这项研究的目的是描述与冷手术刀手术相比,在口腔软组织病变中使用高功率激光引起的组织学伪影。从七个数据库和四个灰色文献中检索了评估和比较在口腔软组织病变活检中使用高功率激光和冷手术刀产生的组织学伪影的临床研究。到2022年7月。使用ROBINS-I工具调查偏倚风险。使用建议分级评估证据的确定性,评估,发展,和评价方法。七项研究符合定性分析的条件。根据获得的结果,这四项研究的偏倚风险很低,三项研究的偏倚风险不明确.证据的确定性被归类为低。有限的证据表明,上皮伪影,如上皮内和上皮下粘连的丧失,伴随着pyknotic,梭形,和/或增色核,在使用高功率激光设备时更为常见。四篇文章报道,高功率激光的使用不会干扰口腔软组织病变的组织病理学诊断。由于数据的异质性,未进行荟萃分析.与使用冷手术刀相比,组织学文物,特别是在上皮组织中观察到的那些,当高功率激光用于口腔病变活检时更常见。必须遵守不同口腔软组织病变治疗中高功率激光的合格标准和充分适应症,以避免损害精确组织病理学诊断的组织伪影。
The objective of this study was to describe the histological artifacts caused by high-power laser use compared to cold scalpel surgery in oral soft tissue lesions. Clinical studies that evaluated and compared histological artifacts resulting from the use of high-power lasers and cold scalpels in oral soft tissue lesions biopsies were retrieved from seven databases and four grey literatures, up to July 2022. The risk of bias was investigated using the ROBINS-I tool. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Seven studies were eligible for qualitative analysis. Based on the results obtained, those four studies had a low risk of bias, and three studies had an unclear risk of bias. The certainty of the evidence was classified as low. Limited evidence showed that epithelial artifacts such as loss of intraepithelial and subepithelial adhesions, accompanied by pyknotic, fusiform, and/or hyperchromic nuclei, were more common when a high-power laser device was used. Four articles reported that the use of high-power lasers did not interfere with the histopathological diagnosis of oral soft tissue lesions. Due to the heterogeneity of the data, a meta-analysis was not performed. Compared to the use of cold scalpels, histological artifacts, particularly those observed in epithelial tissue, are more common when high-powered lasers are used in oral lesions biopsies. The eligibility criteria and adequate indications of high-power lasers in different oral soft tissue lesion treatments must be respected to avoid tissue artifacts that impair precise histopathological diagnosis.