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Laser Management of Resistant Oral Ulcers in Patients with

Behçet's Disease: A Pilot Study.

Samir H. Assaad-Khalil 1; Islam M. Kassem2

Department of Internal Medicine1, Faculty of Medicine &

Department of Cranio-maxillary-facial Surgery 2, Faculty of Dentistry,

Alexandria University, Alexandria, EGYPT.

Behçet’s disease is a chronic

inflammatory disorder affecting

multiple systems and may have

serious implications on patients’

quality of life. In fact, resistant oral

ulcers can jeopardize normal life

style.

BACKGROUND PATIENT # 1

OBJECTIVE

The aim of the present study

has been to assess the efficacy

and safety of the use of Carbon

dioxide laser in management of

resistant intraoral ulcers in

patients with Behçet’s Disease

RESULTS (Cont.)

Subjects

The present study included 15

patients (10 males 5 females) with

Behçet’s disease, diagnosed

according to the International

Classification Criteria, suffering

from recurrent resistant oral

ulcerations and dysphagia failing

to respond to conventional medical

therapy.

Four patients showed multiple

ulcers, the rest single ulcer. The

sites of the ulcers were variable

including cheeks, alveolar mucosa,

tongue, and lips. The ulcers size

varied from 15 to 45 mm2.

RESULTS

Figure (2): Frequency of Diabetic Complications in Type

2 Diabetic Patients

Table IX: Relative Frequency of the Cause of

Hospitalization Due to Diabetic Complications During

the Last 3 Months in Type 2 Diabetic Patients*

CONCLUSION

CONTACT INFORMATIONS

This pilot intervention study

suggests that Carbon dioxide laser

technique can be considered as an

effective and safe therapeutic

modality for the management of

resistant oral ulcers particularly

associated with dysphagia and

pain in patients with Behçet’s

disease.

Prof. Samir Helmy ASSAAD-KHALIL Address: Department of Internal Medicine,

Faculty of Medicine, Alexandria University,

Alexandria, EGYPT.

Phone: +20-1222197789

Fax: +203-4833321

Email: assaadkhalil@hotmail.com

46%

31.80%

18.30%

15.90%

9.70%

3.10%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

A significant improvement of all

studied parameters has been

observed. A 50% improvement in

both the pain score and QoL

Scales. Only 2 patients out of 15

showed recurrence during a six

months follow up period.

P3-2-063

Carbon dioxide laser has been

used to vaporize the ulcers with

caution to avoid bleeding. All

patients were followed up to

evaluate the efficacy and safety of

the used intervention.

This included the impact on

pain, effect on healing, effect on

recurrence and on the quality of

life (The SF-36 QoL Scale and the

Washington QoL in Oral Cancer).

Methods

Preoperative lesion Infiltration of local anesthesia

Lesion after application of CO2 laser After one week

After 3 months After 6 months

Patient Age Gender Site Number of ulcers Size mm

Pre op pain

Post op pain

Time of surgery Reccurence

1 32 M Cheek Single 20 5 2 15 no

2 52 M Lower lip Single 25 4 1 10 no

3 25 F Tongue Single 15 4 2 12 yes

4 33 F Tongue Multiple 20 5 1 19 no

5 43 M Cheek Single 30 4 1 31 no

6 40 M Tongue Single 45 5 1 10 no

7 46 M Alveolar mucosa Single 35 4 1 13 no

8 60 M Lower lip Single 25 4 2 11 no

9 52 M Cheek Multiple 30 5 3 15 no

10 38 F Tongue Single 45 4 2 8 no

11 56 M Alveolar mucosa Single 25 4 1 8 no

12 45 M Cheek Multiple 30 5 2 7 no

13 39 F Lower lip Multiple 45 5 1 6 no

14 62 M Cheek Single 40 4 3 7 yes

15 29 F Cheek Single 30 3 1 9 no

Preoperative cheek lesions Preoperative throat lesions

Post operative cheek lesions Post operative throat lesions

PATIENT # 2

CONCLUSION