Recurrence Rates of Premalignant Lesions after CO2 Laser Vaporization

https://doi.org/10.1078/1615-1615-00124Get rights and content

Summary

Background: Use of the CO2-Laser (λ = 10.6 μm, continuous wave, defocussed) is an established procedure for treatment of premalignant lesions. Through employment of the sp-mode as well as scanners, thermal laser effects can be reduced but, on the other hand, a lesser degree of destruction of dysplastic cells could lead to an increased recurrence rate. The purpose of this study was to evaluate prospectively the recurrence rates resulting from different methods of CO2 laser vaporization.

Methods: From May 1995 to May, 2002, 56 patients with a total of 68 premalignant lesions of the oral mucosa were treated in a prospective clinical study. Twenty-eight lesions were vaporized with the defocussed CO2 laser (cw, 15 W, 5–15 s, mean output 2.12 Wcm−2). In a further 21 lesions, a scanner (Swiftlase) was additionally employed with all other parameters held constant (mean output 212.4 Wcm−2). In the remaining 19 lesions, vaporization was carried out in the sp-mode (pulse duration 80 μs, pulse energy 20 mJ, mean output 228 Wcm−2) in which, as above, a scanner was also used. Follow-up examinations were carried out according to a standard protocol. In May, 2002, the recurrence rate in the 3 groups was determined.

Results: Clinically, use of the scanner in sp-mode resulted in the most irregular tissue resection. This can be accounted for by the irregular paths of the laser beam and the pulsed delivery of the laser energy. The lowest recurrence rates were yielded by the defocussed cw-technique followed by the cw-scanner and the sp-mode.

Conclusions: These results indicate that for treatment of premalignant lesions of the oral mucosa, the best results can be achieved with the defocussed CO2 laser. The incurrence of a deep thermal effect enhances destruction of deeper-lying dysplastic cells. Apparently, other methods with lesser penetration of thermal effects (e. g. sp, scanner) do not reach the deeper-lying cells and, consequently, render higher rates of recurrence.

References (13)

  • J.L. Roodenburg et al.

    CO2-laser surgery of oral leukoplakia

    Oral Surg Oral med Oral Pathol

    (1991)
  • P. Vedtofte et al.

    Surgical treatment of premalignant lesions of the oral mucosa

    Int J Oral Maxillofac Surg

    (1987)
  • R. Crippa

    Report on 103 cases of precancerous and other oral lesions treated with a diode laser

    J Oral Laser Appl

    (2001)
  • H. Deppe

    Experimentelle Untersuchungen zur Laser-assistierten Periimplantitistherapie. Med. Habil

    (1998)
  • H.-H. Horch

    Laser in der Zahn-, Mund-, Kiefer-und Gesichtschirurgie

  • U. Keller

    Laser in der Oralchirurgie

    Zwr

    (1999)
There are more references available in the full text version of this article.

Cited by (6)

View full text