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Asnaashari M, Behnam Roudsari M, Shirmardi MS. Evaluation of the Effectiveness of the Carbon Dioxide (CO2) Laser in Minor Oral Surgery: A Systematic Review. J Lasers Med Sci 2023; 14:e44. [PMID: 38028885 PMCID: PMC10658117 DOI: 10.34172/jlms.2023.44] [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: 04/20/2023] [Accepted: 08/15/2023] [Indexed: 12/01/2023]
Abstract
Introduction: Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues. The carbon dioxide (CO2) laser was one of the first soft tissue removal lasers. Because of the strong affinity of the CO2 laser to water, it is best used for removing, vaporizing, and coagulating these tissues. In minor oral surgery, CO2 laser therapy has shown advantages. Therefore, this study examined the CO2 laser use in minor oral soft tissue surgery. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in this study. A question for research encompassing the inclusion criteria for the participants, intervention, comparison, outcome, and study design (PICOS) was formulated. The search queries were entered into the PubMed/Medline, Scopus, and Embase databases. Consideration was given to publications published between January 1, 2018 and March 15, 2023. Results: The research included 37 studies after narrowing search results, eliminating duplicate titles, and conducting an eligibility review (three animal studies, seven case reports, three case series, and twenty-four clinical studies). CO2 lasers alone or in combination with other therapies successfully treated oral potentially malignant disorders (OPMDs), oral tumors, oral fibrous-epithelial lesions, gingival melanin hyperpigmentation, pyogenic granuloma, socket preservation, mucocele, high labial frenulum attachment, and so on. CO2 lasers reduced intra- and postoperative complications and adverse effects, improved postoperative functional results, ablated tissues with precision, and minimized disease recurrence and malignant transformation. Conclusion: Our study found that the CO2 laser in oral minor surgeries is successful, but further randomized clinical trials and multicenter studies are recommended to compare CO2 laser surgery to other treatments.
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Affiliation(s)
- Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Behnam Roudsari
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sadat Shirmardi
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Silva DFB, Verheul HCCRS, Agripino GG, Neto PA, Alves PM, de Melo DP, de Castro Gomes DQ. Diode laser on excision of giant peripheral odontogenic myxoma: a rare case report and literature review. Lasers Med Sci 2023; 38:38. [PMID: 36630018 DOI: 10.1007/s10103-023-03705-5] [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: 09/30/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
It was to report a rare case of peripheral odontogenic myxoma removed with high-power diode laser and to do an extensive review of studies of odontogenic cysts and tumors treated with high-power laser (HPL). This is a rare case of a 63-year-old male patient with a peripheral odontogenic myxoma measuring approximately 10 cm in the attached gingiva region of tooth 16 removed with a high-power diode laser (808 nm, 3 W, in continuous mode, under constant suction, with 400-µm optical fiber). A literature review was also carried out looking for articles that involved the use of HPL in the treatment of odontogenic cysts and tumors, without restriction of year or language. In the present case, there was no need for suturing, no postoperative discomfort, and minimal bleeding during the procedure. In a 12-month follow-up period, there were no signs of recurrence. Only two cases of intra-osseous odontogenic myxomas treated with HPL and 10 cases involving other odontogenic cysts and tumors were found. All studies showing HPL to be effective in treating these lesions. Despite the different types of lasers used and different parameters, it is observed that lasers are effective in the treatment of odontogenic lesions.
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Affiliation(s)
- Diego Filipe Bezerra Silva
- Post Graduate Program in Dentistry, State University of Paraíba, R. Baraúnas, 351, Bairro Universitário, Campina Grande, Paraiba, 58429-500, Brazil.
| | | | - Gustavo Gomes Agripino
- State University of Paraíba, Rua Cel. Pedro Targino, S/N, Araruna, Paraiba, 58233-000, Brazil
| | - Polion Araújo Neto
- State University of Paraíba, R. Baraúnas, 351, Bairro Universitário, Campina Grande, Paraiba, 58429-500, Brazil
| | - Pollianna Muniz Alves
- Post Graduate Program in Dentistry, State University of Paraíba, R. Baraúnas, 351, Bairro Universitário, Campina Grande, Paraiba, 58429-500, Brazil
| | - Daniela Pita de Melo
- Post Graduate Program in Dentistry, State University of Paraíba, R. Baraúnas, 351, Bairro Universitário, Campina Grande, Paraiba, 58429-500, Brazil
| | - Daliana Queiroga de Castro Gomes
- Post Graduate Program in Dentistry, State University of Paraíba, R. Baraúnas, 351, Bairro Universitário, Campina Grande, Paraiba, 58429-500, Brazil
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An In Vitro Study of the Effect of CO 2 Laser Power Output on Ablative Properties in Porcine Tongue. Life (Basel) 2023; 13:life13010162. [PMID: 36676111 PMCID: PMC9861084 DOI: 10.3390/life13010162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023] Open
Abstract
CO2 lasers have been generally used in oral soft-tissue surgery. Although an increase in power enhances the depth of ablation, the specific correlation between units of power and ablative depth has not been stated. This study aimed to explore ablative depth and width affected by a power unit of 10,600-nm CO2 laser continuous wave at 3 to 10 W in tissue blocks of the swine tongue. The 112 samples were randomly allocated into eight groups according to the power settings. The depth and width of the incision were measured by using the ImageJ program. The 3 W group showed the minimal depth of ablation [0.527 mm (0.474 and 0.817)] and width of ablation [0.147 mm (0.110 to 0.184)]. The maximal depth [3.750 mm (3.362 and 4.118)] and width [0.700 mm (0.541 to 0.860)] were in the 9 W group. The correlation between the ablative depth and power unit was 0.81 (p < 0.001). Based on the regression equation (p < 0.001), the ablative depth (mm) = (the power unit of laser in W × 0.491) − 0.731. In conclusion, the ablative depth of the CO2 laser on soft tissue was strongly correlated to power units enabling the prediction equation.
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Rosenthal M, Baser RE, Migliacci J, Boyle JO, Morris LGT, Cohen MA, Singh B, Shah JP, Wong RJ, Patel S, Ganly I. Flexible fiber-based CO 2 laser vs monopolar cautery for resection of oral cavity lesions: A single center randomized controlled trial assessing pain and quality of life following surgery. Laryngoscope Investig Otolaryngol 2021; 6:690-698. [PMID: 34401493 PMCID: PMC8356859 DOI: 10.1002/lio2.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/06/2021] [Accepted: 04/17/2021] [Indexed: 11/05/2022] Open
Abstract
IMPORTANCE This study reports the impact of laser surgery on quality of life in patients with oral cavity lesions. OBJECTIVE To compare postoperative pain and quality of life in patients treated with flexible fiberoptic CO2 laser vs electrocautery in patients with oral cavity precancerous lesions and early stage cancers. DESIGN Randomized controlled trial. SETTING Single center. PARTICIPANTS Patients with premalignant oral cavity lesions and early stage oral cancer. INTERVENTION Patients were randomized to have surgical resection using either flexible fiber carbon dioxide laser (Laser) or electrocautery (EC). The patients were then followed over a period of 28 days to assess for outcomes including pain, quality of life, performance status, return to work, and return to diet. Quality of life was measured by the University of Washington Quality of Life (UWQOL) questionnaire and the performance status score (PSS). MAIN OUTCOME MEASURE The primary endpoint for this study was the numerical pain rating on postoperative day (POD) 7. RESULTS Sixty-two patients were randomized (32 laser and 30 electrocautery). Lesions excised were carcinoma in 30(48%), dysplasia in 31(50%) and benign in 1(2%). There was no difference in the location of lesion, size of lesion, defect size, type of closure, resection time, and blood loss between Laser and EC arms. Patients who had Laser had less pain compared to EC (mean pain score on POD 7 L = 2.84 vs EC = 3.83, P = 0.11). better UW QOL scores and PSS scores, quicker return to normal diet (median days L = 26.0 vs EC = 28.5, P = 0.17) and faster return to work (median days L = 13.0 vs EC = 16.5, P = 0.14). However, these results were not statistically significant. CONCLUSION There was a trend for patients treated with laser to have less pain and better quality of life scores but these result were not statistically significant. Based on the actual observed difference, a large multicenter RCT with 90 patients in each arm is required to determine the clinical relevance of our results.
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Affiliation(s)
- Matthew Rosenthal
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Raymond E. Baser
- Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jocelyn Migliacci
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jay O. Boyle
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Luc G. T. Morris
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Marc A. Cohen
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Bhuvanesh Singh
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jatin P. Shah
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Richard J. Wong
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Snehal Patel
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Ian Ganly
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
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Korytowska M, Schwab G, Giglio D, Hirsch JM, Holmberg E, Kjeller G, Sand L, Wallström M, Öhman J, Braz-Silva P, Hasséus B. Patient-reported pain after surgical removal of leukoplakia - an observational 1-year follow-up study. Acta Odontol Scand 2021; 79:383-389. [PMID: 33476210 DOI: 10.1080/00016357.2020.1869826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Oral leukoplakia (OL) presents as a white lesion of the oral mucosa and is not typically associated with the sensation of pain. OL should be surgically removed when possible because it is considered a potentially malignant oral disorder (PMOD). This study assessed the pain sensations experienced by patients in association with the occurrence and surgical treatment of OL. METHODS Inclusion criteria were: a clinical diagnosis of OL; biopsy excision; and observation for at least 12 months in the ORA-LEU-CAN study. At the first visit, all the patients were asked about the occurrence of symptoms within the lesion. Ninety-four subjects were assessed over a period of 1 year. All patients underwent complete removal of OL. The patient cohort was divided into three sub-groups: (i) no pain before excision and at the 1-year follow-up; (ii) pain before excision; and (iii) pain at the 1-year follow-up. RESULTS Overall, pain was reported by 21.3% of the patients at the study start whereas 13.8% of the patients reported pain 1 year after surgical treatment. Patient-reported pain from the lesion at study inclusion was significantly associated with lesions found on the lateral side of the tongue (p=.002). Pain reported by patients one year after surgery was significantly related to female gender (p=.038) and the presence of epithelial cell dysplasia (p=.022). CONCLUSION We conclude that surgical removal of OL results in a low risk of long-term post-surgical pain. However, OL located on the lateral side of the tongue and in OL with dysplasia are more likely to be associated with pain.
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Affiliation(s)
- Magdalena Korytowska
- Clinic of Orofacial Medicine, Public Dental Service, NÄL Hospital, Uddevalla, Sweden
| | - Gabriela Schwab
- School of Medicine, Laboratory of Virology, Institute of Tropical Medicine of São Paulo, São Paulo, Brazil
| | - Daniel Giglio
- Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan-Micháel Hirsch
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University, Uppsala, Sweden
- Department of Research & Development, Public Dental Services Region Stockholm, Stockholm, Sweden
| | - Erik Holmberg
- Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Göran Kjeller
- Department of Oral and Maxillofacial Surgery, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Sand
- Department of Oral Biology, Faculty of Odontology, University of Oslo, Oslo, Norway
| | - Mats Wallström
- Department of Oral and Maxillofacial Surgery, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jenny Öhman
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Paulo Braz-Silva
- School of Medicine, Laboratory of Virology, Institute of Tropical Medicine of São Paulo, São Paulo, Brazil
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Bengt Hasséus
- Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinic of Oral Medicine, Public Dental Service, Gothenburg, Sweden
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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: 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.
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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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