostomia and burning
mouth syndrome

xerostomia Zertex
Atarax
820nm 100mw 2J CW 20sec


2 5



820nm 100mw 2J CW 20sec
2 2 3

11


04

12
 05 58


trigeminal neuralgia

- ASA I
mild
epithelial dysplasia

mild epithelial dysplasia CO 2 laser

3
diode 0.5 W/ 2J/ 4sec/ CW x 5
10
2 x3 mm. oral candidiasis 10
diode laser

1. mild epithelial dysplasia of the tongue CO2 laser

3
2. burning tongue
3.

13
 06 54


epithelict dysplasia
hyperkeratosis

mild epithelial dysplasia

- ASA II
hepatoma ASA
IV
1x1
mild epithelial dysplasia

CO2 laser
2 diode laser
focal mild epithelial dysplasia 1
hyperkeratosis
hepatoma diode laser 3-5 W
2 2

epithelict dysplasia CO2 laser biopsy

Hepatoma hyperkeratosis
diode laser

14


15
 07 56



2

2
- ASA I
2 fibrous
band submucosal fibrosis

CO2 laser 4-5 Watt/ CW 2

2
1

CO2 laser submucosal fibrosis

1 discharged with complete recovery

16
 08 69
.

.. 2552
candidal leukoplakia
fluconazole 200mg Topical antifungal agent (Daktarin)
3
1. epithelial dysplasia ( )
2. chronic hyperplastic
candidiasis
3. epithelial dysplasia ( )

- ASAII
2

- mild thickening
mucosa with ulceration, thickening rough and whitish mucosa and mild thickening and
rough whitish patches hyperkeratosis

1. epithelial keratosis no dysplasia CO2

laser exisional biopsy lesion vapurisation
fluoconazole 200 mg chlorhexidine 2
1 coagulum 1

17
 1 vitamin B complex
vitamin C 2 1
2.
1
vitamin B complex Vitamin C

2 6
( ) mild epithelial
dysplasia 1
chemical burning

vasaline
1 (
)
CO2 laser mild to mod epithelial dysplasia
3 laser epithelial peeling using surgical marker and diode laser at
6W/1/4/20HZ on the total lesion of the low lip medication antibiotic and danzen 10
redden mucosa with partially covered
with coagulum and mild swelling vasaline
laser peeling 4
nearly complete healing with 3 areas of redden mucosa and mild pale pink and scattering
of thin whitish maculae LILT 2J on the lower lip medication vit B and C 2
CO2 resurfacing lesion lesion

hyperkeratosis epithelial dysplasia

18


19
 09 84
.

. . . 2549
erosive lichen
planus .. 2553
erosive lichen planus epithelial dysplasis

- ASAIII
(aging hearing loss)


1. Ulceration at lower lip score 5 erosive lichen planus
2. Thickening whitish patches of right buccal mucosa erosive lichen
planus mild to mockrate epitheial dysplasia
3. 7 mm. diameter pedunculated mass with hard in consistency
early invasive oral squamous cell
carcinoma

1. Early erosive oral squamous all carcinoma CO2 laser excisional biopsy
wide excision 1

20
 1

2.
CO2 laser
erosive lichen planus mild to moderate epithelial dysplasia
CO2 laser diode laser
6
chronic inflammation
1 10

2
2
3. 7
diode laser chronic inflammation

erosive lichen
planus, epithelial dysplasia early invasive oral squamous cell carcinoma

21
 09

erosive lichen planus

early invasive oral squamous cell carcinoma

CO2 laser erosive lichen planus

diode laser welding
1
1 oral
squamous cell carcinoma
erosive lichen planus

22
 10 60



torus palatinus 6 (
hyperkeratosis with mild epithelial dysplasia) CO2 laser ablation 1

torus palatinus
- ASA II

hyperkeratosis with some redden areas at torus
palatines 2 x1.5 cm. hyperkeratosis with mild epithelial
dysplasia

CO2 laser 2
focal keratosis with mild epithelial dysplasia
2

coagulation with diode laser/ 2 Watt chronic

inflammation with hyperkeratosis and parakeratosis, no residual dysplasia identified
7
6

CO2 laser ablation diode laser coagulation

23
 11 80

-
7
- ASA III Trigeminal neuralgia Tegretol (200
mg) 1/2 x 2 p.c. tetracycline angioedema

- Generalized atrophic and erosive area associated
with keratotic white lesion at upper and lower labial and buccal gingiva

Incisional biopsy (buccal gingiva #14,15 and #45,46 ) by blade and

diode laser / 2 Watt / CW for coagulation erosive lichen
planus 2 CO2
laser / 2 Watt / CW 2 diode laser / 2
Watt / CW / for coagulation and granulation tissue ablation 0.1% Fluocinolone
acetonide in orabase 2
0.1% Fluocinolone acetonideClotrimazole gel

1 incisional biopsy by blade and Nd YAG laser / 3
Watt / SP / 20 Hz for coagulation and re-epithelialisation 2
erosive lichen planus with mild to moderate epithelial dysplasia
0.1% Fluocinolone acetonide-Clotrimazole gel

24
Nd YAG laser / 1 Watt / 20 Hz ( under local anesthesia) for coagulation at #25-27 buccal
gingivae 0.1% Fluocinolone acetonide-Clotrimazole gel 1
1 (score 2 )

diode laser / 1 Watt / CW
8 (score 0)
3

25
 12 60



3 erosive lichen
planus topical steroid 2 0.05% Dexamethasone mouthwash
2 0.1% fluocinolone acetonide
(palatal gingival#24-25) 2 3 -

-
(palatal gingival#24-25)
ASA II
- generalized atrophic and erosive area associated
with keratotic white striae at upper and lower labial, buccal and palatal gingival (score 5)
erosive lichen planus

Welding technic 2 Nd YAG laser / 1 Watt / 10 Hz Diode laser / 1 Watt (1

month-interval under topical anesthesia 2 ) erosive area
atrophic area (score 2)

topical steroid (0.1% Fluocinolone
acetonide) (0.05% Dexamethasone)
3 2 (score 5)

lichenoid lesion
0.1%
fluocinolone acetonide 3 lesion (score 5)
3

26
 (Fluconazole 200 mg 1 10 )

topical steroid


(palatal gingival#24-25)

27
 13 85
.


1
B cell lymphoma
sinus traet
opening

- ASA III
B cell lymphoma

2 exudate
diode laser welding 1

28
 14 70
.

..2550 4

atrophic type lichen planus
chronic inflammation vitamin B


alteranative chronic inflammation

- ASA II
1
7 chronic inflammation

diode laser 5 ( 1 3
) 1 4 x 6 mm. mild
redden area 3x7 mm. mild redden mucosa

diode laser chronic

inflammation
3

29
 14

diode Laser

3
3 1

30
 15 69
.



1

- ASA II Bipolar mental disorders

10
slough tissue
chronic ulceration

diode laser 1-2 W

2 2 2 -3


daktarin 3 2-3
4

diode laser chronic ulceration

31
 16 58
.


..2543
fibroma

- 1

- ASA III C
INR 1.05

- irritating fibroma 6x5 mm

diode laser 1 2
6

diode laser fibroma

6

32
 16

33
 17 77
.

..2549

-
2
- ASAII

2 x 3
(

) pyogenic granuloma

Pyogenic granuloma CO2 laser surgery 1 1

4

( )

CO2 laser pyogenic granuloma

34
 18 50
.


50

ASAIII 50 urea nitrogen = 30.2 (

5.8-19.1 mg/dl) creatinine = 2.1 ( = 0.5 -1.5 mg/dl) hemoglobin = 7.3
gldl hemotocrit = 22.4 % = 136 ( 173-383 x 103 cll/mm3)
#12 chronic apical abscess

diode laser coagulation

diode laser 1w/CW 1 1

diode laser

35
 18

= 17

36
 diode laser

diode laser

37
 diode laser 1

38
 1

39
 19 58




#14 1 irritating
glossitis
1 #14
6
0.1% triamcinolone acetonide

-
6 #14 1
- ASA I dexamethasone
- redden mild edematous area 1 cm. at
right posterior lateral of the tongue adjacent to #47, no lesion is found at tip of the tongue
irritating mucositis

diode laser / 1 Watt / sec / CW [(x5 at tip of the tongue and

x15 at right side of the tongue) 2 1 lesion
diode / 1 Watt / CW
1

diode laser / 1 Watt / sec / CW x5 x2 coagulation
diode laser / 2 Watt / CW 3
3x4 mm.
diode laser coagulation
1 lesion
permanent fixed for crown #14 2 lesion

40


coagulation

41
 20 63
.

ASAII

Stage II implantation for denture prosthesis; healing

cap placement and prosthesis adjustment

diode laser heading cap

diode laser Stage II

42


ASA

01 54 II Refer BE C
02 79 II Refer P/B C
03 51 I Refer C C
04 60 II Refer B C
05 58 I Refer P/B D/C
06 54 III/ IV Refer P C
07 56 I Refer P D
08 69 II Refer P C
09 84 III Refer/Request P C
10 60 II Refer P F
11 80 III Refer P C
12 60 II Refer P C
13 85 III Refer C D
14 70 II Refer C C
15 69 II Refer C D
16 57 III Refer/Request Be D
17 76 II Refer/Request Be D
18 50 III Refer Bl D
19 58 I Refer C D
20 63 II Refer Bl D

:
=
=
=

43

P = Potentially malignant disorders
B = Burning mouth / burning tongue
Be = Benign soft tissue lesion
Bl = Bleeding disorders
C = Chronic ulceration / chronic inflammation/ irritation glossitis
X = Xerostomia

Refer
Refer/Request

C = Continues Laser therapy as agreed by patients and dentists

D = Discharged c appraisal : complete recovery
F = Follow up as request by patient

44

20 50 84 6 14
1 (ASA II) -




potentially malign an disorders 9
5 3
3
2

-
.. 2554 8 3 5



3
1.


2.


3.

45














58 . 48 .








-

46
-

47




1.

2 .. 2544 2554 6

2.

22 2554

48


( 2)




( )

(Training)

49
3.

25 2554
. .

24-25 2554 ..

Treatment of xerostomia ising combined medications and low
intensity laser therapy: A case report 15 2554 Lasers in Dentistry
Research Group, Khon Kaen University Symposium 2011
. .
:
7 2554 Bimonthly Laser Meeting
. . .


23 2554 -
. .

2-3 2555 . . . .
A review of efficacy of laser
therapy on complicated or non-responsive oral soft tissue lesions of elderly patients from 3

50
 hospitals in Thailand World Federation for Laser Dentistry
27 2555 . .
Happy Life Happy Laser: Episode I oral lesion 28
2555 Bimonthly Laser Meeting
. . .

51


1














( 3)

52


53