Cryogun cryotherapy for oral leukoplakia and adjacent melanosis lesions

Chen, Hsin‐Ming; Cheng, Shih‐Jung; Lin, Hung-Pin; Yu, Chuan‐Hang; Wu, Yang-Che; Chiang, Chun‐Pin

doi:10.1111/jop.12287

Cited by 9 publications

(7 citation statements)

References 26 publications

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“…They report advantages such as bloodless surgery, a low chance of secondary infection, and a relative lack of scarring and pain . A recent study by Chen et al using a ‘cryogun’ for 72 oral leukoplakia lesions, which included 26 mild dysplasia, 7 moderate dysplasia, and 1 severe dysplasia, showed complete regression after multiple cryotherapy sessions. At a mean follow‐up time of 18 months, 8 lesions had recurrences but were effectively controlled by repeated treatment.…”

Section: Conservative Management (Active Surveillance/wait‐and‐see Pomentioning

confidence: 99%

Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges

Tilakaratne

Jayasooriya

Jayasuriya

et al. 2019

Periodontology 2000

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Oral epithelial dysplasia is a spectrum of architectural and cytological epithelial changes caused by accumulation of genetic changes, and is associated with an increased risk of progression to squamous cell carcinoma. It is a microscopic diagnosis of immense clinical importance. The initial reports of oral potentially malignant disorders with oral epithelial dysplasia transforming to oral cancer helped in understanding the nature of oral malignancies. Since then, clinical studies on oral potentially malignant disorders have combined microscopic findings of oral epithelial dysplasia to assess the malignant transformation potential of different grades of epithelial dysplasia. A significant amount of scientific literature has amassed on oral epithelial dysplasia relating to aspects of its diagnosis and management. However, the evidence base is weak as a result of the significant variability of published research. Poorly described study methods, variability in different oral epithelial dysplasia grading systems, inter‐ and intra‐examiner variability causing issues of reliability, inadequate sample size, and inconsistent durations of follow‐up are some of the methodological issues contributing to the failure to provide dependable information. Randomized clinical trials on the malignant transformation potential of oral epithelial dysplasia and its treatment outcomes are limited. This comprehensive literature review on oral epithelial dysplasia summarizes the scientific knowledge published in the scientific literature in English since its first description. The historical development, etiological factors, grading systems, diagnostic criteria, assessment of risk factors and prevention of malignant transformation, management principles of different grades of oral epithelial dysplasia (surgical and nonsurgical), recommendations on follow‐up, and prognostic indicators are discussed in detail.

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Section: Conservative Management (Active Surveillance/wait‐and‐see Pomentioning

confidence: 99%

Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges

Tilakaratne

Jayasooriya

Jayasuriya

et al. 2019

Periodontology 2000

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“…Cryotherapy: Weakly recommended. A meta-analysis (n = 330) of 5 studies aimed at cryotherapy for OLK [33][34][35][36][37] found that after cryotherapy, the total recurrence rate was 16% (95% CI, 10%-25%) during an average follow-up period of 23 months. Among them, 3 studies reported the follow-up time and malignant transformation rate.…”

Section: Resultsmentioning

confidence: 99%

“…Among them, 3 studies reported the follow-up time and malignant transformation rate. Two studies 34,36 with a mean follow-up of 22 months (7-38 months) and 18 months (3-41 months), respectively, did not report the malignant transformation rate, and a study 35 with an average follow-up of 52.8 months (2-127 months) reported a malignant transformation rate of 5.4%.…”

Section: Resultsmentioning

confidence: 99%

Management of oral leukoplakia: a position paper of the Society of Oral Medicine, Chinese Stomatological Association

Chen¹,

Dan²,

Pan

et al. 2021

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objective. The objective of this study was to develop the first edition of a Chinese evidence-based position paper on the management of oral leukoplakia (OLK). Study Design. The consultant group for drafting the position paper consisted of 31 oral medicine specialists and 2 evidence-based medicine specialists. English studies (searched in PubMed, EMBASE, and the Cochrane Library) and Chinese studies (searched in China National Knowledge Infrastructure and WanFang) published before January 2018 were used. The quality of the study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation grid, and the strength of the recommendations was determined based on the results of 3 rounds of voting among the consultant group members using the Delphi method. Results. Twenty-two evidence-based guidelines for clinical management and monitoring of OLK were established in this position paper. A clinical path diagram for oral health practitioners was constructed based on the recommendations. Conclusion. Current evidence suggests that management and monitoring of patients with OLK should be performed by experienced clinicians to control the lesion and for early detection of malignant transformation. However, all recommendations are based on evidence of low or extremely low quality and may require further modification as new evidence is produced. (Oral Surg Oral Med Oral Pathol Oral Radiol 2021;000:1À12)

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“…OLM lesions in patients without smoking habit, with the greatest diameter < 2.8 cm, with epithelial dysplasia, or with a surface keratin thickness 50 mm needed significantly fewer cryogun cryotherapy treatments to achieve complete regression of the OLM lesions than the corresponding OLM lesions. 4 Therefore, we suggest that cryogun cryotherapy is also an effective treatment modality for OLM lesions.…”

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confidence: 99%

Cryogun cryotherapy is the first-line treatment of choice for oral leukoplakia

Cheng

Chiang

2015

Journal of Dental Sciences

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Oral leukoplakia (OL) is the most common oral precancerous lesion. Histologically, approximately 90% of OL lesions show hyperkeratosis and/or epithelial hyperplasia, 5% show epithelial dysplasia or carcinoma in situ, and another 5% show invasive carcinoma. The malignant transformation rates of OL lesions have been reported to be 1e7% for homogenous thick leukoplakia, and 4e15% for granular or verruciform leukoplakia. 1e3 The relatively high malignant transformation rates of OL lesions highlight the importance of early detection and treatment of OL lesions.Although OL lesions can be eradicated by surgical excision, laser surgery, and photodynamic therapy, cryotherapy is also an effective and alternative treatment modality for OL lesions. 1e5 Cryotherapy is a method that locally destroys lesional tissues by freezing in situ. It has several advantages including being a bloodless treatment, has a very low incidence rate of secondary infections, and has a relative lack of scarring and pain. 1e3 Cryotherapy can be carried out with either a "closed" or an "open" system. 1e3 Closedsystem cryotherapy offers a greater degree of temperature control but requires complex, delicate, and expensive equipment. Open-system cryotherapy involves directly applying the cryogen to the lesion with either a cotton swab 2 or a portable spray apparatus such as a cryogun (Brymill Corp., Ellington, CT, USA). 3 When performing opensystem cryotherapy, it is more difficult to maintain a constant lower temperature in the lesional tissues during the whole treatment period. However, it does not require expensive equipment. Cotton-swab cryotherapy is suitable for the treatment of small OL lesions, 2 but cryogun cryotherapy can be used for the treatment of medium and large OL lesions with either smooth or rough surfaces. 3

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Cryogun cryotherapy for oral leukoplakia and adjacent melanosis lesions

Abstract: Cryogun cryotherapy is an effective treatment modality for OLM lesions.

Cited by 9 publications

References 26 publications

Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges

Oral epithelial dysplasia: Causes, quantification, prognosis, and management challenges

Management of oral leukoplakia: a position paper of the Society of Oral Medicine, Chinese Stomatological Association

Cryogun cryotherapy is the first-line treatment of choice for oral leukoplakia

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