Evaluation of photodynamic therapy in treatment of oral erosive lichen planus in comparison with topically applied corticosteroids

Abstract

Background: The treatment of erosive oral lichen planus represents a therapeutic challenge. Despite numerous existing remedies, some of these treatments display disappointing results. Since it is a chronic disease with no current cure, the best treatment should target mainly the reduction of the duration and severity of symptomatic outbreaks with minimal side effects. To date, corticosteroids remain the first choice of treatment for oral lichen planus (OLP) patients. Although, topical corticosteroids have been found to be the safest and the most successful agents in the treatment of OLP, their prolonged use may cause mucosal problems and may lead to systemic complications. Recently, the use of photodynamic therapy has been well introduced in the treatment of oral diseases. Our clinical study was done to evaluate clinically the effect of photodynamic therapy mediated by methylene blue (MB-PDT) on signs and symptoms of erosive oral lichen planus (EOLP) lesions in comparison with the conventional topical corticosteroids (TC) treatment. The present work tried this recent modality of treatment to overcome the disadvantages of TC.

Material and methods: Twenty patients with clinical and histological diagnosis of EOLP were selected from Oral Medicine and periodontology department in Faculty of Dentistry, Alexandria University in a randomized parallel study design. They were divided into two groups; group A (control group) involved ten patients who were instructed to use the conventional TC (kenakort A-orabase). While, group B (study group) contained ten patients who received PDT using diode laser 660nm mediated by methylene blue (MB).

Results: Both groups presented statistically significant difference from baseline to follow up periods. But, the MB-PDT in treatment of EOLP showed more remarkable reduction in pain and lesion scores in comparison with corticosteroids treatment.

Conclusion: The results of this study allow the conclusion that the MB-PDT is considered to be a better treatment for OELP in comparison with TC because it is much more effective in pain reduction and lesion regression.

Keywords: Methylene blue dye; Oral lichen planus treatment; Photodynamic therapy; Topical corticosteroids.