Application of 5-aminolevulinic acid-mediated Waterlase-assisted photodynamic therapy in the treatment of oral leukoplakia

Abstract

Photodynamic therapy (PDT) is an alternative microinvasive approach with satisfying results in the treatment of oral leukoplakia (OL). PDT combined with laser irradiation shows promise, safety and efficacy in treating OL. The efficacy of waterlase (YSGG) combined with PDT was studied by brush and tissue biopsy. Seventy-one patients with histologically diagnosed OL were enrolled, including patients with mild to moderate dysplasia, severe dysplasia and various dysplastic tissues. Patients were evaluated at baseline (t0), the end of treatment (t1) and 1 year later (t2). At t1, PDT showed a significant therapeutic effect on OL with mild to moderate dysplasia. Clinical and histological examinations revealed 60 cases (84.51%) of complete remission and 11 cases (15.49%) of partial remission. On brush biopsy, all PDT-treated patients showed reduced aneuploidy and normal histological findings. Unfortunately, at t2, 9 patients relapsed with OL, which may be related to continued smoking and betel nut chewing. At t2, 5 patients developed new severe epithelial dysplasia and even carcinoma in situ in other areas, mostly the tongue. ALA-mediated PDT combined with YSGG is effective in treating OL, particularly that with mild to moderate dysplasia. However, severe dysplasia may present undesirable effects, and the mechanism remains to be further investigated. ALA-mediated PDT combined with YSGG provides a new method for OL treatment.

Photodynamic therapy (PDT) for oral leukoplakia: a systematic review and meta-analysis of single-arm studies examining efficacy and subgroup analyses

“…The 17 single-arm studies were evaluated for quality using the MINORS criteria. Seven studies scored more than 9 points [ 19 – 21 , 24 , 26 , 28 , 32 ]. Eight studies scored equal to 9 [ 16 , 17 , 22 , 23 , 27 , 29 , 30 , 31 ], and two studies scored less than 9 [ 18 , 25 ].…”

“…A total of 11 studies involving 84 leukoplakia lesions [ 16 , 18 – 21 , 24 , 26 , 27 , 29 , 30 , 32 ] with Recurrence outcomes were analyzed. After statistical analysis using the random effects model, it was concluded that [ES = 0.13, 95%CI: (0.08, 0.18), I 2 = 71.4%, P < 0.001], as shown in Fig.…”

Functionalization of a Cortical Membrane with a Photodynamic Protocol

“…Whereas in the case of the ALAD-PDT protocol, it can be applied directly by the clinician during dental surgery. A further advantage for clinicians and patients is the time of ALAD-PDT application, which requires only 45 min for gel incubation and 7 min of irradiation compared to other photodynamic protocols that require 2–3 h incubation time and 20–25 min for irradiation [ 35 , 36 ]. Altogether, the results of this preliminary study may suggest a possible combination of two different techniques, a photodynamic protocol and a curved cortical membrane, commonly applied in dentistry fields for different purposes, to improve the biological properties of the lamina cortical membranes applied during GBR procedures, in promoting the bone healing and remodeling processes.…”

Novel tetrahydrocurcumin integrated mucoadhesive nanocomposite κ-carrageenan/xanthan gum sponges: a strategy for effective local treatment of oral cancerous and precancerous lesions

“…OPL has gained attention because of the increased risk of cancer development in the oral cavity. It has been reported that 15.8–48.0% of patients with OSCC have a history of oral leukoplakia (Ou et al., 2022 ).…”

“…Therefore, continued research for safer and more efficient chemoprevention and treatment is clearly needed to improve efficiency and reduce treatment costs (H. Wang et al., 2012 ). Cancer chemoprevention through OPL management is a potential strategy to enhance quality of life, prevent malignant transformation, and dramatically decrease mortality rates (Ou et al., 2022 ). However, oral cavity physiology can represent a real barrier for effective drug accumulation (Freag et al., 2018 ).…”