Fractal Dimension and Texture Analysis of Lesion Autofluorescence in the Evaluation of Oral Lichen Planus Treatment Effectiveness

Abstract

Background: Oral Lichen planus (OLP) is a chronic inflammatory disease. Topical steroids are used as the treatment of choice. The alternative is photodynamic therapy (PDT). The study aimed to fabricate optimal biodegradable matrices for methylene blue or triamcinolone acetonide because of a lack of currently commercially available carriers that could adhere to the mucous. Methods: The study was designed as a 12-week single-blind prospective randomized clinical trial with 30 patients, full contralateral split-mouth design. Matrices for steroid and photosensitizer and laser device were fabricated. Fractal and texture analysis of photographs, taken in 405, 450, 405 + 450 nm wavelength, of lesions was performed to increase the objectivity of the assessment of treatment. Results: We achieved two total responses for treatment in case of steroid therapy and one in the case of PDT. Partial response was noted in 17 lesions treated using local steroid therapy and 21 in the case of PDT. No statistically significant differences were found between the effectiveness of both used methods. Statistically significant differences in fractal dimension before and after treatment were observed only in the analysis of photographs taken in 405 + 450 nm wavelength. Conclusions: Photodynamic therapy and topical steroid therapy are effective methods for treating OLP. Using a carrier offers the possibility of a more predictable and effective method of drug delivery into the mucous membrane. Autofluorescence enables the detection of lesions especially at the early stage of their development.

Fractal Dimension Analysis of Melanocytic Nevi and Melanomas in Normal and Polarized Light—A Preliminary Report

“…In our previous study, we confirmed a moderate negative correlation between FD of the surface lesion in the case of the potentially malignant lesion (oral lichen planus). In that study, we observed that the surface FD of lesions was significantly lower than normal mucous [ 55 ]. The analysis of the fractal dimension of the surface of the examined lesions turned out to be a less differentiating parameter than the fractal analysis of the lesion shape.…”

Fractal Analysis Applied to the Diagnosis of Oral Cancer and Oral Potentially Malignant Disorders: A Comprehensive Review

“…Although the present review focused on the diagnostic and prognostic value of fractal analysis in oral oncology, the literature reported some sporadic and preliminary works dealing with the monitoring of treatments as reported by the Polish group of Jurczyszyn et al [51,52], who applied fractal dimension and texture analysis of lesion autofluorescence in the evaluation of oral lichen planus treatment effectiveness and in estimating the effectiveness of oral leukoplakia treatment using the LiteTouch™ Er:YAG Dental laser, or by Varsha et al, who recently explored the pre-and post-treatment objective evaluation of remission in oral lichen planus using fractal analysis and compared it with the visual analog (VAS) scale [53].…”

Technological Aspects and Evaluation Methods for Polymer Matrices as Dental Drug Carriers

“…This makes it possible to determine the percentage unhealed index (PUI), expressing the percentage of the lesion not healed at follow-up visits in relation to the baseline. The changes observed following treatment in the fractal dimension and texture (microcontrast) values of mucosal lesions on intraoral radiographs assessed under different light can be used to analyze the comparative effectiveness of treatment methods [113].…”