Diode laser versus sclerotherapy: bloodless approaches in the treatment of oral pyogenic granuloma (randomised controlled clinical trial)

Abstract

Oral pyogenic granuloma (PG) is traditionally treated by surgical excision which is associated with bleeding, pain and a high rate of recurrence. Our research aimed to clinically assess the effectiveness of diode laser versus sclerotherapy, as bloodless approach, in the treatment of oral PG. We randomly divided 20 patients with oral PG into two groups, with those in the test group being managed via diode laser application and those in the control group via injections of ethanolamine oleate as a sclerosing agent. All patients were evaluated intraoperatively for bleeding severity and postoperatively for pain. The quality of healing was also assessed using Landry healing index after the 1st, 2nd and 4th weeks. Additionally, the patients were recalled after 3, 6 and 9 months from the end of treatment for recurrence evaluation. Our results revealed that intraoperative bleeding did not differ significantly between both groups while postoperative pain decreased significantly in the sclerotherapy group compared to the laser group. For different intervals, the sclerotherapy group had a higher healing quality index than the laser group, although the difference was not statistically significant. However, recurrence occurred in the laser group, there were no cases of recurrence in the sclerotherapy group in all intervals. In conclusion, diode laser treatment of PG is a reliable, less invasive, and sensitive procedure that requires an experienced operator and specialised equipment. However, ethanolamine oleate sclerotherapy is an inexpensive, simple technique besides being less prone to recurrence problems, especially when treatment duration is not a concern.

Keywords: Diode laser; Ethanolamine oleate; Oral pyogenic granuloma; Sclerotherapy.

Fig. 1

Clinical photographs showing a laser-treated case. a Measuring the size of the lesion (length) using periodontal probe. b Removal of the pyogenic granuloma using a laser tip. c Tissue healing after 1st week. d Tissue healing after 2nd week. e Tissue healing after 4th week. f Tissue healing at the 3rd month follow-up time point

Fig. 2

Clinical photographs showing a sclerotherapy-treated case. a Measuring the size of the lesion (length) using a periodontal probe. b Injection of the lesion with the sclerosing agent. c Tissue healing after 1st week. d Tissue healing after 2nd week. e Tissue healing after 4th week. f Tissue healing at the 3rd month follow-up time point

Fig. 3

A representative graph showing a comparison between the two groups. a Bar chart showing bleeding during surgery. b Line chart showing average post-operative pain. c Line chart showing the average healing index between the two groups. d Bar chart showing recurrence status