Surgical Scalpel vs Laser: A Comparative Clinical Study in Intra Oral Incisional Biopsy

Background and objectives: To compare diode laser incision with traditional blade incision for soft tissue incisional biopsy in terms of Hemostasis, Local anesthetic required, Duration of procedure and Post-operative pain. Methods: The following study was conducted in department of oral and maxillofacial surgery, Oxford Dental College, Bengaluru from November 2015 to August 2017. Sixty patients were enrolled in the study based on the indication for incisional biopsy and were randomly divided into two groups of thirty each. The biopsy was carried out using a. B.P handle and 15 no. blade and Diode laser at 980nm wavelength and 3watts power in contact mode with 200nm activated fiber. The biopsies were conducted under infiltration of local anesthesia (2% lignocaine hydrochloride with 1:200,000 adrenaline). The biopsies were marked with laser or incisional before being sent to the oral pathologist. Result: In comparison between two groups: the amount of local anesthesia needed in laser group was (mean 0.91+/-0.44) compared to scalpel group (2.97+/-0.76ml). The loss of blood (as calculated by subtracting the initial weight of gauge from final weight) in the laser group was 0.94+/-0.34mg when compared to scalpel group which was 8.79+/-0.88mg meaning the bleeding was less in laser group. The pain also was less in the laser group when compared to scalpel group both on day one and day three. The duration of the procedure was almost similar. Interpretation & Conclusion: The study showed that the Diode laser is a good alternative for soft tissue incisional biopsies with respect to scalpel as it has less bleeding, less post-operative pain and not much difference in total time for the procedure. With precautions laser biopsy can yield as good a specimen as a scalpel biopsy and in a setting that is comfortable to patient.