Discomfort Following Oral Biopsy Comparing Laser and Punch Biopsy

Catholic University of the Sacred Heart112 enrolled

Overview

Oral biopsy is essential for diagnosing mucosal lesions such as oral lichen planus (OLP). Laser surgery offers a minimally invasive alternative to traditional techniques, but thermal effects may impact healing and postoperative comfort. The aim of this study was to compare the degree of clinical healing and postoperative discomfort between laser and punch scalpel biopsy techniques in patients with OLP. This was a single-center, parallel-group, noninferiority, randomized, blinded, controlled trial. One hundred and twelve adults with clinically and histologically confirmed OLP were randomized and allocated into two groups. Test group (diode laser) and control group (punch scalpel).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

112

Conditions

Oral Lichen Planus Biopsy

Interventions

Biopsies were performed via a diode laser (980 nm wavelength) after local perilesional anaesthesia with 2% mepivacaine with a vasoconstrictor (1:100,000). A 6 mm tissue sample was excised, and the wound was generally allowed to heal by secondary intention; sutures were placed only in selected cases at the discretion of the operator. A specific surgical stent with a diameter of 6 mm was used to ensure identical sample dimensions for both groups.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * clinical and histological OLP diagnosis according to the WHO diagnostic criteria modified by van der Meij and van der Waal (4), age ≥18 years * indication for oral incisional biopsy involving the dorsal tongue and buccal mucosa. Exclusion Criteria: * oral lichenoid lesions (OLLs) according to the recent WHO classification of OPMD; * anamnesis of hematopoietic stem cell transplant; * OSCC concomitant with OLP diagnosis, * inability to attend follow-up visits, * psychiatric disorders, * insufficient Italian language comprehension, * local corticosteroid therapy within the previous three months. * chronic pharmacological treatment with drugs known to influence nociceptive sensitivity

Outcomes

Primary Outcomes

Clinical healing assessed by the modified Landry Healing Index

Wound healing was assessed via the modified healing index after surgery by a blinded operator. This healing index ranges between 0 and 9, with 0 indicating the worst possible healing and 9 indicating the best one.

Time frame: 7 days after the procedure