Complications of CO(2) laser procedures in oral and maxillofacial surgery

Oral Pre-malignancy: An Update on Novel Therapeutic Approaches

PURPOSE OF REVIEW

This review aims to provide a comprehensive overview of the current advances in managing and preventing progression of oral potentially malignant disorders (OPMDs), focusing on their histological and clinicopathological features, and management.

RECENT FINDINGS

Recent studies, including a multicenter cross-sectional study, have identified oral leukoplakia as the most prevalent form of OPMD, comprising over half of the cases examined. Advances in histological grading, specifically the World Health Organization's three-tier system (mild, moderate, and severe dysplasia), have significantly enhanced the accuracy of risk assessment for malignant transformation. Additionally, treatments such as surgical interventions, photodynamic therapy, and chemopreventive and molecularly targeted agents are being evaluated for their safety and efficacy as well as, immune checkpoint inhibitors being evaluated as potential preventive strategies to halt the progression of OPMDs. The management of OPMDs remains challenging due to the lack of standardized screening protocols and varied clinical management approaches. Despite this, recent advancements in diagnostic grading and therapeutic interventions provide a framework for improved treatment outcomes. Continued research into the molecular and cellular mechanisms driving development and progression of OPMDs and innovative treatment trials are essential to optimize strategies that prevent malignant progression and thereby reduce the global health burden of oral cancer.

Excision of Different Oral Benign Exophytic Lesions With a Diode Laser: A Clinical Case Series

Introduction: Lasers are becoming the standard of care for many dental procedures, and are being introduced as a high-tech instrument. They are also becoming more routine in dentistry through the advent of office-based lasers, which are also simple to use within the oral cavity. Many studies have shown the competencies of laser technology for the management of benign oral lesions as these techniques allow for painless and bloodless oral surgery. Cases Report: Nine patients attending the Department of oral and maxillofacial Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran, underwent laser outpatient procedures for the surgical removal of a wide range of benign oral lesions. Regarding the history, present illnesses and clinical figures of all reported cases, the clinician ensured that the lesions were benign and after taking informed consent from every patient, he did complete the excision of lesions with diode lasers. Following the injection of local anesthesia, an 810 nm diode laser was applied for the excisional biopsy of oral lesions. The specimens were sent for histopathological evaluations and the patients were assessed on intraoperative and postoperative complications. The patients were followed up for postoperative complications at one week and 2 weeks post-treatment. Conclusions: According to our findings, a diode laser can be a choice for the outpatient treatment of oral mucosal benign lesions as this technique provides painless and almost bloodless treatment.

Complications following interventional laser surgery for oral cancer and precancerous lesions

Interventional carbon dioxide laser surgery is the preferred method to treat oral precancerous lesions and early invasive squamous cell carcinomas (SCCs). Little is known, however, about the complications that patients experience after such treatment. We retrospectively reviewed the hospital records of 82 patients with new dysplastic oral lesions or early invasive oral SCCs treated by laser surgery in the maxillofacial unit at Newcastle General Hospital. The most common postoperative complications were pain for more than two weeks after operation (n=28), bleeding (n=4), difficulties with speech (n=5), paraesthesia of the lingual nerve (n=17), difficulty swallowing (n=2), obstructive swelling of the submandibular gland (n=22), and tethering of the tongue (n=10). Overall, 78% of patients had one or more complication. In the absence of randomised controlled trials, this study provides the best available evidence for complication rates following interventional surgery. In addition to aiding in the preoperative counselling of patients, the data will help to inform and advise patients particularly during the immediate postoperative period.

Use of the CO(2) laser on orthodontic patients suffering from gingival hyperplasia

OBJECTIVE

The present study aimed to assess the effect of the use of the CO(2) laser on the treatment of gingival hyperplasia in orthodontic patients wearing fixed appliances.

BACKGROUND DATA

Gingival hyperplasia is a condition very frequent in patients undergoing fixed orthodontic treatment. Amongst the treatments available for this is the use of surgical lasers.

METHODS

Ten patients entered this study and signed an informed consent. Seventy-five anterior teeth with gingival hyperplasia were selected for laser surgery. Prior to surgery, the length of the crowns were measured using a digital caliper, and depth of the pocket was probed. The hyperplasic gingival was removed with a CO(2) laser under local anesthesia. Immediately after surgery, measurement of the length of the crowns and probing were carried out and were repeated.

RESULTS

The results were statistically analyzed and significant differences were detected regarding the length of the crown (p = 0.000) and depth of the gingival sulcus (p = 0.000).

CONCLUSION

It is concluded that the use of the CO(2) laser was effective in the treatment of gingival hyperplasia.