Non-thermal CO2 Laser Therapy (NTCLT): A Novel Photobiomodulative Approach for Immediate Pain Relief of Patchy Oral Mucositis Due to Chemotherapy of Solid Tumors.

Introduction: Chemotherapy-induced oral mucositis (COM) is a prominent complication of chemotherapy (CT). Non-thermal CO2 laser therapy (NTCLT) has been demonstrated as an innovative and safe photobiomodulative approach in some kinds of painful oral lesions. The purpose of this study was to evaluate the palliative effects of one session of NTCLT on COM lesions. Methods: Patients with painful COM (WHO grade:≥2) were included in this before-after clinical trial based on the eligibility criteria. The oral lesions were irradiated with a CO2 laser (power: 1 W, scanning the lesions with the rapid circular motion of the defocused handpiece) through a thick layer (3-4 mm) of a transparent gel containing a high-water content. The severity of pain in the lesions was self-assessed using a 0-to-10 visual analogue scale (VAS) for 7 consecutive days. The evaluating physician visited the patients on the 3rd and 7th days in search of any kind of complications. Results: Seventeen adult patients with 35 patches of OM due to chemotherapy of solid tumors completed the trial. Immediately after NTCLT, the mean for non-contact VAS pain scores of the lesions significantly declined from 4.91±2.356 to 0.29±0.622 (P<0.001) and the mean for contact VAS pain scores from 7.77±1.57 to 1.31±1.18 (P<0.001). The mean VAS pain scores of the lesions showed statistically significant differences between the follow-up periods compared to the baseline (P<0.001). The process was completely pain-free and required no anesthesia. After NTCLT, no kind of thermal adverse effects such as irritation, destruction, aggravation and even erythema were observed. Conclusion: Based on the results of this before-after clinical trial, NTCLT has the potential to be considered as a non-invasive and safe palliative option for the pain management of patchy OM due to chemotherapy of solid tumors.

Oral Immunotherapy in Patients with IgE Mediated Reactions to Egg White: A Clinical Trial Study.

BACKGROUND: Oral immunotherapy (OIT) is under consideration as a promising treatment for desensitization of egg-allergic patients. The objective of this study was to assess the effectiveness of egg-white OIT in patients with IgE-mediated allergy to egg white and to compare the clinical and laboratory findings before and after OIT. METHODS: This clinical trial was performed from February to August 2018 in Rasool e Akram Hospital, Tehran, Iran. Patients' selection criteria included a history of allergic symptoms, skin prick test (SPT) reactivity to egg white, and the inability to pass the Oral Food Challenge (OFC). Egg-white OIT was done for eight patients in the OIT group for 6 months while egg-white-free products were administrated for controls. The SPT reactivity, specific IgE, and IgG4 for egg white and ovomucoid were evaluated before and after OIT. RESULTS: Hundred percent of the subjects in OIT group were desensitized and tolerated 40 cc raw egg white following 6-month maintenance whereas none of the controls was able to pass the OFC. The findings obtained from the evaluations indicated a significant decrease in the wheal size and specific IgE to egg white after OIT (P = .001). Furthermore, a significant decrease of IgE/IgG4 ratio to egg white was found in OIT group (P = .01). CONCLUSION: This OIT protocol was successful as all OIT patients were able to continue 6-month OIT process and the reaction threshold to egg white increased in the OIT group. Therefore, it could be regarded as an effective and safe protocol to treat egg-allergic patients.

Clinical Effect of Non-Thermal CO2 Laser Therapy (NTCLT) on Pain Relief of Oral Aphthous Ulcers of Behçet's Disease.

Introduction: Behçet's disease (BD) is a debilitating and chronic vasculitis which can affect multiple organs. Recurrent oral aphthosis is the most common clinical feature of BD. The remarkable pain associated with painful oral ulcers can exert a major impact on the patients' quality of life. Relieving pain of these oral ulcers is an essential approach in the management of mucocutaneous lesions of BD. Non-thermal CO2 laser therapy (NTCLT) as a novel photobiomodulative approach has recently been used for significant and immediate pain reduction of some types of painful oral lesions such as recurrent aphthous stomatitis, pemphigus vulgaris, and so on. In this procedure by some considerations, the conventional CO2 laser is used as a non-surgical, non- thermal, photobiomodulative laser without any visible thermal adverse effects. In this article, we report our experiences about the analgesic effects of NTCLT on painful oral aphthous ulcers of BD. Case Presentation: We report four cases of BD, whose painful oral aphthous ulcers were irradiated with NTCLT. Immediately after NTCLT, the pain of the lesions was significantly relieved with no visible complications. Conclusion: The results of this study suggest that NTCLT could be proposed as a hopeful procedure for significant and instant pain relief of oral aphthous ulcers of BD without any visible thermal adverse effects.

Application of a collagen matrix dressing on a neuropathic diabetic foot ulcer: a randomised control trial.

OBJECTIVE: Diabetic foot ulcers (DFU) are often hard-to-heal, despite standard care. With such a complicated healing process, any advanced wound care to aid healing is recommended. Chitosan/collagen composite hydrogel materials have the potential to promote the regenerative process. In this study, the efficacy of a new collagen matrix dressing including chitosan/collagen hydrogel was compared with a standard dressing of saline-moistened gauze for wound healing in patients with a hard-to-heal neuropathic DFU. METHOD: This is an open labelled, randomised clinical trial. After conventional therapy consisting of debridement, infection control and offloading, patients were randomly allocated to receive either a collagen matrix dressing (the study group, receiving Tebaderm manufacturer) or a saline-moistened gauze dressing (control group) for wound care. The reduction in DFU size and the number of patients with complete healing were measured throughout the treatment and in follow-up. RESULTS: A total of 61 patients with a neuropathic DFU were recruited. Average percentage reduction in DFU size at four weeks was greater in the study group compared with the control group (54.5% versus 38.8%, respectively). Rate of complete healing rate at 20-weeks' follow-up was significantly better in the study group than the control group (60% versus 35.5%, respectively). CONCLUSION: The collagen matrix dressing used in this study accelerated the healing process of patients with a hard-to-heal DFU. Further research may suggest the used of this dressing to shorten the length of time to achieve complete healing.

The Immediate Pain-Relieving Effects of Non-Thermal CO2 Laser Therapy on Genital Ulcers of Behcet's Disease: A Case Report.

Behçet's disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. Oral and genital aphthous ulcers are considered as the hallmarks of BD. The genital ulcers of BD may be extremely painful and often refractory to multiple treatments. In addition, they exert a negative impact on the patient's quality of life. Some investigations have demonstrated the significant and immediate pain-relieving effects of NTCLT (non-thermal CO2 laser therapy) on some oral lesions with no visible adverse effects. In this paper, we report a case of BD whose painful genital ulcers were irradiated with NTCLT and the patient's pain caused by the ulcers relieved immediately and significantly with no visible complications.

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.

Theranostic MUC-1 aptamer targeted gold coated superparamagnetic iron oxide nanoparticles for magnetic resonance imaging and photothermal therapy of colon cancer.

Favorable physiochemical properties and the capability to accommodate targeting moieties make superparamegnetic iron oxide nanoparticles (SPIONs) popular theranostic agents. In this study, we engineered SPIONs for magnetic resonance imaging (MRI) and photothermal therapy of colon cancer cells. SPIONs were synthesized by microemulsion method and were then coated with gold to reduce their cytotoxicity and to confer photothermal capabilities. Subsequently, the NPs were conjugated with thiol modified MUC-1 aptamers. The resulting NPs were spherical, monodisperse and about 19nm in size, as shown by differential light scattering (DLS) and transmission electron microscopy (TEM). UV and X-ray photoelectron spectroscopy (XPS) confirmed the successful gold coating. MTT results showed that Au@SPIONs have insignificant cytotoxicity at the concentration range of 10-100µg/ml (P>0.05) and that NPs covered with protein corona exerted lower cytotoxicity than bare NPs. Furthermore, confocal microscopy confirmed the higher uptake of aptamer-Au@SPIONs in comparison with non-targeted SPIONs. MR imaging revealed that SPIONs produced significant contrast enhancement in vitro and they could be exploited as contrast agents. Finally, cells treated with aptamer-Au@SPIONs exhibited a higher death rate compared to control cells upon exposure to near infrared light (NIR). In conclusion, MUC1-aptamer targeted Au@SPIONs could serve as promising theranostic agents for simultaneous MR imaging and photothermal therapy of cancer cells.

Synergistic Cytotoxic Effect of Gold Nanoparticles and 5-Aminolevulinic Acid-Mediated Photodynamic Therapy against Skin Cancer Cells.

BACKGROUND: Photodynamic therapy (PDT) is a promising therapeutic modality for the treatment of cancer and other diseases. In this study, the epidermoid carcinoma cell line A431 and the normal fibroblasts were used to investigate whether gold nanoparticles (GNPs) can induce an increase in cell death during PDT using 5-aminolevulinic acid (5-ALA) as a photosensitizer. METHODS: Human fibroblast and A431 cells were grown in 96-well plates. The effect of GNPs on the efficacy of 5-ALA-mediated PDT (5-ALA-PDT) was evaluated by comparing the effect of 5-ALA with GNPs to the effect of 5-ALA alone. Cell viability was determined by the methyl- tetrazolium assay. RESULTS: Dark toxicity experiments showed that 5-ALA at concentrations 0.5, 1 and 2 mM had no significant effect on cell viability of both cell lines. However, treatment of cells with 5-ALA (0.5 to 2 mM) and light dose of 25 Jcm(-2) led to 5-10% and 31-42% decrease in cell viability of fibroblast and A431 cells respectively. The data also shows that GNPs in both the absence and the presence of light, results in a dose-dependent decrease in cell viability of both cell lines. However, the sensitivity of cancer cells to GNPs at concentrations more than 24 µg/ml was approximately 2.5- to 4-fold greater than healthy cells. Furthermore, data indicates that 5-ALA in combination with GNPs results in a synergistic reduction in viability of A431 cells. CONCLUSION: In summary, the findings of this study suggest that concomitant treatment with 5-ALA and GNPs may be useful in enhancing the effect of 5-ALA-PDT.

Effects of low-level laser irradiation on the pathogenicity of Candida albicans: in vitro and in vivo study.

OBJECTIVE: The purpose of this study was to evaluate the effects of low-level laser irradiation (LLLI) on the in vitro growth characteristics and in vivo pathogenicity of Candida albicans in a murine model in the absence of a photosensitizer. BACKGROUND DATA: C. albicans is an opportunistic commensal organism that causes a wide variety of diseases in human beings, ranging from superficial infections to life-threatening invasive candidiasis. The incidence of C. albicans infection is increasing, because of the greater frequency of acquired immunodeficiency conditions. A high recurrence rate has been reported for vulvovaginal and oral candidiasis, despite the best available treatments. Therefore, the search for new treatment modalities seems quite rational. METHODS: Candida culture plates were exposed to common clinical energies of LLLI: 3, 5, 10, and 20 J at 685 nm (BTL Laser 5000, Medicinos Projektai, Czech Republic, Prague, max power output 50 mW) and 3, 5, 10, 30, and 50 J at 830 nm (BTL Laser 5000, Medicinos Projektai, Czech Republic, Prague, max power output 400 mW). RESULTS: Following LLLI with energies >10 J at both 685 and 830 nm wavelengths, statistically significant effects were observed in vitro on the turbidimetric growth kinetics of C. albicans and in vivo on the survival rate of infected mice (p value ≤ 0.05). Therefore, this energy could be considered a threshold for clinical investigation. CONCLUSIONS: Translating our data into the clinical setting, it can be proposed that a direct laser-based approach without using a photosensitizing dye can significantly reduce the pathogenicity of Candida albicans. It can also be concluded that laser light at specific wavelengths could be a possible promising novel treatment for superficial and mucocutaneous C. albicans infections.

Effect of gold nanoparticles on photodynamic efficiency of 5-aminolevolenic acid photosensitiser in epidermal carcinoma cell line: an in vitro study.

In the recent years, enhanced functionality of treatment systems based on nanostructures has attracted a lot of interest. Photodynamic therapy (PDT) is one such treatment method. Here, the authors report the results of the investigations on synthesis and characterisation of gold nanoparticles (GNPs) and their application in PDT along with 5-aminolevolenic acid (5-ALA) (as photosensitiser) with no conjugation. Three sizes of GNPs were synthesised and their cytotoxicity was investigated by using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay on epidermal carcinoma cell line. The results showed that the PDT efficiency of ALA increased in presence of GNPs. This effect was more considerable for 4 nm particles.

Promoting wound healing in minor recurrent aphthous stomatitis by non-thermal, non-ablative CO(2) laser therapy: a pilot study.

BACKGROUND AND OBJECTIVE: This randomized controlled clinical trial (RCT) was designed to evaluate the effects of non-thermal, non-ablative CO(2) laser therapy (NACLT) to promote wound healing in minor recurrent aphthous stomatitis (miRAS). STUDY DESIGN/MATERIALS AND METHODS: Ten patients with 20 minor aphthous ulcers completed this study. Each patient had two discrete aphthous ulcers that had developed within 72 h before enrollment. One of the ulcers was randomly allocated to be treated with NACLT and the other one served as placebo. Before laser irradiation, a layer of transparent, non-anesthetic oral gel with high water content was placed on the laser and placebo lesions both. The CO(2) laser device was operated using 1 W power in defocused continuous mode, scanning rapidly over the lesion. The placebo lesion was irradiated with the same laser, but with an inactive probe. The healing times of the lesions were recorded by a blinded physician. RESULTS: The healing period was significantly shorter in ulcers treated by NACLT than in those treated with placebo (p=0.02). The process was not painful and anesthesia was not required. There were no visible side effects after NACLT and during follow-up periods. CONCLUSIONS: The results of this RCT suggest that single session of NACLT could be used to promote wound healing in minor aphthous ulcers, with no visible side effects.

Thermal damage patterns of diode hair-removal lasers according to various skin types and hair densities and colors: a simulation study.

BACKGROUND AND OBJECTIVE: It is important to prevent unwanted side effects of diode hair-removal lasers especially in dark skin tones. This study simulates the thermal damage patterns caused by diode hair-removal lasers in different skin types, hair colors, and hair densities. MATERIALS AND METHODS: LITCIT software has been used with the tissue modeled as two components, the skin and the hair. The absorption coefficients of various skin types (f(mel)=5%, 10%, 15%, and 20%), laser parameters, and optothermal properties of tissue were inputs. RESULTS: For all skin types there was a significant unwanted thermal damage to the epidermis as a result of fluence increase. Using longer pulse durations is accompanied by effective thermal damage to the hair follicle, while preserving the epidermis in skin types II and III, an effect not achieved in darker skins. Regardless of pulse duration, when the distance between hair follicles is ≤ 0.5 mm, there is a significant increase in thermal damage to interfollicular epidermis with high fluences compared with lower hair densities (interfollicular space ≥ 1 mm). In lighter hairs, while using longer pulse durations, higher fluences are needed in order to obtain the same level of thermal damage in the hair follicle as shorter pulse widths. CONCLUSIONS: In lighter skin types, lengthening the pulse duration of diode lasers (up to 400 ms) increases efficacy while preserving epidermis from unwanted thermal damage. However, it is necessary to use lower fluences while using longer pulse duration to avoid irreversible thermal damage to epidermis in darker tones, as is also true for locations with higher hair densities.

Simulation of heat distribution and thermal damage patterns of diode hair-removal lasers: an applicable method for optimizing treatment parameters.

OBJECTIVE: We simulated the heat distribution and thermal damage patterns of diode hair-removal lasers for different spot sizes, pulse durations, and fluences as a guide for optimization. BACKGROUND: Recently, the concept of thermal damage time as a reference for pulse duration has become a subject of debate. METHODS: Laser-Induced-Temperature-Calculation-In-Tissue (LITCIT) was used for the simulations. Skin was modeled as two homogenous layers of epidermis/dermis and two coaxial cylinders as the hair shaft/ follicle. Opto-thermal coefficients of the components and the radiant parameters of the laser (diode, 810 nm) were defined. RESULTS: At constant fluences and pulse durations, the damage occurred deeper when larger spot sizes were used. At constant pulse duration, high fluences caused significant damage to the hair follicle and epidermis. By using longer pulse durations (≤ 400 ms) at constant fluences, there was more effective damage to the hair follicle while sparing the adjacent epidermis and dermis. Because of the time-dependent temperature profiles, an increased pulse duration creates a moderate, gradual rise in the target's temperature. Pulse durations > 400 ms are accompanied by unwanted dermis damage. CONCLUSIONS: Our results show that using very long pulse durations near the tissue damage time (≤ 400 ms) creates better efficacy in treating unwanted hairs while avoiding unwanted damage.

A randomized clinical trial on the effect of low-level laser therapy on chronic diabetic foot wound healing: a preliminary report.

BACKGROUND AND OBJECTIVES: Low-level laser therapy (LLLT) has been shown to promote chronic wound healing in conditions of reduced microcirculation. In this preliminary study, we report the results of using LLLT to heal foot ulcers in patients with diabetes mellitus. MATERIALS AND METHODS: Twenty-three patients with a diabetic foot wound for at least 3 months were included in this double-blind randomized clinical trial. Patients were randomized to receive placebo treatment (n = 10) or LLLT (n = 13) (685 nm, energy density 10 J/cm(2)) in addition to conventional therapy. Patients were followed for 20 weeks. Ulcer size reduction and the number of patients with complete healing were compared between the LLLT and placebo groups. RESULTS: There were no significant differences in baseline characteristics of patients and foot ulcers receiving LLLT and placebo treatment. At week 4, the size of ulcers decreased significantly in the LLLT group (p = 0.04). After 20 weeks, in the LLLT group, eight patients had complete healing and in the placebo group only three patients experienced complete wound healing. The mean time of complete healing in LLLT patients (11 weeks) was less than that in placebo patients (14 weeks) though the difference was not statistically significant. CONCLUSIONS: The study provides evidence that LLLT can accelerate the healing process of chronic diabetic foot ulcers, and it can be presumed that LLLT may shorten the time period needed to achieve complete healing.

Relieving pain in minor aphthous stomatitis by a single session of non-thermal carbon dioxide laser irradiation.

This randomized controlled clinical trial was designed to evaluate the efficacy of single-session, non-thermal, carbon dioxide (CO(2)) laser irradiation in relieving the pain of minor recurrent aphthous stomatitis (miRAS) as a prototype of painful oral ulcers. Fifteen patients, each with two discrete aphthous ulcers, were included. One of the ulcers was randomly allocated to be treated with CO(2) laser (1 W of power in de-focused continuous mode) and the other one served as a placebo. Before laser irradiation, a layer of transparent, non-anesthetic gel was placed on both the laser lesions and the placebo lesions. The patients were requested to grade their pain on a visual analog scale up to 96 h post-operatively. The reduction in pain scores was significantly greater in the laser group than in the placebo group. The procedure itself was not painful, so anesthesia was not required. Powermetry revealed the CO(2) laser power to be 2-5 mW after passing through the gel, which caused no significant temperature rise or any visual effect of damage to the oral mucosa. Our results showed that a low-intensity, non-thermal, single-session of CO(2) laser irradiation reduced pain in miRAS immediately and dramatically, with no visible side effects.

Comparison of carbon dioxide laser and scalpel for breast lumpectomy: a randomized controlled trial.

OBJECTIVE: To investigate whether the CO2 laser is superior to conventional surgical techniques for minor breast surgery in a randomized clinical trial. BACKGROUND DATA: It has been suggested in the literature that application of CO2 laser in breast surgery might be superior to conventional surgery in some aspects. PATIENTS AND METHODS: Sixty women whose breast masses were suitable for excisional biopsy were randomly allocated to laser and control (conventional surgical technique with scalpel) groups. Perioperative and postoperative variables were recorded and analyzed. RESULTS: The patients' ages ranged from 16-63 y. There were no significant differences between the two groups in total operative time (17.4 min with laser and 17.5 min with scalpel). There was a significant decrease in the required dose of lidocaine in the laser group (9.3 mL) compared to the scalpel group (12.4 mL; p = 0.01). In addition, hemorrhage was significantly lower in the laser group (6.6 mL) compared to the control group (11.9 mL; p = 0.006). There was no difference in the grade of the scar or postoperative pain between the two groups. CONCLUSION: Use of the CO2 laser in breast mass biopsy has some advantages, including a lower requirement for local anesthetic and a lower rate of intraoperative bleeding. Furthermore, using the laser does not prolong the operative time.

Low-level laser therapy in management of postmastectomy lymphedema.

The aim of this paper was to study the effects of low-level laser therapy (LLLT) in the treatment of postmastectomy lymphedema. Eleven women with unilateral postmastectomy lymphedema were enrolled in a double-blind controlled trial. Patients were randomly assigned to laser and sham groups and received laser or placebo irradiation (Ga-As laser device with a wavelength of 890 nm and fluence of 1.5 J/cm2) over the arm and axillary areas. Changes in patients' limb circumference, pain score, range of motion, heaviness of the affected limb, and desire to continue the treatment were measured before the treatment and at follow-up sessions (weeks 3, 9, 12, 18, and 22) and were compared to pretreatment values. Results showed that of the 11 enrolled patients, eight completed the treatment sessions. Reduction in limb circumference was detected in both groups, although it was more pronounced in the laser group up to the end of 22nd week. Desire to continue treatment at each session and baseline score in the laser group was greater than in the sham group in all sessions. Pain reduction in the laser group was more than in the sham group except for the weeks 3 and 9. No substantial differences were seen in other two parameters between the two treatment groups. In conclusion, despite our encouraging results, further studies of the effects of LLLT in management of postmastectomy lymphedema should be undertaken to determine the optimal physiological and physical parameters to obtain the most effective clinical response.

Treatment of oral lichen planus with photodynamic therapy mediated methylene blue: A case report

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Oral lichen planus (OLP) is a common chronic disease of uncertain origin. Many patients with OLP are refractory to all available therapies. The photodynamic therapy (PDT) was used as a possible alternative method in the treatment of lichen planus. Two patients with five oral lichen planus lesions were treated using topical PDT mediated by methylene blue (MB-PDT). The patients were followed up on sessions 3, 7, 15 days and 1 to 9 months after PDT. Clinical improvement was achieved in four lesions. Two lesions showed complete remission, and another two lesions had about 50% clinically improvement 3-9 months after a single session of PDT. No response detected in one lesion. MB-PDT blue seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB-PDT in control of OLP for a longer period of time

Treatment of oral lichen planus with photodynamic therapy mediated methylene blue: a case report.

Oral lichen planus (OLP) is a common chronic disease of uncertain origin. Many patients with OLP are refractory to all available therapies. The photodynamic therapy (PDT) was used as a possible alternative method in the treatment of lichen planus. Two patients with five oral lichen planus lesions were treated using topical PDT mediated by methylene blue (MB-PDT). The patients were followed up on sessions 3, 7, 15 days and 1 to 9 months after PDT. Clinical improvement was achieved in four lesions. Two lesions showed complete remission, and another two lesions had about 50% clinically improvement 3-9 months after a single session of PDT. No response detected in one lesion. MB-PDT blue seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB-PDT in control of OLP for a longer period of time.

Methylene blue-mediated photodynamic therapy: a possible alternative treatment for oral lichen planus.

BACKGROUND AND OBJECTIVES: In this study, methylene blue-mediated photodynamic therapy (MB-PDT) was used as a possible alternative method for the treatment of oral lichen planus (OLP). STUDY DESIGN/MATERIALS AND METHODS: Thirteen patients with 26 OLP lesions were enrolled in this study. Patients were instructed to gargle a 5% methylene blue solution in water for 5 minutes. Ten minutes later, irradiation was performed by laser light (lambda = 632 nm, light exposure dose = 120 J/cm(2)). Lesions were evaluated pre and post-operatively and at follow-up sessions by changes in sign and symptom (pain) scores, and size of lesions. RESULTS: Improvement in sign scores was achieved in 16 lesions. Four keratotic lesions disappeared completely. There was a statistically significant decrease in sign and symptom scores 1 week after treatment and at follow-up sessions up to 12 weeks. Average reduction in size of lesions was 44.3%. CONCLUSION: MB-PDT seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB-PDT in control of OLP for a longer period of time.