Low-Level Diode Laser Therapy (LLLT) versus Topical Corticosteroids in the Management of Recurrent Aphthous Stomatitis Patients. A Randomized Controlled Trial

Ahmed Elbarbary,Menatalla Nadim,Heba Hussein,Ahmed Zaky

doi:10.21608/adjc.2021.90071.1109

Ahmed Elbarbary, Menatalla Nadim + Show 2 more

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https://doi.org/10.21608/adjc.2021.90071.1109

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Abstract

Objectives: The current study was conducted to evaluate the effect of low-level laser therapy (LLLT) on recurrent aphthous stomatitis for reduction of pain score and ulcer size. Subjects and Methods: 28 participants with symptomatic minor recurrent aphthous ulcers were randomly allocated into two groups. The treatment group received a 980 nm diode laser and the control group received topical triamcinolone acetonide 0.1%. The measured outcomes included pain score as visual analog scale (VAS) at baseline, second day, and seventh day, and the lesion size at baseline and seventh day. Results: A statistically significant difference was found between the laser and the corticosteroid groups when comparing VAS scores on day two (pain reduction was -2.2 ± 0.9 and -4.786 ± 1 for corticosteroid and laser groups respectively with a p -value of 0.001) and day seven (pain reduction was -4.643 ± 1.646 and -6.071 ± 1.439 for corticosteroid and laser groups respectively with a p -value of 0.024) in favor of the laser group. Moreover, a statistically significant difference was noticed between the laser and the corticosteroid groups regarding the decrease in lesion size (lesion diameter reduction was -3.036 ± 1.447 and -4.536 ± 1.846 for corticosteroid and laser groups respectively with a p -value of 0.024) in favor of the laser group. Two participants experienced severe mouth dryness after corticosteroid application. None of the laser patients experienced any side effects. Conclusion: LLLT can be considered a reliable alternative to topical steroids in the management of recurrent aphthous ulcers since it was more effective in reducing both pain intensity and ulcer size.

Highlights

Recurrent aphthous stomatitis (RAS) is painful, idiopathic, recurrent, inflammatory ulcerations of the oral cavity
The current study aimed to investigate the effect of level laser therapy (LLLT) on recurrent aphthous ulcers for pain and lesion size reduction as compared to topical corticosteroids
The results of the current study showed that there was a statistically significant decrease in lesion diameter and pain scores from baseline to the different study time intervals in each group separately

Summary

Introduction

Recurrent aphthous stomatitis (RAS) is painful, idiopathic, recurrent, inflammatory ulcerations of the oral cavity. Systemic therapy is reserved for cases with more severe symptoms and more frequent episodes Some of these agents have limitations due to their side effects or their minimal effect on decreasing recurrence (Huo et al, 2021). Topical corticosteroids are the most widely-used medications for managing RAS (Chiang et al, 2019) They exert a local antiinflammatory effect with minimal systemic absorption, so they are used for treating many oral inflammatory conditions including RAS (Hamishehkar et al, 2015). Low-level Laser Therapy (LLLT) has been proven to be effective in treating a multitude of illnesses This is due to its proven role in inflammatory modulation, improving tissue regeneration, the healing process, and pain relief. These are results of activation of cellular proliferation, changes in levels of inflammatory mediators, and improving tissue oxygenation (Slebioda & Dorocka-Bobkowska, 2020)

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