A clinical investigation of the management of oral lichen planus with CO 2 laser surgery.

Ten patients with an established histologic diagnosis of lichen planus on various sites of the oral cavity were treated with CO 2 laser therapy under local anesthesia. Power output of 5 W at continuous mode was applied to vaporize the lesions. Eradication was achieved by aiming the laser in a moving criss-cross pattern with defocused spatial overlap. Depth of removal was subepithelial. No suturing of the wound was done. Follow-up occurred at intervals from 6 months to 4 years. The average length was about 3 years. Postlaser healing was uneventful, with little pain, swelling, or bleeding. There was immediate relief in all patients of associated burning sensations and a tolerance to hot and spicy foods. This symptomatic improvement lasted throughout the follow-up. Reepithelialization produced little visible scarring, and the mucosa color and texture were close to normal. Alterations in the immunologic status of the patients were implicated. Histologic rebiopsy in two cases suggested significant improvement, normalization of the epithelium, and a reduction of the subepithelial infiltrate. The CO 2 laser is effective in the immediate relief of symptoms and contributes to the clinical improvement of oral lichen planus. Immunologic studies and long-term follow-up are suggested.