The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus-A systematic review and meta-analysis.

BACKGROUND: Oral lichen planus (OLP) is a chronic immune-mediated disorder that inflicts oral mucosa in 0.5-2% of the population. Surgery, photodynamic therapy, laser therapy and most commonly pharmacological therapy (like corticosteroids) has been used for treating OLP. New phototherapy approaches have been shown to have positive effects on treating some oral lesions and the aim of our study was to assess the effects of different phototherapy treatments on OLP.

METHODS: We conducted a comprehensive electronic search using the determined search strategy in MEDLINE, EMBASE and CENTRAL electronic databases. A hand search of the reference list of the relevant studies and related systematic reviews was also performed.

RESULTS: For low-level laser therapy, before and after studies showed a significant difference in pain (MD = -4.39, CI = 95% -4.83, -3.96) and sign score (MD = -1.86, CI = 95% -2.53, -1.19) after treatment. The comparison between corticosteroid therapy and LLLT also showed a significant difference in their effects for severity (MD = 0.57, CI = 95% 0.04, 1.09), but no differences in sign (MD = 0.21, CI = 95% -0.83, 1.24)and pain (MD = -0.10, CI = 95% -0.57,0.38) score was found between these two methods. Before and after studies of photodynamic therapy did not reveal any differences in lesion size. (MD = -1.95, CI = 95% -4.39, 0.490).

CONCLUSION: Low-level laser therapy seems to be a reliable alternative to corticosteroids for treating OLP without the adverse effects associated with the pharmacological method. No conclusive evidence for the effectiveness of photodynamic therapy in treating OLP lesion exists.