Title Usporedba dvaju visokoenergetskih ablativnih lasera u liječenju oralne leukoplakije Title (english) A comparison between two different high power ablative lasers in the treatment of oral leukoplakia Author Nena Matulić Mentor Dragana Gabrić (mentor)Mentor Vanja Vučićević Boras (komentor)Committee member Vlaho Brailo (predsjednik povjerenstva)Committee member Ivan Alajbeg (član povjerenstva)Committee member Marinka Mravak-Stipetić (član povjerenstva)Committee member Dinko Leović (član povjerenstva)Committee member Darko Macan (član povjerenstva)Granter University of Zagreb Defense date and country 2019-12-20, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616.31 - Stomatology Abstract Leukoplakija je bijela mrlja ili plak koji se ni klinički ni histološki ne može okarakterizirati kao neka druga lezija i nije povezana ni s jednim fizikalnim ili kemijskim uzročnim faktorom, osim upotrebe duhana. Dosadašnji načini liječenja poput ekscizije skalpelom, lokalne ili sistemske primjene retinoida i nekih lasera u manjem ili većem broju slučajeva dovode do recidiva
leukoplakije. Iz tog razloga postoji potreba za pronalaskom učinkovitijih metoda liječenja oralne leukoplakije. Stoga je svrha ovog istraživanja bila odrediti učinkovitosti visokoenergetskih ablativnih lasera u liječenju oralne leukoplakije. Nadalje, svrha je bila međusobno usporediti i procijeniti subjektivne i objektivne postoperativne parametre za dva različita ispitivana ablativna lasera, erbij, itrij, aluminij, garnet laser (Er:YAG) i erbij, kromij
dopiran s itrijem, skandijem, galijem, garnetom laser (Er,Cr:YSGG). U istraživanju su sudjelovala 54 ispitanika, od čega 16 muškaraca i 38 žena. Nasumičnim odabirom ispitanici su bili razvrstani u jednu od dvije ispitivane skupine. U prvoj skupini pacijentima se leukoplakična lezija uklanjala visokoenergetskim ablativnim laserom Er:YAG, a pacijentima u drugoj skupini visokoenergetskim ablativnim Er,Cr:YSGG laserom. Pacijentima je prije početka liječenja utvrđena veličina leukoplakične lezije, izmjerena u milimetrima. Kriterij za procjenu učinkovitosti lasera bila je pojava recidiva leukoplakije u razdoblju praćenja od jedne godine i šest mjeseci.
Rezultati su pokazali da postoji statistički značajna razlika u lokalizaciji pojave lezija između muškaraca i žena. Kod muškaraca lezija se najčešće nalazila na obrazu, dok se kod žena javljala u retromolarnom području i području mekog nepca. Kod muškaraca je bila utvrđena češća pojava recidiva nego kod žena. Lezije liječene Er:Cr:YSGG laserom nakon prve terapije pokazale su manje recidiva nego lezije liječene Er:YAG laserom, te su ispitanici imali nižu razinu postoperativne boli i veću kvalitetu života nakon liječenja Er:Cr:YSGG laserom. Iz navedenih rezultata može se zaključiti da je Er;Cr:YSGG laser učinkovitiji i prihvatljiviji za liječenje oralne leukoplakije nego Er:YAG laser.
Abstract (english) Aim: The aim of this study was to determine the most effective non-invasive surgical therapy in the treatment of oral leukoplakia by means of high energy ablative lasers. In addition, the aim was to compare the efficacy of ablative lasers and to evaluate subjective and objective
postoperative parameters (healing, postoperative pain, quality of life, recurrence), all for the purpose of identifying the optimal laser and precision settings of lasers for clinical use in order to achieve a successful treatment of oral leucoplakias. Previous treatment methods such as scalpel excision, topical or systemic administration of retinoids and some lasers in a smaller or larger number of cases lead to recurrence of leukoplakia. For this reason, there is a need for finding more effective methods of treating oral leukoplakia. Therefore, the purpose of this study was to determine the efficacy of high energy ablative lasers in the treatment of oral leukoplakia. Furthermore, the purpose was to compare and evaluate subjective and objective postoperative parameters for two different ablative lasers such as erbium, yttrium, aluminum, garnet (Er: YAG) and erbium, chromium doped with yttrium, scandium, gallium, and garnet laser (Er: Cr: YSGG).
Materials and methods: The study involved 54 subjects, of whom 16 men and 38 women. By random selection, the subjects were classified into one of the two study groups. In the first group of patients, the leukoplakic lesion was removed by high energy ablation laser Er: YAG
and patients in the second group were treated by use of high energy ablative Er, Cr: YSGG laser. At the very beginning, the size of the leukoplakic lesion was measured in millimeters. The criterion for laser efficacy estimate was the recurrence of leukoplakic lesion during the
one-year and six-month follow-up period. For the statistical analysis of the data, the Fisher's exact test was used for comparing discrete characteristics and the multivariate variance analysis (MANOVA) with three classification variables for comparing continuous characteristics. The Pearson correlation coefficient was used as the correlation measure. The analysis was made using the SAS statistical package on the Windows platform. Values of less than 0.05 were considered significant (p <0.05).
Results: The results showed that there was a statistically significant difference in localization of lesion occurrence between men and women. In men, lesions usually occur on the cheeks, whereas in women they occur in the retromolar area and the area of the soft palate. Men are
more likely to recur than women. After first therapy, the lesions treated by laser Er: Cr: YSGG showed less recurrence than those treated with Er: YAG laser and subjects reported a lower level of postoperative pain and higher quality of life after the treatment with Er: Cr: YSGG laser.
Conclusion: From the aforementioned results, we can conclude that the Er: Cr: YSGG laser is more efficient and more acceptable for the treatment of oral leukoplakia than the Er: YAG laser.
Keywords
oralna leukoplakija
terapija laserom
Er:YAG laser
Er
Cr:YSGG laser
Keywords (english)
oral leukoplakia
laser treatment
Er:YAG laser
Er
Cr:YSGG laser
Language croatian URN:NBN urn:nbn:hr:127:883643 Study programme Title: dental medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2020-01-29 10:00:23
