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Mahuli SA, Rai A, Shree P, Ul Haque Z, Mahuli AV. Efficacy of photobiomodulation in the management of oral Lichen Planus in comparison to topical corticosteroids: Systematic review, meta-analysis, and GRADE-based assessment of certainty of evidence. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101798. [PMID: 38387618 DOI: 10.1016/j.jormas.2024.101798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/29/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND There is an urgent need to update the evidence available on the efficacy of photobiomodulation (PBM) in comparison to topical corticosteroids in the management of Oral Lichen Planus (OLP). METHODS Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE Pubmed, SCOPUS, Lilacs and Google Scholar were searched. Other sources included US National Institutes of Health Ongoing Trials Register, World Health Organization International Clinical Trials Registry Platform and Clinical Trial Registry - India were searched using variations of the keywords "Laser" and "Oral Lichen Planus". Randomized controlled trials comparing PBM and topical corticosteroids in the resolution of pain among OLP patients were included. The studies were assessed using the Cochrane Risk-of-Bias assessment tool. Publication bias was assessed using a funnel plot, and the certainty of evidence was evaluated according to the GRADE guidelines. RESULTS Ten studies were included for qualitative assessment and of these eight were included in the meta-analysis. The included studies used laser parameters of varying strengths and duration. Meta-analysis favoured PBM (n = 274, MD =-0.48, CI -0.66- -0.30) for pain score. No adverse effects were reported for laser therapy. There was high heterogeneity and moderate certainty of evidence, and most studies had a high risk of bias. CONCLUSION There is improvement in the clinical parameters of OLP when treated with PBM in comparison to topical corticosteroids. However, the strength of the evidence for these findings in limited. It is recommended to conduct better long-term trials with large sample size.
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Affiliation(s)
- Simpy Amit Mahuli
- PhD Scholar, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi 834009, India
| | - Arpita Rai
- Associate Professor, Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi 834009, India.
| | - Priya Shree
- Senior Research Fellow (ICMR), Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi 834009, India
| | - Zeya Ul Haque
- Research Fellow, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi 834009, India
| | - Amit Vasant Mahuli
- Associate Professor, Public Health Dentistry, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Bariatu, Ranchi 834009, India
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Soh WK, Cheah KF, Veettil SK, Pandiar D, Nimbalkar S, Gopinath D. Photobiomodulation Therapy in the Management of Oral Lichen Planus: A Systematic Review and Meta-Analysis. Eur J Dent 2024; 18:976-986. [PMID: 38744337 PMCID: PMC11479744 DOI: 10.1055/s-0044-1782213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
Photobiomodulation therapy (PBMT) is a non-invasive and the latest form of therapy used in the treatment of non oncological diseases as well as cancers of various types and locations. The aim of this study was to systematically review and assess the efficacy of PBMT in managing oral lichen planus (OLP) compared to the interventions. A systematic review and meta-analysis were implemented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search using PubMed, Scopus, and Cochrane was conducted to retrieve relevant studies published until June 2023. The outcomes evaluated included the reduction in pain score and clinical severity scores (Prospero No CRD42023428626). A total of eight studies were identified for qualitative synthesis. The pooled analysis incorporating six studies revealed that there are no significant differences for both mean pain score (mean difference [MD] = 0.21, 95% confidence interval [CI] = -0.51, 0.93) as well as clinical score (MD = -0.08, 95% CI = -0.4, 0.25) between PBMT and comparison groups. Subgroup analysis based on corticosteroids as controls showed that there was no significant difference in mean reduction in pain score between PBMT and topical steroids (MD = 0.38, 95% CI = -0.54, 1.31). PBMT is as effective as other interventions in the treatment of OLP, though not superior, and can be a promising alternative treatment for cases resistant to steroids or when steroids are contraindicated. Further studies are recommended to standardize the optimal settings for the treatment of OLP.
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Affiliation(s)
- Wei Kang Soh
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Kwok Fu Cheah
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Sajesh K. Veettil
- Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Deepak Pandiar
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Smita Nimbalkar
- Clinical Oral Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Divya Gopinath
- Basic Medical and Dental Sciences Dept, College of Dentistry, Ajman University, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
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Alam M, Karami S, Mohammadikhah M, Badkoobeh A, Golkar M, Abbasi K, Soufdoost RS, Hakim LK, Talebi S, Namanloo RA, Hussain A, Heboyan A, Tebyaniyan H. The effect of photobiomodulation therapy in common maxillofacial injuries: Current status. Cell Biochem Funct 2024; 42:e3951. [PMID: 38349051 DOI: 10.1002/cbf.3951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 01/28/2024] [Indexed: 02/15/2024]
Abstract
The use of photobiomodulation therapy (PBMT) may be used for treating trauma to the maxillofacial region. The effects of PBMT on maxillofacial injuries were discussed in this review article. The electronic databases Pubmed, Scopus, and Web of Science were thoroughly searched. This review included in vitro, in vivo, and clinical studies describing how PBMT can be used in maxillofacial tissue engineering and regenerative medicine. Some studies suggest that PBMT may offer a promising therapy for traumatic maxillofacial injuries because it can stimulate the differentiation and proliferation of various cells, including dental pulp cells and mesenchymal stem cells, enhancing bone regeneration and osseointegration. PBMT reduces pain and swelling after oral surgery and tooth extraction in human and animal models of maxillofacial injuries. Patients with temporomandibular disorders also benefit from PBMT in terms of reduced inflammation and symptoms. PBMT still has some limitations, such as the need for standardizing parameters. PBMT must also be evaluated further in randomized controlled trials in various maxillofacial injuries. As a result, PBMT offers a safe and noninvasive treatment option for patients suffering from traumatic maxillofacial injuries. PBMT still requires further research to establish its efficacy in clinical practice and determine the optimal parameters.
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Affiliation(s)
- Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ahmed Hussain
- School of Dentistry, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran
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Mohamed RK, Elsayed NM, Mahmoud SA, Gaweesh YY. Photobiomodulation versus corticosteroid in the management of erosive oral lichen planus: a randomized controlled clinical trial. BMC Oral Health 2024; 24:246. [PMID: 38365694 PMCID: PMC10873933 DOI: 10.1186/s12903-024-03976-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/03/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic illness of immune origin that is typically treated with corticosteroids as a gold standard therapy. Photobiomodulation (PBM) may represent an alternative remedy that has the potential to treat a variety of pathological conditions by alleviating pain, reducing inflammation, and promoting tissue healing without the drawbacks of steroid therapies. Thus, the aim of the current study was to compare the effect of photobiomodulation to topical 0.1% triamcinolone acetonide on erosive oral lichen planus. METHODS This randomized controlled clinical trial involved 44 patients complaining of erosive oral lichen planus. Patients were assigned to one of two groups: control group (n = 22) received 0.1% topical triamcinolone acetonide three times daily with miconazole oral gel once daily for 4 weeks, and photobiomodulation group (n = 22) received laser therapy by 980 nm diode laser utilizing output power 300 mW twice weekly for 5 weeks (a total of 10 sessions). The evaluation of patients was performed at baseline, 6 weeks, and 12 weeks postoperatively in terms of pain, clinical scores, and biochemical evaluation of salivary malondialdehyde levels. All recorded data were analyzed using Mann-Whitney test to compare the two studied groups regarding pain, lesion size, and salivary levels of malondialdehyde. Friedman test, followed by post hoc test, was used for comparison of the data within the same group along the 3 periods at baseline, 6 weeks, and 12 weeks. RESULTS Both groups showed significant improvement in pain and clinical scores, with no statistical difference between them. Moreover, there was a significant improvement in salivary malondialdehyde levels for both groups, with no significant difference between them. CONCLUSIONS Photobiomodulation could be a promising therapeutic modality for management of erosive oral lichen planus without the side effects of steroid therapy. The salivary malondialdehyde level could be used as a biomarker to evaluate the disease severity and its response to the treatment. TRIAL REGISTRATION The study has been registered at ClinicalTrials.gov (NCT05951361) (19/07/2023).
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Affiliation(s)
- Reem Kamal Mohamed
- Department of Oral Diagnosis, Oral Medicine, Periodontology and Oral Radiology, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria Governorate, 21527, Egypt.
| | - Naguiba Mahmoud Elsayed
- Department of Oral Diagnosis, Oral Medicine, Periodontology and Oral Radiology, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria Governorate, 21527, Egypt
| | - Sabah Abdelhady Mahmoud
- Department of Biochemistry, Faculty of Medicine, Alexandria University, Champollion street،, Al Mesallah Sharq, Al Attarin, Alexandria, Alexandria Governorate, 21568, Egypt
| | - Yasmine Youssri Gaweesh
- Department of Oral Diagnosis, Oral Medicine, Periodontology and Oral Radiology, Faculty of Dentistry, Alexandria University, Champollion St., Azarita, Alexandria Governorate, 21527, Egypt
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Mineroff J, Maghfour J, Ozog DM, Lim HW, Kohli I, Jagdeo J. Photobiomodulation CME part II: Clinical applications in dermatology. J Am Acad Dermatol 2024:S0190-9622(24)00187-7. [PMID: 38307144 DOI: 10.1016/j.jaad.2023.10.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/07/2023] [Accepted: 10/08/2023] [Indexed: 02/04/2024]
Abstract
Photobiomodulation (PBM) is an emerging treatment modality in dermatology with increasing office and home-based use. PBM is the use of various light sources in the red light (620-700 nm) and near-infrared (700-1440 nm) spectrum as a form of light therapy. PBM is often administered through low-level lasers or light-emitting diodes. Studies show that PBM can be used effectively to treat conditions secondary to cancer therapies, alopecia, ulcers, herpes simplex virus, acne, skin rejuvenation, wounds, and scars. PBM offers patients many benefits compared to other treatments. It is noninvasive, cost-effective, convenient for patients, and offers a favorable safety profile. PBM can be used as an alternative or adjuvant to other treatment modalities including pharmacotherapy. It is important for dermatologists to gain a better clinical understanding of PBM for in-office administration and to counsel patients on proper application for home-use devices to best manage safety and expectations as this technology develops. PBM wavelengths can induce varied biological effects in diverse skin types, races, and ethnicities; therefore, it is also important for dermatologists to properly counsel their skin of color patients who undergo PBM treatments. Future clinical trials are necessary to produce standardized recommendations across conditions and skin types.
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Affiliation(s)
- Jessica Mineroff
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York
| | - Jalal Maghfour
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan
| | - David M Ozog
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Henry W Lim
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; College of Human Medicine, Michigan State University, East Lansing, Michigan
| | - Indermeet Kohli
- The Henry W. Lim, MD, Division of Photobiology and Photomedicine, Department of Dermatology, Henry Ford Health, Detroit, Michigan; Department of Physics and Astronomy, Wayne State University, Detroit, Michigan
| | - Jared Jagdeo
- Department of Dermatology, State University of New York, Downstate Health Sciences University, Brooklyn, New York.
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Panchal KG, Gupta E, Kumar A, Samir PV, Devika GS, Awasthi V, Singh R. Comparing the Effectiveness of Low-Level Laser Therapy and Topical Steroid Therapy Combination Regimen With Routine Topical Steroid Therapy in the Management of Oral Lichen Planus Symptomatic Patients. Cureus 2023; 15:e44100. [PMID: 37750131 PMCID: PMC10518139 DOI: 10.7759/cureus.44100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/23/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND For symptomatic oral lichen planus (OLP), a wide range of therapeutic approaches have been suggested. To minimize discomfort and symptoms among individuals with symptomatic OLP, extensive therapy is frequently needed. Therefore, finding a new therapeutic approach that may effectively manage OLP's symptoms and signs while having few adverse effects continues to be a difficult task. Recently, low-level laser therapy (LLLT) has become a popular alternative therapy option for OLP with no serious side effects. AIM The present research was designed to compare the effectiveness of a combination regimen of LLLT in addition to topical steroids with routine topical steroid therapy separately in order to manage patients with bothersome OLP with an extended period of follow-up. MATERIALS AND METHODS In our trial, 60 patients were chosen and given sequential numbers as they signed up to take part. The participants were divided randomly into two categories: category A (LLLT plus topical steroids) and category B (only topical steroids). The data were entered into the aforementioned prepared case template after receiving informed consent. The aforementioned prepared case template included the following criteria for evaluating the result of the treatment: pain, recurrence, burning sensation, clinical remission, and size of the lesion. Applying the visual analog scale (VAS), pain, as well as burning sensations, were assessed in both categories. With the aid of the Electronic Digital Vernier Caliper (Mitutoyo, China), these individuals were assessed for the dimension of the lesion. RESULTS The pain score on day 21 of intervention in category A was 2.5, while it was 4.63 in category B. The difference in findings was significant statistically at day 21 (p = 0.0032). The pain score on day 28 of intervention in category A was 1.3, while it was 3.0 in category B. The difference in findings was significant statistically at day 28 (p = 0.003). The pain score was greater in the control category as compared to the intervention category. The burning sensation score on day 21 of intervention in category A was 2.5, while it was 4.5 in category B. The difference in findings was significant statistically (p = 0.0024). The burning sensation score at the follow-up phase on day 45 of intervention in category A was 1.1, while it was 3.4 in category B. The difference in findings was significant statistically (p = 0.002). CONCLUSION Newer therapeutic techniques are becoming accessible to oral specialists for controlling oral mucosal disorders as a result of evolving dental trends. The gold standard for treating people with symptomatic OLP continues to be topical corticosteroids. The therapeutic advantages of topical corticosteroids, however, are considerably outweighed by their complementary effect when paired with newer treatment methods like LLLT.
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Affiliation(s)
- Kalagi G Panchal
- Department of Dentistry, Government Dental College and Hospital, Ahmedabad, IND
| | - Ekta Gupta
- Department of Orthodontics and Dentofacial Orthopedics, Siddhpur Dental College and Hospital, Patan, IND
| | - Amit Kumar
- Department of Dentistry, All India Institute of Medical Sciences, Patna, IND
| | - P V Samir
- Department of Pedodontics and Preventive Dentistry, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT), Bhubaneswar, IND
| | - G S Devika
- Department of Pharmaceutical Analysis, Cherraans College of Pharmacy, Coimbatore, IND
| | - Vijaya Awasthi
- Department of Oral Medicine and Radiology, Gentle Dental Care, Jabalpur, IND
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, IND
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Hanna R, Dalvi S, Tomov G, Hopper C, Rebaudi F, Rebaudi AL, Bensadoun RJ. Emerging potential of phototherapy in management of symptomatic oral lichen planus: A systematic review of randomised controlled clinical trials. JOURNAL OF BIOPHOTONICS 2023:e202300046. [PMID: 37017292 DOI: 10.1002/jbio.202300046] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/01/2023] [Accepted: 04/02/2023] [Indexed: 06/19/2023]
Abstract
Phototherapy incorporating photobiomodulation therapy and antimicrobial photodynamic therapy has been utilised as antioxidants in symptomatic oral lichen planus (OLP) management; however, its role of intervention remains controversial. The aim of this systematic review of CRD42021227788 PROSPERO (an international prospective register of systematic reviews in health and social care) registration number was to oversee and determine phototherapy efficacy in patients with symptomatic OLP, identifying and bridging the literature gaps by proposing recommendations for future studies. A search strategy was developed in consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various electronic databases were exercised to search for randomised controlled clinical trials (RCTs). Several search engines were employed to analyse a total of 177 studies of which nine included. A wide range of utilised laser and light-emitted diode wavelengths between 630 and 808 nm and irradiance ranged between 10 and 13 mW/cm2 were noted. 67% of studies reported a high risk of bias and a high heterogeneity obtained from numerical data for quantitative analysis, therefore meta-analysis was impossible to conduct. Despite inconsistency and diversity in phototherapy parameters, treatment protocols, photosensitiser (type, concentration and method of application) and outcome assessment tools, the majority of the studies showed positive results compared with standard care treatments. Hence, a necessity to perform well-designed RCTs with robust methodology is warranted, after acknowledging the current drawbacks and addressing the suggested recommendations highlighted in our review. Moreover, advanced knowledge in understanding further phototherapy-antioxidants molecular mechanistic in symptomatic OLP is required.
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Affiliation(s)
- Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Genoa, Italy
- Department of Restorative and Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller Building, London, UK
| | - Snehal Dalvi
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, India
| | - Georgi Tomov
- Department of Periodontology, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Colin Hopper
- Department of Maxillofacial Surgery, Diagnostics, Medical and Surgical Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller Building, London, UK
| | - Federico Rebaudi
- Department of Expiremental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - Alberto Luigi Rebaudi
- Department of Surgery and Implants, School of Dentistry, Universitat International de Catalunya (UIC), Barcelona, Spain
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Roccon A, Cavallin F, Zanette G, Bacci C. Single session of laser photobiomodulation for symptom management of oral lichen planus: a retrospective study. Lasers Med Sci 2023; 38:43. [PMID: 36656450 PMCID: PMC9849837 DOI: 10.1007/s10103-023-03706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023]
Abstract
This study aimed to evaluate the effectiveness of a single session of laser photobiomodulation (PBM) with flat top handpiece in reducing painful symptoms in patients with Oral Lichen Planus (OLP). The clinical charts of 20 patients of the Dental Clinic of University of Padua (Italy) who underwent a single laser PBM to manage OLP symptomatology were retrospectively analyzed. A 980 nm diode laser and a flat top handpiece with a 1-cm2 spot area were employed to perform the PBM with a single session protocol. VAS pain scores were assessed before and after the laser PBM, the day after, and on the 7th and 30th days after the treatment. No adverse effects occurred within 30 days after treatment. The mean VAS-pain score was 3.8 (SD 2.3) before PBM; 2.6 (SD 2.0) after PBM; 1.9 (SD 2.2) on day 1; 2.0 (SD 2.3) on day 7; and 1.5 (SD 2.2) on day 30. VAS pain decreased significantly over time (p < 0.0001). A single session of laser PBM may be safe and effective in reducing pain for symptomatic OLP patients. Further investigations are required to include placebo or topical corticosteroids as comparators.
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Affiliation(s)
- Andrea Roccon
- Department of Neurosciences, Section of Clinical Dentistry, University of Padua, via Giustiniani, 2, Padova, Italy.
| | | | - Gastone Zanette
- Department of Neurosciences, Section of Clinical Dentistry, University of Padua, via Giustiniani, 2, Padova, Italy
| | - Christian Bacci
- Department of Neurosciences, Section of Clinical Dentistry, University of Padua, via Giustiniani, 2, Padova, Italy
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Andabak-Rogulj A, Vindiš E, Aleksijević LH, Škrinjar I, Juras DV, Aščić A, Brzak BL. Different Treatment Modalities of Oral Lichen Planus-A Narrative Review. Dent J (Basel) 2023; 11:dj11010026. [PMID: 36661563 PMCID: PMC9857452 DOI: 10.3390/dj11010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/22/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology which affects the oral mucosa. OLP varies in its clinical features from a reticular form that is, in most cases, asymptomatic, to atrophic-erosive, and is accompanied by symptoms of burning sensation and pain followed by difficulty in eating. Given the fact that OLP is a disease of unknown etiology, the treatment is symptomatic and involves suppressing the signs and symptoms of the disease using various topical and systemic drugs. The first line of therapy for treating symptomatic OLP is topical corticosteroids, whereas systemic corticosteroids are used for treating persistent lesions that do not respond to local treatment. However, the lack of convincing evidence on the efficacy of previous therapies, including topical corticosteroids, and numerous side effects that have appeared over recent years has resulted in the emergence and development of new therapeutic options. Some of the therapies mentioned are tacrolimus, efalizumab, dapson, interferon, retinoic acid, photochemotherapy with psoralen and ultraviolet A rays (PUVA), aloe vera, antimalarials, antibiotics and others. These therapies only partially meet the properties of efficacy and safety of use, thus justifying the continuous search and testing of new treatment methods.
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Affiliation(s)
- Ana Andabak-Rogulj
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Clinical Hospital Zagreb, 10000 Zagreb, Croatia
| | - Ema Vindiš
- Dental Practice at Healthcare Center Ormož, 2270 Ormož, Slovenia
| | | | - Ivana Škrinjar
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Clinical Hospital Zagreb, 10000 Zagreb, Croatia
| | - Danica Vidović Juras
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Clinical Hospital Zagreb, 10000 Zagreb, Croatia
| | | | - Božana Lončar Brzak
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence:
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Serafini G, De Biase A, Lamazza L, Mazzucchi G, Lollobrigida M. Efficacy of Topical Treatments for the Management of Symptomatic Oral Lichen Planus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1202. [PMID: 36673955 PMCID: PMC9859481 DOI: 10.3390/ijerph20021202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Oral lichen planus (OLP) is a chronic mucosal inflammatory disease associated with T-cell-mediated immunological dysfunction. Symptomatic OLP is a painful condition, and complete healing is often not achieved. The aim of this systematic review was to assess the effectiveness of topical drugs, medications, and other interventions compared to placebo or to other treatments in pain reduction and clinical resolution in adult patients with symptomatic OLP. A detailed electronic literature search was performed through the MEDLINE (PubMed) database between 1 January 2005 and 30 September 2022. Eligible studies were selected based on the inclusion criteria, and a quality assessment was conducted. From 649 titles, 121 articles were selected as abstracts, 75 papers were assessed as full text, along with 15 other papers obtained through a manual search. A total of 15 RCTs were finally included in the review process. Because of the significant heterogeneity in the study design of the included studies, no meta-analysis of the data could be performed. Topical corticosteroids represent the first-line treatment in the management of symptomatic OLP due to their efficacy and minimal adverse effects. Calcineurin inhibitors seem to be equally effective and are indicated in recalcitrant cases, extensive lesions, patients susceptible to oral candidiasis, or cases unresponsive to corticosteroids. Other treatments, such as aloe vera, chamomile, isotretinoin, ozone, and laser therapy, could be beneficial as adjunct therapies in association with first-line treatments.
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Affiliation(s)
- Giorgio Serafini
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
| | | | - Luca Lamazza
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
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Ruiz Roca JA, López Jornet P, Gómez García FJ, Marcos Aroca P. Effect of Photobiomodulation on Atrophic-Erosive Clinical Forms of Oral Lichen Planus: A Systematic Review. Dent J (Basel) 2022; 10:dj10120221. [PMID: 36547037 PMCID: PMC9776719 DOI: 10.3390/dj10120221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Oral lichen planus is a chronic autoimmune inflammatory disease of unknown origin, characterized by various clinical forms of which the atrophic-erosive causes patients the greatest symptomatology. For this reason, there are different treatments that improve the associated signs and symptoms. One of these therapies is photobiomodulation (PBM), which, although new, has a high level of acceptance in dentistry based on evidence. However, there are inconsistent results in its application against lichen planus. The aim of this review was to evaluate the effect of photobiomodulation and its effectiveness as a therapeutic alternative for atrophic-erosive lesions. MATERIAL AND METHODS The databases PubMed, Google Scholar and Cochrane Library were searched to identify studies investigating the photobiomodulation treatment in atrophic-erosive lesions of oral lichen planus. A total of 294 articles were identified, published between 2017 and 2022, and then evaluated; 7 articles that met all the inclusion criteria were included in this study. RESULTS The type of laser light source used in PBM was the diode laser (four cases), the Nd-YAG laser at the same wavelength of 1064 nm (two cases) and the He-Ne laser (one case). The minimum and maximum wavelengths used were 630 nm and 1064 nm, respectively. Most studies used lesions treated with topical corticosteroids as a control group. The follow-up times of the studies were highly variable. CONCLUSIONS Photobiomodulation is a treatment that competently combats oral lichen planus lesions by improving signs and symptoms, with no known adverse reactions so far, which makes it more beneficial compared to more conventional therapies, such as corticosteroids, for which side effects have been found.
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12
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de Carvalho MM, Hidalgo MAR, Scarel-Caminaga RM, Ribeiro Junior NV, Sperandio FF, Pigossi SC, de Carli ML. Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis. Clin Oral Investig 2022; 26:3949-3964. [PMID: 35024960 PMCID: PMC8755514 DOI: 10.1007/s00784-021-04362-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/29/2021] [Indexed: 12/23/2022]
Abstract
Objectives To evaluate the effects of photobiomodulation (PBM) in gingival lesions resulting from autoimmune diseases; to compare PBM and topical corticosteroid (CS) treatment; and to assess PBM outcome over time of follow-up. Materials and methods A comprehensive electronic search was performed in four electronic databases. Treatment effects were measured through visual analog scale of pain (VAS) and clinical evolution of lesion (Thongprasom scale for oral lichen planus (OLP)). Meta-analysis was performed to compare PBM with topical corticosteroid treatment and to evaluate PBM effect over time of follow-up. Results Seventeen studies were included in this review, of which six were used for the meta-analysis. Meta-analysis results showed no significant differences between PBM and topical CS in pain reduction at baseline (MD = 0.20, 95% CI = − 0.92, 1.32, p = 0.72) and 60-day follow-up (MD = 0.63, 95% CI = − 3.93, 5.19, p = 0.79); however, VAS showed significant pain reduction when compared before and after PBM at 30-day (MD = − 3.52, 95% CI = − 5.40, − 1.64, p = 0.0002) and 60-day (MD = − 5.04, 95% CI = − 5.86, − 4.22, p < 0.00001) follow-up. Thongprasom clinical scale for OLP also showed significant improvement at 30-day follow-up (MD = − 2.50, 95% CI = − 2.92, − 2.08, p < 0.00001) after PBM. Conclusion PBM led to significant reduction of pain and clinical scores of the lesions, not having shown significant differences when compared to topical CS. Clinical relevance PBM has been used in the treatment of autoimmune gingival lesions, but so far there is little strong evidence to support its use.
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Affiliation(s)
- Milena Moraes de Carvalho
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil
| | - Marco Antonio Rimachi Hidalgo
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, FOAr/UNESP), UNESP - São Paulo State University, Araraquara, SP, Brazil
| | - Raquel Mantuaneli Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, FOAr/UNESP), UNESP - São Paulo State University, Araraquara, SP, Brazil
| | - Noé Vital Ribeiro Junior
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil
| | - Felipe Fornias Sperandio
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.,Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Suzane Cristina Pigossi
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil
| | - Marina Lara de Carli
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil.
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Mu J, Zeng Q, Wu F, Zhou H. Refractory oral lichen planus: A definition employing statistical analysis. Oral Dis 2022; 28:2172-2174. [PMID: 34990048 DOI: 10.1111/odi.14124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Jingtian Mu
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qingxiang Zeng
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fanglong Wu
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hongmei Zhou
- State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Frontier Innovation Center for Dental Medicine Plus, Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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14
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Bhatt G, Gupta S, Ghosh S. Comparative efficacy of topical aloe vera and low-level laser therapy in the management of oral lichen planus: a randomized clinical trial. Lasers Med Sci 2021; 37:2063-2070. [PMID: 34853932 DOI: 10.1007/s10103-021-03480-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
This randomized clinical trial aimed to compare the efficacy of topical aloe vera with low-level laser therapy in patients with oral lichen planus (OLP). A randomized, parallel arm, single-blind study comprising of 60 patients with OLP was randomly divided into two groups. Group A was given topical aloe vera extract gel applied thrice daily for 2 months, and group B was given low-level laser therapy (LLLT) at 980 nm twice weekly for 2 months. Both groups were followed up for 9 months. Patients were assessed for various parameters according to the Escudier scale at baseline, after treatment at 9 months. Results were assessed using the McNemar-Bowker test and the Mann-Whitney U test. Both individual groups showed significant (p < 0.05) results at the end of the treatment period (0-2 months) and the follow-up period (2-7 months). Intergroup comparison showed significant results in the laser group (reduction of VAS by 44.1%, site score by 24.6%, and activity score by 50%) as compared with the aloe vera group (reduction of VAS by 26.7%, site score by 9.2%, and the activity score by 26%) in the treatment period. In the follow-up period, both groups showed insignificant differences in comparison to each other. Within the limitations of the study, LLLT was more effective as compared with topical aloe vera in managing oral lichen planus during the active treatment time, while both were equally effective during the follow-up period. The clinical study was registered under the Clinical Trials Registry India with the registration number CTRI/2018/04/013147.
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Affiliation(s)
- Girish Bhatt
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India.
| | - Sunita Gupta
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
| | - Sujoy Ghosh
- Department of Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
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Gambino A, Cabras M, Cafaro A, Broccoletti R, Carossa S, Hopper C, Conrotto D, Porter SR, Arduino PG. Preliminary evaluation of the utility of optical coherence tomography in detecting structural changes during photobiomodulation treatment in patients with atrophic-erosive oral lichen planus. Photodiagnosis Photodyn Ther 2021; 34:102255. [PMID: 33727132 DOI: 10.1016/j.pdpdt.2021.102255] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Oral lichen planus (OLP) is a common oral inflammatory condition. Against symptomatic atrophic-erosive OLP, topical steroids, or photobiomodulation (PBM) are deployed. Optical coherence tomography (OCT) provides a real-time, non-invasive, tissue investigation. Aim of this study was to evaluate modifications of OCT pattern in patients with painful atrophic-erosive OLP, before and after treatment with PBM, comparing those results with patients treated with topical steroid. METHODS Two groups of 20 OLP patients were evaluated. Group A underwent two daily application of 0.05 % clobetasol propionate for 8 weeks; group B was treated with eight weekly PBM sessions using a 980/645 nm diode laser. OCT scans were performed before and after treatment, and six months after end of the proposed protocol. Changes of width of stratified epithelium (EP) and lamina propria (LP) were quantified. RESULTS After 8-weeks, both groups experienced a significant increase of EP width (p < 0.05), and a significant decrease of LP width (p < 0.05), with Δ-EP in Group A significantly higher than Group B (p = 0.0015); conversely, Δ-LP was not significantly different (p > 0.05). After six months, significant increase of EP width remained only in group B (p = 0.01), with no significant decrease of LP mean width in both groups (p > 0.05). CONCLUSIONS Increase of EP and decrease of LP might be explained as consequence of clobetasol and PBM ability to promote epithelial healing, and to reduce interface inflammation. When investigated with OCT, clobetasol appears to provide more significant short-term structural changes, whereas PBM might guarantee long-term alterations.
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Affiliation(s)
- Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy.
| | - Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Adriana Cafaro
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Stefano Carossa
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Colin Hopper
- Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Davide Conrotto
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Stephen R Porter
- Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
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16
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Wang B, Fan J, Wang L, Chai L. Photobiomodulation Therapy/Photodynamic Therapy Versus Steroid Therapy for Oral Lichen Planus: A Systematic Review and Meta-Analysis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:145-154. [PMID: 33601953 DOI: 10.1089/photob.2020.4930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objective: To evaluate the efficiency of photobiomodulation therapy (PBMT) or photodynamic therapy (PDT) in treating oral lichen planus (OLP) as well as identifiy the side effects when compared with steroid therapy. Background: Nowadays, PBMT and PDT are increasingly applied for treating OLP with minimal adverse effects. Methods: The electronic databases of PubMed, Cochrane Central Register of Controlled Trial, Web of Science, and Embase were searched until March 13, 2020. Randomized controlled trials (RCTs) with 1 month of follow-up period were selected. Two reviewers extracted data from selected studies independently. Cochrane collaboration's tool for assessing risk of bias was used for assessing the quality of the RCTs. The random-effects model was employed for meta-analysis. Results: One thousand fifteen studies were initially identified. Finally, nine RCTs were included for quality assessment and seven studies for meta-analysis. Four RCTs were of unclear risk of bias and five were assessed as high risk of bias. The comparison showed no significant differences for pain scores [visual analog scale (VAS)] [mean differences (MD) = 0.38, confidence interval (CI) = 95% -0.64 to 1.40] and severity scores (reticular-atrophic-erosive scores) (MD = 1.67, CI = 95% -1.13 to 4.46) between topical corticosteroid therapy and PBMT after 1 month. For PDT, no significant differences were observed for sign scores (Thongprasm sign scoring) (MD = -0.31, CI = 95% -1.52 to 0.91) and pain scores (VAS) (MD = -2.30, CI = 95% -5.88 to 1.28) of the lesions when compared with topical corticosteroid therapy after 1 month of follow-up period. One study reported the discomfort of the affected area in patients of the PDT group when probe tip was moved. Conclusions: PBMT and PDT could be reliable alternatives to topical corticosteroids for OLP with no or less severe complications in a short-term period. However, further well-designed RCTs with long-term period are recommended to consolidate the conclusions in this regard.
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Affiliation(s)
- Bingjie Wang
- Department of Stomatology, The Affiliated People's Hospital of Ningbo University (Ningbo Yinzhou People's Hospital), Ningbo, China
| | - Jiayan Fan
- Department of Stomatology, Ningbo No.2 Hospital, Ningbo, China
| | - Liang Wang
- Department of Stomatology, Ningbo No.2 Hospital, Ningbo, China
| | - Luyi Chai
- Department of Stomatology, The Affiliated People's Hospital of Ningbo University (Ningbo Yinzhou People's Hospital), Ningbo, China
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Jain R, Mhapuskar A, Prasad Hiremutt D, Kale I, Kalyanpur K, Bhadani H. Comparison of efficacy of combination therapy (Low Level Laser Therapy (LLLT) and topical steroid) with topical steroid therapy only in patients with symptomatic oral lichen planus – In vivo study. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_126_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Ślebioda Z, Dorocka-Bobkowska B. Low-level laser therapy in the treatment of recurrent aphthous stomatitis and oral lichen planus: a literature review. Postepy Dermatol Alergol 2020; 37:475-481. [PMID: 32994766 PMCID: PMC7507163 DOI: 10.5114/ada.2020.98258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/17/2018] [Indexed: 12/17/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) present inflammatory, recurrent diseases of the oral mucosa with not fully understood aetiology. Despite numerous attempts to discover an effective treatment for RAS and OLP, the current main treatment strategies are largely confined to the reduction of symptoms. Low-level laser therapy (LLLT) is of interest as a novel treatment modality. The aim of the paper was to discuss the mechanism of action and the biological effects of LLLT and to critically review and summarize recent clinical reports on the management of RAS and OLP. Most of the studies demonstrated the beneficial effect of LLLT in accelerating the healing process and pain reduction. However, the results should be interpreted with caution due to the limited number of studies available and empirical design using various irradiation parameters.
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Affiliation(s)
- Zuzanna Ślebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
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19
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Hanna R, Dalvi S, Benedicenti S, Amaroli A, Sălăgean T, Pop ID, Todea D, Bordea IR. Photobiomodulation Therapy in Oral Mucositis and Potentially Malignant Oral Lesions: A Therapy Towards the Future. Cancers (Basel) 2020; 12:cancers12071949. [PMID: 32708390 PMCID: PMC7409159 DOI: 10.3390/cancers12071949] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022] Open
Abstract
Photobiomodulation therapy (PBMT) is an effective treatment modality, which has the significant advantage of enhancing a patient’s quality of life (QoL) by minimising the side effects of oral cancer treatments, as well as assisting in the management of potentially cancerous lesions. It is important to note that the major evidence-based documentation neither considers, nor tackles, the issues related to the impact of PBMT on tumour progression and on the downregulation of cellular proliferation improvement, by identifying the dose- and time-dependency. Moreover, little is known about the risk of this therapy and its safety when it is applied to the tumour, or the impact on the factor of QoL. The review aimed to address the benefits and limitations of PBMT in premalignant oral lesions, as well as the conflicting evidence concerning the relationship between tumour cell proliferation and the applied dose of photonic energy (fluence) in treating oral mucositis induced by head and neck cancer (H&N) treatments. The objective was to appraise the current concept of PBMT safety in the long-term, along with its latent impact on tumour reaction. This review highlighted the gap in the literature and broaden the knowledge of the current clinical evidence-based practice, and effectiveness, of PBMT in H&N oncology patients. As a result, the authors concluded that PBMT is a promising treatment modality. However, due to the heterogeneity of our data, it needs to undergo further testing in well-designed, long-term and randomised controlled trial studies, to evaluate it with diligent and impartial outcomes, and ensure laser irradiation’s safety at the tumour site.
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Affiliation(s)
- Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy; (S.D.); (S.B.)
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Correspondence: ; Tel.: +93-010-353-7446
| | - Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy; (S.D.); (S.B.)
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 441110, India
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy; (S.D.); (S.B.)
| | - Andrea Amaroli
- Department of Orthopaedic Dentistry, First Moscow State Medical University (Sechenov University), Trubetzkaya Street, 8, Bldg. 2, 119146 Moscow, Russia;
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (T.S.); (I.D.P.)
| | - Ioana Delia Pop
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania; (T.S.); (I.D.P.)
| | - Doina Todea
- Department of Pulmonology, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400332 Cluj-Napoca, Romania;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania;
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Chronic oral graft-versus-host disease: induction and maintenance therapy with photobiomodulation therapy. Support Care Cancer 2020; 29:1387-1394. [DOI: 10.1007/s00520-020-05626-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
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21
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Photobiomodulation-Underlying Mechanism and Clinical Applications. J Clin Med 2020; 9:jcm9061724. [PMID: 32503238 PMCID: PMC7356229 DOI: 10.3390/jcm9061724] [Citation(s) in RCA: 242] [Impact Index Per Article: 60.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/14/2020] [Accepted: 06/01/2020] [Indexed: 02/07/2023] Open
Abstract
The purpose of this study is to explore the possibilities for the application of laser therapy in medicine and dentistry by analyzing lasers' underlying mechanism of action on different cells, with a special focus on stem cells and mechanisms of repair. The interest in the application of laser therapy in medicine and dentistry has remarkably increased in the last decade. There are different types of lasers available and their usage is well defined by different parameters, such as: wavelength, energy density, power output, and duration of radiation. Laser irradiation can induce a photobiomodulatory (PBM) effect on cells and tissues, contributing to a directed modulation of cell behaviors, enhancing the processes of tissue repair. Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), can induce cell proliferation and enhance stem cell differentiation. Laser therapy is a non-invasive method that contributes to pain relief and reduces inflammation, parallel to the enhanced healing and tissue repair processes. The application of these properties was employed and observed in the treatment of various diseases and conditions, such as diabetes, brain injury, spinal cord damage, dermatological conditions, oral irritation, and in different areas of dentistry.
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Kalhori KA, Vahdatinia F, Jamalpour MR, Vescovi P, Fornaini C, Merigo E, Fekrazad R. Photobiomodulation in Oral Medicine. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:837-861. [DOI: 10.1089/photob.2019.4706] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | - Farshid Vahdatinia
- Dental Implants Research Center, Dental School of Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Jamalpour
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Paolo Vescovi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Carlo Fornaini
- Group of Applied ElectroMagnetics, Department of Engineering and Architecture, University of Parma, Parma, Italy
- Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, UFR d'Odontologie, Université Nice Sophia Antipolis, Nice, France
| | - Elisabetta Merigo
- Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, UFR d'Odontologie, Université Nice Sophia Antipolis, Nice, France
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Merigo E, Rocca JP, Pinheiro ALB, Fornaini C. Photobiomodulation Therapy in Oral Medicine: A Guide for the Practitioner with Focus on New Possible Protocols. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:669-680. [PMID: 31589560 DOI: 10.1089/photob.2019.4624] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Photobiomodulation (PBM) is the term to define the wide range of laser applications using low-energy densities and based on photochemical mechanisms where the energy is transferred to the intracellular mitochondrial chromophores and respiratory chain components. In literature, a great number of works are reported showing the advantages of PBM use in many oral diseases such as recurrent aphthous stomatitis, herpes infections, mucositis, and burning mouth syndrome. Different factors may explain the increasing reported use of PBM in oral medicine: the absence of side effects, the possibility of safely treating compromised patients such as oncologic patients, the possibility of a noninvasive approach not associated with pain or discomfort, and the possibility of performing short sessions. The review's aim is to describe the possible applications of PBM in oral medicine, giving practitioners simple guide for practice together with the information of a new treatment possibility "at home" performed by the patient himself under supervision.
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Affiliation(s)
- Elisabetta Merigo
- Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France.,Dentistry, Special Needs and Maxillo-Facial Surgery Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy
| | - Jean-Paul Rocca
- Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France
| | | | - Carlo Fornaini
- Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France.,Dentistry, Special Needs and Maxillo-Facial Surgery Unit, Hospital Guglielmo da Saliceto, Piacenza, Italy.,GAEM, Group of Applied ElectroMagnetics, Department of Engineering and Architecture, University of Parma, Parma, Italy
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24
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Parker S, Cronshaw M, Anagnostaki E, Bordin-Aykroyd SR, Lynch E. Systematic Review of Delivery Parameters Used in Dental Photobiomodulation Therapy. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:784-797. [PMID: 31573388 DOI: 10.1089/photob.2019.4694] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: This systematic review of published data critically appraises the consistency in the reported delivery parameters used in photobiomodulation (PBM) therapies research within clinical dentistry and makes reporting recommendations for future clinical protocols. Background: Key to the standardization of randomized clinical trials and associated peer-reviewed articles is the disclosure of all laser and light-emitting diode operating parameters. The current status shows a lack of full parameters and significantly impacts on the ability to integrate published data with current and future investigation into clinical PBM therapy. Materials and methods: Search engines, PubMed, Google Scholar, and Cochrane, were scanned for investigation into the effects of PBM therapy research within clinical dentistry. Key words "Low-Level-Laser," "PBM," "Photobiomodulation," "Oral" and "Therapy" were used and a total of 754 articles identified, spanning a period of 9 years and 1 month between February 2009 and March 2018. Only human clinical trials were considered. Fifty-two articles were included in this investigation and the reported basic delivery parameters used in PBM therapies research were considered for each clinical trial. Results: The overall reported basic delivery parameters used in PBM therapies research were too inadequate to be able to be replicated in further studies. These included parameters related to the power meter, beam cross-sectional dynamics, fluence, and wider aspects of dosimetry. Conclusions: The delivery parameters used in PBM therapy research within clinical dentistry, investigated in this study, presented a wide variation in their recording or nonrecording of all significant elements needed to have scientific validity. A constant inconsistency in delivering valid, reliable, PBM therapy doses, to target tissues was also identified. The lack of consensus in delivering a sound protocol for PBM therapy, is partly due to the lack of adequate reported materials and methods, which are essential for replication of individual studies. One way to resolve this problem is for Journals to insist on all comprehensive parameter records, used in PBM therapies, to be part of author guidelines in submitting articles of studies on PBM therapy in clinical dentistry.
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Affiliation(s)
- Steven Parker
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Mark Cronshaw
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | - Eugenia Anagnostaki
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
| | | | - Edward Lynch
- School of Dental Medicine, University of Nevada, Las Vegas, Nevada
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Bhattacharya P, Patil K, Guledgud M. Effectiveness of 904 nm Gallium-Arsenide Diode Laser in Treatment of Oral Lichen Planus: Report of 2 Cases. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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26
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Mussttaf RA, Jenkins DFL, Jha AN. Assessing the impact of low level laser therapy (LLLT) on biological systems: a review. Int J Radiat Biol 2019; 95:120-143. [DOI: 10.1080/09553002.2019.1524944] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Ruwaidah A. Mussttaf
- School of Computing, Electronics and Mathematics, University of Plymouth, Plymouth, UK
| | - David F. L. Jenkins
- School of Computing, Electronics and Mathematics, University of Plymouth, Plymouth, UK
| | - Awadhesh N. Jha
- School of Biological and Marine Sciences, University of Plymouth, Plymouth, UK
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Vieira DL, Leite AF, Figueiredo PTDS, Vianna LM, Moreira-Mesquita CR, de Melo NS. A Conservative Approach for Localized Spongiotic Gingivitis Hyperplasia Using Photodynamic Therapy: A Case Report and Review of the Literature. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:57-61. [DOI: 10.1089/photob.2018.4454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Danielle Leal Vieira
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - André Ferreira Leite
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | | | - Leonora Maciel Vianna
- Department of Pathology, Pathological Anatomy Center, University Hospital of Brasilia, University of Brasília, Brasília, Brazil
| | | | - Nilce Santos de Melo
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
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Vieira DL, Leite AF, de Souza Figueiredo PT, Vianna LM, Moreira-Mesquita CR, de Melo NS. A Conservative Approach for Localized Spongiotic Gingivitis Hyperplasia Using Photodynamic Therapy: A Case Report and Review of the Literature. Photomed Laser Surg 2018:pho.2018.4454. [PMID: 30335567 DOI: 10.1089/pho.2018.4454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To describe a clinical case of successful conservative management of Localized Juvenile Spongiotic Gingivitis Hyperplasia (LJSGH) using photodynamic therapy (PDT) and reviews the current literature on this pathology. BACKGROUND DATA LJSGH is a recently described rare disease with controversial treatment results. As of today, 13 publications report surgical treatment approaches. The use of CO2 laser and cryotherapy was reported only in one study. The use of PDT was not previously reported. PATIENTS AND METHODS A 9-year-old male patient was referred to our institution with the chief complaint of asymptomatic "inflamed gingiva" starting 1 year before. Clinical examination revealed an erythematous line accompanying the gingival contour, with a certain degree of hyperplasia. The diagnosis of LJSGH was performed based on clinical features and later confirmed histopathologically. A novel approach using PDT was then proposed. The photosensitizer was methylene blue, and a semiconductor laser diode was used. RESULTS One week after starting PDT, gingival hyperplasia was partially reduced. Immediately after the end of treatment, a significant reduction of gingival hyperplasia was observed. PDT proved to be safe, quick and painless, with no esthetic harm. CONCLUSIONS This case illustrates the benefit of a more conservative approach as opposed to surgical procedure, with good clinical response and decreased morbidity over a 2-year follow-up period.
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Affiliation(s)
- Danielle Leal Vieira
- 1 Department of Dentistry, Faculty of Health Sciences, University of Brasília , Brasília, Brazil
| | - André Ferreira Leite
- 1 Department of Dentistry, Faculty of Health Sciences, University of Brasília , Brasília, Brazil
| | | | - Leonora Maciel Vianna
- 2 Department of Pathology, Pathological Anatomy Center, University Hospital of Brasilia, University of Brasília , Brasília, Brazil
| | | | - Nilce Santos de Melo
- 1 Department of Dentistry, Faculty of Health Sciences, University of Brasília , Brasília, Brazil
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29
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Hoseinpour Jajarm H, Asadi R, Bardideh E, Shafaee H, Khazaei Y, Emadzadeh M. The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus—A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2018; 23:254-260. [DOI: 10.1016/j.pdpdt.2018.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/07/2018] [Accepted: 07/02/2018] [Indexed: 02/03/2023]
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30
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Bhattacharya PT, Patil K, Guledgud MV. Effectiveness of 904nm Gallium-Arsenide Diode Laser in Treatment of Oral Lichen Planus: Report of 2Cases. ACTAS DERMO-SIFILIOGRAFICAS 2018; 110:325-327. [PMID: 29857947 DOI: 10.1016/j.ad.2018.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/29/2018] [Accepted: 02/10/2018] [Indexed: 11/30/2022] Open
Affiliation(s)
- P T Bhattacharya
- Profesor asistente, Departamento de Medicina Oral y Radiología, Facultad y Hospital Sarjug Dental, Darbhanga, Bihar, India.
| | - K Patil
- Profesor y jefe, Departamento de Medicina Oral y Radiología, Facultad JSS Dental, Mysore, Karnataka
| | - M V Guledgud
- Profesor, Departamento de Medicina Oral y Radiología, Facultad JSS Dental, Mysore, Karnataka, India
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Epstein JB, Raber-Durlacher JE, Huysmans MC, Schoordijk MC, Cheng JE, Bensadoun RJ, Arany PR. Photobiomodulation Therapy Alleviates Tissue Fibroses Associated with Chronic Graft-Versus-Host Disease: Two Case Reports and Putative Anti-Fibrotic Roles of TGF-β. Photomed Laser Surg 2018; 36:92-99. [DOI: 10.1089/pho.2017.4297] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joel B. Epstein
- Cancer Dentistry, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Health Center, Los Angeles, California
- Department of Oral Medicine, City of Hope, Duarte, California
| | - Judith E. Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Academic Medical Center, Amsterdam, The Netherlands
- Department of Oral Medicine, and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | | | | | - Jerry E. Cheng
- Department of Oral Medicine, City of Hope, Duarte, California
- Kaiser Permanente, Los Angeles, California
| | | | - Praveen R. Arany
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, New York
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Via Nizza 230, Turin 10100, Italy.
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33
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Akram Z, Abduljabbar T, Vohra F, Javed F. Efficacy of low-level laser therapy compared to steroid therapy in the treatment of oral lichen planus: A systematic review. J Oral Pathol Med 2017; 47:11-17. [DOI: 10.1111/jop.12619] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Zohaib Akram
- Department of Periodontology; Faculty of Dentistry; Ziauddin University; Karachi Pakistan
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Kingdom of Saudi Arabia
| | - Fawad Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
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34
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Al-Maweri SA, Kalakonda B, Al-Soneidar WA, Al-Shamiri HM, Alakhali MS, Alaizari N. Efficacy of low-level laser therapy in management of symptomatic oral lichen planus: a systematic review. Lasers Med Sci 2017; 32:1429-1437. [DOI: 10.1007/s10103-017-2233-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/12/2017] [Indexed: 12/21/2022]
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35
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Othman NA, Shaker OG, Elshenawy HM, Abd-Elmoniem W, Eldin AM, Fakhr MY. The effect of diode laser and topical steroid on serum level of TNF-alpha in oral lichen planus patients. J Clin Exp Dent 2016; 8:e566-e570. [PMID: 27957272 PMCID: PMC5149093 DOI: 10.4317/jced.52665] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 05/22/2016] [Indexed: 12/26/2022] Open
Abstract
Background Oral lichen planus (OLP) is a common chronic inflammatory mucosal disease with a multifactorial etiology. It is a T-cell mediated autoimmune disease in which the cytotoxic CD8+T cells trigger apoptosis of the basal cells of oral epithelium. Various treatment regimens have been employed for management of symptomatic OLP. This study was carried out to evaluate the effect of topical steroids as well as laser on the clinical signs and symptoms detected by reticular, atrophic, erosive score (RAE score) and tumor necrosis factor- α (TNF-α) level in the serum of patients with symptomatic OLP. Material and Methods The study was conducted on twenty-four patients (18 females and 6 males) with symptomatic OLP that were allocated into two groups. Each included twelve patients. The first group treated either with diode laser (970nm SIROLaser Advance class IIIb, SIRONA The Dental Company, Germany) twice weekly with maximum of ten sessions while the second group were treated with topical corticosteroids (0.1% triamcinolone acetonide orabase, Kenacort-A Orabase Pomad, DEVA HOLDING A.Ș, Istanbul, Turkey) for four weeks. Results Corticosteroids group showed less clinical signs and symptoms of reticular, atrophic, erosive RAE score (p=0.02) and TNF-α serum level (p=0.028) than diode laser group with no reported therapy side effects or complications in any of the treated patients. Conclusions Topical steroids reduce pain, reticular, atrophic, erosive RAE score and TNF-α serum level more than laser treatment. Moreover, laser treatment can be used as an alternative treatment when steroids are contraindicated for the treatment of symptomatic OLP. Key words:Oral lichen planus, diode laser, topical steroid, RAE score, TNF-α.
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Affiliation(s)
- Nagwa-Abdelhamid Othman
- Prof, Dr. Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University
| | - Olfat-Gamil Shaker
- Prof, Dr. Department of Biochemistry, Faculty of Medicine, Cairo University
| | | | - Wessam Abd-Elmoniem
- Associate, Prof,Dr. Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University
| | - Amany-Mohy Eldin
- PhD. Department of Surgery and Oral Medicine, National Research Center
| | - Mariam-Yehia Fakhr
- PhD. Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University
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Wang Y, Huang YY, Wang Y, Lyu P, Hamblin MR. Photobiomodulation of human adipose-derived stem cells using 810nm and 980nm lasers operates via different mechanisms of action. Biochim Biophys Acta Gen Subj 2016; 1861:441-449. [PMID: 27751953 DOI: 10.1016/j.bbagen.2016.10.008] [Citation(s) in RCA: 358] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/04/2016] [Accepted: 10/12/2016] [Indexed: 10/20/2022]
Abstract
Photobiomodulation (PBM) using red or near-infrared (NIR) light has been used to stimulate the proliferation and differentiation of adipose-derived stem cells. The use of NIR wavelengths such as 810nm is reasonably well accepted to stimulate mitochondrial activity and ATP production via absorption of photons by cytochrome c oxidase. However, the mechanism of action of 980nm is less well understood. Here we study the effects of both wavelengths (810nm and 980nm) on adipose-derived stem cells in vitro. Both wavelengths showed a biphasic dose response, but 810nm had a peak dose response at 3J/cm2 for stimulation of proliferation at 24h, while the peak dose for 980nm was 10-100 times lower at 0.03 or 0.3J/cm2. Moreover, 980nm (but not 810nm) increased cytosolic calcium while decreasing mitochondrial calcium. The effects of 980nm could be blocked by calcium channel blockers (capsazepine for TRPV1 and SKF96365 for TRPC channels), which had no effect on 810nm. To test the hypothesis that the chromophore for 980nm was intracellular water, which could possibly form a microscopic temperature gradient upon laser irradiation, we added cold medium (4°C) during the light exposure, or pre-incubated the cells at 42°C, both of which abrogated the effect of 980nm but not 810nm. We conclude that 980nm affects temperature-gated calcium ion channels, while 810nm largely affects mitochondrial cytochrome c oxidase.
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Affiliation(s)
- Yuguang Wang
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA
| | - Ying-Ying Huang
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA
| | - Yong Wang
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Peijun Lyu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, 02114, USA; Department of Dermatology, Harvard Medical School, Boston, MA, 02115, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, 02139, USA.
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Epstein JB, Raber-Durlacher JE, Lill M, Linhares YPL, Chang J, Barasch A, Slief RIC, Geuke M, Zecha JAEM, Milstein DMJ, Tzachanis D. Photobiomodulation therapy in the management of chronic oral graft-versus-host disease. Support Care Cancer 2016; 25:357-364. [DOI: 10.1007/s00520-016-3401-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 08/29/2016] [Indexed: 01/01/2023]
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Possible alternative therapies for oral lichen planus cases refractory to steroid therapies. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:496-509. [PMID: 27068310 DOI: 10.1016/j.oooo.2016.02.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 01/15/2016] [Accepted: 02/02/2016] [Indexed: 02/05/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disorder with a multifactorial etiopathogenesis. Immune dysregulation plays a critical role in the development and progression of this disease. Patients' lives may be affected by pain caused by atrophic-erosive lesions. Given the obscure etiology, treatment is usually symptomatic. Topical steroids remain the mainstay of management. However, their therapeutic benefits are not always evident. There are substantial data on the possible therapeutic strategies that are effective in OLP cases refractory to steroids. This review provides an overview of the current approaches for the management of steroid-refractory OLP. The miscellaneous treatment regimens include tacrolimus, pimecrolimus, thalidomide, low-level laser therapy, photodynamic therapy, and surgical excision. Some results obtained from these studies were promising. However, further studies, especially randomized controlled trials with strict inclusion and exclusion criteria and larger sample sizes, are required for the evaluation of the long-term safety and efficacy of these therapies.
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Kazancioglu HO, Erisen M. Comparison of Low-Level Laser Therapy versus Ozone Therapy in the Treatment of Oral Lichen Planus. Ann Dermatol 2015; 27:485-91. [PMID: 26512161 PMCID: PMC4622881 DOI: 10.5021/ad.2015.27.5.485] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 11/27/2013] [Accepted: 01/27/2014] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The treatment options for oral lichen planus (OLP) are numerous and include topical and systemic agents. Intralesional and systemic corticosteroids are used; however, the therapeutic results are often disappointing. OBJECTIVE To compare the influence of ozone, laser, and topical corticosteroid therapies in the treatment of OLP. METHODS One hundred twenty adult patients with ≤3 cm atrophic-erosive biopsy-proven OLPs in the tongue or buccal mucosa were recruited into the study. They were randomly assigned, by preoperative envelope drawing, to be treated with low-level laser therapy (LLLT group), ozone therapy (ozonated group), and topical corticosteroid therapy (positive control group). A placebo treatment containing base ointment without the active corticosteroid component was administered to patients in the negative control group. Response rate scores were determined on the basis of changes in the appearance score and pain score of the lesions between baseline and after each treatment. RESULTS The study subjects consisted of 56 male and 64 female OLP patients with a combined mean age of 42.6±8.3 years (range, 28~55 years). No statistically significant difference was detected in clinical severity among the groups. The sign scores decreased in almost all scoring groups; however, statistically significant improvement was found in the ozonated and corticosteroid-treated groups. Symptom improvement was achieved after treatment with LLLT, ozone, and corticosteroid (p<0.05). The efficacy indices were significantly higher in the ozonated and corticosteroid-treated groups. CONCLUSION Ozone and corticosteroid therapies were more effective than 808-nm LLLT in the treatment of OLP.
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Affiliation(s)
- Hakki Oguz Kazancioglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey
| | - Merve Erisen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Mücke T, Gentz I, Kanatas A, Ritschl LM, Mitchell DA, Wolff KD, Deppe H. Clinical trial analyzing the impact of continuous defocused CO2 laser vaporisation on the malignant transformation of erosive oral lichen planus. J Craniomaxillofac Surg 2015. [DOI: 10.1016/j.jcms.2015.06.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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41
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Merigo E, Fornaini C, Meleti M, Manfredi M, Vescovi P. Low-Level Laser Therapy in odontostomatologia: istruzioni per l’uso. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30064-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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42
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El Shenawy HM, Eldin AM. A Comparative Evaluation of Low-Level Laser and Topical Steroid Therapies for the Treatment of Erosive-Atrophic Lichen Planus. Open Access Maced J Med Sci 2015; 3:462-6. [PMID: 27275271 PMCID: PMC4877840 DOI: 10.3889/oamjms.2015.072] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/04/2015] [Accepted: 06/08/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disease that causes bilateral white striations, papules, or plaques on the buccal mucosa, tongue, and gingivae. Erythema, erosions, and blisters may or may not be present. Several empirical therapies have been used in the treatment of (OLP). OBJECTIVE To evaluate the effect of low level laser therapy (LLLT) versus topical steroids for the treatment of erosive-atrophic lichen planus. SUBJECTS AND METHODS Twenty-four patients with erosive-atrophic (OLP) were categorized into two groups. In the first group patients were treated with 970 nm diode laser irradiation, while, in the second group patients used topical corticosteroids (0.1% triamcinolone acetonide orabase). The gender, medical history and pain score were recorded. The pain score was measured before and after treatment by visual analogue scale (VAS). RESULTS Steroid-treated group (0.1% triamcinolone acetonide orabase) show reduced pain score than laser group. CONCLUSION Topical steroids are more effective than LLLT. LLLT may be used as an alternative treatment for symptomatic OLP when steroids are contraindicated.
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Affiliation(s)
| | - Amany Mohy Eldin
- Orodental Division Department, National Research Centre, Cairo, Egypt
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Ní Ríordáin R, Shirlaw P, Alajbeg I, Al Zamel GY, Fung PL, Yuan AD, McCreary C, Stoopler ET, De Rossi SS, Lodi G, Greenberg MS, Brennan MT. World Workshop on Oral Medicine VI: Patient-reported outcome measures and oral mucosal disease: current status and future direction. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:152-60.e11. [DOI: 10.1016/j.oooo.2015.01.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/26/2014] [Accepted: 01/14/2015] [Indexed: 02/08/2023]
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Ryan K, Hegarty AM, Hodgson T. Aetiology, diagnosis and treatment of oral lichen planus. Br J Hosp Med (Lond) 2014; 75:492-6. [DOI: 10.12968/hmed.2014.75.9.492] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Anne M Hegarty
- Consultant in Oral Medicine in the Department of Oral Medicine, Charles Clifford Dental Hospital, Sheffield S10 2SZ
| | - Tim Hodgson
- Consultant in Oral Medicine, Eastman Dental Hospital UCLH Foundation Trust and Eastman Dental Institute UCL, London
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Dillenburg CS, Martins MAT, Munerato MC, Marques MM, Carrard VC, Sant'Ana Filho M, Castilho RM, Martins MD. Efficacy of laser phototherapy in comparison to topical clobetasol for the treatment of oral lichen planus: a randomized controlled trial. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:068002. [PMID: 24887747 DOI: 10.1117/1.jbo.19.6.068002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 04/30/2014] [Indexed: 06/03/2023]
Abstract
Oral lichen planus (OLP) is a relatively common chronic mucocutaneous inflammatory disease and a search for novel therapeutic options has been performed. We sought to compare the efficacy of laser phototherapy (LPT) to topical clobetasol propionate 0.05% for the treatment of atrophic and erosive OLP. Forty-two patients with atrophic/erosive OLP were randomly allocated to two groups: clobetasol group (n=21): application of topical clobetasol propionate gel (0.05%) three times a day; LPT group (n=21): application of laser irradiation using InGaAlP diode laser three times a week. Evaluations were performed once a week during treatment (Days 7, 14, 21, and 30) and in four weeks (Day 60) and eight weeks (Day 90) after treatment. At the end of treatment (Day 30), significant reductions in all variables were found in both groups. The LPT group had a higher percentage of complete lesion resolution. At follow-up periods (Days 60 and 90), the LPT group maintained the clinical pattern seen at Day 30, with no recurrence of the lesions, whereas the clobetasol group exhibited worsening for all variables analyzed. These findings suggest that the LPT proved more effective than topical clobetasol 0.05% for the treatment of OLP.
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Affiliation(s)
- Caroline Siviero Dillenburg
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Marco Antonio Trevizani Martins
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Medicine, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Maria Cristina Munerato
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Medicine, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Márcia Martins Marques
- University of São Paulo, School of Dentistry, Department of Dentistry, São Paulo, São Paulo 05508-000, Brazil
| | - Vinícius Coelho Carrard
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Manoel Sant'Ana Filho
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
| | - Rogério Moraes Castilho
- University of Michigan, School of Dentistry, Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, Ann Arbor, Michigan 48109-1078
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul, School of Dentistry, Department of Oral Pathology, Porto Alegre, Rio Grande do Sul 90035-003, Brazil
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Long H, Zhou Y, Xue J, Liao L, Ye N, Jian F, Wang Y, Lai W. The effectiveness of low-level laser therapy in accelerating orthodontic tooth movement: a meta-analysis. Lasers Med Sci 2013; 30:1161-70. [DOI: 10.1007/s10103-013-1507-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/27/2013] [Indexed: 10/25/2022]
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Pavlic V, Vujic-Aleksic V. Phototherapy approaches in treatment of oral lichen planus. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2013; 30:15-24. [PMID: 24118508 DOI: 10.1111/phpp.12074] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/12/2013] [Indexed: 02/06/2023]
Abstract
Oral lichen planus (OLP) is a chronic immunologic mucocutaneous inflammatory disease of the oral mucosa. Since the etiopathology of OLP is idiopathic, treatment is usually symptomatic, therefore showing low predictability. Currently, topical corticosteroids are widely accepted as the standard therapy. However, for patients unresponsive to standard therapy for OLP, new treatment modalities have been sought. Phototherapy has recently been accepted as an alternative or adjunctive treatment modality for many conditions in medicine and dentistry. The aim of this study is to present the advantages and disadvantages of the different kinds of phototherapy used in treatment of OLP (UV phototherapy, lasers, and photodynamic therapy). The main outcome measures compared were improvement of signs and symptoms and OLP recurrence. Although some phototherapy techniques in the selected articles have demonstrated limited effects, there is no solid basis in evidence for the effectiveness of any of these treatments for OLP. Therefore, further research, especially randomized controlled clinical trials with long-term follow-up, is needed to give any solid recommendation on the use of phototherapy in the field of OLP treatment.
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Affiliation(s)
- Verica Pavlic
- Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina
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