Clinical and histopathological variance in healing of leukoplakia with diode lasers versus scalpel: evidence based comparative study

Introduction- Leukoplakia’s are premalignant lesions with a significant 0-20% potential for malignant transformation. There are various ways to prevent malignant transformation, surgical interventions are amongst one are recommended for their removal. Laser ablation is one of the favored procedures with sequential histopathology using one of the many types of lasers. The efficacy of such procedure with respect to the lesion location is, however, unclear. Many studies are contradictory. Some shows laser ablations as prevention of malignisation other see it as increased risk. Aim and Objectives- To compare the a) efficacy of diode laser versus scalpel; b) clinical healing and; c) histopathological changes. Material and Method- Ablation of the leukoplakia lesion by 810nm diode laser in outpatients (Group A) or excising the leukoplakia lesion using conventional method [scalpel] (Group B) from different region including buccal mucosa, tongue, alveolar ridge. In total 20 lesions were treated under local anesthesia in altogether 20patients. Initially, all lesions were histopathologically confirmed by taking punch biopsy from the encountered lesion. Follow up was done in the interval of 7days, 3weeks, 6months, 9months and 12 months. Results- Conventional method found to be more beneficial in all aspects though laser ablation has proved to have patient compliance, faster healing and no scar formation but malignant transformation is found to be more in laser ablation procedure. Conclusion- Higher risk of reoccurrence and malignant transformation of leukoplakia is observed, especially verrucous type.Thus scalpel method overshadows the laser ablation method as per the current study. Hence more studies are required to confirm its pros and cons.