Relieving pain in oral lesions of pemphigus vulgaris using the non-ablative, non-thermal, co2 laser therapy [NTCLT]: preliminary results of a novel approach

Introduction: Pemphigus vulgaris [PV] is a chronic, serious autoimmune mucocutaneous bullous disease. Oral lesions in PV may be extremely painful. This pain may adversely affect the patients' oral intake and quality of life. This before-after clinical trial was designed to assess the pain relieving effects of single session of non-ablative, non-thermal CO2 laser therapy [NTCLT] in oral lesions of PV

Methods: Fifty painful oral lesions of fourteen patients with PV were illuminated by CO2 laser [power: 1 W, scanning the lesions with rapid circular motion of the handpiece] passing through a thick layer of transparent gel with high water content. The pain severity of the oral lesions was reported by the patients up to the fourth postoperative day. They were also asked to continue their existing systemic treatment during the course of this study as a precondition for the participation

Results: The severity of contact and non-stimulate [non-contact] pain declined immediately and significantly after NTCLT [P < 0.001]. The pain relieving effect was sustained during the four successive days of follow-up. The procedure was pain free and no kind of analgesics was required. Following NTCLT, there were no visible thermal complications such as destruction, ablation or irritation of the oral lesions

Conclusion: The results of the trial proposed that single session of NTCLT could immediately and significantly relieve pain in oral lesions of PV, without any visible thermal complications

Low level laser therapy in management of chemotherapyinduced oral mucositis: prophylaxis or treatment?

Chemotherapy-induced oral mucositis [COM] is a common, debilitating complication of cancer therapy. The aims of this study were to evaluate the effect of low level laser therapy [LLLT] on prevention of COM in patients with hematologic malignancies. Fifty-five patients hospitalized to undergo chemotherapy in Imam Hospital were included into the study. These patients were divided into two groups. The oral cavity of the patients were illuminated by continues laser beam using a GaAlAs laser device with wavelength of 630 nm, power output 30 mW, and dose of 5 J/cm2 for six days [LLLT group]. The patients in the second group underwent placebo irradiation [power output equal to zero] with the similar protocol. The severity of the COM was clinically evaluated based on WHO grading scale. The patientys' quality of life was assessed before and after the intervention according to EORTC QLQ-C30 questionnaire. The incidence of COM in LLLT group [31%] was less than the placebo group [41%]. Mean duration of COM healing was 4.8 and 12 days in LLLT and placebo groups, respectively [p=0.03]. Xereostomia was significantly less severe in LLLT group in comparison with the placebo group [p=0.007]. Conclusion: Our findings showed that LLLT significantly reduced the incidence of oral mucositis of WHO grade 3 and 4 as the most debilitating form of oral mucositis, in which oral alimentation is impossible. Also, LLLT could reduce duration of oral mucositis, decreased the risk of secondary infection, and accelerated return to normal nutrition