Human papilloma virus lesions of the oral cavity: healing and relapse after treatment with 810-980 nm diode laser.

This study evaluated the therapeutic efficacy of laser therapy in treating oral human papilloma virus (HPV) lesions. In particular, mode of action, healing, postoperative patient compliance, visual numeric scale (VNS) pain index, and recurrence were analyzed. During 2001-2012, in 170 patients (80 women and 90 men), 174 intraoral and lip HPV lesions were detected and excised by diode laser of different wavelengths (810-980 nm), with an average power of 2.1 W, in continuous wave mode, using 300 to 320 µm optical fibers. In most cases (95.4%), complete healing occurred in the first 30 days. There were no adverse effects and all patients were carefully followed up until complete healing occurred, documenting any complications. There was only one recurrence, which was later treated successfully; the mean VNS pain score was below one. In treating HPV lesions, the diode laser is not only a valuable tool for their eradication but especially it reduces relapses, thanks to the characteristics of the laser light.

Diode laser (808 nm) applied to oral soft tissue lesions: a retrospective study to assess histopathological diagnosis and evaluate physical damage.

The diode laser is today widely used in oral pathology to excise lesions; however, some controversy surrounds laser surgery, specifically the accuracy of pathological diagnosis and the control over thermal tissue damage. This study aimed to establish if physical damage induced by the diode laser could affect the histopathological diagnosis and to evaluate the damage caused to the resection margins. Between 2005 and 2010, at S. Gerardo Hospital, Milan, 608 cases of soft tissue lesions localized in the oral cavity (cheek, gingiva, buccal mucosa, tongue, and lips) were examined. Specimens were excised with an 808-nm diode laser, output 1.6-2.7 W, in continuous-wave mode with fibers of 320 µm. Specimens were fixed in 10% buffered formalin solution and examined separately under an optical microscope by two pathologists. In all of the specimens, changes to the epithelium, connective tissue and blood vessels, shape of incision damage, and overall width of modified tissues were evaluated. The data for specimens larger than 3 mm excised with the diode laser were not significant in terms of stromal changes or vascular stasis, while epithelial and stromal changes were significantly more frequent in specimens with a mean size below 3 mm; the diagnosis was not achievable in 46.15%. Our data show that the diode laser is a valid therapeutic instrument for excising oral lesions larger than 3 mm in diameter, but induces serious thermal effects in small lesions (mean size below 3 mm). However, from a clinical standpoint, it is suggested necessary that the specimens taken have in vivo a diameter of at least 5 mm in order to have a reliable reading of the histological sample.