Abstract
Background: Oral leukoplakia (OL) is a potential neoplasmic lesion. The aim of this study was to apply texture analysis (TA) and fractal dimension analysis (FDA) to estimate the effectiveness of OL treatment using an Er:YAG laser. Methods: Eighteen patients with 32 lesions were treated. Laser procedures were conducted using the LiteTouch™ Er:YAG Dental Laser. The diameter of the operational tip was 1.3 mm, the power was 50 mJ, the frequency was 50 Hz, and the wavelength was 2940 nm. TA was based on long and short-run emphasis inverse moments, difference entropy, inverse difference moment, and wavelet decomposition for two-dimensional photography. FDA was measured using the box-counting method. Results: Total response was achieved in 50% of lesions, partial response was observed in 47%, and 3% of lesions did not respond to treatment. Recurrence occurred in 34% of lesions. TA features indicated pathological images depicting leukoplakia and complete reconstruction of the correct mucosal image after laser ablation. The discrete wavelet transformation feature detects much larger structures than the properties derived from the run-length matrix and co-occurrence matrix. Conclusions: The Er:YAG laser is an effective treatment method in cases of oral leukoplakia. Leukoplakia treatment by Er:YAG laser is an effective modality, as revealed by the oral mucosa microstructure. TA and FDA are promising methods to estimate the effectiveness of OL treatment.
Highlights
Oral leukoplakia (OL) is a potential neoplasmic lesion [1]
123 laser achieved in 16 patients (50%), a partial response was observed in 15 patients (47%) and one patient (3%)
Our present study revealed no differences between the reference and post-op groups, and no differences were observed between the reference and intermediate groups in contrast to texture analysis
Summary
Oral leukoplakia (OL) is a potential neoplasmic lesion [1]. OL is a white patch or plaque that cannot be clinically identified as any other disease. Malignant transformation risk is between 0.2 and 9% [2]. The rate of malignant transformation depends on the follow-up time and demographic factors [3]. Nonhomogeneous OL presents a higher risk for malignant transformation [4]. Warnakulasuriya and Ariyawardana revealed a total transformation rate of 14.5% for nonhomogeneous leukoplakia [5]. Classical surgery is still helpful in the case of small lesions. Widespread lesions that involve the whole mucous membrane of the cheeks, tongue, bottom of the oral cavity, or alveolar ridge are important clinical problems. Oral leukoplakia (OL) is a potential neoplasmic lesion. TA features indicated pathological images depicting leukoplakia and complete reconstruction of the correct mucosal image after laser ablation
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