Abstract
Photobiomodulation (PBM) therapy is a promising approach for the management of inflammatory conditions and autoimmune lesions, such as oral lichen planus (OLP). The aim of this retrospective study was to assess the effectiveness of PBM in the management of painful and erosive/ulcerative OLP and to compare it with the standard of care that is the topical application of corticosteroids. 96 patients were included with erosive and painful OLP. 48 patients received PBM therapy and 48 received corticosteroids. Data was collected retrospectively on pain using the visual analogue scale; clinical aspects of lesions were assessed with the REU score, and the recurrence rate was noted. One session of PBM therapy with a helium-neon red light (635 nm) was carried out every 48 h for 6 weeks. Treatments were mainly made in contact mode, using a fiber with a diameter of 600 µm (0.6 mm). The output power of the laser beam was calibrated by a power meter. A delivered power of 0.1 W was used for 40 s in a continuous wave (CW), corresponding to a delivered energy of 4 J. The delivered energy density related to the fiber diameter was 1415 J/cm2. Each treated point was considered as 1 cm2 of diameter. PBM therapy within these parameters was carried out on each point until the totality of the lesion was covered, including the non-erosive OLP area. Furthermore, healthy mucosa within 5 mm of the lesion was also irradiated with the same conditions. This PBM treatment was performed during 6 consecutive weeks. The topical corticosteroid treatment consisted of cortisone application to cover the OLP 3 times/day for 6 weeks. Follow-up was made at 6 weeks and at 3, 6 and 12 months. After 6 weeks, both groups showed complete absence of pain, and a complete disappearance of ulcerative/erosive areas. No significant difference was found for both groups concerning the recurrence rate of erosive OLP during the follow-up period; values were 0% at 6 weeks for both groups and 79% and 87.5% for the corticosteroid and PBM group, respectively, at 12 months of follow-up. PBM is effective for managing OLP and is significantly similar to topical corticosteroids without any need for the use of medication and with no reported side effects.
Highlights
Photobiomodulation (PBM) therapy, previously known as low-level laser therapy, is the therapeutic use of light in order to modulate biological activity [1]
The North American Association of Laser Therapy (NAALT) and the World Association of Laser Therapy (WALT) reached a consensus in 2014 on adopting the term photobiomodulation instead of low-level laser therapy [1]. It is well-established that PBM therapy can be effective in numerous indications, such as in the management of oral inflammation due to high-dose chemotherapy and/or head and neck radiotherapy in cancer patients, as an assistance in tempero-mandibular joint disorders, and other indications [1,2]
The exact mechanism of action of PBM is not fully understood; it is well-established that PBM acts primarily by increasing adenosine triphosphate (ATP) production and causing a short transient burst of reactive oxygen species, which have a beneficial impact on the inflammatory process [1,2,3]
Summary
Photobiomodulation (PBM) therapy, previously known as low-level laser therapy, is the therapeutic use of light in order to modulate biological activity [1]. The North American Association of Laser Therapy (NAALT) and the World Association of Laser Therapy (WALT) reached a consensus in 2014 on adopting the term photobiomodulation instead of low-level laser therapy [1]. It is well-established that PBM therapy can be effective in numerous indications, such as in the management of oral inflammation due to high-dose chemotherapy and/or head and neck radiotherapy in cancer patients, as an assistance in tempero-mandibular joint disorders, and other indications [1,2]. Recent studies have suggested that PBM may activate transcription factors and signaling pathways and may have a protective mechanism [3,4]
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