Fibrotomy with diode laser (980 nm) and habit correlation in oral submucous fibrosis: a report of 30 cases

Abstract

To evaluate the efficacy of laser fibrotomy in patients with oral submucous fibrosis (OSMF) and also to correlate the habit variables causing OSMF. Thirty patients diagnosed clinically and histopathologically with OSMF were included in the study. Laser fibrotomy was done under local anesthesia using Zolar diode laser (980 nm frequency) at 2-W power in contact mode with fibro-optic cutting tip. The patients were advised to practice mouth-opening exercises rigorously, and topical corticosteroid was given for burning sensation and pain for 6 months. Pre- and post-treatment comparison of mouth opening, burning sensation, tongue protrusion, and cheek flexibility was analyzed after a follow-up period of 9 months. After a follow-up period of 9 months from the surgical intervention, the mean value of difference in pre- and post-treatment of VAS score, mouth opening, and tongue protrusion was found to be 3.3 ± 2.1, 7.7 ± 5.1, 1.6 ± 2.7, and 0.38 ± 0.61 respectively. Using the Wilcoxon signed rank test, all the above difference in mean was found to be significant with p value < 0.05. With above suggested significant results, lasers can provide an alternative and better means for surgical fibrotomy, relieving trismus in moderate OSMF as they are minimally invasive, cause less hemorrhage, and have faster healing and minimal surgical site scaring and relapse.

Treatment outcomes of laser therapy in oral submucous fibrosis-a systematic review

“…The characteristics of all included studies are summarized in Table 1. All the studies [11][12][13][14][15]18,19 were clinical and published between 2005 and 2008. In terms of study design, all the studies were observational cross-sectional in nature and there was not a single study on randomized controlled trial.…”

“…Most commonly used classification system used for grading OSF was of Khanna and Andrade. 20 All the studies 11,12,14,18,19 included stage II and III OSF patients except for one which included stage III and stage IVA patients. 13 The number of study participants ranged between 8 and 30 and the mean age was between 27 and 35.8 years.…”

“…Only one study did not report gender distribution of the subjects, 11 while remaining six studies had majority of the male subjects. [12][13][14][15]18,19 The follow-up period across studies ranged from 3 to 36 months.…”

“…Three different types of lasers were used in the included studies. Amongst these, diode laser was used in majority of the studies (n = 4) 11,13,18,19 whereas KTP-32 and ErCr:YSGG lasers were employed in two 12,14 and one study 15 respectively. Nayak et al, 14 Choudhary et al, 15 Mudigonda et al 18 and Gupta et al 19 reported power density of the laser used which were 8 W/cm, 2 1.5 W/cm 2 , 5 W/cm 2 and 2 W/cm 2 respectively.…”

“…Amongst these, diode laser was used in majority of the studies (n = 4) 11,13,18,19 whereas KTP-32 and ErCr:YSGG lasers were employed in two 12,14 and one study 15 respectively. Nayak et al, 14 Choudhary et al, 15 Mudigonda et al 18 and Gupta et al 19 reported power density of the laser used which were 8 W/cm, 2 1.5 W/cm 2 , 5 W/cm 2 and 2 W/cm 2 respectively. The wavelength (980 nm) of the laser used was reported by Gupta et al 19 only and none of the included studies reported the treatment time of the laser application.…”