A comparative evaluation: Oral leukoplakia surgical management 
using diode laser, CO2 laser, and cryosurgery

Natekar, Madhukar; Raghuveer, Hosahallli-Puttaiah; Rayapati, Dilip-Kumar; Shobha, Eshwara-Singh; Prashanth, Nagesh-Tavane; Rangan, Vinod; Panicker, Archana G

doi:10.4317/jced.53602

Cited by 20 publications

(22 citation statements)

References 25 publications

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“…Several studies discussed the competencies of laser technologies for OLs, as the development of this technique is moving toward a painless and bloodless oral surgery. 2 3 4 Our work sustains this thesis and confirms CO 2 laser as a valid option for treatment of OLs as biopsy, vaporization, or removal.…”

Section: Discussionsupporting

confidence: 72%

“…It has been recommended to treat benign OLs, such as fibromas, vascular anomalies, mucoceles, ranulae, gingival hyperplasias with different causes (idiopathic or due to side effects of medications), aphthous ulcers, mucosal frenula, or tongue ties (ankyloglossia), as well as premalignant lesions such as oral leukoplakia, erythroplakia, papillomas, and lichen planus. 4 5 6 7 8 Some reports on the use of the CO 2 laser also support the possibility of treating malignant oral diseases in early stages with excisional biopsies, as well as mucosal melanomas. 2 9…”

mentioning

confidence: 97%

“…2 3 CO 2 laser has been compared with other nonsurgical methods like diode laser and cryotherapy: CO 2 and diode lasers have significantly better outcomes than cryosurgery in the management of oral leukoplakia in terms of pain, swelling, and slough formation. 4…”

mentioning

confidence: 99%

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Managing Benign and Malignant Oral Lesions with Carbon Dioxide Laser: Indications, Techniques, and Outcomes for Outpatient Surgery

Saibene

Rosso

Castellarin

et al. 2019

Surg J

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Purpose Because of its affinity for water-based tissues, carbon dioxide (CO2) laser has become an instrument of choice for treating oral mucosa conditions, ranging from inflammatory to malignant lesions. The aim of this work is to systematically evaluate the outcomes of laser surgery over a wide range of lesions, while providing a solid and reproducible protocol for CO2 laser surgery in the outpatient management of oral lesion. Methods Seventy-eight patients underwent 92 laser outpatient procedures for treatment of a wide range of benign and malignant lesions. We performed 60 removals, 11 exeretic biopsies, 15 vaporizations, and 3 vaporization/removal combined. We analyzed laser parameters applied for each technique and provided a systematic evaluation of surgical results. Results No problems occurred intraoperatively in any of the patients. Five patients complained marginal pain, while 3 patients had postsurgery bleeding. All treatments were successful, with the notable exception of 3 relapsing verrucous proliferative leukoplakias and an infiltrating squamous cell carcinoma of the tongue requiring radicalization. We did not record any adverse reactions to drugs or lesions due to laser action. Concordance between clinical diagnosis and pathology results was at 94.8%. Conclusions Our data indicate that CO2 laser is a solid choice for outpatient treatment of oral lesions. This technique grants painless and almost bloodless treatment, with negligible recurrence rates. Providing a solid reference for laser settings and operative techniques could provide a foundation for further exploring this tool while offering the basis for a positive comparison between different surgical techniques and options.

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Section: Discussionsupporting

confidence: 72%

mentioning

confidence: 97%

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Managing Benign and Malignant Oral Lesions with Carbon Dioxide Laser: Indications, Techniques, and Outcomes for Outpatient Surgery

Saibene

Rosso

Castellarin

et al. 2019

Surg J

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“…These effects are closely related to the laser settings (fibre, power, exposure time). The best results, in terms of healing, occur with a fluency of about 4 J/cm 2 [21,22,23,24].…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Laser-Assisted Surgical Excision of Leukoplakias and Hyperkeratosis of Oral Mucosa: A Case Series in A Group of Patients

Lauritano

Lucchese

Gabrione

et al. 2019

IJERPH

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Introduction: In the different branches of dentistry, the use of laser to solve different clinical situations is increasing due to numerous advantages that have been studied in literature since the 70s. Leucoplakia and hyperkeratosis can benefit from laser-assisted treatment. In most cases biopsy sampling, histological examination and, if no malignant cells are present, the follow-up is needed. However, even if the lesion is free of dysplasia patients often ask to eliminate these white spots that are always a cause of concern. Aim: From these numerous requests comes the idea of setting up a laser-assisted protocol as less invasive as possible to be offered to patients. The aim of the study is to find a laser-assisted protocol for the surgical excision of leucoplakia and hyperkeratosis that can both improve the clinical aspect of the lesion and be sustainable for patients. The null hypothesis has been identified in the following statement: the treatment is effective and efficient at the same time; where effectiveness was tested with the following criteria: size of the lesion, tactile perception, discomfort, pain; and efficiency with the following criteria: pain and discomfort perceived during the treatment. Materials and methods: To collect all data, a specially designed medical record was used. The diode laser was used with a pulsed mode and the maximum power corresponds to 1.8 W. No anaesthesia was used. Before laser-assisted treatment, the fibre was activated and was used with a contact overflowing. Results: Our results show a decrease in the size of the lesion statistically significant. No pain was referred during treatment, except for a slight burning sensation. Conclusion: In conclusion we can state that the treatment is both efficient and effective.

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“…The authors concluded that all three surgical modalities used in this study were effective for treatment of OL, and the overall summation of the results of the study showed that laser therapy (CO 2 and diode) seems to offer better clinically significant results than cryotherapy. 16 It has been mentioned that diode laser with wavelengths ranging from 810 to 980 nm in a continuous or pulsed mode can be used as a possible method of soft tissue surgery in the oral cavity. 17,18 The major advantages mentioned in the literature for the use of CO 2 and diode lasers are minimal postoperative swelling and scarring, improved wound healing, and decreased postoperative pain and swelling due to transfer of high laser energy to the lesional site, resulting in minimal tissue damage.…”

Section: Ijaimsmentioning

confidence: 99%

Excision of Oral Leukoplakia using 970 nm Diode Laser

David¹,

Agrawal²,

Thakur³

2017

International Journal of Advanced and Integrated Medical Sciences

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Oral leukoplakia (OL) is one of the most commonly seen potentially malignant disorders with varied clinical presentations. A wide variety of medical and surgical treatment modalities have been tried for its management with varying successes. Laser ablation of the lesion is considered as one of the treatment modalities. Conventional surgery may be followed by some side effects like scar formation, contraction, and contamination of surgical field. Using high-power laser has some advantages like less pain, swelling, bleeding, ability to decontaminate, thus preventing secondary infection. This article presents a case of leukoplakia in the right buccal mucosa, which was managed using a 6 W diode laser of 970 nm .The healing occurred uneventfully over a period of 1 month postoperatively with minimal patient discomfort. The case establishes the efficacy of diode laser in the management of OL.

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A comparative evaluation: Oral leukoplakia surgical management using diode laser, CO2 laser, and cryosurgery

Cited by 20 publications

References 25 publications

Managing Benign and Malignant Oral Lesions with Carbon Dioxide Laser: Indications, Techniques, and Outcomes for Outpatient Surgery

Managing Benign and Malignant Oral Lesions with Carbon Dioxide Laser: Indications, Techniques, and Outcomes for Outpatient Surgery

The Effectiveness of Laser-Assisted Surgical Excision of Leukoplakias and Hyperkeratosis of Oral Mucosa: A Case Series in A Group of Patients

Excision of Oral Leukoplakia using 970 nm Diode Laser

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