Importance of the vaporization margin during CO₂ laser treatment of oral leukoplakia: A survival study

Abstract

Oral leukoplakia (OL) is one of the most common potentially malignant disorder of the oral cavity (van der Waal, 2009). It was recently defined by a WHO collaborative centre as "white plaque with a questionable risk of malignancy once all other similar clinical lesions that carry no increased risk of cancer have been excluded" (Warnakulasuriya et al., 2021). It has an estimated prevalence of 4.11% (95% CI = 1. 98-6.97;Mello et al., 2018); an annual risk of malignant transformation of between approximately 2% and 3% (Carrard & van der Waal, 2018) and the pooled proportion of malignant transformation is 9.8% (95% CI: 7.9-11.7), according to a systematic review covering the last 5 years (Aguirre-Urizar et al., 2021).When treating OL, it is important to firstly eliminate any possible etiological factors, such as tobacco or alcohol consumption. If the lesion cannot be related to any of the above, or if it persists for longer than 3 months after the aforementioned factors have been eliminated, a biopsy must be taken in order to confirm the diagnosis

Evaluation of the Effectiveness of the Carbon Dioxide (CO2) Laser in Minor Oral Surgery: A Systematic Review

“…25 A research study also identified small bone necrosis at a rate of 8%, delayed wound healing at a rate of 4%, and sclerotic scars at a rate of 4%. 21  Lesion resolution rates were reported in 43.2% 20 and 47.4% 18 of the patients. The disease-free survival rate during the first year was 52.9% in a study.…”

“…19 Another study reported pain in 28.2% of the lesions. 18 Another study revealed 20% of the subjects felt pain on day 4. 22  Recurrence rates in studies were: 54.17 %, 19 52.6% after a mean of 4.8 years, 18 44.0% after a mean of 19.7 months, 21 35.1%, 20 20% after 1 month, 22 13.63 %, 25 9.1%, 23,42 and 3.3% with a nodal recurrence.…”

“…18 Another study revealed 20% of the subjects felt pain on day 4. 22  Recurrence rates in studies were: 54.17 %, 19 52.6% after a mean of 4.8 years, 18 44.0% after a mean of 19.7 months, 21 35.1%, 20 20% after 1 month, 22 13.63 %, 25 9.1%, 23,42 and 3.3% with a nodal recurrence. 26  Malignant transfor mation (MT) was different from no MT after 1 year, 23 2% MT at 18 months of the study, 19 2.27%, 42 2.6% MT after 174 and 26 months of the study, 18 4% during the 48th month of the study, 21 CO2 laser and minor oral surgery CO2: carbon dioxide, PVL: proliferative verrucous leukoplakia, OPMDs: Oral potentially malignant disorders, Er,Cr:YSGG: Erbium, chromium-doped yttrium, scandium, gallium and garnet, ND:YAG: Neodymium-doped yttrium aluminum garnet, Er:YAG: Erbium-doped yttrium-aluminum-garnet, PDT: Photodynamic therapy, NRS: numerical rating scale, TSS: Thongprasom sign score, .…”

“…Oral tumors and OPMDs were found in three studies. [24][25][26] Some studies showed no postoperative complications 20,42,43 ,and one study found no complication in 64.1% of the patients, 18 whereas others claimed the following complications:  Postoperative pain: In a research study, 23 the numerical rating scale (NRS) score declined considerably from 1 month to 1 year. In additional trials, visual analog scale (VAS) ratings varied from 2 to 4, 44 0 after 7 days, 25 1.8 on the first day before declining to 0.03 on day 7, 26 and 6 in 10.4% of the patients.…”

“…43  The incidence of postoperative bleeding was 5.12%, 25 5.8%, 19 and 6.6% of the subjects. 26  Other postoperative symptoms include superinfected lesions at a rate of 5.8%, 19 granulomas at a rate of 20% 21 and 7.7%, 18 edema and erosion, 44 erythema in all of the patients at the end of day 5, 22 and temporary numbness. 25 A research study also identified small bone necrosis at a rate of 8%, delayed wound healing at a rate of 4%, and sclerotic scars at a rate of 4%.…”