Le anomalie vascolari dei tessuti molli del cavo orale

Objectives To examine the vascular anomalies most frequently found in dental practice. Vascular anomalies are diseases characterized by functional and/or morpho-structural alterations of various nature, severity and extension which can affect every type of vessel (arterial, venous or lymphatic) of any caliber or anatomical region. Generally they are congenital and benign though they may cause complications such as ulceration, bleeding, superinfection, functional, and/or aesthetic deficit. Materials and methods Currently, the reference classification is the one adopted by the International Society for the Study of Vascular Anomalies (ISSVA), which distinguishes vascular or vasoproliferative neoplasms, including hemangiomas, from vascular malformations, these latter being further subdivided into low-flow and high bloodstream malformations. The diagnosis of vascular anomalies can not be separated by pathological history and clinical examination of the patient, even if for a certain diagnosis it is necessary to perform instrumental examinations including the echo color doppler ultrasound, a rapid examination, which is repeatable and devoid of ionizing radiation. The treatment involves different techniques, depending on the type of vascular lesion diagnosed; in particular, laser therapy is the most suitable for low-flow anomalies. This technique presents three different approaches: the excisional biopsy being indicated for suspicious lesions which need a histological examination; the transmucousal thermophotocoagulation (TMT) which involves the use of laser in “no contact” mode; and the intralesional photocoagulation (ILP) which uses the laser fiber inside the lesion and is suitable for deepest vascular anomalies. Results and conclusions . According to recent literature and clinical experience, we can say that vascular anomalies are a heterogeneous group of diseases for which treatment is necessary to perform a correct diagnostic clinical-instrumental approach; laser devices, with a wavelength similar to the oxidized hemoglobin, are the gold standard for the treatment of low flow blood abnormalities, both for ease of use and the excellent haemostatic effects.