Dental Problems

Surgical Treatment for Leukoplakia

DenturesLeukoplakia conditions can also be treated following surgical procedures. There are various methods of surgical treatment for leukoplakia which are discussed below in this article. Let us examine them.

Surgical treatment for leukoplakia:

To give a proper treatment for any condition including leukoplakia, microscopic examination is essential for which biopsy is generally taken. Most meaningful areas for which biopsy specimen is taken are the sites which display greater irregularities on the surface such as fissures and cracks and the ones which are associated with the erythematous areas.

Conventional surgery:

  • An incision is made around the lesions including safe margins.
  • This incision must be wide and deep.
  • Then the affected area is checked and dissected from this underlying tissue.
  • A flap with sliding mucosa is prepared to cover the wound. Skin hook and fine iris scissors must be used for reducing trauma.
  • It is necessary to undermining the mucosal flap in a fairly extensive way so that there will be less amount of tension when it gets advanced into position.
  • Excessive tension will cause circulation restriction and could result in necrosis in some cases.
  • After proper mucosal flap mobilization, it is advanced and black sutures with multiple interruption are used for the free edges approximation.
  • Postoperative ice bags applications to the area is advised for minimizing swelling and bleeding.

Cryosurgery:

In this procedure, the tissue is exposed to the extremely cold condition for the production of irreversible cell damage. At -20 degree Celsius, the cell death occurs.

  • Cryo probe or disc type probe refrigerated by the liquid nitrogen or a pressurized nitrogen oxide may be used.
  • A rewarming device is incorporated inside the probe, thus, the tissue could be rapidly frozen and it can be thawed as required.
  • The surface of the lesion is moistened by the water soluble jelly and then the probe is applied. In tissue, it produces a very lower temperature.
  • First freeze ir for a minute, then followed by five minute thaw. Then, a second one minute freeze is administered.
  • White area of the necrosis is produced by the freezing procedure.
  • This process is repeated for 2 or 3 times in order to produce maximum destruction.
  • Freezing process induces the formation of crystals in the intracellular spaces and within the cell. When there are rapid cooling rates, intracellular ice crystal might rupture the membrane of the cell and can lead to cell death.
  • Slower cooling process produces large size ice crystals within the spaces present between the cells. As these crystals grow, water is withdrawn from the neighboring cells, this leads to an increased electrolyte concentration in the cells. Soon, this reaches the toxic levels and when thawing commences, the osmotic shock initiates the death of cell.
  • The death of the cell also occurs by a change in the microvasculature part which has been exposed to cryosurgery.

Fulguration (electrosurgery and electrocautery):

  • In this technique, there is a destruction of tissues using high voltage electric current. They also movable electrode to control its action.
  • Advantages of fulgurations include its ability to provide easy hemorrhage control and to coagulate lesion.
  • Disadvantages of this include foul odor (distasteful), need for the profound local anesthesia and/or sometimes general anesthesia, hazards of explosion, slow healing process, scarring and pain.

Note: Individuals going for any treatment procedure for any condition must go for thorough examination and diagnosis. You must also take complete guidance for the after affects of the treatment and medications.

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