Photobiomodulation therapy and antimicrobial photodynamic therapy for orofacial lesions in patients with COVID-19: A case series

Abstract

Oral lesions related to the novel Coronavirus Disease 2019 (COVID-19) have been increasingly described; however, clinical and epidemiological information is still scant. Although a diversity of therapeutic strategies for the management of these lesions are present in the literature, one can note a lack of standardization and doubtful effectiveness. Thus, the present study aimed to report a series of cases in which a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) was used for orofacial lesions in patients suffering from COVID-19. It was noted, in all cases, a marked improvement in tissue repair and pain relief within a few days; moreover, the patients recovered their orofacial functions satisfactorily. Based on the present series of cases and having in mind the conspicuous lack of information on the different aspects of COVID-19, the protocol which combined aPDT with PMBT seemed to be effective in the management of COVID-19-related orofacial lesions.

Photobiomodulation (PBMT) and Antimicrobial Photodynamic Therapy (aPDT) In Oral Manifestations of Patients Infected by SARS-CoV-2: Systematic Review and Meta-Analysis

“…When they awaited spontaneous regression of the lesions, medications such as Acyclovir, mouthwash with 0.12% chlorhexidine, ascorbic acid, 21,22 were used, in addition to individual medication protocols for each patient due to Covid-19 infection. 27.28 Teixeira, Ramires and Garcez 23,24,25 implemented associative protocols between the PBMT and aPDT techniques, and observed relief of painful symptoms in the first 24 hours and healing of the lesion within 4 days, in accordance with the findings of Maya (2020) for the treatment of palatal ulcers. 29 In the observational evaluation criteria of the 5 articles in question, it is important to emphasize that oral lesions appeared in these patients positive by Covid-19, concomitantly with loss of taste and smell, worsening of Covid-19 symptoms and were more severe in people older and systemically compromised.…”

“…PBMT associated with aPDT showed the best results with relief of painful symptoms in the first 24 hours and healing of the lesion within 4 days. 23,24,25 Cases where laser therapy was not used as adjuvant, were young patients, mean age of 38.2 years and the lesions had their spontaneous regression within a considerable time, between 4 to 16 days.…”

“…13,14,15,16,17,18 This systematic review contributes to the amount of 11 clinical cases that used PBMT and/or aPDT as therapeutic resources for lesions in the oral cavity of patients affected by COVID-19, or awaiting natural regression of the lesions with topical medication, in some cases. 21,22,23,24 . The cases were patients admitted to public and private hospitals with symptoms characteristic of COVID-19 and confirmed through the rat-PCR 26 .…”

“…All studies were carried out in Brazil, they were case reports in the literature and were published between January and May 2021, in English, where patients were admitted to hospitals with symptoms characteristic of COVID-19 and later confirmed through the examination RT-PCR. However, they used different therapeutic approaches for lesions in the oral cavity, including PBMT, 21,22 PBMT associated with aPDT 23,24 and awaiting spontaneous regression of the lesions without any laser intervention. 21,22 Thus, 5 articles found in the literature presented a total of 11 cases using PBMT and aPDT as therapeutic strategies for the regression of oral lesions and painful symptoms in patients with COVID-19 (Tab 02).…”

“…Teixeira et al (2021) 23 and Ramires et al (2021) 24 used similar protocols, the first one using an association of aPDT and PBMT for two days. For PBMT, a DUO® Laser device (MMOptics, São Carlos, SP, Brazil) was used at 660 nm, contact mode, point to point, with 100 mW, 33 J / cm 2 , 0.5 J and 5 s per point.…”