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A randomized controlled trial comparing surgical excisional biopsies using CO2 laser, Er:YAG laser and scalpel.

Abstract

This randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT03001791) compared excisional biopsies of fibrous hyperplasia performed using a CO2 laser (140Hz, 400μs, 33mJ), Er:YAG laser (35Hz, 297μs, 200mJ, air-water cooling), or scalpel (15c blade). Clinical parameters recorded were duration of the intervention, intraoperative bleeding, need for electrocauterization and/or suturing, postoperative side effects, complications, pain, and intake of analgesics. Histopathological linear measurements of the thermal damage zone were performed on the laser biopsies. Results showed that the duration of the intervention was significantly shorter for both lasers compared to the scalpel (P<0.001). Intraoperative bleeding occurred less frequently with the CO2 laser (P<0.001). Additional electrocautery was used in 92% of Er:YAG laser interventions (P<0.001). Postsurgical complications, pain, and the intake of analgesics did not differ between the groups. The measured thermal damage zones differed significantly between the CO2 laser (median of 72.6μm) and Er:YAG laser (30.9μm) (P<0.001). This RCT showed that CO2 laser, Er:YAG laser, and scalpel are all adequate for excisional biopsies of small lesions in the oral mucosa. While patient postoperative morbidity is similar, the ideal instrument can be selected according to the surgical advantages preferred for the individual situation.

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  • Authors+Show Affiliations

    ,

    Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. Electronic address: valerie.suter@zmk.unibe.ch.

    ,

    Pathology Länggasse, Ittigen, Switzerland.

    Applied Oral Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31230766

    Citation

    Suter, V G A., et al. "A Randomized Controlled Trial Comparing Surgical Excisional Biopsies Using CO2 Laser, Er:YAG Laser and Scalpel." International Journal of Oral and Maxillofacial Surgery, 2019.
    Suter VGA, Altermatt HJ, Bornstein MM. A randomized controlled trial comparing surgical excisional biopsies using CO2 laser, Er:YAG laser and scalpel. Int J Oral Maxillofac Surg. 2019.
    Suter, V. G. A., Altermatt, H. J., & Bornstein, M. M. (2019). A randomized controlled trial comparing surgical excisional biopsies using CO2 laser, Er:YAG laser and scalpel. International Journal of Oral and Maxillofacial Surgery, doi:10.1016/j.ijom.2019.05.012.
    Suter VGA, Altermatt HJ, Bornstein MM. A Randomized Controlled Trial Comparing Surgical Excisional Biopsies Using CO2 Laser, Er:YAG Laser and Scalpel. Int J Oral Maxillofac Surg. 2019 Jun 20; PubMed PMID: 31230766.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A randomized controlled trial comparing surgical excisional biopsies using CO2 laser, Er:YAG laser and scalpel. AU - Suter,V G A, AU - Altermatt,H J, AU - Bornstein,M M, Y1 - 2019/06/20/ PY - 2019/02/14/received PY - 2019/03/13/revised PY - 2019/05/10/accepted PY - 2019/6/25/entrez KW - biopsy KW - hyperplasia KW - mouth mucosa KW - pain KW - surgical instruments JF - International journal of oral and maxillofacial surgery JO - Int J Oral Maxillofac Surg N2 - This randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT03001791) compared excisional biopsies of fibrous hyperplasia performed using a CO2 laser (140Hz, 400μs, 33mJ), Er:YAG laser (35Hz, 297μs, 200mJ, air-water cooling), or scalpel (15c blade). Clinical parameters recorded were duration of the intervention, intraoperative bleeding, need for electrocauterization and/or suturing, postoperative side effects, complications, pain, and intake of analgesics. Histopathological linear measurements of the thermal damage zone were performed on the laser biopsies. Results showed that the duration of the intervention was significantly shorter for both lasers compared to the scalpel (P<0.001). Intraoperative bleeding occurred less frequently with the CO2 laser (P<0.001). Additional electrocautery was used in 92% of Er:YAG laser interventions (P<0.001). Postsurgical complications, pain, and the intake of analgesics did not differ between the groups. The measured thermal damage zones differed significantly between the CO2 laser (median of 72.6μm) and Er:YAG laser (30.9μm) (P<0.001). This RCT showed that CO2 laser, Er:YAG laser, and scalpel are all adequate for excisional biopsies of small lesions in the oral mucosa. While patient postoperative morbidity is similar, the ideal instrument can be selected according to the surgical advantages preferred for the individual situation. SN - 1399-0020 UR - https://www.unboundmedicine.com/medline/citation/31230766/A_randomized_controlled_trial_comparing_surgical_excisional_biopsies_using_CO2_laser,_Er:YAG_laser_and_scalpel L2 - https://linkinghub.elsevier.com/retrieve/pii/S0901-5027(19)31178-6 DB - PRIME DP - Unbound Medicine ER -