Recurrence of Oral Leukoplakia after CO2 Laser Resection: A Prospective Longitudinal Study

Abstract

Aim: The aim of this study is to assess the efficacy of CO2 laser treatment in oral leukoplakia and to analyse the recurrence rate of oral leukoplakia lesions at 18-month follow-up. Materials and methods: A prospective clinical study regarding CO2 laser treatment for oral leukoplakia was conducted, in which 39 patients with a total of 53 oral leukoplakias were included. Follow-up was performed at 18 months post-surgery and the following variables were studied: sex, age, associated risk factors, clinical classification, size, location and presence of epithelial dysplasia, recurrence, and rate of malignant transformation after resection. Results: In the analysis of the final results 18 months after baseline, a treatment success rate of 43.75% was observed. Oral leukoplakia recurred in 54.17% of cases, and 2.08% of leukoplakias progressed to cancer. Among all the studied variables (age, tobacco use, size, location, clinical type or histology), no significant differences were found with regard to recurrence. Conclusion: The use of CO2 laser therapy to treat leukoplakia lesions is sufficient to remove such lesions. However, parameters that can assess recurrence need to be sought.

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

“…44 Others reported burning in 20% 22 and 37.5% 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.…”

“…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%.…”

“…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. 19 Another study reported pain in 28.2% of the lesions. 18 Another study revealed 20% of the subjects felt pain on day 4.…”

“…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, .…”

Management of hormonal induced recurrent ulcerative fibrous epulis with osseous metaplasia: A case report

“…Paglioni et al concluded in a systematic review that laser excision might reduce the recurrence of some oral lesions like leukoplakia 37 . On the contrary, Rodriguez‐Lujan et al reported that further assessment of different parameters that affect recurrence should be evaluated after laser removal of oral lesions 38 . In the present case report, it is questionable whether laser excision would have prevented the recurrence of the lesion in the presence of other risk factors including the hormonal changes post‐pregnancy, the medications, and the medical history of ulcerative colitis.…”