Biopsy of Different Oral Soft Tissues Lesions by KTP and Diode Laser: Histological Evaluation

Abstract

Introduction. Oral biopsy aims to obtain clear and safe diagnosis; it can be performed by scalpel or laser. The controversy in this latter application is the thermal alteration due to tissue heating. The aim of this study is the histological evaluation of margins of “in vivo” biopsies collected by diode and KTP lasers. Material and Methods. 17 oral benign lesions biopsies were made by diode 808 nm (SOL, DenMatItalia, Italy) and KTP 532 nm (SmartLite, DEKA, Italy). Samples were observed at OM LEICA DM 2000; margin alterations were evaluated through Leica Application Suite 3.4. Results. Epithelial and connective damages were assessed for each pathology with an average of 0.245 mm and a standard deviation of ±0.162 mm in mucoceles, 0.382 mm ± 0.149 mm in fibromas, 0.336 mm ± 0.106 mm in hyperkeratosis, 0.473 mm ± 0.105 mm in squamous hyperplasia, 0.182 mm in giant cell granuloma, and 0.149 mm in melanotic macula. Discussion. The histologic aspect of lesions influenced the response to laser, whereas the greater inflammation and cellularity were linked with the higher thermal signs. Many artifacts were also associated to histologic procedures. Conclusion. Both tested lasers permitted sure histologic diagnosis. However, it is suggested to enlarge biopsies of about 0.5 mm, to avoid thermal alterations, especially in inflammatory lesions like oral lichen planus.

Histological Effects of an Innovative 445 Nm Blue Laser During Oral Soft Tissue Biopsy

“…Due to the important role of the biopsy, as the specimen taken is uniquely and thus not repeatable, even from a medical-legal point of view, this procedure needs to be performed within the full safety margins [14,15]. Since laser has been used in a versatile way as a useful device in the surgical field, even for biopsies, there have been several studies aimed to test its safety [10,18,20]; but there are several authors who, especially in the past, valued controversies in the use of these devices in the field of biopsy surgery [14,15,24]. The critical aspect is not the difficult diagnosis of the specimen, since the various laser devices are now able to guarantee a histological diagnosis, if used with the right parameters and by a skilled operator, but the legibility of the peri-incisional margins of the specimen.…”

“…The histological study of the thermal effect is necessary to define the healthy tissue surrounding the lesion, which must be taken in order not to alter [6] the reading of the specimen, and be related to the specific laser device used, for its thermal effect, if it is used for biopsies of potentially malignant epithelial lesions [18,34].…”

“…Several studies have been made about the thermal effect on soft tissues of the oral cavity, both "ex vivo" and "in vivo", with CO 2 [6,16], diode [17], KTP [18], Nd:YAG [19] and Er:YAG [20] laser devices.…”

Effect of diode laser depigmentation on gingival tissue of dogs.

“…Laser depigmentation is a superior treatment modality for a number of conditions when compared to traditional techniques in terms of precision cutting, hemostasis and lowering the risk of other complications commonly seen such as pain, edema and infection (Romeo et al, 2014).…”

Clinical application of diode laser radiation for surgical treatment of patients with dental diseases

“…В хирургической стоматологии высокоинтенсивное лазерное излучение применяется как альтернатива режущим инструментам. Как многопрофильный хирургический инструмент, это физическое воздействие обладает широким спектром биологического действия, высоким гемостатическим эффектом, стерильностью и бактерицидным действием, минимальным травмированием тканей, незначительным послеоперационным отеком и отсутствием или слабовыраженным болевым синдромом [3][4][5]. Несмотря на разнообразие стоматологических лазеров наиболее финансово доступными и распространенными являются диодные лазеры.…”