Clinical responses of patients with systemic diseases to the photodynamic therapy of oral lichen planus

BACKGROUND

 Oral lichen planus (OLP) is a chronic disease commonly detected in older aged patients with female predominance. Treatment of OLP in diabetic and hypertensive patients usually shows some difficulties which require a more safe and effective treatment modality such as Photodynamic therapy (PDT). The current study aims to evaluate the role of PDT in treating OLP in diabetic and hypertensive patients.

METHODS

We evaluated the role of PDT in treating erosive OLP of type 2 diabetic and hypertensive patients. The following parameters were evaluated for each case at the time zero, after2 weeks, and 4 weeks of the study: subjective responses, objective responses, and the size of the lesion.

RESULTS

 Our study included 9 diabetic and 7hypertensive patients with an age range of 30:60 years old. There were statistically significant differences between the diabetic and hypertensive patients in the objective response, area of ulceration, and the area of erythema at the end of the 4th week of the study (p<0.05).

CONCLUSION

 PDT is an effective treatment modality for diabetic and hypertensive patients with no side effects or patient discomfort.

Clinical and radiographic diagnostic study of strontium ranelate and metal-substituted hydroxyapatite bone graft materials in diabetes mellitus with chronic periodontitis

Background

The present study aimed to assess the clinical and radiographic effect of strontium ranelate and metal-substituted hydroxyapatite as bone graft materials on treating chronic periodontitis among diabetes mellitus patients.

Methods

A randomized split-mouth study was conducted on 20 sites in 10 controlled type II diabetic patients suffering from chronic periodontitis. After phase I therapy, the sites were randomly allocated by a computer-generated table into two groups. Group 1: A mucoperiosteal flap was elevated in 10 sites, followed by the placement of strontium ranelate mixed with Gengigel. Group 2: A mucoperiosteal flap was elevated in 10 opposite sites, followed by the placement of metal-substituted hydroxyapatite mixed with Gengigel. Clinical parameters were assessed at baseline and 3- and 6-month intervals. Cone-beam computed tomography (CBCT) was used at baseline and after six months to assess bone gain.

Results

The two treatment modalities resulted in a statistically significant reduction in clinical parameters at the 3- and 6-month intervals compared to the mean baseline value. Intergroup comparison showed a significant reduction in probing pocket depth and clinical attachment loss in group 1 compared to group 2. Comparison of the two sides by CBCT showed a significant increase in the alveolar bone height in the SR group than the metal-substituted hydroxyapatite group.

Conclusion

Clinical and radiographic results showed a significant improvement in the two groups and provided evidence that strontium ranelate is promising in treating periodontal diseases.

Could photodynamic therapy be utilized as a treatment modality for oral lichen planus?

BACKGROUND

Oral lichen planus (OLP) is a chronic inflammatory disease. There is no standard treatment modality for OLP. Recently, photodynamic therapy (PDT) has been advocated as a new treatment modality for OLP.

AIM

The aim of the present study is to compare the effect of PDT using methylene blue (MB) as a photosensitizer to the effect of topical corticosteroids in the treatment of erosive OLP lesions.

MATERIALS AND METHODS

Our study included 20 patients with erosive OLP. Patients were divided into two groups. The study group included 10 patents which received MB-PDT. Patients were instructed to use MB as mouth path for 5 min. After 10 min, we applied focal red light on OLP lesions (wavelength 660 nm, Intensity 100-130 m W/cm2) for 2 min. The PDT was applied twice a week for four weeks. In the control group, 10 patients were instructed to apply topical betamethasone valerate ointment 100 mg on OLP lesion three times per day for four weeks. Subjective, objective scores and lesion size were recorded at time zero, after 2 weeks and after 4 weeks from the start of treatments.

RESULTS

Both groups showed statistically significant differences between time zero and the 4^th week of treatment in subjective, objective scores and the area of the lesions. MB-PDT showed a higher degree of improvement than topical corticosteroids between time zero and the 4^th week of treatment.

CONCLUSION

Photodynamic therapy can be used as a treatment for erosive OLP. PDT offers improvement of OLP subjective and objective scores without major side effects.