Er:YAG Laser Versus Cold Knife Excision in the Treatment of Nondysplastic Oral Lesions: A Randomized Comparative Study for the Postoperative Period
Broccoletti R, Cafaro A, Gambino A, Romagnoli E, Arduino PG.
Photomed Laser Surg. 2015;33(12):604-60.
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.