title: A randomized controlled clinical and histopathological trial comparing excisional biopsies of oral fibrous hyperplasias using CO2and Er:YAG laser.
abstract: This study was conducted in order to compare clinical and histopathological outcomes for excisional biopsies when using pulsed CO2laser versus Er:YAG laser. Patients (n = 32) with a fibrous hyperplasia in the buccal mucosa were randomly allocated to the CO2(140 Hz, 400 μs, 33 mJ) or the Er:YAG laser (35 Hz, 297 μs, 200 mJ) group. The duration of excision, intraoperative bleeding and methods to stop the bleeding, postoperative pain (VAS; ranging 0-100), the use of analgesics, and the width of the thermal damage zone (μm) were recorded and compared between the two groups. The median duration of the intervention was 209 s, and there was no significant difference between the two methods. Intraoperative bleeding occurred in 100% of the excisions with Er:YAG and 56% with CO2laser (p = 0.007). The median thermal damage zone was 74.9 μm for CO2and 34.0 μm for Er:YAG laser (p < 0.0001). The median VAS score on the evening after surgery was 5 for the CO2laser and 3 for the Er:YAG group. To excise oral soft tissue lesions, CO2and Er:YAG lasers are both valuable tools with a short time of intervention and postoperative low pain. More bleeding occurs with the Er:YAG than CO2laser, but the lower thermal effect of Er:YAG laser seems advantageous for histopathological evaluation.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Valerie G A
authors.initials: VGA
authors.lastname: Suter
authors.affiliation: Pathology Länggasse, Bern, Switzerland.
authors.forename: Hans Jörg
authors.initials: HJ
authors.lastname: Altermatt
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. bornst@hku.hk.|Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong, SAR, China. bornst@hku.hk.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000494:pharmacology; D001706:Biopsy; D016063:Blood Loss, Surgical; D003710:Demography; D004564:Electrocoagulation; D005260:Female; D006801:Humans; D006965:Hyperplasia; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects / Q000473:pathology* / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D014945:Wound Healing / Q000187:drug effects; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: Bleeding; Fibrous hyperplasia; Laser; Oral mucosa; Pain; Thermal damage zone