Laser in the management of oral soft tissue lesions

OBJECTIVES The application of laser in the treatment of oral soft tissue lesions offers many advantages for both the operator and the patient. Precise incisions, excellent control of bleeding, more rapid healing, and fewer post-operative pain symp-toms are its particular characteristics. The aim of this Module is to summa-rize, in light of the most recent literature and the clinical expertise of the authors, the role of the laser in the treatment of oral soft tissue lesions. MATERIALS AND METHODS Since the laser effects are linked to the absorption of energy by the tissues, the choice of a suitable wavelength, for the tissue and the lesion to be treated, is essential. All modern lasers can be used in oral surgery, but knowing the depth of penetration and target tissue of each wavelength reduces the un-wanted effects. RESULTS The use of the laser for the excision of benign lesions such as fibromas, HPV-related lesions, and mucoceles guarantees excellent results, due to the non-invasive laser techniques and the reduction of the risk of recurrence. Ex-cellent results are also obtained with the use of the lasers in the excision or photocoagulation of vascular malfor-mations, pyogenic granulomas, or, gen-erally, all those inflammatory lesions characterized by generous reactive an-giogenesis, due to the reduced risk of bleeding. On the other hand, although the latest literature affirms the safety of laser, the peri-incisional thermal effect induced by the laser in clinically suspicious le-sions must be considered, which can alter the histological evaluation of the lesions with potential infiltration. There-fore, it is recommended, in the case of potentially malignant lesions, to extend approximately 3 mm beyond the mar-gins of the lesion. CONCLUSIONS The use of the laser cannot disregard the necessity of a learning curve in order to apply the best suitable laser parame-ters without incurring procedural errors. CLINICAL SIGNIFICANCE Modern minimally invasive dentistry is increasingly directed towards the quality of treatments, especially the surgical ones. The less invasive nature of laser treatments has allowed them to become alternatives to convention-al methods in many cases, that have the same surgical results but do not provide the bio-stimulant and analge-sic effects of laser-assisted therapy.