Discomfort Following Oral Biopsy Comparing Laser and Punch Biopsy

Clinical Healing and Patient Discomfort Following Oral Biopsy in Oral Lichen Planus: a Randomized Controlled Non-inferiority Trial Comparing Laser and Punch Biopsy

Oral biopsy is essential for diagnosing mucosal lesions such as oral lichen planus (OLP). Laser surgery offers a minimally invasive alternative to traditional techniques, but thermal effects may impact healing and postoperative comfort. The aim of this study was to compare the degree of clinical healing and postoperative discomfort between laser and punch scalpel biopsy techniques in patients with OLP.

This was a single-center, parallel-group, noninferiority, randomized, blinded, controlled trial. One hundred and twelve adults with clinically and histologically confirmed OLP were randomized and allocated into two groups. Test group (diode laser) and control group (punch scalpel).

Inclusion Criteria:

• clinical and histological OLP diagnosis according to the WHO diagnostic criteria modified by van der Meij and van der Waal (4), age ≥18 years
• indication for oral incisional biopsy involving the dorsal tongue and buccal mucosa.

Exclusion Criteria:

• oral lichenoid lesions (OLLs) according to the recent WHO classification of OPMD;
• anamnesis of hematopoietic stem cell transplant;
• OSCC concomitant with OLP diagnosis,
• inability to attend follow-up visits,
• psychiatric disorders,
• insufficient Italian language comprehension,
• local corticosteroid therapy within the previous three months.
• chronic pharmacological treatment with drugs known to influence nociceptive sensitivity