APPLICATION OF Nd–YAG LASER TREATMENT FOR ORAL LEUKOPLAKIA

Keywords:surgical, fiber,  Time:31-03-2016

High energy lasers are used as an alternative to conventional surgery for treatment of oral leukoplakia.

The purpuse of this study is to monitor the effectiveness of Nd-YAG laser as treatment for oral leukoplakia. Seventeen patients were followed-up with oral leukoplakia for the period 2005-2011.Early postoperative results were monitored considering criteria pain, redness, swelling each 1, 3, 7 days. The effect from the treatment was determined by recording the changes in size of the lesions each 1, 2, 3 months. The results which reflect effectiveness of treatment within the observed period showed that twelve patients were complete respondents, two responded partially, and three did not respond. The treatment of oral leukoplakia through the application of Nd-YAG laser is characterized with good therapeutic effect and smooth postoperative period, without significant pain and discomfort, making it appropriate clinical solution.

Cases of cancer in humans tend to become more frequent, while reasons for this are referred to a number of exogenous and endogenous factors. Genetic damage in the epithelium accumulates during the process of carcinogenesis and leads to the loss of cell cycle regulation and the emergence of uncontrolled reproduction. (4) Oral preneoplasia is damage in the epithelium, progress of which continues for months or for years and in some cases it turns into cancer.

The etiology and pathogenesis of oral leukoplakia are not fully known, there are no specific histological findings.  There are risk factors involved in the disease progress. They are most commonly related to tobacco use, consumption of alcohol and the HPV infection. (8, 9) Diagnosis of oral leukoplakia is mainly carried out through a direct visual inspection, vital dye staining is also used as well as stomatoscopy and spectroscopy, exfoliative cytodiagnosis.

The histological examination of biobsy material, combined with the modern means of immunohistochemistry may allow early registration of changes in the tissues, before the clinical expression of the ongoing changes at a cellular level.

Approach in the treatment of oral leukoplakia involves removal of risk factors, impact on the lesion and follow-up of the deseased. Depending on the clinical and histological features, topically or systemically are being applied medications, surgical and electrosurgical excision procedures followed by plastics, cryotherapy, low or high energy lasers. (4, 5, 6, 9) High energy lasers are used as an alternative to surgical treatment. (5, 7) Carbon dioxide (CO2) laser has a wavelength of 10 600 nm, it is well absorbed by intra and extracellular fluids, it quickly reaches temperature and evaporates the target tissues and the surrounding area of thermal necrosis.

It is used with a focused wave mode for axcision of the lesions, and with a defocused wave mode for evaporating. Diod lasers are used in different modes for excision of the lesions.