Does a Pulsed Mode Offer Advantages Over a Continuous Wave Mode for Excisional Biopsies Performed Using a Carbon Dioxide Laser?

Pulsed versus continuous wave CO2 laser excisions of 100 oral fibrous hyperplasias: A randomized controlled clinical and histopathological study

“…The VAS values could have been influenced by the intake of analgesic in this subgroup. In a previous pilot study from our group, there was no significant difference between two groups treated by the two laser modes used . The larger group of patients in the present study exhibited a borderline significance demonstrating a lower intake of analgesics for the cf group.…”

“…However, there is still controversy over whether this is also the case under clinical conditions. A pilot study comparing the effects of the CO 2 laser using a pulsed (char‐free/cf) versus a continuous wave (cw) mode for excisional biopsies of fibrous hyperplasias failed to demonstrate any significant differences in their outcome . The aim of the present study was to compare the performance at excisional biopsies of fibrous hyperplasias when using a cf versus a cw mode regarding the thermal damage zone, duration taken for surgery, complications and postoperative pain sensation in a large sample size.…”

“…The CO 2 laser with a wavelength of 10.6 µm has become a widely accepted modality to treat intraoral benign soft tissue pathologies like fibromas, papillomas, mucoceles, vascular malformations, gingival overgrowth, aphthous ulcers, mucosal frenulas as well as potentially malignant disorders such as leukoplakias . Furthermore, laser excision of oral malignancies in early stages (T1N0 or T2N0) and verrucous carcinomas in more advanced stages have been described .…”

Model development and experimental validation for analyzing initial transients of irradiation of tissues during thermal therapy using short pulse lasers

“…For example, Levi et al showed greater hemorrhage post irradiation with CW lasers than with microsecond pulsed lasers with similar wavelength using in vivo pig models. Clinical histopathology on human buccal specimens by Suter et al identified that a significant difference between the thermal damage zones produced by pulsed and CW laser modes exists. However, their results were inconclusive in determining whether one of the modes is more effective than the other in terms of thermal dose delivered.…”

“…Both CW and pulsed lasers have been employed for the ablation of subsurface tumors. Pulsed lasers deliver very high peak powers due to the extremely short duration for which the pulses last, producing a greater and more confined thermal dose at the zone of irradiation during the initial period of transient heating than that of CW lasers . Histological studies allow for analysis of the heat affected zone during laser irradiation which may not be evident from temperature measurements alone and have demonstrated the advantages of pulsed lasers.…”