Cryosurgery

uses of cryosurgery for dental student

1. CryosurgeryCryosurgery

2. CryosurgeryCryosurgery

Cryosurgery is a procedure Cryosurgery is a procedure
using freezing temperature to using freezing temperature to
destroy the tissue. (destroy the tissue. (done by done by
liquid nitrogen or nitrous liquid nitrogen or nitrous
oxideoxide))

3. CryosurgeryCryosurgery

-15°C is necessary to produce intra--15°C is necessary to produce intra-
cellular ice formation cellular ice formation

-50°C is advocated for the -50°C is advocated for the
destruction of malignant neoplasms destruction of malignant neoplasms

liquid nitrogen probes reach a liquid nitrogen probes reach a
temperature of approximately temperature of approximately
-180°C and a spray -198°C -180°C and a spray -198°C

4. CryoprobesCryoprobes

A cryoprobe is surgical instrument A cryoprobe is surgical instrument
with a cold tip. with a cold tip.

The temperature is determined by The temperature is determined by
the boiling point of the refrigerant the boiling point of the refrigerant
liquid . liquid .

5. Probe tips come in a variety of Probe tips come in a variety of
shapes and sizesshapes and sizes..

6. Uses of cryosurgery in oral Uses of cryosurgery in oral
surgerysurgery

Ablation of warts and small Ablation of warts and small
tumourstumours healing is usually good healing is usually good
with minimal scarring.with minimal scarring.

Ablation of haemangiomasAblation of haemangiomas has has
the advantage that there is no the advantage that there is no
haemorrhage and the surface may haemorrhage and the surface may
be left intact.be left intact.

7. Uses of cryosurgery in oral Uses of cryosurgery in oral
surgerysurgery

Treatment of bony cavitiesTreatment of bony cavities
reduce recurrence of lesions such reduce recurrence of lesions such
as as odontogenic keratocystsodontogenic keratocysts or or
central giant cell granulomacentral giant cell granuloma..

Blocking of nervesBlocking of nerves the most the most
common condition treated in this common condition treated in this
way is way is trigeminal neuralgiatrigeminal neuralgia that no that no
longer responds to therapy with longer responds to therapy with
drugsdrugs..

8. Cryosurgery techniquesCryosurgery techniques

local anaesthesia local anaesthesia

the probe is applied to the the probe is applied to the
lesion and switched on lesion and switched on

The probe is held firmly The probe is held firmly
onto the lesion until an ice-onto the lesion until an ice-
ball forms ball forms

The time of application will The time of application will
usually be about 1 min usually be about 1 min

9. Cryosurgery techniquesCryosurgery techniques

The probe should not be pulled awayThe probe should not be pulled away

On turning the machine off there On turning the machine off there
should be a rapid thaw and the probe should be a rapid thaw and the probe
is released. is released.

One or two further applications are One or two further applications are
made after 1 minmade after 1 min

a water-soluble gel may be used to a water-soluble gel may be used to
aid contact with the bone surface. aid contact with the bone surface.

10. AdvantagesAdvantages

No haemorrhage No haemorrhage

Minimal Minimal
postoperative pain postoperative pain

Good recovery of Good recovery of
nerve functionnerve function

Minimal scarringMinimal scarring

Bone structure Bone structure
maintained maintained

Blood vessel Blood vessel
recoveryrecovery

Adjacent normal Adjacent normal
tissues recovertissues recover

Excellent for Excellent for
haemangiomashaemangiomas

Possible treatment Possible treatment
of painful nerve of painful nerve
lesionslesions

11. DisadvantagesDisadvantages

Cannot be used to cut Cannot be used to cut
tissues tissues

Difficulty in assessing Difficulty in assessing
extent of treatment extent of treatment

Excessive swelling Excessive swelling
(could endanger (could endanger
airway)airway)

Effects at the periphery Effects at the periphery
(dysplastic changes (dysplastic changes
can be potentiated)can be potentiated)

Whole lesion not Whole lesion not
available for available for
pathology pathology

Tumour growth Tumour growth
may be may be
acceleratedaccelerated

Not effective for Not effective for
lymphangiomaslymphangiomas

12. Treatment of buccal Treatment of buccal
haemangiomahaemangioma

13. Treatment of mucoceleTreatment of mucocele

14. Treatment of lingual Treatment of lingual
haemangiomahaemangioma

15. Treatment of ranulaTreatment of ranula