A comparative randomized clinical trial to assess the effectiveness of the diode lasers in both contact and non-contact mode and 0.1% triamcinolone acetonide mouth paste in treatment of oral ulcers—an in vivo study

Abstract

Ulceration is the breach in the oral epithelium, which typically exposes nerve endings in the underlying lamina propria, resulting in pain and soreness. Oral ulcers are very common, with an estimated point prevalence of 4% worldwide. Current treatment options available include topical agents, systemic and topical corticosteroids, cauterization, antibiotics, multivitamins, adhesive pastes, local antiseptics, analgesics, anti-inflammatory, mouth rinses containing active enzymes, and photobiomodulation therapy (PBMT). Laser constitutes an alternative to processes that alleviate pain and inflammatory reaction and is now widely used in management of diseases that require tissue regeneration. Keeping in mind the analgesic, anti-inflammatory, and bio-stimulatory properties of PBMT, we conducted a study to analyze the effectiveness of PBMT in both contact and non-contact mode in relation to pain in ulcer, size, and healing time. A total of 45 patients with ulcers were included and randomly divided them into 3 equal groups undergoing laser therapy (contact mode, non-contact mode) and conventional treatment, i.e., 0.1%triamcinolone acetonide. All the patients were examined on day 0, 2, 4, and 6 to check for pain, size of ulcer, and healing time. Also, frequency of recurrence was also assessed in a 1-year follow-up. ANOVA followed by post hoc comparison by Bonferroni method was done which revealed that PBMT in non-contact mode provided immediate pain relief and significantly reduced healing time with less recurrence followed by PBMT in contact mode. PBMT in non-contact mode was more effective in relieving pain and reducing the healing time during the treatment of oral ulcers compared with triamcinolone acetonide and laser in contact mode. Also, less recurrence was seen even after 1-year of follow-up. Hence, it can be concluded that PBMT in non-contact and contact mode is a safe and clinically effective therapy for treating oral ulcers.