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

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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.

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Notes

  1. A non-parametric test of variance was chosen due to non-normal distribution of cell numbers.

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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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Authors and Affiliations

  1. Graduate Program of Surgery and Experimentation, Discipline of Operative Technique and Experimental Surgery, Department of Surgery, Medical School, São Paulo Federal University (UNIFESP), São Paulo, Brazil

    Flávio Francisco de Godoy Peres & Hélio Plapler

  2. Discipline of Oral Pathology, Department of Biosciences and Oral Diagnosis, Dental School, São Paulo State University (UNESP), São José dos Campos, Brazil

    Adriana Aigotti Haberbeck Brandão & Yasmin Rodarte Carvalho

  3. Department of Biostatistics, Institute of the Child, Medical School, University of São Paulo (USP), São Paulo, Brazil

    Ulysses Dória Filho

  4. Departamento de Cirurgia - Disciplina de Técnica Operatória e Cirurgia Experimental, Universidade Federal de São Paulo, Rua: Botucatu, 740 - Vila Clementino, São Paulo - SP, Brazil, CEP 04023-900

    Flávio Francisco de Godoy Peres

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  1. Flávio Francisco de Godoy Peres
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  2. Adriana Aigotti Haberbeck Brandão
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Correspondence to Flávio Francisco de Godoy Peres.

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de Godoy Peres, F.F., Aigotti Haberbeck Brandão, A., Rodarte Carvalho, Y. et al. A study of actinic cheilitis treatment by two low-morbidity CO2 laser vaporization one-pass protocols. Lasers Med Sci 24, 375–385 (2009). https://doi.org/10.1007/s10103-008-0574-y

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