Diode laser versus sclerotherapy: bloodless approaches in the treatment of oral pyogenic granuloma (randomised controlled clinical trial)

Abstract

Oral pyogenic granuloma (PG) is traditionally treated by surgical excision which is associated with bleeding, pain and a high rate of recurrence. Our research aimed to clinically assess the effectiveness of diode laser versus sclerotherapy, as bloodless approach, in the treatment of oral PG. We randomly divided 20 patients with oral PG into two groups, with those in the test group being managed via diode laser application and those in the control group via injections of ethanolamine oleate as a sclerosing agent. All patients were evaluated intraoperatively for bleeding severity and postoperatively for pain. The quality of healing was also assessed using Landry healing index after the 1st, 2nd and 4th weeks. Additionally, the patients were recalled after 3, 6 and 9 months from the end of treatment for recurrence evaluation. Our results revealed that intraoperative bleeding did not differ significantly between both groups while postoperative pain decreased significantly in the sclerotherapy group compared to the laser group. For different intervals, the sclerotherapy group had a higher healing quality index than the laser group, although the difference was not statistically significant. However, recurrence occurred in the laser group, there were no cases of recurrence in the sclerotherapy group in all intervals. In conclusion, diode laser treatment of PG is a reliable, less invasive, and sensitive procedure that requires an experienced operator and specialised equipment. However, ethanolamine oleate sclerotherapy is an inexpensive, simple technique besides being less prone to recurrence problems, especially when treatment duration is not a concern.

Excision of Pyogenic Granuloma (PG) With Diode Laser on the Lower Lip in an Unusual Location: A Case Report

“…It shows a higher occurrence in gingiva [ 1 ]. It can be also expressed in lips, tongue, soft and hard palate, and also oral mucosa [ 2 - 3 ]. This lesion usually presents asymptomatic and slow-growing characteristics, despite the fact some cases can present a faster growth, while others remain stable for a long time.…”

An alternative method for esthetic and functional management of oral pyogenic granuloma

“…5,[14][15][16] Management of PG may become controversial in the event an operator hesitates to remove the whole lesion with esthetic considerations. Although some methods that are thought to have a low invasion were tried for treatment, such as laser surgery, 17 cryosurgery, 18 and sclerotherapy, 17 recurrences following these procedures were also reported. 7 Thus, surgical excision is the standard choice of treatment in almost every scenario, and if the excision does not extend to the periosteum to completely remove irritant factors such as calculus, root surface irregularities, and bone irregularities, recurrent lesions may occur, especially in lesions in the attached gingiva, 19 which are the most common.…”