A feasible procedure in dental practice: the treatment of oral dysplastic hyperkeratotic lesions of the oral cavity with the CO2 laser.

OBJECTIVES: The aim of this work is to report some cases of surgical removal of hyperkeratotic lesions of the oral cavity with the CO(2) laser.

BACKGROUND: Hyperkeratosis is an abnormal thickening of the stratum corneum caused by increased deposition of keratin, and its histopathologic features show wide variations. These changes are significant because they determine different biologic behavior. Several techniques are used to treat these lesions, including scalpel incision, electrosurgery, cryosurgery, photodynamic therapy, and some drugs. The use of surgical lasers has been proposed as an effective way of treating such lesions safely. The CO(2) laser is the most used laser on the oral cavity because of its affinity for water and high absorption by the oral mucosa. Several benefits of the use of the CO(2) laser are reported in the literature in regard to surgical procedures carried out on the oral cavity.

PATIENTS AND METHODS: All patients had histopathologic diagnosis of hyperkeratosis and mild epithelial dysplasia and were routinely prepared for surgery under local anesthesia. The surgical procedures were carried out by using a CO(2) laser (Sharplan 20 C; Laser Industries, Tel Aviv, Israel, λ10,600 nm, φ∼2 mm, CW/RSP). The beam was focused to delimit each lesion, and then lesions were excised, and the removed specimens were sent for histopathology. At the end of the surgery, the beam was used in a defocused manner to promote better hemostasis. Neither sutures nor dressings were used after the surgery. No medication but mouthwashes was prescribed to all patients in the postoperative period.

CONCLUSIONS: The use of the CO(2) laser does not reduce the risk of relapses of the lesion, but it is an easy-to-use technique and results in both a quick surgical procedure and trouble-free postoperative period and may be safely used in dental practice.