Wound healing after therapy of oral potentially malignant disorders with a 445-nm semiconductor laser: a randomized clinical trial

Abstract

Objectives: Oral potentially malignant disorders (OPMDs) are the most clinically relevant precursor lesions of the oral squamous cell carcinoma (OSCC). OSCC is one of the 15 most common cancers worldwide. OSCC is with its high rate of mortality an important cause of death worldwide. The diagnosis and therapy of clinically relevant precursor lesions of the OSCC is one of the main parts of prevention of this malignant disease. Targeted therapy is one of the main challenges concerning an oncologically safe tissue removal without overwhelming functional and aesthetic impairment.

Materials and methods: In this randomized controlled trial, a newly introduced intraoral 445-nm semiconductor laser (2W; cw-mode; SIROLaser Blue, Dentsply Sirona, Bensheim, Germany) was used in the therapy of OPMDs. Duration and course of wound healing, pain, and scar tissue formation were compared to classical cold blade removal with primary suture by measuring remaining wound area, tissue colorimetry, and visual analogue scale. The study includes 40 patients randomized using a random spreadsheet sequence in two groups (n1 = 20; n2 = 20).

Results: This comparative analysis revealed a significantly reduced remaining wound area after 1, 2, and 4 weeks in the laser group compared to the cold blade group (p < 0.05). In the laser group, a significantly reduced postoperative pain after 1 week was measured (p < 0.05).

Conclusion: Laser coagulation of OPMDs with the investigated 445-nm semiconductor laser is a safe, gentle, and predictable surgical procedure with beneficial wound healing and reduced postoperative discomfort.

Clinical relevance: Compared to the more invasive and bloody cold blade removal with scalpel, the 445-nm semiconductor laser could be a new functional less traumatic tool in the therapy of OPMDs. The method should be further investigated with regard to the identification of further possible indications.

Trail registration: German Clinical Trials Register No: DRKS00032626.

Keywords: Diode laser; Leukoplakia; OPMD; OSCC; Oral precursor lesion; Oral squamous cell carcinoma; Oral surgery.

Fig. 1

Clinical view of the wound healing after 445-nm laser ablation: a before surgery; b postoperative view; c 7 days follow-up; d 14 days follow-up; e 28 days follow-up

Fig. 2

Clinical view of the wound healing after cold blade excision: a before surgery; b postoperative view; c 7 days follow-up; d 14 days follow-up; e 28 days follow-up

Fig. 3

Wound area (in mm.²) of the two groups. Statistically significant differences were found 7, 14, and 28 days after surgery (p < 0.05; *)

Fig. 4

Tissue colorimetry (TC): Color difference (ΔE) of the two groups. There were no statistically significant differences found after surgery and after 7, 14, or 28 days (p < 0.05)