*4.2. Efficiency*

The treatment can therefore be considered efficient for the following reasons: first, the values reported by the subjects are average values and their trend is, even if slightly, decreasing; all patients completed the clinical trial and reported less post-intervention discomfort respect to the initial biopsy performed with a blade.

Because no anaesthesia was administered and so neither adrenalin, there were the possibility of having an intraoperative bleeding that could compromise the visibility of the operative field. Thanks

to the use of the laser we could provide a bloodless operating field with an excellent visibility of the lesion margins and a smoother treatment, defined the low invasiveness of laser-assisted treatment.

Since the margins were well photocoagulated, no stitches were placed but the area was left to heal by second intention.

After seven days, the complete epithelialization of the area was observed in almost all cases, only in two cases there was still presence of fibrin deposits. None of the patients had an infection of bacterial origin of the wound.

At the end of the treatment there were no retrospective cicatricle outcomes. Regard to lesions that were placed in areas of functional interest, such as the labial commissure, they did not report any functional existences of any kind.

In the following figures the data from lesions treated with our protocol at time T0 and four weeks later, at time T4 (Figures 5a,b, 6a,b and 7a,b)

**Figure 5.** (**a**) Hyperkeratosis during the first visit: the area appears whitish and irregular, (**b**) The same area four weeks after treatment.

(**a**) **Figure 6.** *Cont.*

**Figure 6.** (**a**): Mucosa of the left cheek of a patient affected by leucoplakia right after the removal of stitches positioned after biopsy sampling. (**b**): Same area three weeks after laser treatment.

**Figure 7.** (**a**) Whitish and irregular area in the gingival mucosa. (**b**) Three weeks after the beginning of the treatment.
