# A Review of CO\({}_{2}\) Laser-Mediated Therapy for Oral Mucosal Lesions
## 4 Discussion  
After registering and presenting all outcomes of the above-mentioned studies, further discussion of these results is required. However, it is generally difficult to compare different \begin{table}
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**Author** & **Study Type** & **Participants** & **Intervention** & **Outcomes** \\ \hline \multirow{9}{*}{[PERSON] et al. (2017)} & \multirow{9}{*}{Comparative study} & 30 patients with & \multirow{9}{*}{Group 1: diode Laser, Group 2: CO\({}_{2}\)-laser, Group 3: nitrous oxide cryosurgery, harmful habits (alcohol, tobacco, etc.)} & \multirow{9}{*}{Significant differences for edema, pain, and scar} \\  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \cline{1-1}  & & & & \\ \hline \hline \end{tabular}
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Table 1: _Cont._studies, given the alternating study parameters, the intermittently differing lesion types, and various study circumstances. In the case of oral leukoplakia, when comparing CO2 laser to classic surgery, the studies that were included in this review mainly concluded that shorter operating times, less bleeding, less pain, and less postoperative swelling were all advantages presented by the CO2 laser, with emphasis on the bleeding and swelling parameters. [PERSON] et al. [37] and [PERSON] et al. 's [38] studies may have a lower impact on our review due to the larger number of patients that received conventional surgery than those who were subjected to laser treatment. However, in [PERSON] et al. 's study, every procedure was carried out by the same surgeon, and detailed information about the interventions was provided, which in turn, increases the study's significance. Both approaches required the same amount of tissue to be removed, namely 3 mm of perilesional tissues were needed to be excised for recurrence prophylaxis. Therefore, equal invasiveness can be attributed to both approaches. However, CO2 laser may be a more suitable choice since less postoperative scarring was also reported when compared to classical surgery. Furthermore, when comparing the CO2 laser to the diode laser and to cryosurgical therapy, the latter seems to have had the least positive results, including increased pain on the day of surgery, scar formation, increased postoperative pain, and swelling present even after a 2-week period. In contrast to these results, the patients that received the CO2 and diode lasers only reported slight pain levels, which were higher in the CO2 laser group, on the day of surgery and postoperatively. When referring to lesion recurrence and malignant transformations of oral leukoplakia lesions, the main issue encountered in comparing these results was the extremely variable follow-up period (ranging from 2 to 102 months). A general consensus was attempted in order to obtain guidelines suitable for the clinical approach concerning lesion recurrence and malignant transformations. The average outcomes of our reviewed studies confirm that most of the patients' evolution was non-pathological. However, an average of 25% of patients did present with recurrent lesions during the follow-up period, while malignant developments and other complications were relatively low. When assessing such parameters, the lesion's location, grade of dysplasia, type, and the presence of risk factors, such as smoking, alcohol consumption, and the existence of previous malignancies, must be taken into account. In the case of oral erythrolakia, only a few studies were published over the last decade. [PERSON] et al. (2014) concluded that CO2 laser surgery is effective as long as the lesion is confined to dysplasia of any degree, and that postoperative recurrence was associated with the size or the area (larger than 80 mm2) [47]. Significant findings were also emphasized by [PERSON] et al.