Received: 22 July 2016 – Accepted: 28 September 2016 – Published: 10 October 2016 Copyright © 2016 CASE REPORT Excision of Squamous Papilloma in a Child with Diode Laser: A Case Report Ashank Mishra* *Associate Professor, Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, India. ABSTRACT The present article reports a case of 3-year-old child with swelling of gingiva on upper front teeth since few weeks and its management with diode laser. The lesion was excised with laser and sent for histopathological examination. The fnal diagnosis was squamous papilloma. For intraoral soft tissue surgical techniques, the laser is a feasible substitute to the scalpel. In the contemporary dental practice using laser technology, procedures can be executed with less invasive methods especially in pediatric practice. J. Periodont. Pract.  DOI: http://dx.doi.org/10.20936/jpp/160202 INTRODUCTION Epulis is a non-specifc term any tumour like enlargement situ- ated on the gingiva or alveolar mucosa. They are of three types i.e. fbromatous, ossifying and acanthomatous. The etiology of epulis could be attributed to irritative factors or hormonal changes. The treatment is focused to remove the etiological factors and excision of the lesion. 1–3 The aim of this article is to present the case report of a child of 3-year-old with swelling of gingiva and to review the current litera- ture concerning the clinical and histopathological features of this uncommon lesion in children and its management with Diode laser. CASE REPORT A 3-year-old boy was referred by a pediatrician for evaluation of a swelling of gum on the upper front teeth. Child’s parents revealed that swelling was present since past few weeks. The swelling started as small painless growth gradually progressed to present size. They revealed that the patient had no relevant medi- cal history. Extra oral examination revealed no abnormality. Intra oral clinical examination revealed solitary growth on the anterior aspect of the left central and lateral primary incisor (Fig. 1). It was 2.5 × 4 cm in dimension, pale pink in color, sessile, frm and ovoid in shape with pebbly or papillary surface. All inspectory fndings were confrmed on palpation. It was a painless frm non- compressible swelling. It was provisionally diagnosed as fbroma. Surgical Procedure After local anesthesia was given, a diode laser with a wavelength of 940 nm (EZLASE), fber with a diameter of 400 µm, at 2 watts in continuous mode (Fig. 2) and straight hand pieces through which the laser beam is applied to the oral soft tissue in contact type treatment mode was used. The patients, the surgeon and the operative staff wore safety glasses throughout the procedure. The lesion was excised totally and hemostasis was done with laser without need for suture application. The tissue was sent for his- topathological examination (HPE). The patient was recalled every 1 month for 3 months for revaluation (Fig. 3). The HPE report (Fig. 4) revealed a benign, fnger-like pro- liferation of stratifed squamous orthokeratinised epithelium with prominent of stratum granulosum. Areas of hyperkera- totic epithelium is evident with no features of dysplasia. Mild basilar hyperplasia in the lower third of epithelium was evident. Kolicytes in the stratum spinosum was evident with perinuclear halo. Stroma showed mild chronic infammatory cells with lym- phocyte predominance. The above features are suggestive of oral squamous papilloma. DISCUSSION As far as the treatment of fbroma is concerned, a conservative surgical excision is usually curative and is the treatment of choice in most cases reported in the literature regarding children under the age of 10. 1 Electrosurgery is another option and has been used in paediat- ric dentistry in various procedures such as frenectomy, incision of hyperplastic gingiva, biopsies and pulpotomy 4,5 Electrosurgery’s main advantage is the direct tissue haemostasis without the need for sutures. In addition, there can be access to areas diffcult to reach and reduction of chair time, factors extremely valuable in paediat- ric dentistry. Laser therapy has been suggested as an alternative *Address reprint requests to Dr. Ashank Mishra, Associate Professor, Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, India. Email: drashankmishra@gmail.com KEYWORDS child, squamous papilloma, diode laser