Abstract :
Context and Objective: Scalpel has been the gold standard tool for intraoral surgery. Since a few decades, lasers have also stepped up as operating instruments, be it cutting, ablation or photobiomodulation. In our research, we compared the efficacy of scalpel and diode laser in intraoral maxillofacial surgery.
Setting and Design: In the duration of 3 years, a total of 100 patients were included in our study which were divided into two groups of 50 patients each; 50 in the test group for scalpel and 50 in the control group for laser.
Materials and Methods: Inclusion criteria includes clinically diagnosed intraoral soft tissue lesions/growth indicative of tissue ablation, incision, excision, or biopsy. Exclusion criteria: Non consenting and/or non-cooperative patients. Presence of uncontrolled or advanced systemic diseases, immunocompromising diseases, porphyria or medications that cause photosensitivity (eg. Chloroquine, methotrexate etc) and serious eye defects.
Results: While laser provided a clean surgical field by facilitating haemostasis during bleeding, its healing time was slower as compared to laser during the first postoperative week. 2% Lignocaine HCl with 1:80000 adrenaline was used as a local anaesthetic agent. Swelling and redness were both found to be pronounced in scalpel as opposed to laser which produced a coagulum ring of eschar formation during cutting.
Discussion: Scalpel offers unmatched precision and speed during surgery. Its only drawback is bleeding which may be inconvenient for the surgeon. Laser not only clears the surgical field of the operator but also reduces the risk of bleeding from highly vascular areas like the tongue. The heat from the laser tip negates any additional measures required for cleaning.
Summary and Conclusions: The 980 nm diode laser promises versatility and surgical efficacy during intraoral maxillofacial procedures and can be a good alternative to the conventional cold scalpel, offering equal patient satisfaction.
Keyword :
Immunocompromising diseases, Postoperative swelling, Maxillofacial surgery