Department of Periodontics and Implantology, Rajas Dental College and Hospital, Tirunelveli, India.
North Bengal Medical College and Hospital, Siliguri, India.
Clin Adv Periodontics. 2023 Mar;13(1):46-49. doi: 10.1002/cap.10217. Epub 2022 Sep 1.
Gingival depigmentation procedure has gained widespread popularity in the recent years due to increased esthetic demands among patients. Among the various depigmentation procedures, cryosurgery is inexpensive and straightforward method. This case report discusses a rare complication associated with tetrafluoroethane (TFE) cryosurgical depigmentation method.
A 27-year-old systemically healthy male patient reported with the complaint of esthetic concerns associated with gingival melanin pigmentation. Cryosurgery with TFE was planned for the maxillary first quadrant. The patient developed angioedema immediately after exposure to the TFE cryogen during the procedure. Cold urticaria was considered, and the patient was prescribed nonsedating antihistamines for a week. One month follow-up showed completely healed and depigmented gingiva without any recession or attachment loss.
TFE cryosurgery depigmentation was found to be an effective depigmentation procedure. However, various complications including cold urticaria have been associated with its application. Therefore, the procedure's success depends on the proper case selection, complete isolation of the operating area, and preoperative test for gingival tissue response.
Why is this case new information? Cold urticaria formation after applying cryosurgery has never been reported in the literature to the best of the authors' knowledge. What are the keys to the successful management of this case? Preoperative testing for tissue response to cryosurgery will prevent complications like cold urticaria. What are the primary limitations to success in this case? Improper medical history and not taking tissue response test for cryosurgery.
由于患者对美观的需求增加，近年来牙龈脱色术得到了广泛的关注。在各种脱色程序中，冷冻手术是一种廉价且简单的方法。本病例报告讨论了与四氟乙烷（TFE）冷冻脱色方法相关的一种罕见并发症。
一名 27 岁的系统健康男性患者因牙龈黑色素沉着的美观问题就诊。计划对上颌第一象限进行 TFE 冷冻手术。患者在手术过程中接触 TFE 制冷剂后立即出现血管性水肿。考虑为冷荨麻疹，给予患者一周的非镇静抗组胺药。一个月的随访显示，牙龈完全愈合并脱色，无退缩或附着丧失。
TFE 冷冻手术脱色被认为是一种有效的脱色程序。然而，其应用与各种并发症有关，包括冷荨麻疹。因此，该程序的成功取决于适当的病例选择、手术区域的完全隔离以及牙龈组织反应的术前测试。
为什么这是新信息？据作者所知，在文献中从未报道过应用冷冻手术后形成冷荨麻疹。成功管理这种情况的关键是什么？冷冻手术对组织反应的术前测试将预防冷荨麻疹等并发症。在这种情况下成功的主要限制是什么？病史不完整，未进行冷冻手术的组织反应测试。
