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Shivhare P, Haidry N, Kumar A, Parihar A, Singh A, Subramanyam S. Diode Laser in the Management of Leukoplakia - A Retrospective Study. Ann Maxillofac Surg 2022; 12:178-184. [PMID: 36874766 PMCID: PMC9976845 DOI: 10.4103/ams.ams_117_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 01/12/2023] Open
Abstract
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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Affiliation(s)
- Peeyush Shivhare
- Department of Dentistry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Naqoosh Haidry
- Department of Dentistry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Ajay Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Ajay Parihar
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ankur Singh
- Department of Oral Medicine and Radiology, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Shalini Subramanyam
- Department of Oral Medicine and Radiology, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat, India
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Saldivia-Siracusa C, González-Arriagada WA. Difficulties in the Prognostic Study of Oral Leukoplakia: Standardisation Proposal of Follow-Up Parameters. FRONTIERS IN ORAL HEALTH 2021; 2:614045. [PMID: 35047990 PMCID: PMC8757698 DOI: 10.3389/froh.2021.614045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/13/2021] [Indexed: 12/24/2022] Open
Abstract
Oral leukoplakia is the most prevalent potentially malignant disorder of the oral cavity. To evaluate its potential for malignancy, appropriate documentation of the biological parameters is crucial, allowing the patients' progression to be assessed. We hypothesized a lack of standardization in the parameters employed for the prognostic study of oral leukoplakia; our aims were to determine the different parameters used for follow-up according to definition, importance, and frequency of use, and to provide a standardization proposal of follow-up research. We made a scoping review to identify papers with the keywords “leukoplakia,” “oral,” and “follow-up” published until June 2019 in English, Spanish and Portuguese literature through an online search in PUBMED, SCIELO, and SCOPUS databases. In total, 514 articles were initially identified, and fifty-nine publications were selected, of which 37 were retrospective. The reports included a total of 18,660 patients between 13 and 98 years old, with a mean age of 57.6 years. Tobacco and alcohol habits were positive for 77 and 37% of the patients, respectively. Our results showed that reported leukoplakias were predominantly located on buccal mucosa (40.4%), were homogeneous (60.8%), multiple (59.9%), smaller than 2 cm (74.4%) and histopathologically non-dysplastic (71%). The mean follow-up time was 55 months, with a 13% malignant transformation rate. The categorization and definition of multiple variables were notably diverse. Age, sex, habits (tobacco and alcohol), site, size, distribution, morphology, degree of dysplasia, and evolution were the chosen parameters for our proposal. The current study reflected the lack of consensus found in the literature regarding parameters for diagnosis or follow-up, impacting negatively on clinical and research results. standardization comprises an efficient way to facilitate the prognosis assessment of oral leukoplakia, being beneficial for clinical practice, and enabling better quality information to apply in research.
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Affiliation(s)
| | - Wilfredo Alejandro González-Arriagada
- Patología y Diagnóstico Oral, Facultad de Odontología, Universidad de Valparaíso, Valparaíso, Chile
- Centro de Investigación Interoperativo en Ciencias Odontológicas y Médicas (CIICOM), Universidad de Valparaíso, Valparaíso, Chile
- *Correspondence: Wilfredo Alejandro González-Arriagada
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de Pauli Paglioni M, Migliorati CA, Schausltz Pereira Faustino I, Linhares Almeida Mariz BA, Oliveira Corrêa Roza AL, Agustin Vargas P, Franco Paes Leme A, Bianca Brandão T, Prado Ribeiro AC, Ajudarte Lopes M, Santos-Silva AR. Laser excision of oral leukoplakia: Does it affect recurrence and malignant transformation? A systematic review and meta-analysis. Oral Oncol 2020; 109:104850. [PMID: 32540612 DOI: 10.1016/j.oraloncology.2020.104850] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/18/2022]
Abstract
Oral leukoplakia (OL) is a white lesion with high potential of recurrence and malignant transformation. The variable clinical and histopathological features of OL may potentially impact both treatment and prognosis. Current literature shows that post treatment rates of recurrence and malignant transformation vary widely. The use of surgical lasers have been proposed with the objective of improving outcomes. We performed a systematic review and a comprehensive meta-analysis dedicated to pooling the rates of recurrence and malignant transformation of OL lesions treated using the main types of surgical lasers available. Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 36 articles met the inclusion criteria. Selected studies included OL lesions that were treated by evaporation or excision using Nd:YAG laser, Er:YAG laser, CO2 laser, KTP laser, or diode laser. The results of this systematic review and meta-analysis suggest that surgical laser excision of OL may decrease recurrence rates but have no effect on the malignant transformation of OL when compared with conventional treatments.
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Affiliation(s)
- Mariana de Pauli Paglioni
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
| | | | | | | | | | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | | | | | | | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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The Effectiveness of Laser-Assisted Surgical Excision of Leukoplakias and Hyperkeratosis of Oral Mucosa: A Case Series in A Group of Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020210. [PMID: 30642122 PMCID: PMC6352160 DOI: 10.3390/ijerph16020210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 12/26/2018] [Accepted: 01/09/2019] [Indexed: 01/19/2023]
Abstract
Introduction: In the different branches of dentistry, the use of laser to solve different clinical situations is increasing due to numerous advantages that have been studied in literature since the 70s. Leucoplakia and hyperkeratosis can benefit from laser-assisted treatment. In most cases biopsy sampling, histological examination and, if no malignant cells are present, the follow-up is needed. However, even if the lesion is free of dysplasia patients often ask to eliminate these white spots that are always a cause of concern. Aim: From these numerous requests comes the idea of setting up a laser-assisted protocol as less invasive as possible to be offered to patients. The aim of the study is to find a laser-assisted protocol for the surgical excision of leucoplakia and hyperkeratosis that can both improve the clinical aspect of the lesion and be sustainable for patients. The null hypothesis has been identified in the following statement: the treatment is effective and efficient at the same time; where effectiveness was tested with the following criteria: size of the lesion, tactile perception, discomfort, pain; and efficiency with the following criteria: pain and discomfort perceived during the treatment. Materials and methods: To collect all data, a specially designed medical record was used. The diode laser was used with a pulsed mode and the maximum power corresponds to 1.8 W. No anaesthesia was used. Before laser-assisted treatment, the fibre was activated and was used with a contact overflowing. Results: Our results show a decrease in the size of the lesion statistically significant. No pain was referred during treatment, except for a slight burning sensation. Conclusion: In conclusion we can state that the treatment is both efficient and effective.
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Arora KS, Bansal R, Mohapatra S, Verma A, Sharma S, Pareek S. Prevention of Malignant Transformation of Oral Leukoplakia and Oral Lichen Planus Using Laser: An Observational Study. Asian Pac J Cancer Prev 2018; 19:3635-3641. [PMID: 30583693 PMCID: PMC6428544 DOI: 10.31557/apjcp.2018.19.12.3635] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objectives: The present observational study was conducted with an aim to evaluate the efficacy of diode laser in
management of homogenous oral leukoplakia (OL) and reticular oral lichen planus (OLP), so that these potentially
malignant disorders can be limited and further malignant transformation can be prevented. Further the assessment
of associated postoperative complications after laser therapy was also carried out. Study Design: Present study was
carried out using diode laser 810nm on 60 subjects, of whom 30 subjects were of homogenous OL and 30 subjects
were of reticular OLP aged between 20 – 60 years, the diagnosis of which was histopathologically confirmed. Results:
Of the 60 subjects none complained of pain during and immediately after surgery with no bleeding at any stage of the
procedure. By the end of 3rd day post operative most subjects reported no pain and swelling and very few subjects had
negligible pain and swelling when evaluated. On subsequent follow-up of 1,2 and 4 week(s) none of the subject reported
of pain, swelling or bleeding and it was noted that all the areas treated with laser had healed without scarring with no
signs of recurrence. Fibrosis was seen in two male patients and one female patient treated for OL and OLP respectively.
Conclusion: Patient compliance and contentment without any postoperative complications were observed to be of high
degree in the present study. Thus diode laser can be considered as a best alternative to conventional surgical treatment
modality in managing OL and OLP and preventing its further transformation.
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Affiliation(s)
- Karandeep Singh Arora
- Department of Oral Medicine and Radiology, M. M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India.
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Del Corso G, Gissi DB, Tarsitano A, Costabile E, Marchetti C, Montebugnoli L, Foschini MP. Laser evaporation versus laser excision of oral leukoplakia: A retrospective study with long-term follow-up. J Craniomaxillofac Surg 2015; 43:763-8. [DOI: 10.1016/j.jcms.2015.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 01/10/2023] Open
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Ilaria G, Marco M, Elisabetta M, Giovanni M, Carlo F, Maddalena M, Mauro B, Paolo V. Advantages of new technologies in oral mucosal surgery: an intraoperative comparison among Nd:YAG laser, quantic molecular resonance scalpel, and cold blade. Lasers Med Sci 2015; 30:1903-10. [PMID: 25994929 DOI: 10.1007/s10103-015-1769-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 05/13/2015] [Indexed: 11/26/2022]
Abstract
The aim of this study is to evaluate the possible intraoperative advantages of Nd:YAG laser and quantic molecular resonance (QMR) scalpel in oral soft tissue surgery. One hundred sixty-three interventions were evaluated. Group 1 (G1) included 77 interventions performed with Nd:YAG laser, group 2 (G2) 45 with QMR scalpel, and group 3 (G3) 41 with cold blade. Parameters analyzed were as follows: speed of incision, time of intervention, intraoperative bleeding, number of stitches, patient compliance, and operator comfort. Data were analyzed using software STATA 12 (StataCorp LP, College Station, TX, USA). Mean speed of incision was 0.54 mm/s in G1, 2.83 mm/s in G2, and 1.58 mm/s in G3, Nd:YAG laser being the slowest. However, no significant differences among times of intervention were found. In particular, interventions in G1 (221.15 ± 220.89 s) have a mean duration lower than G2 (280.56 ± 248.31 s) and G3 (316.10 ± 248.69 s). Intraoperative bleeding occurred in 29.9 % (n = 23/77) of interventions in G1, 97.8 % (n = 44/45) in G2, and 97.6 % (n = 40/41) in G3 (p < 0.0001). Mean number of stitches in G1 was statistically lower (G1, 0.10; G2, 2.07; G3, 2.29; p < 0.0001). No differences with regard to patient compliance were detected. Operator comfort was higher in G1 (p < 0.0003). Nd:YAG laser and QMR scalpel give several advantages in oral mucosal surgery: Nd:YAG laser cuts tissue slowly, but it provides a good visibility and excellent hemostasis. QMR scalpel allows a very rapid cutting with no considerable temperature increase, but there is major risk of bleeding and need for sutures with lower operator comfort.
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Affiliation(s)
- Giovannacci Ilaria
- Department of Biomedical, Biotechnological and Translational Sciences, Center of Oral Laser Surgery and Oral Medicine, Dental School, University of Parma, Via Gramsci, 14-43125, Parma, Italy
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Das S, Mohammad S, Singh V, Gupta S. Neodymium:Yttrium aluminum garnet laser in the management of oral leukoplakia: A case series. Contemp Clin Dent 2015; 6:S32-5. [PMID: 25821371 PMCID: PMC4374315 DOI: 10.4103/0976-237x.152934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Oral leukoplakia is a nonscrappable whitish patch described as a potentially malignant disorder with high prevalence in India. Besides medicinal treatment, neodymium: Yttrium aluminum garnet (Nd: YAG) laser is also used for the management of oral leukoplakia. This study evaluated the role of Nd: YAG laser in the management of oral leukoplakia and also investigated postoperative complications along with long-term prognosis of the disease. SETTINGS AND DESIGNS The study is a prospective cohort study conducted for 24 months (June 2011 to May 2013) in Lucknow. MATERIALS AND METHODS The study comprised of 42 patients, both male and female of Indian origin and diagnosed with oral leukoplakic lesions. Patients with biopsy proven squamous cell carcinoma and medically compromised are excluded from the study. All patients has undergone ablation of lesion by pulsed Nd: YAG laser and were followed after 24 h, 72 h, 1-week and then successively for 1, 3, 6 months and then 1(st) and 2(nd) postoperative years. RESULTS Pain and slough were evaluated by Wicoxon rank test (P = 0.0001 statistically significant) which decreased from 24 h to 1-week and became nil in subsequent follow-ups. Similarly, McNemar's test (P = 0.001 statistically significant) was used for evaluation of burning sensation, paresthesia, infection and recurrences. Recurrence was noted in 2 patients but following the second application, there were no recurrences over the period of further follow-up. None of the patient suffered from an infection, paresthesia or anesthesia. CONCLUSION Hence, Nd: YAG laser was found to be effective in ablating leukoplakia. It is convenient, economical with minimum complications and morbidities.
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Affiliation(s)
- Somdipto Das
- Department of Head and Neck Oncology, Mazumdar Shaw Cancer Centre, Narayana Hrudalaya, Bengaluru, Karnataka, India
| | - Shadab Mohammad
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vibha Singh
- Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shalini Gupta
- Department of Oral and Maxillofacial Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
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The treatment of oral leukoplakia with the CO2 laser: A retrospective study of 65 patients. J Craniomaxillofac Surg 2015; 43:677-81. [PMID: 25913630 DOI: 10.1016/j.jcms.2015.03.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 01/21/2015] [Accepted: 03/18/2015] [Indexed: 02/04/2023] Open
Abstract
The use of CO2 laser has become a routine procedure for the treatment of oral leukoplakia. In this retrospective study, we evaluated 65 patients with oral leukoplakia treated with CO2 laser vaporization. The main location was the tongue (n = 21/65, 32.3%). The initial biopsy showed mild/moderate dysplasia in almost half the patients (n = 29, 44.6%) and hyperplasia without dysplasia in around a third of the patients (n = 21, 32.3%). The recurrence and malignant transformation rates were 33.8% (n = 22) and 15.4% (n = 10), respectively. The follow-up mean (standard deviation) was 15.0 (10.6) months. The procedure-related complications rate was 7.7% (n = 5). The Kaplan-Meier curves for time to recurrence showed differences only for gingiva lesions compared to tongue lesions (log rank, p = 0.032). Malignant leukoplakia transformation is independent of treatment, although it seems advisable to treat leukoplakia with or without dysplasia.
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Akbulut N, Kursun ES, Tumer MK, Kamburoglu K, Gulsen U. Is the 810-nm diode laser the best choice in oral soft tissue therapy? Eur J Dent 2014; 7:207-211. [PMID: 24883028 PMCID: PMC4023194 DOI: 10.4103/1305-7456.110174] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: To evaluate the safety and efficacy of an 810-nm diode laser for treatment of benign oral soft tissue lesions. Materials and Methods: Treatment with the 810-nm diode laser was applied to a group of eighteen patients with pathological frenulum and epulis fissuratum; five patients with oral lichen planus, oral leukoplakia, and mucous membrane pemphigoid; and four patients with pyogenic granuloma. Results: Although the conventional surgery wound heals in a fairly short time, in the present study, the simple oral soft tissue lesions healed within two weeks, the white and vesiculobullous lesions healed completely within six weeks, and the pyogenic granuloma lesions healed within four weeks. Any complication was treated by using the 810-nm diode laser. Conclusions: Patient acceptance and satisfaction, without compromising health and function, have been found to be of a high degree in this present study. Thus, we can say that the use of the 810-nm diode laser may indeed be the best choice in oral soft tissue surgery.
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Affiliation(s)
- Nihat Akbulut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Gaziosmanpasa, Tokat, Turkiye
| | - E Sebnem Kursun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkiye
| | - M Kemal Tumer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Gazi, Ankara, Turkiye
| | - Kivanc Kamburoglu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkiye
| | - Ugur Gulsen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkiye
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Nazeer SS, Asish R, Venugopal C, Anita B, Gupta AK, Jayasree RS. Noninvasive assessment of the risk of tobacco abuse in oral mucosa using fluorescence spectroscopy: a clinical approach. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:057013. [PMID: 24870273 DOI: 10.1117/1.jbo.19.5.057013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 05/01/2014] [Indexed: 06/03/2023]
Abstract
Tobacco abuse and alcoholism cause cancer, emphysema, and heart disease, which contribute to high death rates, globally. Society pays a significant cost for these habits whose first demonstration in many cases is in the oral cavity. Oral cavity disorders are highly curable if a screening procedure is available to diagnose them in the earliest stages. The aim of the study is to identify the severity of tobacco abuse, in oral cavity, as reflected by the emission from endogenous fluorophores and the chromophore hemoglobin. A group who had no tobacco habits and another with a history of tobacco abuse were included in this study. To compare the results with a pathological condition, a group of leukoplakia patients were also included. Emission from porphyrin and the spectral filtering modulation effect of hemoglobin were collected from different sites. Multivariate analysis strengthened the spectral features with a sensitivity of 60% to 100% and a specificity of 76% to 100% for the discrimination. Total hemoglobin and porphyrin levels of habitués and leukoplakia groups were comparable, indicating the alarming situation about the risk of tobacco abuse. Results prove that fluorescence spectroscopy along with multivariate analysis is an effective noninvasive tool for the early diagnosis of pathological changes due to tobacco abuse.
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Affiliation(s)
- Shaiju S Nazeer
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Biophotonics and Imaging Laboratory, Poojappura, Thiruvananthapuram 695 012, Kerala, IndiabMar Ivanios College, Department of Physics, Thiruvananthapuram 695 01
| | - Rajashekharan Asish
- Government Dental College, Department of Oral Medicine and Radiology, Thiruvananthapuram 695 011, Kerala, India
| | - Chandrashekharan Venugopal
- Government Dental College, Department of Oral Medicine and Radiology, Thiruvananthapuram 695 011, Kerala, IndiadGeneral Hospital, Kerala Health Services, Trivandrum, Kerala, India
| | - Balan Anita
- Government Dental College, Department of Oral Medicine and Radiology, Thiruvananthapuram 695 011, Kerala, IndiaeGovernment Dental College, Department of Oral Medicine and Radiology, Kozhikkode 673 008, Kerala, India
| | - Arun Kumar Gupta
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Biophotonics and Imaging Laboratory, Poojappura, Thiruvananthapuram 695 012, Kerala, IndiafNational Institute of Mental Health and Neuro Sciences, Department of
| | - Ramapurath S Jayasree
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Biomedical Technology Wing, Biophotonics and Imaging Laboratory, Poojappura, Thiruvananthapuram 695 012, Kerala, India
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Er,Cr:YSGG laser therapy for oral leukoplakia minimizes thermal artifacts on surgical margins: a pilot study. Lasers Med Sci 2013; 28:1591-7. [DOI: 10.1007/s10103-013-1266-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 01/07/2013] [Indexed: 01/21/2023]
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Meister J, Franzen R, Eyrich G, Bongartz J, Gutknecht N, Hering P. First clinical application of a liquid-core light guide connected to an Er:YAG laser for oral treatment of leukoplakia. Lasers Med Sci 2010; 25:669-73. [PMID: 20393767 DOI: 10.1007/s10103-010-0782-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Accepted: 03/23/2010] [Indexed: 11/27/2022]
Abstract
For medical applications, erbium lasers are usually equipped with articulated mirror arms or special glass fibers. However, only with mirror arms is it so far possible to transmit high average powers or pulse energies in the region of 1 J to achieve suitable energy densities for fast tissue preparation. An alternative to the glass fiber systems mentioned above are liquid-core light guides. An extremely flexible liquid-core light guide was used to connect a dental Er:YAG laser system to an especially adapted dental laser applicator. The core liquid was continuously circulated during laser irradiation to transmit pulse energies up to 1.1 J. A modified laser handpiece was used for exemplary clinical treatment. The experimental setup with the highly flexible light guide was completed successfully, and its ease of handling for a dental surgeon was demonstrated in the clinical treatment of leukoplakia of the oral cheek mucosa. Complete ablation of the epithelium with the laser was performed. One year postoperatively, the patient remains disease-free. This article describes the technical realization of a liquid-core light guide system for medical applications. We report about the first successful clinical treatment of oral hyperkeratosis using this new light guide technology.
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Affiliation(s)
- Jörg Meister
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Medical Faculty, RWTH Aachen University, Aachen, Germany.
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Romeo U, Palaia G, Del Vecchio A, Tenore G, Gambarini G, Gutknecht N, De Luca M. Effects of KTP laser on oral soft tissues. An in vitro study. Lasers Med Sci 2010; 25:539-43. [PMID: 20162316 DOI: 10.1007/s10103-010-0756-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Accepted: 01/15/2010] [Indexed: 12/12/2022]
Abstract
A biopsy is a surgical procedure performed to establish a clear diagnosis of a lesion in order to clarify a clinical diagnostic suspicion. During a biopsy procedure it is fundamental to maintain safe and readable cut margins in order to permit histological visualization of possible marginal infiltrations or malignant transformation of a lesion. The aim of this study was to evaluate the histological peripheral damage caused by application of a KTP (potassium titanium phosphate) laser during oral soft tissue biopsy procedures. A KTP laser (lambda 532 nm) at different power settings and fluences was used to obtain 45 samples from pig cadaver tongues. The samples were then subdivided into five groups of nine samples each. A final specimen was taken by scalpel as a control. All samples were put into test tubes containing 10% buffered formalin solution, and were examined separately under an optical microscope by two pathologists to evaluate the peripheral thermal damage induced by the laser. In all specimens the cut edges of the incision were free from histological artefacts, especially when lower settings were applied. Statistical analysis showed no differences among the groups. The KTP laser demonstrated surgical effectiveness and caused little peripheral damage to the cut edges, and therefore would always allow a safe histological diagnosis to be obtained.
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Affiliation(s)
- Umberto Romeo
- Department of Odontostomatological Science, Sapienza University of Rome, Viale Regina Elena 287a, 00168, Rome, Italy.
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