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Ou M, Huang X. Histological evaluation of mouse tongue incisions after Er:YAG laser surgery with different pulse energies versus after conventional scalpel surgery. Lasers Med Sci 2023; 38:181. [PMID: 37568046 DOI: 10.1007/s10103-023-03852-9] [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: 02/25/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
PURPOSE To identify the surgical instrument that allows for optimal healing of tongue incisions. METHODS An Er:YAG laser was compared with different pulse energies to a conventional scalpel for the incision of mouse tongue tissues. Mice were sacrificed through cervical dislocation at 24, 48, and 72 h postoperatively, followed by extraction of their tongues for incision experiments. The healing of the incisions and expression of inflammation- and pain-related factors in the tongues were compared between the surgical procedure groups. RESULTS In laser-treated mice, tongue incisions healed the fastest when the laser output energy was 60 MJ per pulse. Macrophage chemotaxis toward the incisional area was triggered on the first postoperative day for the 60-MJ group, while the time for macrophage chemotaxis to the surgical area was later in the 80-MJ group. Tumor necrosis factor-alpha expression increased and then decreased in the 80-MJ group; however, it gradually decreased in the 60-MJ and conventional scalpel groups. Prostaglandin E2 expression increased and then decreased in the 80-MJ and conventional scalpel groups but gradually decreased in the 60-MJ group. The expression of transforming growth factor beta 1 gradually decreased in the 60-MJ and 80-MJ groups but gradually increased in the conventional scalpel group. CONCLUSION Compared with surgical procedures using conventional scalpels, those using an Er:YAG laser with appropriate pulse energies can inhibit inflammation in the incisional area and promote incision healing. The use of an Er:YAG laser with appropriate pulse energies can alleviate intraoperative and postoperative pain in the incisional area.
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Affiliation(s)
- Mingming Ou
- Department of Stomatology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Xiaofeng Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing, 100050, China.
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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.
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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
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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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Matulić N, Bago I, Sušić M, Gjorgievska E, Kotarac Knežević A, Gabrić D. Comparison of Er:YAG and Er,Cr:YSGG Laser in the Treatment of Oral Leukoplakia Lesions Refractory to the Local Retinoid Therapy. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:362-368. [PMID: 31081716 DOI: 10.1089/photob.2018.4560] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of this study was to compare the efficacy of Er:YAG and Er,Cr:YSGG laser in the treatment of oral leukoplakia refractory to conventional retinoid therapy. Materials and methods: The study sample consisted of 54 patients (16 men and 38 women) who were histopathologically diagnosed with oral leukoplakia that was refractory to conventional retinoid therapy. Patients were randomly allocated into two groups according to the type of the laser used for treatment of oral leukoplakia: Group 1. Er:YAG laser; Group 2. Er,Cr:YSGG laser. Patients were recalled at 6 months and 1 year after treatment to evaluate possible recurrence and assess the patients' postoperative quality of life. Results: After initial ablation, the degree of residual lesion was significantly greater in the Er:YAG laser group (74.1%), compared with the Er,Cr:YSGG group (18.5%) (p = 0.0001). Six months and 1 year after the second ablation, there was no lesion recurrence in either laser group. Fourteen days after the initial ablation, the visual analog scale (VAS) pain rating and the total oral health impact profile score fell significantly in both groups (p < 0.0001). However, in the Er,Cr:YSGG laser group, the average value of the VAS rating was significantly lower than in the Er:YAG laser group (p = 0.039). Conclusions: The Er:YAG and Er,Cr:YSGG lasers showed similar efficacy in the treatment of oral leukoplakia and resulted in full postoperative recovery without recurrence after 1 year of follow-up.
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Affiliation(s)
- Nena Matulić
- 1 School of Dental Medicine, Department of Oral Surgery, University of Zagreb, Zagreb, Croatia
| | - Ivona Bago
- 2 Department of Endodontics and Restorative Dentistry and School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Mato Sušić
- 3 Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Elizabeta Gjorgievska
- 4 Department of Pediatric and Preventive Dentistry, School of Dental Medicine, St Cyril and Methodius University in Skopje, Skopje, Macedonia
| | - Ana Kotarac Knežević
- 3 Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Dragana Gabrić
- 3 Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Arduino PG, Cafaro A, Cabras M, Gambino A, Broccoletti R. Treatment Outcome of Oral Leukoplakia with Er:YAG Laser: A 5-Year Follow-Up Prospective Comparative Study. Photomed Laser Surg 2018; 36:631-633. [DOI: 10.1089/pho.2018.4491] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Paolo Giacomo Arduino
- Oral Medicine Section, Department of Surgical Sciences, CIR–Dental School, University of Turin, Turin, Italy
| | - Adriana Cafaro
- Oral Medicine Section, Department of Surgical Sciences, CIR–Dental School, University of Turin, Turin, Italy
| | - Marco Cabras
- Oral Medicine Section, Department of Surgical Sciences, CIR–Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Oral Medicine Section, Department of Surgical Sciences, CIR–Dental School, University of Turin, Turin, Italy
| | - Roberto Broccoletti
- Oral Medicine Section, Department of Surgical Sciences, CIR–Dental School, University of Turin, Turin, Italy
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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.
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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,
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Broccoletti R, Cafaro A, Gambino A, Romagnoli E, Arduino PG. Er:YAG Laser Versus Cold Knife Excision in the Treatment of Nondysplastic Oral Lesions: A Randomized Comparative Study for the Postoperative Period. Photomed Laser Surg 2015; 33:604-9. [PMID: 26588688 DOI: 10.1089/pho.2015.3967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this prospective study was to estimate the effects of Erbium substituted: Yttrium Aluminium Garnet (Er:YAG) laser, compared with traditional scalpel, on the early postoperative sequelae of nondysplastic oral lesion removal. BACKGROUND DATA There is limited evidence that laser surgery could exhibit advantages over scalpel in oral mucosal surgery. METHODS The investigators studied a cohort of 344 patients; 394 lesions were randomized and treated. Outcome statistically evaluated variables were: age, gender, the site and size of investigated lesions, visual analogue score (VAS) of pain, the Oral Health Impact Profile questionnaire (OHIP-14) and the Quality of Life test (QOL), and number of analgesics taken in the 1st week after surgery. RESULTS Significant differences were found if considering the surgical time, VAS, and QOL and OHIP-14 questionnaires; regarding those data, the Er:YAG laser appeared to be faster and less painful than traditional scalpel (p < 0.05). For bigger lesions, patients statistically took more painkillers if they had undergone traditional surgery. Considering the site of the treated lesions, Er:YAG laser was less painful, especially in the gingiva and palate (p < 0.05). CONCLUSIONS This is the first randomized controlled surgical trial reported for the management of nondysplastic oral lesions with the use of an Er:YAG laser. With many limitations, the present report identifies significant difference in the immediate postoperative surgical period between the two treatments, meaning that the Er:YAG laser seemed to be less painful, and better accepted by patients, than traditional scalpel.
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Affiliation(s)
- Roberto Broccoletti
- 1 Oral Medicine Section, Department of Surgical Sciences, University of Turin , Turin, Italy
| | - Adriana Cafaro
- 1 Oral Medicine Section, Department of Surgical Sciences, University of Turin , Turin, Italy
| | - Alessio Gambino
- 1 Oral Medicine Section, Department of Surgical Sciences, University of Turin , Turin, Italy
| | - Ercole Romagnoli
- 2 Department of Surgical Sciences and Integrated Diagnostics, Genoa University , Genoa, Italy
| | - Paolo Giacomo Arduino
- 1 Oral Medicine Section, Department of Surgical Sciences, University of Turin , Turin, Italy
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Seoane J, González-Mosquera A, García-Martín JM, García-Caballero L, Seoane-Romero JM, Varela-Centelles P. Pseudoepitheliomatous hyperplasia after diode laser oral surgery. An experimental study. Med Oral Patol Oral Cir Bucal 2015; 20:e554-9. [PMID: 26116841 PMCID: PMC4598923 DOI: 10.4317/medoral.20519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 03/01/2015] [Indexed: 11/08/2022] Open
Abstract
Background To examine the process of epithelial reparation in a surgical wound caused by diode laser. Material and Methods An experimental study with 27 Sprage-Dawley rats was undertaken. The animals were randomly allocated to two experimental groups, whose individuals underwent glossectomy by means of a diode laser at different wattages, and a control group treated using a number 15 scalpel blade.
The animals were slaughtered at the 2nd, 7th, and 14th day after glossectomy. The specimens were independently studied by two pathologists (blinded for the specimens’ group). Results At the 7th day, re-epithelisation was slightly faster for the control group (conventional scalpel) (p=0.011). At the 14th day, complete re-epithelization was observed for all groups. The experimental groups displayed a pseudoepitheliomatous hyperplasia. Conclusions It is concluded that, considering the limitations of this kind of experimental studies, early re-epithelisation occurs slightly faster when a conventional scalpel is used for incision, although re-epithelisation is completed in two weeks no matter the instrument used. In addition, pseudoepitheliomatous hyperplasia is a potential event after oral mucosa surgery with diode laser. Knowledge about this phenomenon (not previously described) may prevent diagnostic mistakes and inadequate treatment approaches, particularly when dealing with potentially malignant oral lesions. Key words:Diode laser, animal model, oral biopsy, oral cancer, oral precancer, pseudoepitheliomatous hyperplasia.
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Affiliation(s)
- Juan Seoane
- Cantón Grande 5, Apt. 1 E, 15003 A Coruña, Spain,
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Varoni E, Decani S, Franchini R, Baruzzi E, Lodi G. Macchie bianche o leucoplachia? Quando preoccuparsi? DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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