Photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review

Akram, Zohaib; Javed, Fawad; Hosein, Mervyn; Alqahtani, Mohammed A.; Alshehri, Fayez; Alzahrani, Ahmed Ibrahim; Vohra, Fahim

doi:10.1111/phpp.12371

Cited by 77 publications

(26 citation statements)

References 34 publications

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“…The use of aPDT is well documented for many diseases and conditions such as infected leg ulcers, 20 diabetic foot, 21 and chronic skin ulcers. 22 With specific regard to the oral environment, its action includes the treatment of leukoplakia, 17 lichen planus, 23 periodontal pockets, 24 peri-implantitis, 25 and oral decontamination as well. 26,27 In the specific case of palatal ulcers during orthodontic therapy, this is the first case report to use this approach to solve this type of injury.…”

Section: Discussionmentioning

confidence: 99%

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Maya¹,

Ladeira

Maya

et al. 2020

J Lasers Med Sci

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Introduction: One of the unexpected side effects of the Haas type palatal expander is ulcers progressing to necrotic lesions in the palatal area due to poor hygiene. The use of antibiotic therapy is mandatory. However, long periods of healing/pain and the need for a systemic host response with the aid of metabolization, especially in children, are issues that should be taken into account in the management of this type of injury. Since phototherapy modalities (antimicrobial photodynamic therapy [aPDT] and photobiomodulation therapy [PBMT]) are able to enhance and accelerate the healing process and reduce the bacterial load, this case report aimed to describe the use of the above-mentioned therapies to treat palatal ulcers occurring during orthodontic expansion. Case Report: The patient, a 10-year-old boy, with a chief complaint of bleeding and continuous pain in the region of his expander was verified on a follow-up visit. After a dental examination, the expander was removed and two necrotic lesions which were in contact with the acrylic part of the tooth-tissue expander were found in the palatal region. The proposal was to use one aPDT session with methylene blue followed by 4 sessions of PBMT with a red laser diode. On the 5th day, reorganized tissue was verified, with the absence of bleeding, swelling, and pain. On the 20th day of follow-up, the area showed no signs of inflammation, healthy tissue without any pathological clinical symptoms, and complete wound healing. Conclusion: The concomitant use of PBMT and aPDT therapies may be considered feasible as an adjunct treatment to manage palatal ulcers resulting from the incorrect use of tooth-tissue types of expanders

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Section: Discussionmentioning

confidence: 99%

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Maya¹,

Ladeira

Maya

et al. 2020

J Lasers Med Sci

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“…A few studies investigated the efficacy of PDT in reducing the clinical symptoms of OLP, i.e. lesion size and symptoms, and found mixed clinical responses 22,[44][45][46][47][48][49] . Furthermore, limited evidence exists regarding the histological, immunological effects of PDT in OLP.…”

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confidence: 99%

Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study

Cosgarea

Pollmann

Sharif

et al. 2020

Sci Rep

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Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP. Lichen planus (LP) is a common T cell mediated, chronic inflammatory disorder which affects the oral mucosa and causes major discomfort, its etiology is still not entirely elucidated 1-4. Oral LP (OLP) affects the buccal mucosa, tongue and gingiva, and usually presents with symmetrical, bilateral or multiple lesions 5,6. The erosive and atrophic forms may present with remarkable burning and pain sensations that restrict food intake and performance of oral hygiene measures leading to weight loss, nutritional deficiencies 7,8 , loss of teeth and function with a major impact on the quality of life (QOL). These OLP forms are often resistant to treatment 9,10 and have a higher tendency to malignant transformation 11,12. At present, topical corticosteroids are widely accepted as the primary choice of OLP therapy, but other therapeutical protocols have also been investigated, i.e. topical and systemic retinoids, calcineurin inhibitors, aloe-vera, and thalidomide 6,7,13-25. However, some of these treatment options proved to be ineffective or only partially effective 12. Photodynamic therapy (PDT) as an easy-to-use and safe treatment option induces cell and tissue damage by combining the use of a photosensitizer and light that activates the photosensitizer by exposure to low-level visible light in an appropriate wavelength. The general principle of PDT was first described in 1900 by the work of Raab and Tappeiner who evaluated the effects of acridine on malaria-causing protozoa showing a lethal effect of this combination on a species of paramecium (Infusoria) 26. They discovered the optical property of fluorescence and that...

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“…In addition, the authors pointed out that the assessment of PDT efficacy is difficult given that there is no consensus on the parameters which should be used and in most studies the follow-up period was too short. Furthermore, they emphasized the need to compare the results with a control group consisting of patients treated with corticosteroids (46).…”

Section: The Role Of Photodynamic Therapy In Oral Lichen Planusmentioning

confidence: 99%

Photodynamic therapy as a new therapeutic approach of oral lichen planus

Tocut¹,

Mitran²,

Mitran³

et al. 2019

JMMS

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Oral lichen planus (OLP) is a chronic, immunologically mediated disease, defined by periods of exacerbation and quiescence. The disease is associated with a low mortality risk, but in some instances, morbidity can be important, especially in extensive, erosive forms, with a significant impact on the quality of life. OLP is a chronic T-cell mediated inflammatory disease involving the oral cavity, the most common lesions being located on the oral mucosa, tongue and gums. Its etiology remains in part unknown, but several factors proved to be involved in the development of the disease (drugs, dental materials, infectious agents, psychological factors, autoimmunity and genetic predisposition). The therapeutic approach should take into account the type of lesion and the extent of the disease, as well as the possible adverse effects. Although several therapies are available, OLP treatment still remains a challenge. Photodynamic therapy (PDT) is widely used in dermatology, finding applicability in the treatment of an increasing number of conditions. Recent research has shown the role of PDT in the treatment of OLP. It is a minimally invasive therapy with few side effects and promising results. Keywords  oral lichen planus, photosensitizer, therapy Highlights  The therapeutic approach in the OLP remains a challenge; although many therapies are available, none of them can still be considered the ideal therapeutic approach.  PDT seems to be a promising therapy, but with heterogeneous results due to lack of standardization (the available studies using different sources of light, wavelengths and photosensitizers).

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Photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review

Cited by 77 publications

References 34 publications

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study

Photodynamic therapy as a new therapeutic approach of oral lichen planus

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