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Seyyedi et al

Figure 2. Comparison of the Pain Intensity Mean at Measured Figure 3. Comparison of the Mean Ulcer Size at Measured Time-
Time-Intervals in Three Studied Groups. Intervals in Three Studied Groups.

size of the ulcer on the first day in the pulsed CO laser group. In various studies that have investigated the effect
2
group was higher than the other two groups; however, of lasers on aphthous ulcers in the mouth, other types
the observed difference was not statistically significant of lasers have also been used. The difference in the type
(P value = 0.93). Comparing the mean ulcer diameter of lasers used is in the properties of the laser protocol
difference on the first day with the intervals of the third, (power, dose, wavelength, time of examination after the
fifth and seventh days in the pulsed carbon dioxide laser laser). In the present research, the reduction of pain in
group revealed that the difference between the mean ± patients with recurrent oral aphthous ulcers was observed
standard error of the ulcer size on the first day and those immediately after the laser and at follow-up hours, 12, 24,
on the third and fifth days was not significant. However, 40, and 72 hours after the intervention. Zand et al showed
the mean difference between the first and seventh days was the effect of the continuous CO laser with the power of 1
2
significant. In the continuous CO laser group, comparing W in immediate pain reduction in follow-up hours, 4, 8,
2
the mean ulcer diameter difference on the first day with 12, 24, 40, 72, and 96 hours after the treatment. 2
the third day was not significant, while the difference in Sharon-Buller and Sela reported a case of using a
the average diameter of the lesion on the first day with CO laser for pain relief of recurrent aphthous lesions
2
the fifth and seventh days was significant. In the control in a 50-year-old patient. Using a CO laser with a
2
group, the observed results comparing the first day with wavelength of 10 600 nm and power of 1-1.5 W and
the third day were meaningless, and in comparison with the radiation duration of 5 seconds without topical
the first day and the fifth and seventh days they were anesthesia, she reported an immediate and prolonged
meaningful (Figure 3 and Table 2). pain reduction of the lesion. In a study by Zeini Jahromi
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et al, the evaluating effects of the continuous CO laser
2
Discussion in comparison with the diode laser and silent laser on
The results of this study approve a significant pain recurrent aphthous stomatitis indicated that patients in
reduction in patients with RAS because of using pulsed the group of continuous CO lasers with power of 2 W
2
and continuous CO lasers in comparison with the control compared to patients in the other two groups experienced
2

Table 2. Comparison of Lesion Size Average in Time of Pain Evaluation in Each Group
Pulsed CO Laser Continuous CO Laser Usual Treatment P Value
2 2
Mean ± Standard Deviation
day 1 4.17 ± 1.94 3.9 ± 2.07 3.8 ± 0.84 0.93
day 3 4 ± 1.18 3.7 ± 2.22 3 ± 1.6 0.67
day 5 2.42 ± 2.11 1.4 ± 2.2 0.8 ± 0.84 0.37
Lesion size day 7 1.17 ± 1.81 0.6 ± 1.34 0 ± 0 0.4
P value inside the groups 0.02 <0.001 <0.001
Mean ± Standard Error
Total 2.94 ± 0.61 2.4 ± 0.67 1.9 ± 0.67 0.53

S70 Journal of Lasers in Medical Sciences Volume 11, Suppl 1, Autumn 2020