The potential role of Photodynamic therapy in oral premalignant and malignant lesions: A systematic review

Abstract

Background Photodynamic therapy (PDT) is considered as a valid treatment option in various branches of dentistry. This systematic review aims to evaluate the usefulness of PDT for treatment of oral premalignant and malignant lesions. Methods The MeSH terms “Photodynamic therapy” and “PDT,” in combination with other terms, have been searched by three search engines (PubMed, ISI Web of Science, and the Cochrane Library), and a systematic review has been performed. The Population, Intervention, Comparison, Outcomes, and Study design (PICOS) has been applied as method to outline our study eligibility criteria. Risk of Bias in Non‐randomized Studies of Intervention (ROBINS‐I) has been performed too. Results Initial results were 1513. Definitely, 27 studies met our selection criteria. Conclusions Topical PDT is an easy to perform technique, well‐tolerated treatment and it appears to be an effective method with encouraging achievements in the treatment of premalignant and malignant lesions of the soft tissues of the oral cavity; nevertheless more studies are required to integrate the up‐to‐date experience of this application.

Photodynamic Therapy Using 5-Aminolevulinic Acid (Ala) for the Treatment of Chronic Periodontitis: A Prospective Case Series

“…The direct method involves high-energy photons directly damaging vital parts of bacterial cells, while the indirect antimicrobial PDT can be described as an oxygen-dependent photochemical reaction generated by the activation of a PS through a light source. The combination of a non-toxic PS, visible light with appropriate wavelength and oxygen leads to the production of highly reactive and cytotoxic ROS (singlet oxygen), consequently destroying cells [63][64][65][66][67][68]. The randomized controlled split-mouth clinical trial by Birang et al [69] evaluated the role of adjunctive PDT in patients suffering from chronic periodontitis, highlighting significant short-term improvements (three months follow-up) in terms of bacterial count, CAL, and PD.…”

Noninvasive Imaging Methods to Improve the Diagnosis of Oral Carcinoma and Its Precursors: State of the Art and Proposal of a Three-Step Diagnostic Process

“…A variant of AF is fluorescence induced by exogenous fluorophores, such as toluidine blue or 5-amino-laevulinic acid [125]. In these cases, exogenous fluorophores are not only used for diagnostic purposes but also for low-dose laser therapy techniques such as photodynamic therapy (PDT), which is a minimally invasive treatment for malignant and premalignant lesions, previously diagnosed by conventional biopsy, according to the selective destruction of only cells that retain fluorophores topically administered to the dysplastic/neoplastic lesion [126][127][128][129][130][131].…”

Early-Phase Interventional Trials in Oral Cancer Prevention

“…Topical PDT using 5-aminolevlunic acid and either laser or LED light source has demonstrated good results in small studies [90,91] and a recent systematic review of 27 relevant studies concluded that PDT appears to offer advantages for oral potentially malignant lesions refractory to other treatments. In addition, side effects of topical PDT are mild and it remains an option for patients who refuse traditional surgical interventions [92]. LightOx, a commercial partnership invested in developing light-based therapies for oral cancer, have developed a novel class of small-molecule, topically applied therapies, with phototoxic properties combined with hydroxamic acid to increase solubility [93].…”