Laser therapy decreases oral leukoplakia recurrence and boosts patient comfort: a network meta-analysis and systematic review.

Oral leukoplakia (OLK) is a prevalent precancerous lesion with limited non-pharmacological treatment options. Surgery and various lasers are the mainstay of treatment; however, their relative efficacy and optimal choice remain unclear. This first network meta-analysis compared the effects of different lasers and surgical excision on post-treatment recurrence and comfort in OLK patients. We searched four databases for relevant randomized controlled trials (RCTs) up to April 2023. The primary outcome was post-treatment recurrence, and secondary outcomes included intraoperative hemorrhage and postoperative pain scores. The Cochrane Risk of Bias tool was used to assess the study quality. Meta-analysis and network meta-analysis were employed to determine efficacy and identify the optimal intervention. A total of 11 RCTs including 917 patients and 1138 lesions were included. Er,Cr:YSGG laser treatment showed significantly lower recurrence rates compared to CO2 laser (OR: 0.04; 95% CI: 0.01-0.18), CO2 laser with margin extension (OR: 0.06; 95% CI: 0.01-0.60), Er:YAG laser (OR: 0.10; 95% CI: 0.03-0.37), electrocautery (OR: 0.03; 95% CI: 0.00-0.18), and standard care (OR: 0.08; 95% CI: 0.02-0.33). Er,Cr:YSGG laser also ranked the best for reducing recurrence, followed by standard care and CO2 laser combined with photodynamic therapy (PDT). Er:YAG and Er:Cr:YSGG lasers minimized bleeding and pain, respectively. None of the interventions caused severe adverse effects. For non-homogeneous OLK, Er:YAG, Er:Cr:YSGG, and CO2 laser combined with PDT offer promising alternatives to surgical excision, potentially reducing recurrence and improving patient comfort. Further high-quality RCTs are necessary to confirm these findings and determine the optimal laser-PDT combination for OLK treatment.

Luo R ，Wang Y ，Li R ，Ma Y ，Chen H ，Zhang J ，Shen J ... -  《BMC Oral Health》

Comparison of Er:YAG and Er,Cr:YSGG Laser in the Treatment of Oral Leukoplakia Lesions Refractory to the Local Retinoid Therapy.

Matulić N ，Bago I ，Sušić M ，Gjorgievska E ，Kotarac Knežević A ，Gabrić D ... -  《Photobiomodulation Photomedicine and Laser Surgery》

Malignant transformation of oral leukoplakia treated with carbon dioxide laser: a meta-analysis.

Dong Y ，Chen Y ，Tao Y ，Hao Y ，Jiang L ，Dan H ，Zeng X ，Chen Q ，Zhou Y ... -  《-》

Oral leukoplakia treatment with the carbon dioxide laser: A systematic review of the literature.

We conducted a systematic review of the literature to evaluate treatment of oral leukoplakia with the carbon dioxide (CO2) laser. A comprehensive search of studies published between 1981 and 2015 and listed in the PubMed (National Library of Medicine, NCBI) database yielded 378 articles which were screened in detail. Relevant studies were selected according to predetermined inclusion and exclusion criteria. A total of 33 articles met the final inclusion criteria and were analysed in detail in accordance with the PRISMA-P statement. These full-text papers were classified as synopses (n = 7), recurrence and malignant transformation studies (n = 17), comparative studies between CO2 laser and cold knife surgery (n = 3) and studies evaluating the efficacy of CO2, Nd:YAG and KTP lasers. According to the literature the CO2 laser is the workhorse of oral leukoplakia treatment due to its effectiveness and low associated morbidity. However, randomized clinical trials are needed to compare CO2 laser with other lasers. The results of our systematic review showed that there is no consensus regarding the factors involved in higher recurrence and malignization rates, so further studies are needed.

Mogedas-Vegara A ，Hueto-Madrid JA ，Chimenos-Küstner E ，Bescós-Atín C ... -  《-》

Clinical comparison between Er: YAG and CO2 laser in treatment of oral tumorous lesions: A meta-analysis.

Liu R ，Sun K ，Wang Y ，Jiang Y ，Kang J ，Ma H ... -  《-》