Introduction: In the different branches of dentistry, the use of laser to solve different clinical situations is increasing due to numerous advantages that have been studied in literature since the 70s. Leucoplakia and hyperkeratosis can benefit from laser-assisted treatment. In most cases biopsy sampling, histological examination and, if no malignant cells are present, the follow-up is needed. However, even if the lesion is free of dysplasia patients often ask to eliminate these white spots that are always a cause of concern. Aim: From these numerous requests comes the idea of setting up a laser-assisted protocol as less invasive as possible to be offered to patients. The aim of the study is to find a laser-assisted protocol for the surgical excision of leucoplakia and hyperkeratosis that can both improve the clinical aspect of the lesion and be sustainable for patients. The null hypothesis has been identified in the following statement: the treatment is effective and efficient at the same time; where effectiveness was tested with the following criteria: size of the lesion, tactile perception, discomfort, pain; and efficiency with the following criteria: pain and discomfort perceived during the treatment. Materials and methods: To collect all data, a specially designed medical record was used. The diode laser was used with a pulsed mode and the maximum power corresponds to 1.8 W. No anaesthesia was used. Before laser-assisted treatment, the fibre was activated and was used with a contact overflowing. Results: Our results show a decrease in the size of the lesion statistically significant. No pain was referred during treatment, except for a slight burning sensation. Conclusion: In conclusion we can state that the treatment is both efficient and effective.

Aim. The aim of this study is to perform a laser-assisted protocol as less invasive as possible to be offered to patients. Materials and Methods. 20 patients were included in this study, of which 9 were affected by hyperkeratosis and 11 were affected by leukoplakia. The sample consisted of 11 men (55%) with an average age of 55 years old and 9 women (45%) with an average age of 67 years old, the average age of the sample was of 61 years old. A diode laser which wavelength was 940 nm, the fiber had a length of 9 mm and diameter of 300 microns was used; a pulsed mode was selected with a Ton corresponding to Toff and corresponding to 10-3 seconds, the period corresponds to the summary of Ton and Toff that is 2x10-3 seconds. The treatment consisted of four sessions a week and a follow-up visit one month after the last treatment session. The following data were collected before treatment, and in the final follow-up session: • The measure of the lesion. • The appearance of the lesion. • The discomfort of the lesion measured with an arbitrary numerical scale from 0 to 5. • The pain caused by the lesion measured, with an NRS scale (Numerical Rating Scale, Downie, 1978; Grossi, 1983), • The tactile perception, that is the sensation of roughness that the patient felt passing the tongue on the area where the lesion was present, with an arbitrary numerical scale from 0 to 5. Results. Dimension of lesion: the dimension between the two-time intervals was reduced by an average of 40%. Discomfort analysis: the perception of the discomfort caused by laser therapy resulted approximate to zero. Pain: no patient reported pain during therapeutic treatment. Tactile perception: there is a significant reduction in tactile perception. Discussion. In conclusion we can state that the treatment is a valid alternative to conventional surgery with scalpel if the lesion has a size greater than 8 mm, below this limit it is better to completely eliminate the lesion during biopsy. From what has been observed, lesions with a maximum size of 2 cm can regress during the four sessions set: obviously the larger the lesion, the more time needed to allow the lesion to regress.