Low-level laser therapy (LLLT) in the treatment of recurrent aphthous stomatitis (RAS) – a promising treatment option: A report of two cases

Abstract

Recurrent aphthous stomatitis (RAS) is a chronic, ulcerative condition of the oral mucosa that affects 10-25% of the population. The etiopathogenesis of the disease is not fully understood, although a polygenic mode of inheritance and immunological dysregulation have been suggested in several studies. The contribution of numerous predisposing factors, such as a deficiency of iron, vitamin B12 or folic acid, trauma, emotional stress, endocrine disturbances, or allergy, have also been considered. So far, no causative treatment for RAS has been developed; instead, topical and systemic drugs are used to reduce pain and inflammation, and to lengthen the period of remission. Low-level laser therapy (LLLT) is a non-invasive and atraumatic therapeutic method that involves the local application of a high-density, monochromatic, narrow-band light source. With the use of the appropriate power and wavelength, the therapy brings anti-inflammatory and analgesic results, and wound healing is promoted. Several reports on the beneficial effects of LLLT in RAS have been presented recently. This report describes 2 cases of adult patients with RAS treated with LLLT to relieve pain and promote the healing of the ulcers. The clinical presentations with the signs and symptoms are discussed and illustrated, along with the treatment algorithms and outcomes.

Effectiveness of Photobiomodulation in Reducing Pain of Oral Mucosal Diseases: A Case Series

“…PBM limits the production of proinflammatory mediators, including tumor necrosis factor-α (TNF-α), Interleukin-1 (IL-1), IL-1β, and IL-6 in damaged neurons, inhibits prostaglandins E2 and increases the production of plasminogen, as well as stimulates post-traumatic maturation and regeneration. 19,22,[26][27][28] In addition, PBM can increase tissue microcirculation/oxygenation and stimulate the growth of epithelial, endothelial, and mesenchymal cells. 29 Enhanced tissue microcirculation can lead to an increase in the delivery of nutritional substances related to the elevated mitosis rate, resulting in neoangiogenesis.…”

Láser de baja frecuencia para aftas mayores recurrentes. Caso Clínico

“…La estomatitis aftosa recurrente (RAS), corresponde a una de las lesiones orales más frecuentes [1][2][3] . Se define como una enfermedad inflamatoria crónica, dolorosa, caracterizada por lesión levemente eritematosa con una úlcera central cubierta por una membrana fibrinopurulenta (coloración blanquecino-amarillenta) de rápida resolutividad (2 a 3 semanas) que se localizan principalmente en la mucosa oral y lengua 4 . Dentro de ellas las aftas mayores son menos comúnes que las menores o herpetiformes y afectan tanto mucosa queratinizada como no-queratinizada, causando dolor y disfagia, lesiones de más de 10 mm de diámetro, más profundas, y que a menudo generan cicatrices, pudiendo permanecer de 2 semanas a 3 meses 3 .…”

808-Nm Near-Infrared Laser Photobiomodulation versus Switched-Off Laser Placebo in Major Aphthae Management: A Randomized Double-Blind Controlled Trial

“…AS comes in three forms, which are morphologically classified as minor aphtha or Mikulicz-ulcers, which show a diameter of 2-10 mm, major aphtha, also called mucosal necrotic periadenitis or Sutton ulcers (>10 mm in diameter), and herpetiform ulcerations, which consist of multiple small ulcers [4]. No causal treatment for RAS has been developed so far; systemic and topical medications are used to reduce inflammation and pain and to support the natural period of remission [5]. Management of oral ulcers is based on the severity of the lesions and usually involves the administration of corticosteroids [5].…”

“…No causal treatment for RAS has been developed so far; systemic and topical medications are used to reduce inflammation and pain and to support the natural period of remission [5]. Management of oral ulcers is based on the severity of the lesions and usually involves the administration of corticosteroids [5]. However, there is a lack of high-efficacy evidence for them [6], particularly for systemic interventions.…”

“…Furthermore, trigger foods and acidic foods and drinks should be avoided [1,4,7]. These primarily symptomatic therapies may, however, induce side effects; steroid medications can cause candidiasis, and tetracycline or chlorhexidine mouthwashes can shorten ulcer duration but are contraindicated in children and may induce tooth discoloration [5]. Therefore, alternative treatment modalities have been developed to relieve pain and improve AS healing, such as traditional Chinese medicine [8], acupuncture [9], psychotherapy [10], and low-level/intensity laser therapy (LLLT) [11,12].…”