Comparison of Conventional Surgery and CO 2 Laser on Intraoral Soft Tissue Pathologies and Evaluation of the Collateral Thermal Damage Ibrahim Tuncer, D.D.S., M.Sc., 1 Ceyda O ¨ zc ¸ akır-Tomruk, D.D.S., Ph.D., 1 Kemal S ¸encift, D.D.S., Ph.D., 1 and Sedat C ¸o ¨ log ˘lu, D.D.S., Ph.D. 2 Abstract Objective: The aim of the study was to compare conventional surgery with carbon dioxide (CO 2 ) laser applied on oral soft tissue pathologies and to evaluate the effect of collateral thermal damage on histopathological diagnosis. Anesthesia need, postoperative pain, and intraoperative and postoperative complications were ex- amined as part of the comparison. Methods: Forty-three patients (32 female and 11 male) with a mean age of 54 (54  7.0) requiring soft tissue surgeries were randomly assigned to receive treatment either with conventional surgery using a scalpel or with a CO 2 laser technique. Anesthesia method and need, postoperative pain, systemic pain medications if needed, and intra- and postoperative complications were recorded. Excised tissues were evaluated histopathologically for the effect of thermal damage. Results: All patients were anesthetized with local anesthesia in the conventional group whereas only 10 (42%) patients needed local anesthesia after topical anes- thetic application in the laser group. In the conventional group, 18 (90%) patients need analgesics after the op- eration, compared with seven (29%) patients in the laser group. No intra- or postoperative complications were seen for either procedure. Histological examination of 39 specimens showed that collateral thermal damage on the incision line did not affect the histopathological diagnosis. Conclusions: CO 2 laser is an effective instrument for soft tissue excisional biopsies with minimal intraoperative and postoperative complications and good pain con- trol. CO 2 laser applications are suggested as an alternative method to conventional surgery on oral soft tissues. Introduction M any laser systems, each with their own benefits and drawbacks, are used in dentistry. Of them, CO 2 , Argon- Ion, Er:YAG and Nd:YAG lasers are generally used for the treatment of soft tissue pathologies. 1–4 In addition to their use as an adjunct to conventional surgical methods, lasers are now the treatment of choice or the sole treatment modality for a variety of pathologies. The disadvantages of lasers include eradication of the specimen for histologic examination, slower healing rate, and high cost of equipment. The most common advantages are less bleeding, improved sterility, decreased scarring and swell- ing, reduced postoperative pain, greater precision and im- proved cutting control. 5–9 The CO 2 laser, which has a wavelength of 10.6 mm, has become a favorite instrument in the treatment of soft tissue pathologies because of its affinity for water-based tissues. 9–11 It destroys tissue with minimal surrounding tissue damage. Its hemostatic nature make the CO 2 laser ideally suited for excision and vaporization of mucosal tissue in the oral cavity. 10,12 In oral surgery, the clinical application of CO 2 laser has been recommended to treat benign oral lesions such as fibromas, papillomas, hemangiomas, gingival hyperplasias from various causes, aphthous ulcers, ankyloglossias, and premalignant lesions like lichen planus and oral leuokopla- kia. 13,14 The CO 2 laser does not possess any enhanced ability to cure oral disease when compared with conventional pro- cedures such as the scalpel, electrosurgery or cryotherapy. Rather, it is a precise means of excising soft tissue lesions with little upset to the patient. 15 Recent studies present conflicting results on the efficacy of CO 2 lasers when compared with other surgical instruments. Some clinical reports have indicated that the early phase of wound healing after laser surgery is faster than that after scalpel surgery and is associated with less postoperative pain, less blood loss, and shorter operative time. 10,16 In contrast, 1 University of Yeditepe, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey. 2 University of Yeditepe, Faculty of Medicine, Department of Pathology, Istanbul, Turkey. Photomedicine and Laser Surgery Volume 28, Number 1, 2010 ª Mary Ann Liebert, Inc. Pp. 75–79 DOI: 10.1089=pho.2008.2353 75