Discussion

Laser surgery ensures, besides the safe removal of the oral lesions, the considerable maintenance of oral functions. The fact that we can adhere strictly to removal of the pathologic tissues only and that the wound healing takes place with minimal scarring, assures favourable reception of the procedure from both functional (nourishment, speech, mimics) and aesthetic points of view. This goal is achieved by all three individual laser surgical interventions (coagulation, vaporisation, excision) or, occasionally, by their combined application. Thus, the radically required by the severity of the lesion can be counterbalanced by the maximal potential preservation of the healthy tissues. Favourable aesthetics and functional results were seen in cases of CO2 or argon laser coagulation and vaporisation. The cutting procedure is favourable by CO2 laser beam.

Due to its 2- 4 mm depth of effect the Nd YAG laser ensures better coagulation than the carbon dioxide one, it can also close larger vessels although larger healthy tissues get damaged. The Nd YAG laser is highly favourable in the treatment of haemophilic patients and major vascular lesions.

The combined laser (CO2+Nd YAG) application makes it possible to achieve proper coagulative and cutting effect corresponding to the properties of the structures. In more haemophilic cases wider coagulation is made mostly with Nd YAG beam and less CO2 is applied while in interventions requiring less coagulation the CO2 laser outweighs the use of Nd YAG.. By combined application the coagulation and cutting effect could be adjusted to any desirable extent.

Laser therapy represents significant savings for the national economy the purchase of the laser equipment requires a single investment, but further maintenance or material costs are unremarkable. The instrumental demand of the laser operations is minor. as a rule, not even sutures are necessary. Since the results in a high response rate after only the first treatment, the manifold travelling by patients can be avoided and their absence from work is minimal. One day after surgery, 90% of those operated on are already capable of resuming work. We consider it a remarkable advantage of lasing that the initial treatment ensures a response equal to two, three, or several cryotreatments.

Based on the experience gained so far we are of the opinion that one of the most important oral surgical indications of the laser beam are the therapy of oral precancerosis, haemangiomas, epulis and the treatment of haemophilic patients.