scholarly journals Efficacy of Lasers in the Treatment of Tobacco Abuse Induced Oral Leukoplakia

2021 ◽  
Vol 6 (2) ◽  
Author(s):  
Kaushik SK ◽  

Background: Oral leukoplakia is defined as a white patch or plaque, which cannot be characterized clinically or histopathologically as any other disease entity and is recognized as a common precancerous lesion of the oral mucous membrane. Definitive management crucial due to its notoriety for recurrences and malignant transformation depending on the anatomic location, clinical features, degree of epithelial dysplasia and causative factors. High power pulse diode laser has some advantages like less pain, swelling, prevention of metastasis, edema, less bleeding and infection. The prime objective of the study was to evaluate clinically and histopathologically the disease course with six monthly follow up. Methods: Thirty cases who had white lesion in the buccal mucosa with positive history of oral tobacco abuse, clinically diagnosed cases of oral leukoplakia confirmed by histopathology were selected for inclusion in the study and treated by LASER. The outcomes after the clinical and histopathologic determinants were processed with standard statistical tests, the results were derived and findings concluded. Results: Cases were distributed as per the size and histopathologic report and LASER ablation was administered Recurrence was noticed in 4 cases (16.6%) after six months follow up. No case transformed to malignancy during the study follow up period. Conclusion: Management of oral leukoplakia prevents not only recurrence and malignant transformation, but also postoperative dysfunction. Laser ablation of tobacco abuse induced leukoplakia is a simple effective and safe alternative to conventional surgical local excision with predictable outcome which can be undertaken as a routine OPD day care set up.

2020 ◽  
Vol 8 (12) ◽  
Author(s):  
Vanessa Einsfeld ◽  
Ana Claudia Ramos ◽  
Beatriz Barbosa ◽  
Alberto Zen ◽  
Grasieli de Oliveira Ramos ◽  
...  

Introdução: Quando estamos frente às lesões potencialmente malignas, torna-se imprescindível o acompanhamento rigoroso dessas lesões, pois são lesões frequentes e com risco de transformação maligna consideravelmente relevante, a leucoplasia e a queilite actínica, são as lesões mais comuns encontradas na cavidade bucal. Objetivo: relatar um caso de lesão potencialmente maligna em mucosa labial. Relato de caso: Paciente sexo masculino compareceu à clínica de Diagnóstico VI da Universidade do Oeste de Santa Catarina, com a presença de lesão branca em lábio inferior, o mesmo já se encontrava em acompanhamento há seis anos, com diagnóstico prévio de queilite actínica sem atipia celular (duas biópsias prévias). Aposentado, trabalhava anteriormente como agricultor, ex-fumante e ex-etilista. Clinicamente observava-se lesão esbranquiçada, com aspecto verruciforme, localizada em lábio inferior, medindo 2 cm no maior diâmetro. Além disso, o lábio encontrava-se endurecido, com aspecto roliço. Duas hipóteses de diagnóstico foram levantadas: queilite actínica associada a leucoplasia e carcinoma verrucoso. O paciente foi submetido à nova biópsia incisional. No laudo constatou-se tratar de queilite actínica com displasia epitelial leve e o tratamento proposto foi o uso de protetor labial FPS30, além de acompanhamento clínico semestral. Conclusão: O acompanhamento desse caso clínico foi possível observar alteração no perfil citológico, onde nas primeiras biópsias não era possível observar atipia celular e na biópsia mais recente foi observado uma displasia epitelial leve, portanto o acompanhamento das lesões potencialmente malignas é fundamental para prevenir sua transformação maligna, e uma nova biópsia deve ser realizada sempre que for observada alteração no aspecto clínico da lesão.Descritores: Leucoplasia; Queilite; Biópsia; Lábio.ReferênciasPindborg JJ, Reichart PA, Smith CJ, Van der Waal I. World Health Organization International histological classification of tumours. Histological typing of câncer and precancer of the oral mucosa. Berlin: Springer; 1997.Marley JJ, Linden GJ, Cowan CG, Lamey PJ, Warnakulasuriya KAAS, Scully C. Management of potentially malignant oral mucosa lesions by consultant UK oral and maxillofacial surgeons.  Br J Oral Maxillofac Surg. 1996;34(1):28-36.Neville BW, Dam DD, Allen CM, Chi AC . Patologia oral e maxilofacial. 3. ed. Rio de Janeiro; 2016.Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007;36(10):575-80.Gupta PC, Murti PR, Bhonsle RB, Mehta FS, Pindborg JJ. Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10-yr follow-up study of 12.212 users. Oral Dis. 1995;1(1):54-8.Maito FDM. Avaliação da expressão do PCNA no epitélio lingual de camundongos submetidos à ingestão e aplicação tópica de álcool a 40 GL [dissertação]. Porto Alegre: Faculdade de Odontologia – UFRGS;2001.Markopoulos A, Albanidou-Farmaki E, Kayavis I. Actinic cheilitis: clinical and pathologic characteristics in 65 cases. Oral Dis. 2004;10(4):212-16.Cintra JS, Torres SCM, Silva MBF, Manhães Júnior LRC, Silva Filho JP, Junqueira JLC. Queilite Actínica: estudo epidemiológico entre trabalhadores rurais no município de Paracaia– SP. Ver Assoc Paul Cir Dent. 2013;67(2):118-21.Greespan D, Jordan RCK. The white lesions that kills – aneuploide dysplastic oral leukoplakia. N Engl J Med. 2004;350(14):1382-84.Bánóczy J. Follow-up studies in oral leukoplakia. J Maxillofac Surg. 1977;5(1):69-75.Huber MA. White oral lesions, actinic cheilitis, and leukoplakia: confusions in terminology and definition: facts and controversies. Clin Dermatol. 2010;28(3):262-68.Reibel J. Prognosis of oral pre-malignant lesions: significance of clinical, histopathological and molecular biological characateristics. Crit Rev Oral Biol Med. 2003;14(1):47-62.Scheifele C, Reichart PA, Oral leukoplakia in manifest squamous epithelial carcinoma. A clinical prospective study of 101 patients, Mund Kiefer Gesichtschir. 1998;2(6):326-30.Schepman K, der Meij E, Smeele L, der Waal I. Concomitant leukoplakia in patients with oral squamous cell carcinoma. Oral Dis. 1999;5(3):206-9.Kaugars GE, Pillion T, Svirsky JA, Page DG, Burns JC, Abbey LM. Actinic cheilitis: a review of 152 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(2):181-86.Abreu MAMA, Silva OMP, Pimentel DRN, Hirata CHW, Weckx LLM, Alchorne MMA et al. Actinic cheilitis adjacent to squamous carcinoma of the lips as an indicator of prognosis. Braz J Otorhinolaryngol. 2006;72(6):767-71.Patrício JFC. Evolução das lesões pré-malignas orais: orientações para os médicos dentistas [dissertação]. Porto: Universidade do Porto; 2011.Shah AY, Doherty SD, Rosen T. Actinic cheilitis: a treatment review. Int J Dermatol. 2010; 49(11):1225-34.Pimenta FJ, Cordeiro GT, Pimenta LGGS, Viana MB, Lopes J, Gomez MV et al.  Molecular alterations in the tumor suppressor gene WWOX in oral Leukoplakias. Oral Oncol. 2008;44(8):753-58Paulo LFB, Rosa RR, Rocha MA, Durighetto Junior AF. Incidência e prevalência das lesões brancas associadas ao tabagismo atendidos no ambulatório da Unidade de Diagnóstico Estomatológico da Universidade Federal de Uberlândia no período de 1997 a 2008. Horizonte Cientifico. 2011;2:1-20.Gandolfo S, Pentenero M, Broccoletti R, Pagano M, Carrozzo M, Scully C. Toluidine blue uptake in potentially malignant oral lesions in vivo: clinical and histological assessment. Oral Oncol. 2006;42(1):89-95.Mashberg A, Samit A. Early diagnosis of asympomatic oral and oropharyngeal squamous cancers. CA Cancer J Clin. 1995;45(6):328-51.Mendes SF, Ramos GO, Rivero ERC, Modolo F, Grando LJ, Meurer MI. Techniques for precancerous lesion diagnosis. J Oncol. 2011. ID 326094.Dib LL, Kowalski LP, Curi MM. Lesões cancerizáveis de boca. In: Kowaski LP, Anelli A, Salvajoli JV, Lopes LF. Manual de condutas diagnosticas e terapêuticas em oncologia. 2.ed. São Paulo: Âmbito Editores; 2002.


Cancer ◽  
1984 ◽  
Vol 53 (3) ◽  
pp. 563-568 ◽  
Author(s):  
Sol Silverman Jr ◽  
Meir Gorsky ◽  
Francina Lozada, Dds, Ms

Oral Oncology ◽  
2020 ◽  
Vol 110 ◽  
pp. 105014
Author(s):  
Ilkay Evren ◽  
Elisabeth R. Brouns ◽  
Leon J. Wils ◽  
Jos B. Poell ◽  
Carel F.W. Peeters ◽  
...  

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Adriana Spinola Ribeiro ◽  
Patrícia Ribeiro Salles ◽  
Tarcília Aparecida da Silva ◽  
Ricardo Alves Mesquita

The aim of this paper was to assess the nonsurgical treatment of oral leukoplakia (OL). A medline search from 1983 to 2009 was conducted. The topical or systemic nonsurgical treatments or combination of both was reviewed. The primary outcomes of interest were clinical resolution, malignant transformation, follow-up, and recurrence of OL. Studies showed a rate higher than 50% of clinical resolution with photodynamic therapy, beta-carotene, lycopene, or vitamin A. Few studies reported rates of recurrence from 5 to 67% and of malignant transformation from 8 to 23%. There is a lack of randomized clinical trials that assess the effectiveness of nonsurgical treatment of OL. At this time, randomized controlled trials for nonsurgical treatment of OL demonstrate no evidence of effective treatment in preventing malignant transformation and recurrence. It reinforces that even after clinical resolution, OL should be regularly followed.


2017 ◽  
Vol 18 (9) ◽  
pp. 775-780 ◽  
Author(s):  
Dante Migliari ◽  
Vivian Galletta ◽  
Luciane Azevedo

ABSTRACT Introduction To analyze factors that may affect recurrence, development of new lesions, and malignant transformation in patients with oral leukoplakia (OL) following surgical treatment with lasers. Materials and methods A total of 40 patients were enrolled in this study, 17 females (mean age of 64.5 years; 33–88 years) and 23 males (mean age of 56.6 years; 28–84 years) with an overall mean age of 60.5 years. A total of 49 lesions were diagnosed and treated; 9 patients had more than one site affected. Mean time of follow-up was 22 months (6–71 months). Data were assessed by univariate Cox and multivariate Cox regression analyses. Results Recurrence (OL at the same site of the initial lesion) was observed in 11 patients (27.5%) while 4 patients (10%) developed new lesions, and 2 patients (5%) experienced malignant transformation. Only two clinical factors were statistically associated with the outcome for the development of new lesions: patients . 60 years and female gender (p < 0.1). Neither of the outcomes of recurrences and malignant transformations was significantly correlated with any of the risk factors analyzed. Conclusion Surgical laser is not a deterrent for the outcomes evaluated; additionally, the design of this study did not allow us to determine whether the laser treatment had provided a great benefit by significantly reducing the rate of malignant transformation among the patients. Clinical significance It is highly important to inform patients with OL that their condition can be treated, when possible, surgical laser, and that this treatment may be helpful in bringing down the odds of malignant transformation of their lesions. In addition, the patients should also be brought to the attention of the necessity of a continued clinical monitoring regardless of the outcome following a surgical intervention. How to cite this article Galletta V, Azevedo L, Lodi G, Migliari D. Factors affecting Clinical Outcomes after Treatment of Oral Leukoplakia with CO2 and Diode Laser. J Contemp Dent Pract 2017;18(9):775-780.


2020 ◽  
Vol 24 (12) ◽  
pp. 4563-4569 ◽  
Author(s):  
Primali Rukmal Jayasooriya ◽  
Kitmini Dayaratne ◽  
Upul Bandara Dissanayake ◽  
Saman Warnakulasuriya

2021 ◽  
pp. 317-320
Author(s):  
Luciane Azevedo ◽  
Mariana Tuma ◽  
Suzana Orsini ◽  
Dante Migliari

Oral leukoplakia (OL) has the potential for malignant transformation; unfortunately, there are no strategies to prevent this possible outcome. Surgical intervention has been reported to be effective in reducing but not eliminating the risk of malignant transformation. Meta-analyses have reported that patients who underwent excision of OL lesions had a significantly lower chance of malignant transformation than those whose lesions were not excised. The present study aimed to report a case of successful management of extensive OL using a high-power laser. The patient has been under periodic monitoring, and we aim to continue the follow-up as long as possible. Recurrence or signs of malignancy were not observed at the 2-year follow-up.


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