Evaluation of diode laser efficacy in treating benign oral soft tissue masses: A case series

Abstract

Introduction and importance: The diode laser, with a wavelength ranging from 810 to 980 nm, is a modern treatment modality that offers significant advantages in the management of benign oral soft tissue masses. Therefore, this report aimed to assess the efficacy of diode laser application for excisional biopsy of such masses.

Case presentation: Three female patients, aged 9, 39, and 45 years, visited the Oral Medicine Clinic with complaints of painless masses in the oral cavity persisting for two to three months. Their intraoral examination showed the presence of pedunculated or sessile exophytic lesions with a smooth surface. The lesions appeared as single, pink to red protrusions located in various sites, including the left buccal mucosa, right lateral border of the tongue, and lower gingiva.

Clinical discussion: Excisional biopsy of the masses was carried out in the patients using the diode laser. The surgical procedures ranged from 10 to 20 min, with minimal intraoperative bleeding and precise cutting, while no pain was reported. Postoperatively, at two weeks and four months follow-up, the intraoral wounds exhibited excellent healing without complications such as pain, bleeding, swelling, scarring, infection, or mass recurrence. The clinical diagnosis of irritational fibroma (two cases) and fibrous epulis were confirmed by histopathological examination.

Conclusion: Diode laser emerges as a highly efficacious method for the excisional biopsy of benign oral soft tissue masses, providing intraoperative and postoperative advantages over scalpel surgery.

Keywords: Benign tumor; Biopsy; Diode laser; Excision; Oral mucosa.

Fig. 1

Clinical presentation of irritation fibroma in a 9-year-old female patient treated with a diode laser. (A) Tumor measuring 0.8 × 0.6 × 0.6 cm on the lateral right side of the tongue; (B) Post-excision biopsy using a diode laser technique; (C) Histopathological examination revealed hyperkeratotic squamous epithelium, dense collagen stroma, packed spindle-shaped fibroblasts with collagen and areas of hyalinization, minimal inflammatory cells and vascularity (magnification at 100×). (D) A healing ulcer, 1 cm in diameter, was observed on the right lateral border of the tongue after two weeks of treatment; (E) The lesion completely healed after six weeks of treatment.

Fig. 2

Removal of fibrous epulis on the gingiva in a 39-year-old female by diode laser. (A) Tumor measuring 1 × 0.8 × 0.5 cm on the left lower gingiva; (B) Post-excision biopsy with the diode laser technique; (C) Histopathological examination revealed hyperplastic squamous epithelium, fibrous tissue, inflammatory cell infiltration, capillary blood vessel proliferation, and some hemorrhage in the fibrous epulis, with no evidence of malignancy (magnification at 20×); (D) Clinical presentation at the second visit, two weeks after treatment, showing a healing ulcer covered with a pseudomembrane at the site of the excised tumor; (E) The lesion disappeared completely after four weeks of treatment.

Fig. 3

Clinical presentation of fibroma in a 45-year-old female patient. (A) A tumor measuring 0.6 × 0.5 × 0.3 cm on the left buccal mucosa; (B) The lesions after excision biopsy with a diode laser; (C) Histopathological appearance showed hyperkeratosis and the mass within a dense collagen stroma, hyaline degenerated fibro-collagen connective tissue, minimal inflammatory cells and vascularity (magnification at 100×). D) An ulcer measuring 0.2 × 0.1 cm on the left buccal mucosa after 14 days of treatment; (E) The lesion completely healed within four weeks of treatment.