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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 2008 January-February;57(1-2):1-7
language: English, Italian
Oral laser surgical pathology: a preliminary study on the clinical advantages of diode laser and on the histopathological features of specimens evaluated by conventional and confocal laser scanning microscopy
Capodiferro S. 1, Maiorano E. 2, Loiudice A. M. 1, Scarpelli F. 3, Favia G. 1
1 Department of Odontostomatology and Surgery University of Bari, Bari, Italy
2 Department of Pathological Anatomy University of Bari, Bari, Italy
3 Department of Restaurative Dentistry University of Florence, Florence, Italy
Aim. The effects of diode laser therapy reported in literature are both clinical and biological. The aim of the present preliminary study was to verify the clinical benefits such as reduction of postoperative pain, inflammatory response and bleeding and also the benefits concerning wound healing and histopathological alterations of specimens related to diode laser surgery.
Methods. The study was carried out on a group of 25 patients; we evaluated histologically the surgical specimens both by conventional optical microscopy and by autofluorescence by confocal laser scanner microscopy, paying attention to the incision margins and to the eventual presence of thermally induced changes/ damages. Both benign and premalignant or malignant lesions were treated with diode laser, with an output ranging from 2 to 7 Watt.
Results. Clinically we had several advantages (haemostasis, reduction of pain, healing without suture) and wound healing was always complete in 20-30 days. In the specimens evaluated histologically we noticed a good precision of surgical margins while changes induced by laser such as coagulation of proteins were present only with high power density output. Considering that nowadays the use of diode laser in the treatment of premalignant or malignant lesions is still debated, in this preliminary study no difficulty occurred with the observation of the specimens and no alterations were found.
Conclusion. Thanks to the preliminary results obtained with this study, we encourage the use of diode laser also for malignant lesions, considering that an important factor to obtain specimens without alterations is the choice of the laser setting, strictly related to clinical experience, clinical situation, site and biological nature of the lesion.