title: Laser applications for benign oral lesions.
abstract: OBJECTIVE
  Different subspecialists treat benign intraoral lesions using various approaches including surgical excision, medical therapy, sclerotherapy, and laser photocoagulation. The goal of this study was to establish whether lasers could effectively target and destroy oral lesions containing endogenous chromophores, while minimizing injury to unaffected adjacent tissues and critical structures.
  
  
  METHODS
  This retrospective study involved 26 cases of benign oral lesions, both vascular and pigmented, which were addressed by means of selective laser treatment. Pathologies were port-wine stains, hereditary hemorragic teleangectasia, hemangiomas, venous and arteriovenous malformations, pyogenic granuloma, and hairy reconstructive flaps. Electronic medical records and photographic documentation were reviewed. Three blinded staff personnel not involved with patient care in this study evaluated photographs taken prior to the first and after the final laser treatments. Observers rated the percentage clearance of the lesions or the ablation of bleeding, and the assessed values were averaged for each patient.
  
  
  RESULTS
  An average of 30-95% lightening was observed in the intraoral port-wine stains, 90% in the hemangiomas, 70% in arteriovenous malformations, 81% for venous malformations, 86% for venous lakes, and 100% for the pyogenic granuloma. Bleeding was ablated in all hereditary hemorrhagic telangiectasia lesions treated using the pulsed dye laser with or without the Alexandrite laser. Intraoral hair growing on the skin paddle of microvascular flaps was completely removed in one of the three cases treated using the Alexandrite laser. In the two remaining cases, some hair removal was achieved, but because the residual hairs were grey or white (absence of melanocytic chromophore), photocoagulation was less effective.
  
  
  CONCLUSIONS
  Lasers are a safe and effective means to selectively destroy specific chromphores. Such specific targeting ensures complete destruction of pathological tissue, decreasing the possibility of relapse and/or recurrence. Selective laser treatment of benign intraoral lesions represents a niche application that fills a gap in the multidisciplinary management of several conditions such as oral vascular anomalies and hairy reconstructive flaps.
authors: Carolyn and Peter Lynch Center for Laser and Reconstructive Surgery, Division of Facial Plastic and Reconstructive Surgery, Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, 02114.
authors: Alice
authors: A
authors: Frigerio
authors: Carolyn and Peter Lynch Center for Laser and Reconstructive Surgery, Division of Facial Plastic and Reconstructive Surgery, Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, 02114.
authors: Oon T
authors: OT
authors: Tan
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D017789:Granuloma, Pyogenic / Q000601:surgery; D006391:Hemangioma / Q000601:surgery; D006801:Humans; D054025:Lasers, Dye / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D009059:Mouth Diseases / Q000601:surgery*; D010781:Photography; D019339:Port-Wine Stain / Q000601:surgery; D012189:Retrospective Studies; D016037:Single-Blind Method; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000601:surgery; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000601:surgery
keywords: Alexandrite laser; free flap; hereditary hemorragic telengectasia; infantile hemangioma; intraoral vascular malformation; oral cavity; port-wine stain; pulsed dye laser; pyogenic granuloma