New consideration in laser vaporization of Oral Leukoplakia

Oral Leukoplakia (OL) is one of the most common premalignant lesions of oral cavity. It is defined by WHO as a white patch or plaque on the oral mucosa, that cannot be removed by scraping and cannot be classified clinically or microscopically as any other diseases. After an incisional histopathological biopsy to confirm the diagnosis, there are different approaches for OL that depend on the size of lesion and the presence of dysplasia. These approaches are: “Wait and see”, Pharmacological therapy, Surgical excision, Cryosurgery, Laser vaporization or Photodynamic therapy. Definitive treatment of OL is very important because of its recurrence rate and its occasionally observed malignant. It is reported in literature that the rate of recurrence is 7.7-38.1%, while malignant transformation is 2.6-9%. Usage of CO 2 , KTP and Diode laser surgery for oral mucosal lesions in particularly for the treatment of OL has widely been recommended due to presence of many advantages. Recently, new recurred patches of OL has been observed, that may originate from potentially unstable mucosa from the margins of the lesion. Therefore, it is worth that more investigations should be carried out by using laser vaporization treatment and at least one year of follow up, adding safety margins 3 mm in width also in depth, will help to avoid the potentially unstable mucosa. This new consideration not only may reduce the recurrence rate but also reduce the peripheral recurrence and the malignant transformation of oral Leukoplakia.