Lesson 1Parameter selection and settings: continuous vs pulsed mode, suggested power ranges for excision, duty cycle, tip activation and calibrationThis section addresses diode laser parameter selection, juxtaposing continuous and pulsed modes, stipulating safe power ranges, duty cycle ramifications, and pragmatic approaches for tip activation, calibration, and test firing to ensure efficient cutting with negligible thermal injury.
Continuous versus pulsed mode indicationsRecommended power ranges for excisionDuty cycle effects on tissue interactionFiber tip initiation and maintenanceCalibration, test firing, and safety checksLesson 2Comparison to scalpel excision: bleeding control, operative time, postop pain, healing quality, and histologic artefact implicationsThis section juxtaposes diode laser excision with scalpel surgery, tackling intraoperative bleeding, operative duration, postoperative discomfort, healing calibre, and prospective histologic artefacts that could impinge on diagnostic precision and reporting.
Bleeding control and field visibilityOperative time and efficiencyPostoperative pain and analgesic needsHealing patterns and scar formationHistologic artifact and margin assessmentLesson 3Risks, complications and mitigation: delayed healing, thermal necrosis, scarring, nerve damage and their preventionThis section dissects risks and complications of diode soft tissue surgery, such as deferred healing, thermal necrosis, scarring, nerve impairment, and infection, proffering preventive tactics, early detection indicators, and evidence-based management regimens.
Mechanisms of thermal tissue damageRecognizing delayed healing patternsPreventing and managing scarringAvoiding and managing nerve injuryInfection control and wound careLesson 4Specimen handling and when to send for histopathology after laser excisionThis section expounds on managing tissue specimens post-diode excision, incorporating handling to curtail thermal artefact, fixation protocols, labelling, pathology form completion, and benchmarks for invariably dispatching samples for histopathologic scrutiny.
When to submit tissue for histologyMinimizing laser-induced artifactFixation, containers, and labelingCompleting pathology request formsCommunicating findings to patientsLesson 5Laser selection rationale: why diode (810–980 nm) for soft tissue excision — absorption by haemoglobin and melanin, haemostasis benefitsThis section rationalises diode laser preference in the 810–980 nm spectrum for numerous soft tissue interventions, accentuating absorption by haemoglobin and melanin, haemostasis, diminished bleeding, and judicious selection among diode apparatuses.
Optical absorption in hemoglobin and melaninHemostatic advantages over scalpelClinical indications favoring diode useSelecting wavelength and fiber sizeLimitations compared with other lasersLesson 6Patient assessment: medical history, medications (anticoagulants, photosensitisers), lesion evaluation and differential diagnosisThis section particularises thorough preoperative assessment, incorporating medical history, medication scrutiny for anticoagulants and photosensitisers, lesion depiction, differential diagnosis, and documentation to vindicate diode laser employment or referral.
Targeted medical and dental historyReviewing anticoagulants and photosensitizersExtraoral and intraoral lesion mappingFormulating a differential diagnosisCriteria for referral before surgeryLesson 7Preoperative preparation and informed consent specifics for laser soft tissue proceduresThis section concentrates on preoperative readiness, encompassing patient instruction, bespoke informed consent components for laser utilisation, pre-op photography, antisepsis, and corroboration of laser safety protocols and emergency preparedness in the surgery.
Explaining laser benefits and limitationsDocumenting laser-specific consent itemsPreoperative photography and chartingOral rinses and field antisepsisVerifying laser safety and eyewearLesson 8Indications and case selection: benign mucosal lesions suitable for diode excision and contra-indicated lesions requiring biopsy or referralThis section steers case selection for diode excision, detailing benign mucosal lesions apt for laser ablation, clinical warning signs necessitating biopsy or referral, and documentation requisite for underpinning safe, justifiable treatment choices.
Benign lesions suitable for diode excisionLesion features requiring urgent referralWhen incisional biopsy is preferredPhotographic and chart documentationCommunicating options and limitationsLesson 9Immediate postoperative management: wound care, analgesia, topical agents, follow-up scheduleThis section elucidates organised postoperative care following diode laser surgery, including wound sanitation, analgesic schedules, topical remedies, dietary counsel, and evidence-based follow-up periods to foster unproblematic healing and patient ease.
Postoperative wound hygiene instructionsSystemic and local analgesia protocolsUse of topical gels, rinses, and dressingsDiet, activity, and oral habit restrictionsFollow-up visit timing and documentationLesson 10Anaesthesia planning: local anaesthetic choices and techniques, epinephrine considerations, managing patients on anticoagulantsThis section appraises anaesthesia planning for diode soft tissue surgery, incorporating local anaesthetic selection, epinephrine deployment for haemostasis, injection methodologies, and hazard evaluation and adaptation for patients on anticoagulants or antiplatelet drugs.
Selecting local anesthetic agentsEpinephrine benefits and contraindicationsInfiltration and nerve block techniquesAssessing anticoagulant and antiplatelet riskCoordinating with physicians when neededLesson 11Step-by-step operative technique: tissue marking, incision/excision technique with contact fibre, lateral sweeping, depth control, haemostatic strategiesThis section proffers a sequential diode excision protocol, covering lesion demarcation, fibre alignment, incision and lateral sweeping methodologies, depth and margin oversight, haemostatic manoeuvres, and intraoperative modifications to uphold safety and accuracy.
Preoperative marking and isolationFiber angulation and contact techniqueIncision patterns and sweeping motionDepth control and margin managementIntraoperative hemostatic strategies
