Keywords
Enxerto gengival livre
Laserterapia
Periodontia
How to Cite
Abstract
Introduction: Proliferative verrucous leukoplakia (PVL) is a distinct and rare form of multifocal oral leukoplakia, characterized by a progressive and persistent clinical course and associated with a high rate of malignant transformation. Objective: This study aims to report a clinical case of PVL treated using a free gingival graft (FGG) and high-power diode laser, with a follow-up period of 1 year and 8 months. Case report: A 45-year-old leucoderma female patient, with no history of smoking or alcohol consumption, presented to the periodontics clinic referred by the histopathology service, with an extensive PVL lesion measuring 9 cm × 0.6 cm, located on the gingiva, alveolar mucosa, and lower lip. A previous histopathological diagnosis revealed moderate epithelial dysplasia. One week after the initial evaluation, a partial-thickness flap was performed to completely remove the lesion, followed by the placement of a free gingival graft (FGG) onto the surgical bed. The excised tissue was sent for microscopic analysis, which revealed severe epithelial dysplasia. After 30 days, the FGG was found to be fully integrated into the recipient bed. However, four white plaques with morphological features similar to the initial lesion were observed, although they were limited to keratinized tissue, with no recurrence in the alveolar or labial mucosa. An excisional biopsy was performed on the lesions in the gingiva of teeth 31 and 33, revealing mild epithelial dysplasia. Photocoagulation of the remaining lesions was performed after 7 days using a high-power diode laser (808 ± 10 nm) as an adjunct treatment. Conclusion: The use of FGG proved to be a promising approach for expanding the band of keratinized mucosa and preserving the supporting tissues, facilitating future surgical interventions. Furthermore, the high-power diode laser was effective in controlling the remaining lesions, as no recurrence was observed in the treated areas after 20 months of follow-up.
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