A comparative evaluation of diode laser ablation versus scalpel excision for management of oral leukoplakia

Introduction: Leukoplakia is among the most common potentially malignant disorders encountered in clinical dental practice. The treatment of leukoplakia includes nonsurgical and surgical management. The surgical treatment includes excision, electrocauterisation, laser surgery or cryosurgery. This retrospective study aimed to analyse the efficacy of diode lasers in the management of leukoplakia. Methods: The sample consists of 56 cases with 77 leukoplakia sites treated with diode laser between January 2018 and December 2020 with a minimum of six months follow-up. For each patient, personal data was collected along with site of lesions, leukoplakia phase, type of treatment performed (laser ablation or laser excision), side effects, recurrences and malignant transformation. Inferential statistical analysis was then conducted. Results: After applying exclusion criteria, 56 cases with 77 leukoplakia sites were included in this study. Males aged >45 years were predominantly affected. Homogeneous leukoplakia (48.1%) was the most common phase. Recurrences were noted in 19.48% of the cases. Compared to laser excision, laser ablation had more recurrences. Gingival lesions showed a higher recurrence rate than other sites in the oral cavity. None of the cases showed malignant transformation. Discussion: Laser offers many advantages over other conventional methods including lesser postoperative pain and swelling, bloodless dry operating field and increased patient comfort and requires minimal local anaesthesia. The study concluded that diode laser is an effective surgical treatment modality for treating leukoplakia. Furthermore, the laser excision technique was found to be superior to laser ablation due to lesser recurrence.

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“…Moreover, previous studies confirmed that laser surgery had a lesser recurrence rate than scalpel surgery. [ 14 , 15 ]…”

Section: Discussionmentioning

confidence: 99%

“…Recurrences may also be related to patient’s gender, non-cooperation to quit the habit, dysplastic activity, location of the lesion and the presence of lesion for a prolonged period. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

Diode Laser in the Management of Leukoplakia - A Retrospective Study

Shivhare

Haidry

Kumar

et al. 2022

Annals of Maxillofacial Surgery

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“…The use of lasers in soft tissue management maximized the health of the oral tissues. 8 The efficacy of laser surgery has also been observed in the removal of mucoceles ,10 in overcoming the limitations of surgical methods of treatment in oral submucous fibrosis patients with favourable results 11 , reducing the incidence and severity of hematoma, swelling and pain during the first week after periosteal releasing incision during guided bone regeneration 12 , improving the visibility, reducing the amount of anaesthesia required, offering a promising treatment for the ablation of oral leukoplakia 13 and minimizing trauma in second stage implant surgery 14 amongst its many other applications.…”

Section: Introductionmentioning

confidence: 99%

Diode laser or scalpel: A comparison of the two “Cutting Edge” surgical tools in maxillofacial surgery

Roy,

Gupta,

Mittal

et al. 2024

JOHS

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Context and Objective: Scalpel has been the gold standard tool for intraoral surgery. Since a few decades, lasers have also stepped up as operating instruments, be it cutting, ablation or photobiomodulation. In our research, we compared the efficacy of scalpel and diode laser in intraoral maxillofacial surgery. Setting and Design: In the duration of 3 years, a total of 100 patients were included in our study which were divided into two groups of 50 patients each; 50 in the test group for scalpel and 50 in the control group for laser. Materials and Methods: Inclusion criteria includes clinically diagnosed intraoral soft tissue lesions/growth indicative of tissue ablation, incision, excision, or biopsy. Exclusion criteria: Non consenting and/or non-cooperative patients. Presence of uncontrolled or advanced systemic diseases, immunocompromising diseases, porphyria or medications that cause photosensitivity (eg. Chloroquine, methotrexate etc) and serious eye defects. Results: While laser provided a clean surgical field by facilitating haemostasis during bleeding, its healing time was slower as compared to laser during the first postoperative week. 2% Lignocaine HCl with 1:80000 adrenaline was used as a local anaesthetic agent. Swelling and redness were both found to be pronounced in scalpel as opposed to laser which produced a coagulum ring of eschar formation during cutting. Discussion: Scalpel offers unmatched precision and speed during surgery. Its only drawback is bleeding which may be inconvenient for the surgeon. Laser not only clears the surgical field of the operator but also reduces the risk of bleeding from highly vascular areas like the tongue.The heat from the laser tip negates any additional measures required for cleaning. Summary and Conclusions:The 980 nm diode laser promises versatility and surgical efficacy during intraoral maxillofacial procedures and can be a good alternative to the conventional cold scalpel, offering equal patient satisfaction.

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