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Lasers in Medical Science

, Volume 24, Issue 3, pp 375–385 | Cite as

A study of actinic cheilitis treatment by two low-morbidity CO2 laser vaporization one-pass protocols

  • Flávio Francisco de Godoy Peres
  • Adriana Aigotti Haberbeck Brandão
  • Yasmin Rodarte Carvalho
  • Ulysses Dória Filho
  • Hélio Plapler
Original Article

Abstract

Therapeutic approaches to chronic actinic cheilitis focus on the removal or destruction of diseased epithelium. The CO2 laser has become an important therapeutic alternative, achieving clinical resolution in around 90% of patients. Although many laser physical parameters have been reported, some are known for their low potential for scar induction without compromising the success of the results. The aim of this clinicohistological study was to compare the therapeutic responses to two low-morbidity protocols involving a single laser pass. A total of 40 patients with chronic multicentric and microscopically proven disease were randomly submitted to two conservative CO2 laser protocols using a bilateral comparative model. The degree of histological atypia of the epithelium was determined in 26 patients both pre- and postoperatively for both protocols. Other histological phenomena were assessed in addition to this central analysis parameter. Clinical recurrence occurred in 12.5% of patients for each protocol, together with a significant reduction in the degree of epithelial atypia (p < 0.001), which was occasionally complete. However, no difference was found between the protocols (p > 0.05). Using these morphological parameters it was not possible to determine whether postoperative epithelial atypias in part of the sample were reactive or residual in nature. A few patients may show minor postoperative lesions. Due to their potential to achieve clinical and importantly microscopic resolution, the studied protocols may be used for mild through moderate dysplastic epithelium and clinically diffuse disease.

Keywords

Actinic cheilitis Oral precancer Laser surgery Oral epithelial dysplasia Histopathology 

Notes

Acknowledgements

We thank Mr. Marcos Vieira de Azevedo (BSc) for Laser Physics consultancy, Dr. Fernanda Bertini Moreira (DDS, MSc) and Dr. Cláudio Hideki Kubo (DDS, PhD) for support on patients’ anesthesia, Ms. Ana Lourdes da Silva Machado (BSc, MSc) for skilful histological preparation and all other people that somehow have co-operated in this research work.

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Copyright information

© Springer-Verlag London Ltd 2008

Authors and Affiliations

  • Flávio Francisco de Godoy Peres
    • 1
    • 4
  • Adriana Aigotti Haberbeck Brandão
    • 2
  • Yasmin Rodarte Carvalho
    • 2
  • Ulysses Dória Filho
    • 3
  • Hélio Plapler
    • 1
  1. 1.Graduate Program of Surgery and Experimentation, Discipline of Operative Technique and Experimental Surgery, Department of Surgery, Medical SchoolSão Paulo Federal University (UNIFESP)São PauloBrazil
  2. 2.Discipline of Oral Pathology, Department of Biosciences and Oral Diagnosis, Dental SchoolSão Paulo State University (UNESP)São José dos CamposBrazil
  3. 3.Department of Biostatistics, Institute of the Child, Medical SchoolUniversity of São Paulo (USP)São PauloBrazil
  4. 4.Departamento de Cirurgia - Disciplina de Técnica Operatória e Cirurgia ExperimentalUniversidade Federal de São PauloSão Paulo - SPBrazil

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