Objectives: We compared the efficacies of cold knife excision and carbon dioxide (CO2) laser fiber excision of oral cavity leukoplakia. Methods: Between August 2009 and June 2011, 45 patients who underwent excision of oral cavity leukoplakia were assessed for operative time, use of bipolar cautery, blood loss, and number of intraoperative margins needed. Patients were assigned randomly to either a cold knife group (23 procedures) or a CO2 laser fiber group (24 procedures) at the time of the procedure. Results: The times of excision were similar in the CO2 laser fiber group (1.64 min/cm2) and the cold knife group (1.70 min/cm2). There were large differences between the CO2 laser fiber group and the cold knife group in the categories of bipolar cautery uses per square centimeter (0.34 uses versus 3.32 uses) and blood loss (0.19 g/cm2 versus 2.55 g/cm2). The average number of margins needed to clear a specimen by frozen section was 1.21 for the CO2 laser fiber group and 1.83 for the cold knife group. Conclusions: The CO2 laser fiber did not show an advantage in operative time. The CO2 laser fiber did show better outcomes in the areas of blood loss, bipolar cautery use, and intraoperative margins needed.
