Comparing the Effectiveness of Low-Level Laser Therapy and Topical Steroid Therapy Combination Regimen With Routine Topical Steroid Therapy in the Management of Oral Lichen Planus Symptomatic Patients

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Sep 26

PMID 37750131

Authors

Kalagi G Panchal

Ekta Gupta

Amit Kumar

P V Samir

G S Devika

Vijaya Awasthi

Ramanpal Singh

Affiliations

Soon will be listed here.

Abstract

Background: For symptomatic oral lichen planus (OLP), a wide range of therapeutic approaches have been suggested. To minimize discomfort and symptoms among individuals with symptomatic OLP, extensive therapy is frequently needed. Therefore, finding a new therapeutic approach that may effectively manage OLP's symptoms and signs while having few adverse effects continues to be a difficult task. Recently, low-level laser therapy (LLLT) has become a popular alternative therapy option for OLP with no serious side effects.

Aim: The present research was designed to compare the effectiveness of a combination regimen of LLLT in addition to topical steroids with routine topical steroid therapy separately in order to manage patients with bothersome OLP with an extended period of follow-up.

Materials And Methods: In our trial, 60 patients were chosen and given sequential numbers as they signed up to take part. The participants were divided randomly into two categories: category A (LLLT plus topical steroids) and category B (only topical steroids). The data were entered into the aforementioned prepared case template after receiving informed consent. The aforementioned prepared case template included the following criteria for evaluating the result of the treatment: pain, recurrence, burning sensation, clinical remission, and size of the lesion. Applying the visual analog scale (VAS), pain, as well as burning sensations, were assessed in both categories. With the aid of the Electronic Digital Vernier Caliper (Mitutoyo, China), these individuals were assessed for the dimension of the lesion.

Results: The pain score on day 21 of intervention in category A was 2.5, while it was 4.63 in category B. The difference in findings was significant statistically at day 21 (p = 0.0032). The pain score on day 28 of intervention in category A was 1.3, while it was 3.0 in category B. The difference in findings was significant statistically at day 28 (p = 0.003). The pain score was greater in the control category as compared to the intervention category. The burning sensation score on day 21 of intervention in category A was 2.5, while it was 4.5 in category B. The difference in findings was significant statistically (p = 0.0024). The burning sensation score at the follow-up phase on day 45 of intervention in category A was 1.1, while it was 3.4 in category B. The difference in findings was significant statistically (p = 0.002).

Conclusion: Newer therapeutic techniques are becoming accessible to oral specialists for controlling oral mucosal disorders as a result of evolving dental trends. The gold standard for treating people with symptomatic OLP continues to be topical corticosteroids. The therapeutic advantages of topical corticosteroids, however, are considerably outweighed by their complementary effect when paired with newer treatment methods like LLLT.

References

Derikvand N, Ghasemi S, Moharami M, Shafiei E, Chiniforush N . Management of Oral Lichen Planus by 980 nm Diode Laser. J Lasers Med Sci. 2017; 8(3):150-154. PMC: 5662505. DOI: 10.15171/jlms.2017.27. View

He Y, Deng J, Zhao Y, Tao H, Dan H, Xu H . Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis. BMC Oral Health. 2020; 20(1):302. PMC: 7640434. DOI: 10.1186/s12903-020-01260-x. View

Thongprasom K, Luengvisut P, Wongwatanakij A, Boonjatturus C . Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up. J Oral Pathol Med. 2003; 32(6):315-22. DOI: 10.1034/j.1600-0714.2003.00130.x. View

Mahdavi O, Boostani N, Jajarm H, Falaki F, Tabesh A . Use of low level laser therapy for oral lichen planus: report of two cases. J Dent (Shiraz). 2014; 14(4):201-4. PMC: 3977514. View

Dillenburg C, Martins M, Munerato M, Marques M, Carrard V, Filho M . Efficacy of laser phototherapy in comparison to topical clobetasol for the treatment of oral lichen planus: a randomized controlled trial. J Biomed Opt. 2014; 19(6):068002. DOI: 10.1117/1.JBO.19.6.068002. View

Slade G . Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997; 25(4):284-90. DOI: 10.1111/j.1600-0528.1997.tb00941.x. View

Akram Z, Javed F, Hosein M, Al-Qahtani M, Alshehri F, Alzahrani A . Photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review. Photodermatol Photoimmunol Photomed. 2017; 34(3):167-174. DOI: 10.1111/phpp.12371. View

Passeron T, Zakaria W, Ostovari N, Mantoux F, Lacour J, Ortonne J . Treatment of erosive oral lichen planus by the 308 nm excimer laser. Lasers Surg Med. 2004; 34(3):205. DOI: 10.1002/lsm.20016. View

Rad M, Hashemipoor M, Mojtahedi A, Zarei M, Chamani G, Kakoei S . Correlation between clinical and histopathologic diagnoses of oral lichen planus based on modified WHO diagnostic criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(6):796-800. DOI: 10.1016/j.tripleo.2009.02.020. View

10.

Carrozzo M, Francia di Celle P, Gandolfo S, Carbone M, Conrotto D, Fasano M . Increased frequency of HLA-DR6 allele in Italian patients with hepatitis C virus-associated oral lichen planus. Br J Dermatol. 2001; 144(4):803-8. DOI: 10.1046/j.1365-2133.2001.04136.x. View

11.

Kollner K, Wimmershoff M, Landthaler M, Hohenleutner U . Treatment of oral lichen planus with the 308-nm UVB excimer laser--early preliminary results in eight patients. Lasers Surg Med. 2003; 33(3):158-60. DOI: 10.1002/lsm.10202. View

12.

Ferrara N, Gerber H, LeCouter J . The biology of VEGF and its receptors. Nat Med. 2003; 9(6):669-76. DOI: 10.1038/nm0603-669. View

13.

Dalirsani Z, Seyyedi S . Treatment of Plaque-Like Oral Lichen Planus with CO2 Laser. Indian J Dermatol. 2022; 66(6):698-703. PMC: 8906308. DOI: 10.4103/ijd.ijd_1170_20. View

14.

Pfutze M, Niedermeier A, Hertl M, Eming R . Introducing a novel Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) in pemphigus. Eur J Dermatol. 2007; 17(1):4-11. DOI: 10.1684/ejd.2007.0090. View

15.

El Shenawy H, Eldin A . A Comparative Evaluation of Low-Level Laser and Topical Steroid Therapies for the Treatment of Erosive-Atrophic Lichen Planus. Open Access Maced J Med Sci. 2016; 3(3):462-6. PMC: 4877840. DOI: 10.3889/oamjms.2015.072. View

16.

Bez C, Hallett R, Carrozzo M, Lodi G, Gandolfo S, Carrassi A . Lack of association between hepatotropic transfusion transmitted virus infection and oral lichen planus in British and Italian populations. Br J Dermatol. 2002; 145(6):990-3. DOI: 10.1046/j.1365-2133.2001.04518.x. View

17.

Trehan M, Taylor C . Low-dose excimer 308-nm laser for the treatment of oral lichen planus. Arch Dermatol. 2004; 140(4):415-20. DOI: 10.1001/archderm.140.4.415. View

18.

Cafaro A, Arduino P, Massolini G, Romagnoli E, Broccoletti R . Clinical evaluation of the efficiency of low-level laser therapy for oral lichen planus: a prospective case series. Lasers Med Sci. 2013; 29(1):185-90. DOI: 10.1007/s10103-013-1313-6. View

19.

Thomas M, Augustin H . The role of the Angiopoietins in vascular morphogenesis. Angiogenesis. 2009; 12(2):125-37. DOI: 10.1007/s10456-009-9147-3. View

20.

Piboonniyom S, Treister N, Pitiphat W, Woo S . Scoring system for monitoring oral lichenoid lesions: a preliminary study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 99(6):696-703. DOI: 10.1016/j.tripleo.2004.07.013. View