Is CO2 laser effective in the surgical management of oral potentially malignant disorders? A systematic review and meta-analysis.

PURPOSE

This study aimed to evaluate the effectiveness of carbon dioxide (CO2) lasers in the surgical management of oral potentially malignant disorders (OPMDs), lesions of the oral mucosa with a risk of malignant transformation. The research question focused on whether CO2 lasers reduce recurrence rates and postoperative pain compared to other treatment modalities.

METHODS

This review was conducted in accordance with the PRISMA statements, and registered in PROSPERO (CRD42023438873). A systematic review and meta-analysis were conducted by searching 12 electronic databases for articles published between 2000 and August 31, 2023. Two independent reviewers screened studies based on inclusion criteria, selecting 16 studies: 12 non-randomized controlled trials (NRCTs) and 4 randomized controlled trials (RCTs). The Joanna Briggs Institute Critical Appraisal Checklist and the RoB 2 tool were used to assess the risk of bias. Meta-analyses were performed to compare recurrence rates and postoperative pain between CO2 laser therapy and other treatment modalities.

RESULTS

CO2 laser therapy showed a lower recurrence rate compared to other treatment modalities, with an odds ratio of 0.36 (95% CI: 0.12-1.04; Z = 1.89), though this difference was not statistically significant (p = 0.06). For postoperative pain, the standardized mean difference was - 0.16 (95% CI: -1.37 to 1.05; Z = 0.26), with no significant difference between groups.

CONCLUSION

CO2 lasers provide several advantages and hold promise for treating OPMDs. However, further research is needed to fully establish their therapeutic efficacy and explore their application in other oral lesions.