| Autor: |
Rui Luo, Yanan Wang, Ruixin Li, Yanan Ma, Haitao Chen, Jian Zhang, Jun Shen |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
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| Zdroj: |
BMC Oral Health, Vol 24, Iss 1, Pp 1-11 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
1472-6831 |
| DOI: |
10.1186/s12903-024-04179-9 |
| Popis: |
Abstract Background 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. Methods 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. Results 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. Conclusion 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. |
| Databáze: |
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| Externí odkaz: |
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