Management of recurrent aphthous ulcers with therapeutic Nd:YAG laser, using two different methods

BACKGROUND

Low-level laser therapy (LLLT) has been applied for the management of craniomaxillofacial disorders, including intraoral wounds, as well as recurrent aphthous stomatitis (RAS) lesions. However, the proper combination of laser features and tissue characteristics remains the major challenge in the realm of photobiomodulation (PBM).

OBJECTIVES

The aim of the present study was to assess the feasibility of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser therapy in treating RAS lesions, and to compare 2 techniques, different with regard to the distance between the fiber tip and the ulcer.

MATERIAL AND METHODS

A total of 138 patients (94 males and 44 females) with untreated RAS were divided into 3 groups: focused laser (energy density: 48 J/cm2; power density: 0.797 W/cm2; spot size: 0.1256 cm2); defocused laser (energy density: 21 J/cm2; power density: 0.354 W/cm2; spot size: 0.2826 cm2); and placebo. In the focused group, laser irradiation was performed with the laser tip kept 1 mm away from the lesion. Acrylic cylinders were prepared to precisely fit the handpiece tip and hold it in the proper position. In the defocused group, acrylic cylinders were prepared to set the laser tip 6 mm away from the lesion to obtain defocused irradiation. Finally, in the placebo group, a routine laser therapy procedure was carried out with a helium-neon (He-Ne) red light laser. The lesion size, and pain intensity and duration were recorded.

RESULTS

Photobiomodulation showed a significantly more efficient pain relief as compared to the placebo group (p < 0.001) and also significantly better results in decreasing pain duration (p < 0.001). Besides, the diameter of the lesions in the exposed cases decreased during the 3 consecutive days of the study, while an increase in the diameter of the lesions was noticed in the placebo group.

CONCLUSIONS

The Nd:YAG laser therapy, with the conditions and adjustments of the present study, may be successfully applied to manage RAS lesions, using either focused and defocused scanning techniques.

CO2-laser treatment of ulcerative lesions

This article reports the successful use in our clinic of CO(2)-laser to reduce severe pain in the treatment of oral aphthosis. The patients, presenting stress-related, chemoradiotherapy-induced, and immuno-related oral aphthosis, reported immediate pain relief and rapid recovery. Treatment technique and laser parameters are described.

Laser palliation of oral manifestations of human immunodeficiency virus infection

BACKGROUND

The author describes the use of lasers to palliate the oral manifestations of the human immunodeficiency virus, or HIV, infection. He discusses the advantages to both patients and dentists, but he does not address the use of lasers as a modality to treat or cure HIV infection.

CASE DESCRIPTION

Many oral manifestations of HIV infection can be used as markers for degree of immunosuppression. These manifestations may be treated with antibiotics, analgesics and antineoplastics, which may interact and interfere with antiviral agents used to treat the disease and possibly may exacerbate it. The author describes laser palliation of the oral manifestations of three HIV-positive patients.

CLINICAL IMPLICATIONS

Dentists will see more patients living longer with HIV as the disease becomes more treatable. Lasers have been shown to be effective instruments in palliation of oral manifestations of HIV infection.

[Experience in irradiating with helium-neon lasers to treat patients with relapsing aphthous stomatitis]

Seventy-five patients with relapsing aphthous stomatitis (41 with the fibrinous form, 25 with glandular form, and 9 with necrotic form) were treated using He-Ne laser and a photosensitizer. A good therapeutic effect was attained.

The effect of low-power lasers on intraoral wound healing

Two types of helium-neon lasers were examined for their effectiveness in increasing the rate of wound healing by biostimulation. The diode helium-neon laser (670 nm) was as effective as the gas helium-neon laser (632 nm) in significantly speeding the rate of healing in rats. Thermal properties of low-power lasers and a controlled clinical case of helium-neon laser treatment of human aphthous stomatitis lesions were reported.

[The laser therapy and laser acupunture of patients with chronic recurrent aphthous stomatitis]

Laser therapy and laser acupuncture of the biologically active sites were administered to 24 patients with chronic recurrent aphthous stomatitis. The biologically active sites were selected individually with due consideration for the underlying somatic condition. Good results were achieved in the patients with the fibrous form of chronic aphthous stomatitis. Secretory and serum immunoglobulin levels were monitored over the course of laser treatment.

[Studies on the therapeutic efficacy of a HeNe laser]

Numerous manufactures recommend He-Ne-Lasers for a wide range of applications in medicine and dentistry. An athermal biostimulating mechanism of action is postulated to result in rapid reduction of pain and accelerated wound healing. The efficacy of a commercially available He-Ne-Laser in the treatment of alveolitis, solitary aphthae, ulcers caused by dentures, herpes simplex labialis, marginal periodontopathy and pericoronitis was investigated in 90 cases. Except for a placebo effect no reproducible therapeutic effects could be seen. Nevertheless, there is a high degree of acceptance for laser application by most of patients.