Discussion
OPMDs, postoperative pain, reduced pain, pain
OPMDS, MINOR, COLD, DISORDERS, ORAL LEUKOPLAKIA, SCAR TISSUE, COLD
Cold blade excision is the gold standard in the therapy of oral potentially malignant disorders but may lead to postoperative patient discomfort or functional impairing. Scar tissue formation after resection of the lesions may require surgical reconstruction. Conventional laser systems as CO2 lasers are technically sophisticated, are expensive, and are not feasible in many outpatient settings. Thus, an interesting alternative would be to minimize the negative impact of the cold blade excision without losing the positive therapeutic benefits. The aim of this study was the first evaluation of a recently established compact 445-nm semiconductor laser in this specific indication considering wound healing and patient discomfort in comparison to the standard cold blade excision.The present study showed that wound healing after laser ablation with the 445-nm laser is favorable compared to the standard therapy. Remaining wound area after laser therapy shows a predictable continuous decrease over time with significantly smaller remaining wound areas in the laser group. No relevant wound area was measured after 4 weeks in the laser group. Tissue colorimetry showed comparable wound healing after laser and excision therapy without significant differences. This implicates a comparable predictability with a little shorter wound healing course in the laser group. There is a lot of literature supporting a wound healing propagation by laser light. Laser light of different wavelengths was shown to support wound healing in different intraoral an extraoral settings. Parker et al. describe in a recent systematic review on different short- and long-wave laser wavelengths for intraoral indications, positive effects of laser light on wound healing compared to scalpel treatment in 46%, and no difference in 46% of the included studies [After 1 week, the postoperative pain perception in the laser group was significantly lower than in the comparison group. Even if this can only be an indication in the context of an unblinded study and without recording the actual use of analgetics in the outpatient setting and its influence on the assessment of the pain intensity, this implies a possible analgesic effect of the laser treatment compared to the classical surgical approach. The scientific data on this is promising. Lopez-Jornet et al. were able to show reduced pain perception after treatment of oral leukoplakia using a CO2 laser in comparison to classic excision using a scalpel in a randomized controlled study [Various wavelengths and protocols for the use of diodes, gas, and solid-state lasers have been published, but there is no uniform consensus regarding the optimal procedure, wavelength, and the time course of the energy deposition [The duration of the intervention differed only slightly in both patient groups with only a minor, non-significant tendency to prolong the operating time through the use of laser coagulation. The laser coagulation of potentially malignant lesions of the oral mucosa using a 445-nm semiconductor laser, like the laser-based excision methods already described extensively in the literature, represents a time- and resource-efficient therapy method that can be easily integrated into the clinical process with little additional effort [An effective therapy of potentially malignant lesions of the oral mucosa was achieved according to clinical standards using the recently established 445-nm semiconductor laser. This study is subject to certain limitations, which are mainly related to the population available for analysis. First, there is a selection bias regarding patients suffering from OPMDs, as potential risk factors such as tobacco use or chronic mechanical irritation may also affect wound healing differently in the laser and excision group compared to the general population. Second the limited number of participants (