1
|
Vilar-Villanueva M, Somoza-Martín JM, Blanco-Carrión A, García-García A, García-Carnicero T, Marichalar-Mendía X, Gallas-Torreira M, Gándara-Vila P. Importance of the vaporization margin during CO 2 laser treatment of oral leukoplakia: A survival study. Oral Dis 2023; 29:2689-2695. [PMID: 35942539 DOI: 10.1111/odi.14345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/16/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The main purpose of this study was to assess the response of oral leukoplakia to CO2 laser vaporization treatment, as well as determining possible factors that may affect recurrence of lesions. MATERIALS AND METHODS A retrospective study was conducted, in which the medical records of patients who had been clinically and histologically diagnosed with oral leukoplakia and treated with CO2 laser between 1996 and 2019 at the Oral Medicine Teaching Unit of the Faculty of Dentistry of the University of Santiago de Compostela were reviewed. RESULTS Fifty-eight patients were included: 36 female and 22 male subjects, with a mean age of 63.7 years old (SD ±13.1). The average follow-up time was 57.5 months (SD ±57.9). A relapse rate of 52.6% was determined. Of all the studied variables, the margin was the only one for which a statistically significant association with recurrence of lesions was demonstrated (p < 0.05). CONCLUSION The vaporization of lesions using CO2 laser with a safety margin of at least 3 mm from the clinical limits of OL is a key factor in preventing recurrence.
Collapse
Affiliation(s)
- Marta Vilar-Villanueva
- Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Manuel Somoza-Martín
- Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Tamara García-Carnicero
- Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Xabier Marichalar-Mendía
- Department of Nursing I, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
- Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
- Osakidetza, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
| | - Mercedes Gallas-Torreira
- School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
2
|
Nayak DR, Balakrishnan R, Dalakoti P, Bhanu U, Nair S, Poojary K. KTP 532 Laser Assisted Surgery for Oral Cavity Malignancy-A Retrospective Study. Indian J Otolaryngol Head Neck Surg 2023; 75:416-419. [PMID: 37275071 PMCID: PMC10235248 DOI: 10.1007/s12070-022-03214-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 09/24/2022] [Indexed: 11/18/2022] Open
Abstract
Aims and Objective To determine the effectiveness of KTP 532 in surgically treating early and early advanced oral malignancy with no surgical reconstruction of primary site. Materials and methods It is a retrospective study of 67 cases operated between 2000 to 2013 including T1, T2 and Early T3 cases, approved by ethical committee. All the cases underwent Laser assisted excision of tumour with or without Neck Dissection or Adjuvant Radiotherapy. Age of the cases varied from 20 to 80 years with mean age of 49 years. 47 cases were males and 20 were females. 26 cases in the study had neck nodes clinically whereas 41 cases had N0 status. Neck dissection was done (SOND or MRND) in 61 cases. In 6 cases (N0) no neck dissection was done. Results 61 cases had no loco-regional residual disease on their last follow up. Six cases had loco-regional recurrence within 6 months and salvage surgery was done. The overall mean survival was 81 months (92, 82 and 71 months in Stage I, II,III respectively). 3 year disease free survival rate was 91% as calculated using Kaplan- Meier Scale. In all these cases tumour was excised with KTP 532 laser and no reconstruction was done. Wound was allowed to heal with secondary intention. Conclusion Laser assisted excision of oral malignancy is an alternative to conventional treatment with more precision, less morbidity, shorter hospital stay and better functional outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03214-x.
Collapse
Affiliation(s)
- Dipak Ranjan Nayak
- Former Professor and Head of Department, Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - R. Balakrishnan
- Professor , Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - Pooja Dalakoti
- Assistant Professor, Dept of Otorhinolaryngology- Head and Neck Surgery, Government Medical College, Haldwani, India
| | - Uday Bhanu
- Former Junior Resident, Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - Suraj Nair
- Former Junior Resident, Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| | - Kailesh Poojary
- Professor , Dept of Otorhinolaryngology- Head and Neck Surgery, Kasturba Medical College, Manipal, India
| |
Collapse
|
3
|
Tan YQ, Li ZT, Zhou G. Developmental synergism in the management of oral potentially malignant disorders. Photodiagnosis Photodyn Ther 2023; 42:103563. [PMID: 37031901 DOI: 10.1016/j.pdpdt.2023.103563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 03/21/2023] [Accepted: 04/07/2023] [Indexed: 04/11/2023]
Abstract
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the oral cavity or lips. The unifying theme of OPMDs is their potential risk for cancer development. Therefore, the primary objective of the management should be to prevent carcinogenesis. Beyond diagnosis, current strategies for the management of OPMDs predominantly include non-surgical and surgical interventions and a "watch-and-see" approach, such as disease monitoring or surveillance, and preventive strategies. Though no optimal clinical treatment has gained universal approval for reducing or preventing malignant development of OPMDs. Therefore, an urgent need exits for improved treatment properties and effective predictive markers for OPMDs treatment. This review aims to outline recent synergism regarding to the management of OPMDs. Developing new technologies and improved application parameters to promote the treatment efficacy and a novel management prescription approach to OPMDs are proposed.
Collapse
Affiliation(s)
- Ya-Qin Tan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei- MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Zheng-Tao Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei- MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei- MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| |
Collapse
|
4
|
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: 14] [Impact Index Per Article: 3.5] [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.
Collapse
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
| |
Collapse
|
5
|
Malignant transformation of oral leukoplakia treated with carbon dioxide laser: a meta-analysis. Lasers Med Sci 2018; 34:209-221. [DOI: 10.1007/s10103-018-2674-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/25/2018] [Indexed: 01/11/2023]
|
6
|
Cloitre A, Rosa RW, Arrive E, Fricain JC. Outcome of CO2 laser vaporization for oral potentially malignant disorders treatment. Med Oral Patol Oral Cir Bucal 2018; 23:e237-e247. [PMID: 29476671 PMCID: PMC5911355 DOI: 10.4317/medoral.21984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 12/04/2017] [Indexed: 11/23/2022] Open
Abstract
Background Oral cancer is a public health issue worldwide. Oral potentially malignant disorders (OMPDs) are lesions of the oral mucosa that are predisposed to malignant transformation. The mainstay of OMPDs treatment around the world is now the carbon dioxide (CO2) laser but the reported recurrence and malignant transformation rates vary widely in the literature. We aimed to estimate the recurrence and the malignant transformation rates of OPMDs treated with CO2 laser at the University Hospital of Bordeaux, in France, from 2010 to 2014, and to identify associated factors with recurrence or malignant transformation. Material and Methods We conducted a retrospective study in patients with a minimum follow-up of 12 months. Collected variables included characteristics of the patients (gender, age, alcohol and tobacco consumption, previous diagnosis of graft-versus-host disease, previous treatments for OPMD or for upper aerodigestive tract cancers and human immunodeficiency virus infection), characteristics of the lesions (form, colour, size, location, degree of dysplasia), laser treatment outcome (complications, recurrence, malignant transformation). Results Twenty-five patients were included. Mean follow-up was 28.9 months. Recurrence was observed in 11 patients (44%). Annual recurrence rate was 18.3% and annual malignant transformation rate was 1.7%. Hyperplasia without dysplasia was the only factor found to be statistically associated with recurrence. Conclusions Our results suggest that OMPDs treated by CO2 laser vaporization have high recurrence rates, particularly those presenting hyperplasia. A standardized definition of recurrence would be necessary for inter-study comparisons. Long-term follow-up is recommended in order to detect and treat squamous cell carcinoma in its early stages. Key words:CO2 lasers, precancerous conditions, malignant transformation, oral cancer, recurrence.
Collapse
Affiliation(s)
- A Cloitre
- Université de Nantes UFR d'Odontologie, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France,
| | | | | | | |
Collapse
|
7
|
Monteiro L, Barbieri C, Warnakulasuriya S, Martins M, Salazar F, Pacheco JJ, Vescovi P, Meleti M. Type of surgical treatment and recurrence of oral leukoplakia: A retrospective clinical study. Med Oral Patol Oral Cir Bucal 2017; 22:e520-e526. [PMID: 28809365 PMCID: PMC5694172 DOI: 10.4317/medoral.21645] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 02/19/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Oral leukoplakia (OL) is the most typical potentially malignant disorder of the oral mucosa. We aimed to evaluate the clinical outcome of oral leukoplakia treated with several types of lasers and with the use of quantic molecular resonance (QMR) lancet, in terms of recurrence rate. MATERIAL AND METHODS Eighty-seven previously untreated OL (52 occurring in females and 35 in males, mean age of 59.4 ± 13.9 years) were consecutively submitted to surgical treatment at University Hospital of Parma, Italy, and Hospital de Valongo, Portugal, (1999 to 2012). Interventions were subclassified into 5 groups according to the instrument used for the surgical removal of OL (cold blade - 17; Nd:YAG 1064nm laser - 14; Er:YAG 2940nm laser - 33; CO2 10600nm laser - 15; and QMR scalpel - 8). The mean follow-up period after treatment was 21.6 months (range 1-151 months). The outcome of treatment was scored through the same clinical protocol in the two participating units. Statistical analysis were carried by univariate analysis using chi-square test (or Pearson's test when appropriate). RESULTS Recurrences were observed in 24 cases of OL (27.6%). Malignant transformation occurred in one patient (1.1%) after a period of 35 months. Statistical comparison of the 5 surgical treatment modalities showed no differences in clinical outcomes nor in the recurrence rate of OL. However, when Er:YAG laser group was compared with traditional scalpel, a significantly better outcome in cases treated with Er:YAG laser (P = 0.015) was highlighted. CONCLUSIONS Our results suggests that Er:YAG laser could be a promising option for the treatment of OL.
Collapse
Affiliation(s)
- L Monteiro
- Medicine and Oral Surgery Department, Instituto Univesitário de Ciências da Saúde, Rua Central de Gandra, 1317, 4585-116 Gandra PRD, Portugal,
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Koss SL, Baxter P, Panossian H, Woo P, Pitman MJ. Serial in-office laser treatment of vocal fold leukoplakia: Disease control and voice outcomes. Laryngoscope 2017; 127:1644-1651. [DOI: 10.1002/lary.26445] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 10/18/2016] [Accepted: 11/08/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Shira L. Koss
- Department of Otolaryngology-Head and Neck Surgery; New York Eye and Ear Infirmary of Mount Sinai
| | - Peter Baxter
- Department of Otolaryngology-Head and Neck Surgery; Mount Sinai Medical Center
| | - Haig Panossian
- Department of Otolaryngology-Head and Neck Surgery; Mount Sinai Medical Center
| | - Peak Woo
- Department of Otolaryngology-Head and Neck Surgery; Mount Sinai Medical Center
| | - Michael J. Pitman
- Department of Otolaryngology-Head and Neck Surgery; Voice and Swallowing Institute, Columbia University Medical Center; New York New York U.S.A
| |
Collapse
|
9
|
Gönen ZB, Yılmaz Asan C, Etöz O, Alkan A. Oral leukoplakia associated with amalgam restorations. J Oral Sci 2016; 58:445-8. [PMID: 27665986 DOI: 10.2334/josnusd.16-0071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The World Health Organization has defined oral leukoplakia (OL) as "a white patch or plaque of the oral mucosa that cannot be characterized clinically or pathologically as any other disease". A 21-year-old male with OL presented with a bilateral burning sensation in the buccal mucosa. The patient had amalgam restorations, and an epicutaneous patch test indicated a positive response to amalgam. The amalgam restorations were therefore removed and the cavities were refilled with a composite resin restorative material. During 5 years of follow-up, there was no recurrence of the oral lesions. This case illustrates that amalgam fillings may cause OL lesions. (J Oral Sci 58, 445-448, 2016).
Collapse
Affiliation(s)
- Zeynep B Gönen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University
| | | | | | | |
Collapse
|
10
|
Mogedas-Vegara A, Hueto-Madrid JA, Chimenos-Küstner E, Bescós-Atín C. Oral leukoplakia treatment with the carbon dioxide laser: A systematic review of the literature. J Craniomaxillofac Surg 2016; 44:331-6. [PMID: 26920045 DOI: 10.1016/j.jcms.2016.01.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 12/21/2015] [Accepted: 01/27/2016] [Indexed: 10/22/2022] Open
Abstract
We conducted a systematic review of the literature to evaluate treatment of oral leukoplakia with the carbon dioxide (CO2) laser. A comprehensive search of studies published between 1981 and 2015 and listed in the PubMed (National Library of Medicine, NCBI) database yielded 378 articles which were screened in detail. Relevant studies were selected according to predetermined inclusion and exclusion criteria. A total of 33 articles met the final inclusion criteria and were analysed in detail in accordance with the PRISMA-P statement. These full-text papers were classified as synopses (n = 7), recurrence and malignant transformation studies (n = 17), comparative studies between CO2 laser and cold knife surgery (n = 3) and studies evaluating the efficacy of CO2, Nd:YAG and KTP lasers. According to the literature the CO2 laser is the workhorse of oral leukoplakia treatment due to its effectiveness and low associated morbidity. However, randomized clinical trials are needed to compare CO2 laser with other lasers. The results of our systematic review showed that there is no consensus regarding the factors involved in higher recurrence and malignization rates, so further studies are needed.
Collapse
Affiliation(s)
- Alfonso Mogedas-Vegara
- Oral and Maxillofacial Department, Vall D'Hebron University Hospital, Universidad Autónoma de Barcelona, Passeig de la Vall D'Hebron 119-129, 08035 Barcelona, Spain.
| | - Juan-Antonio Hueto-Madrid
- Oral and Maxillofacial Department, Vall D'Hebron University Hospital, Universidad Autónoma de Barcelona, Passeig de la Vall D'Hebron 119-129, 08035 Barcelona, Spain
| | - Eduardo Chimenos-Küstner
- Oral Medicine, Oral Pathology, Oral Surgery Department, Universidad de Barcelona, Feixa Llarga s/n, L'Hospitalet Ll., 08907 Barcelona, Spain
| | - Coro Bescós-Atín
- Oral and Maxillofacial Department, Vall D'Hebron University Hospital, Universidad Autónoma de Barcelona, Passeig de la Vall D'Hebron 119-129, 08035 Barcelona, Spain
| |
Collapse
|
11
|
Kalavrezos N, Scully C. Mouth Cancer for Clinicians Part 6: Potentially Malignant Disorders. ACTA ACUST UNITED AC 2016; 42:866-8, 871-4, 877. [PMID: 26749794 DOI: 10.12968/denu.2015.42.9.866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. CLINICAL RELEVANCE This article offers the dental team an overview of oral potentially malignant disorders.
Collapse
|
12
|
Clinical investigation of carbon dioxide laser treatment for lingual leukoplakia. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2015.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
13
|
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.
Collapse
|
14
|
Affiliation(s)
- T Yap
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - M McCullough
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| |
Collapse
|
15
|
Rani V, McCullough M, Chandu A. Assessment of laminin-5 in oral dysplasia and squamous cell carcinoma. J Oral Maxillofac Surg 2013; 71:1873-9. [PMID: 23891017 DOI: 10.1016/j.joms.2013.04.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 04/25/2013] [Accepted: 04/27/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE Laminin-5 is an important protein in the establishment of an intact basement membrane. The aims of this study were to assess the expression of laminin-5 (γ2 chain) using cyclin D1 and Ki-67 in hyperplastic oral mucosal lesions, oral dysplasia, and squamous cell carcinoma (SCC). MATERIALS AND METHODS Paraffin-embedded tissue blocks of 134 patients were stained for laminin-5, cyclin D1, and Ki-67 using immunohistochemistry and assessed by virtual microscopy. Statistical analysis was performed using Kruskal-Wallis tests and Mann-Whitney U tests for post hoc assessment. RESULTS Laminin-5, cyclin D1, and Ki-67 were found to have significant differences in expression for the different categories of dysplasia, SCC, and hyperplasia (P < .001). Cyclin D1 and Ki-67 expression levels were significantly increased in moderate and severe dysplasia and SCC, with no significant difference in expression between hyperplasia and mild dysplasia or between biopsies of severe dysplasia and SCC. Laminin-5 expression was only significantly increased in SCC, confirming it as a marker of malignant transformation and invasion. CONCLUSIONS The results of this study indicate that overexpression of laminin-5 is found only in SCC and not dysplastic lesions. Therefore, laminin-5 has potential as a marker for the intraoperative assessment of cancer excision margins and could be used as a target for chemotherapeutic agents.
Collapse
Affiliation(s)
- Vidya Rani
- Research Fellow, Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | | | | |
Collapse
|
16
|
How should we manage oral leukoplakia? Br J Oral Maxillofac Surg 2012; 51:377-83. [PMID: 23159193 DOI: 10.1016/j.bjoms.2012.10.018] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 10/26/2012] [Indexed: 11/20/2022]
Abstract
The aim of this article is to review the management of oral leukoplakia. The topics of interest are clinical diagnosis, methods of management and their outcome, factors associated with malignant transformation, prognosis, and clinical follow-up. Global prevalence is estimated to range from 0.5 to 3.4%. The point prevalence is estimated to be 2.6% (95% CI 1.72-2.74) with a reported rate of malignant transformation ranging from 0.13 to 17.5%. Incisional biopsy with scalpel and histopathological examination of the suspicious tissue is still the gold standard for diagnosis. A number of factors such as age, type of lesion, site and size, dysplasia, and DNA content have been associated with increased risk of malignant transformation, but no single reliable biomarker has been shown to be predictive. Various non-surgical and surgical treatments have been reported, but currently there is no consensus on the most appropriate one. Randomised controlled trials for non-surgical treatment show no evidence of effective prevention of malignant transformation and recurrence. Conventional surgery has its own limitations with respect to the size and site of the lesion but laser surgery has shown some encouraging results. There is no universal consensus on the duration or interval of follow-up of patients with the condition.
Collapse
|
17
|
Brouns EREA, Baart JA, Karagozoglu KH, Aartman IHA, Bloemena E, van der Waal I. Treatment results of CO2laser vaporisation in a cohort of 35 patients with oral leukoplakia. Oral Dis 2012; 19:212-6. [DOI: 10.1111/odi.12007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 07/25/2012] [Accepted: 07/29/2012] [Indexed: 11/29/2022]
Affiliation(s)
- EREA Brouns
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - JA Baart
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - KH Karagozoglu
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - IHA Aartman
- Department of Social Dentistry and Behavioural Sciences; Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - E Bloemena
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
- Department of Pathology; VU University Medical Center (VUmc); Amsterdam The Netherlands
| | - I van der Waal
- Department of Oral and Maxillofacial Surgery and Oral Pathology; VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| |
Collapse
|
18
|
Wojdas A, Szczygielski K, Kosek J, Ratajczak J, Jurkiewiczc D. [The application of KTP laser in otolaryngology - 3 years experience]. Otolaryngol Pol 2012; 65:281-4. [PMID: 22000146 DOI: 10.1016/s0030-6657(11)70691-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Accepted: 05/10/2011] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The KTP laser is popularly called the green laser is a type of Nd: YAG laser zawdzięczający its name from the additional element of KTP crystal which is a wavelength of 532 nm. AIM The aim of this paper is to present our 3-year experience in the application of KTP laser in otolaryngology. MATERIAL In the Department of Otolaryngology, CSK MON Military Medical Institute in Warsaw from 2008, performed 211 operations using the green laser. The study group was 89 women and 122 men aged 12 to 94 years (mean age 53.2 years). METHODS The surgery was performed 15-watt KTP Aura laser. All guestrooms are fibers with a diameter of 0.2, 0.4 and 0.6 mm, and guides for inserting the fiber ends are not. Results: In 3-year period have made a 211 KTP laser surgery including the nasal cavity, mouth, larynx and trachea, and the outer ear. In the procedure adopted one day 76 people, and at least 111 patients stayed in hospital for 4 days. RESULTS In our material patients after UPPP tonsillectomy and operations, in addition to a negligible bleeding during surgery, rarely also had late bleeding (5%). In our clinic konchoplastyki performed based on the so-called. technique of “cross-hatching”. The laryngeal endoscopic surgery is used micromanipulator, if we are to remove a large tumor of the larynx much better to use the guide laryngeal. CONCLUSIONS The KTP laser is an important tool in the operational procedures in otolaryngology in large part due to the high activity and its complexity hemostatycznemu assistant. Become familiar with the operation of the laser and improvement of surgical techniques allows patients to propose a modern surgical procedures. Improves the possibility of radical treatment of tumors of the larynx endoscopic method.
Collapse
Affiliation(s)
- Andrzej Wojdas
- Klinika Otolaryngologiczna, Wojskowy Instytut Medyczny w Warszawie.
| | | | | | | | | |
Collapse
|
19
|
Lo J, McNaughtan J, Rani V, Maric D, Smith A, McCullough M, Chandu A. An immunohistochemical analysis of cell cycle markers in oral mucosal dysplastic lesions treated by laser therapy. A pilot study. J Maxillofac Oral Surg 2011; 10:190-4. [PMID: 22942585 DOI: 10.1007/s12663-011-0211-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 03/20/2011] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Over the past 15 years, dysplastic oral mucosal lesions have been treated by laser ablation with variable success. A recent study have shown that the type of laser utilized may be important for patient outcome, however, it may also be changes at a cellular level that could be an important factor in determining recurrence outcome. The aims of this study were to assess cellular markers related to oral dysplastic lesions treated by two different laser types. METHODS AND MATERIALS Twenty patients with a histopathological diagnosis of dysplasia treated with laser ablation between the years 1992 and 2003 were assessed. Tissue blocks of the original diagnostic biopsy specimens were stained with specific cell cycle markers (Cyclin-D1 and Ki67) via immunohistochemistry and presence of the marker were analysed by virtual microscopy. Patients were assessed according to grade of dysplasia [(mild vs. moderate vs. severe) and the type of laser used (Potassium Titanyl Phosphate (KTP) vs. Carbon Dioxide (CO(2))]. RESULTS No significant difference in Cyclin-D1 and Ki67 levels were found between the two groups with different grades of dysplasia, however, decreased Cyclin-D1 was found in those patients treated with KTP laser (P = 0.028). CONCLUSIONS The findings of the present study may indicate cell cycle makers such as Cyclin-D1, may be responsible for the behaviour of dysplastic lesions treated with laser therapy, rather than the type of laser itself, which was reported in previous studies.
Collapse
|
20
|
Abstract
Advances in technology are changing the ways that patients experience dental treatment. Technology helps to decrease treatment time and makes the treatment more comfortable for the patient. One technological advance is the use of lasers in dentistry. Lasers are providing more efficient, more comfortable, and more predictable outcomes for patients. Lasers are used in all aspects of dentistry, including operative, periodontal, endodontic, orthodontic, and oral and maxillofacial surgery. Lasers are used for soft and hard tissue procedures in the treatment of pathologic conditions and for esthetic procedures. This article discusses how lasers work and their application in the various specialties within dentistry.
Collapse
Affiliation(s)
- James Green
- Oral and Maxillofacial Surgery, The Brooklyn Hospital Center, 121 Dekalb Avenue, Brooklyn, NY 11201, USA.
| | | | | |
Collapse
|
21
|
|