You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
The Application of a Carbon Dioxide Laser in the Treatment of Superficial Oral Mucosal Lesions
Abstract 1:
Abstract To evaluate the safety and advantages of using carbon dioxide ( CO2 ) laser in the treatment of oral mucosal lesion , including vascular malformations , precancerous lesions , and verrucous nevus , a retrospective analysis was conducted for 73 patients with oral mucosal lesions who received CO2 laser treatment during June 2012 to December 2013 , including 25 patients with vascular malformations , 22 patients with oral leukoplakia , 18 patients with oral mucosal lichen planus , and 8 patients with oral mucosal and labial mucosal verrucous nevus . The lesions ranged from 0.8 × 0.8 cm to 4 × 3 cm . Twenty patients with lesions removed using the traditional scalpel , assisted with an electric knife , were the control group . The operative time was from 3 to 10 minutes , with an average of 5.5 minutes ; the average amount of intraoperative bleeding was 5 mL. None of the 73 patients had postoperative infections , and all wounds healed well after the surgery . The patients were followed up for 1 year . Two patients with oral leukoplakia showed recurrence after the surgery , and a reoperation achieved satisfactory treatment effects . The operative time of the control group was in the range of 4 to 15 minutes , with an average of 9.5 minutes , and the average amount of intraoperative bleeding was 10 mL. None of the 20 patients had postoperative infections , and the wounds also showed healing well after the surgery . The application of CO2 laser in the treatment of oral mucosal lesions has the advantages of reduced bleeding , a clear view during surgery , and a shorter operative time


Title 2:
Carbon Dioxide Laser Fiber for the Excision of Oral Leukoplakia
Abstract 2:
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 r and omly 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


Title 3:
Complications following interventional laser surgery for oral cancer and precancerous lesions.
Abstract 3:
Interventional carbon dioxide laser surgery is the preferred method to treat oral precancerous lesions and early invasive squamous cell carcinomas ( SCCs ) . Little is known , however , about the complications that patients experience after such treatment . We retrospectively review ed the hospital records of 82 patients with new dysplastic oral lesions or early invasive oral SCCs treated by laser surgery in the maxillofacial unit at Newcastle General Hospital . The most common postoperative complications were pain for more than two weeks after operation ( n=28 ) , bleeding ( n=4 ) , difficulties with speech ( n=5 ) , paraesthesia of the lingual nerve ( n=17 ) , difficulty swallowing ( n=2 ) , obstructive swelling of the subm and ibular gl and ( n=22 ) , and tethering of the tongue ( n=10 ) . Overall , 78 % of patients had one or more complication . In the absence of r and omised controlled trials , this study provides the best available evidence for complication rates following interventional surgery . In addition to aiding in the preoperative counselling of patients , the data will help to inform and advise patients particularly during the immediate postoperative period


Title 4:
Clinical trial analyzing the impact of continuous defocused CO2 laser vaporisation on the malignant transformation of erosive oral lichen planus.
Abstract 4:
The erosive oral lichen planus ( OLP ) represents a management challenge to the clinician and can have debilitating consequences to patients ' quality of life . The aims of this work were to determine the incidence of malignant transformation to squamous cell carcinoma ( SCC ) in patients undergoing traditional symptomatic treatments ( oral salve containing lidocaine hydrochloride or systemic diclofenac ) compared to patients that were managed with a defocused continuous CO2 laser beam . A total of 171 patients with histologically confirmed erosive OLP were included into this study . After treatment , patients were assessed until completion of wound healing , at least every 3 - 6 months for the first 2 years , and every 6 - 12 months thereafter . The study included 87 women ( 50.9 % ) and 84 men ( 49.1 % ) . A total of 103 patients ( 60.2 % ) underwent symptomatic conservative treatment , and 68 patients ( 39.8 % ) underwent continuous defocused CO2 laser treatments .  SCC developed in 16 patients ( 9.4 % ) , 2 patients ( 2.9 % ) after continuous defocused CO2 laser treatment and 14 patients ( 13.6 % ) with symptomatic treatment only . This study provides insight into the potential impact of the CO2 laser in the management of patients with erosive OLP  and the influence on the recurrence rate of erosive OLP , as well as malignant transformation to oral SCC
According to the literature the CO2 laser is the workhorse of oral leukoplakia treatment due to its effectiveness and low associated morbidity .