Laser patterned microcoagulation (LPM) in the management of desquamative gingivitis secondary to oral lichen planus: A randomized controlled pilot clinical trial (LPM TRIAL)

Abstract

The application of laser patterned microcoagulation (LPM) for the management of desquamative gingivitis secondary to oral lichen planus (OLP) was investigated. This single-centre, randomized, sham-controlled, single-blinded, parallel-arm pilot clinical trial included 30 patients diagnosed with OLP manifesting only as desquamative gingivitis. Permuted block randomization was performed. LPM was performed in the test group and sham treatment was provided to the control group along with 0.1% triamcinolone acetonide application. Diode laser with 940nm wavelength with a tip diameter of 400μm and power 0.5 W was utilized in pulsed contact mode for 250 ms to induce thermal injury zones. Five joules of energy were delivered at a fluence of 4kJ/Cm2 at the tip. LPM led to a significant reduction in the number and size of gingival lesions in the test group. Compared to the control group (4.07 ± 0.80), pain reduction was significant in the test group (6.4 ± 0.51, p = 0.000). Oral diseases severity score for pain at three months in test group (1.87 ± 0.64) was significantly lesser than in control (2.47 ± 0.64, p = 0.021) and Thongprasom's score at six months was 0.33 ± 0.49 in test and 1.33 ± 0.49 in control group (p = 0.000). LPM was well-tolerated by all patients, with no significant adverse effects. This study provides evidence of the effectiveness and safety of LPM as a novel treatment modality for the management of desquamative lesions of OLP suggesting accelerated healing and reduced inflammation.

Keywords: Gingiva; Gingival diseases; LASER; Lichen planus.