PURPOSE: This study aimed to evaluate the effectiveness of carbon dioxide (CO2) lasers in the surgical management of oral potentially malignant disorders (OPMDs), lesions of the oral mucosa with a risk of malignant transformation. The research question focused on whether CO2 lasers reduce recurrence rates and postoperative pain compared to other treatment modalities. METHODS: This review was conducted in accordance with the PRISMA statements, and registered in PROSPERO (CRD42023438873). A systematic review and meta-analysis were conducted by searching 12 electronic databases for articles published between 2000 and August 31, 2023. Two independent reviewers screened studies based on inclusion criteria, selecting 16 studies: 12 non-randomized controlled trials (NRCTs) and 4 randomized controlled trials (RCTs). The Joanna Briggs Institute Critical Appraisal Checklist and the RoB 2 tool were used to assess the risk of bias. Meta-analyses were performed to compare recurrence rates and postoperative pain between CO2 laser therapy and other treatment modalities. RESULTS: CO2 laser therapy showed a lower recurrence rate compared to other treatment modalities, with an odds ratio of 0.36 (95% CI: 0.12-1.04
Z = 1.89), though this difference was not statistically significant (p = 0.06). For postoperative pain, the standardized mean difference was - 0.16 (95% CI: -1.37 to 1.05
Z = 0.26), with no significant difference between groups. CONCLUSION: CO2 lasers provide several advantages and hold promise for treating OPMDs. However, further research is needed to fully establish their therapeutic efficacy and explore their application in other oral lesions.