Daily Cosmetic Research Analysis
Three clinically oriented cosmetic-surgery papers stand out: a split‑mouth RCT comparing 450 nm diode laser ablative versus non‑ablative gingival depigmentation, a retrospective cohort introducing a scar‑sparing totally transaxillary endoscopic release for congenital muscular torticollis, and a case series demonstrating indocyanine green fluorescence to assess parathyroid perfusion during minimally invasive thyroidectomy. Together, they refine aesthetic outcomes while safeguarding function and s
Summary
Three clinically oriented cosmetic-surgery papers stand out: a split‑mouth RCT comparing 450 nm diode laser ablative versus non‑ablative gingival depigmentation, a retrospective cohort introducing a scar‑sparing totally transaxillary endoscopic release for congenital muscular torticollis, and a case series demonstrating indocyanine green fluorescence to assess parathyroid perfusion during minimally invasive thyroidectomy. Together, they refine aesthetic outcomes while safeguarding function and safety.
Research Themes
- Aesthetic dentistry and soft-tissue depigmentation
- Minimally invasive, scar-sparing surgical techniques
- Intraoperative fluorescence imaging for endocrine surgery safety
Selected Articles
1. "Laser assisted gingival melanin depigmentation using diode 450 nm; ablative vs. non-ablative techniques: randomized clinical trial".
In a split-mouth, single-blind RCT (n=20), both ablative and non‑ablative 450 nm diode laser techniques significantly reduced gingival pigmentation at 1, 6, and 12 months. Ablative treatment achieved immediate, complete depigmentation with fewer repigmentation events but higher intraoperative discomfort, whereas non‑ablative treatment caused less pain but typically required more sessions.
Impact: This RCT directly informs technique selection for cosmetic gingival depigmentation by quantifying trade-offs between efficacy, repigmentation, and patient discomfort over 12 months.
Clinical Implications: Individualize choice: select ablative laser for patients prioritizing single‑session, complete depigmentation and lower repigmentation risk but who can tolerate higher intraoperative discomfort; select non‑ablative for patients preferring lower pain and faster healing, accepting additional sessions.
Key Findings
- Both ablative and non‑ablative 450 nm diode lasers significantly reduced Oral Pigmentation Index and Melanin Pigmentation Index at 1, 6, and 12 months.
- Ablative technique achieved immediate and complete depigmentation with fewer repigmentation events but higher intraoperative discomfort.
- Non‑ablative technique resulted in less pain but typically required more sessions to achieve optimal depigmentation.
- Pain and discomfort were assessed using a modified McGill Pain Questionnaire in a split‑mouth, single‑blind design (n=20).
Methodological Strengths
- Split‑mouth randomized, single‑blind design reduces inter‑subject variability
- 12‑month follow‑up with validated pigmentation indices
Limitations
- Small sample size (n=20) and single‑center study
- Potential operator and detection bias; limited generalizability
Future Directions: Conduct larger, multicenter CONSORT‑compliant RCTs comparing energy parameters and session algorithms, and include long‑term recurrence, cost‑effectiveness, and comprehensive patient‑reported outcomes.
2. Totally transaxillary endoscopic surgical release for congenital muscular torticollis.
In a retrospective matched cohort (n=24), totally transaxillary endoscopic release for congenital muscular torticollis achieved comparable functional outcomes to open surgery while significantly improving combined scar and subjective assessment scores. No severe postoperative complications occurred, and operative time decreased to 40–50 minutes with experience.
Impact: By relocating the incision to the axilla, TTESR eliminates a visible neck scar while preserving outcomes, offering a meaningful advance in pediatric aesthetic and functional surgery.
Clinical Implications: Consider TTESR for appropriate CMT candidates when scar minimization is a priority; anticipate similar hospital stay, operative time, and blood loss to open surgery, with improved cosmetic outcomes and no increase in severe complications.
Key Findings
- Retrospective matched cohort of 24 children: 6 TTESR vs 18 OSR.
- Both groups showed marked improvement in cervical range of motion; no significant differences in length of stay, operative time, or blood loss.
- TTESR significantly improved combined scar evaluation and subjective assessment scores compared with OSR.
- No severe postoperative complications; TTESR operative time decreased to 40–50 minutes with experience.
Methodological Strengths
- Matched comparative cohort controlling for age and lesion location
- Detailed procedural description enabling reproducibility and learning curve assessment
Limitations
- Retrospective, non-randomized design with small TTESR sample size
- Follow-up duration and standardized cosmetic scales beyond combined score not fully detailed
Future Directions: Prospective multicenter trials with standardized cosmetic and functional metrics, cost‑effectiveness, and longer follow‑up to validate TTESR generalizability and durability.
3. Indocyanine Green Fluorescence to Assess Parathyroid Glands Function during MIVAT.
In a 9‑patient case series of minimally invasive video‑assisted total thyroidectomy, intraoperative ICG fluorescence enabled real‑time visualization of parathyroid perfusion, guiding preservation and autotransplantation. Biochemical trends aligned with ICG findings, supporting feasibility and a potential role in reducing hypocalcemia.
Impact: Adds practical evidence that ICG fluorescence is a feasible, real‑time adjunct to preserve parathyroids during minimally invasive thyroidectomy, aligning cosmetic benefits with endocrine safety.
Clinical Implications: Surgeons performing minimally invasive thyroidectomy can consider ICG fluorescence to assess parathyroid perfusion, potentially reducing postoperative hypocalcemia through targeted preservation or autotransplantation.
Key Findings
- Case series of 9 patients undergoing minimally invasive video-assisted total thyroidectomy with standardized ICG dosing.
- Real-time near-infrared imaging clearly visualized parathyroid vascularization, guiding preservation and autotransplantation into the sternothyroid muscle.
- Postoperative calcium and PTH monitoring showed transient decreases in two patients, overall consistent with intraoperative ICG assessments.
- Demonstrated feasibility and safety; supports development of standardized ICG scoring during thyroid surgery.
Methodological Strengths
- Standardized intraoperative imaging protocol with biochemical correlation
- Clear feasibility data in a defined minimally invasive surgical setting
Limitations
- Small single-center case series without a control group
- Short-term postoperative assessment; long-term hypoparathyroidism rates not established
Future Directions: Prospective controlled studies to validate ICG scoring against long-term hypocalcemia and hypoparathyroidism, and to define thresholds for preservation versus autotransplantation.