Department of Preventive Dental Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia.
Professor of Oral Medicine Department, Faculty of Dentistry, Alexandria University, Egypt.
Photodiagnosis Photodyn Ther. 2017 Sep;19:56-66. doi: 10.1016/j.pdpdt.2017.04.014. Epub 2017 Apr 25.
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.
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).
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.
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.
治疗糜烂性口腔扁平苔藓是一个治疗挑战。尽管有许多现有的治疗方法，但其中一些治疗方法的效果并不理想。由于该病是一种慢性疾病，目前尚无治愈方法，因此最佳治疗方法主要应针对减少症状发作的持续时间和严重程度，同时尽量减少副作用。迄今为止，皮质类固醇仍然是口腔扁平苔藓（OLP）患者的首选治疗方法。尽管局部皮质类固醇已被发现是治疗 OLP 最安全和最有效的药物，但长期使用可能会引起粘膜问题，并可能导致全身并发症。最近，光动力疗法已被广泛应用于口腔疾病的治疗。我们的临床研究旨在评估亚甲蓝介导的光动力疗法（MB-PDT）对糜烂性口腔扁平苔藓（EOLP）病变的体征和症状的临床疗效，并与传统的局部皮质类固醇（TC）治疗进行比较。本研究试图采用这种最近的治疗方式来克服 TC 的缺点。
从亚历山大大学牙科学院口腔医学和牙周病学系选择了 20 名经临床和组织学诊断为 EOLP 的患者，采用随机平行研究设计，将他们分为两组；A 组（对照组）包括 10 名患者，他们被指示使用传统 TC（kenakort A-orabase）。而 B 组（研究组）包含 10 名接受二极管激光 660nm 介导的亚甲蓝（MB）的 PDT 治疗的患者。
两组与基线相比在随访期间均有统计学差异。但是，与皮质类固醇治疗相比，MB-PDT 治疗 EOLP 时疼痛和病变评分的降低更为显著。
本研究的结果表明，与 TC 相比，MB-PDT 被认为是治疗 OELP 的更好方法，因为它在减轻疼痛和病变消退方面更有效。
