Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Effectiveness of methylene blue photosensitizers compared to that of corticosteroids in the management of oral lichen planus: a systematic review and meta-analysis

  • Waingade, Manjushri (Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital) ;
  • Medikeri, Raghavendra S (Department of Periodontics, Sinhgad Dental College and Hospital) ;
  • Rathod, Pooja (Department of Oral Medicine and Radiology, Sinhgad Dental College and Hospital)
  • Received : 2022.01.14
  • Accepted : 2022.03.31
  • Published : 2022.06.01
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Abstract

This study aimed to systematically review the effectiveness of methylene blue (MB) photosensitizers in the management of symptomatic oral lichen planus (OLP). Electronic online databases and manual searches were performed for randomized controlled trials (RCTs) published in English between January 2010 and February 2022. RCTs comparing photodynamic therapy (PDT) and corticosteroid therapy at baseline and follow-up period were identified. The Cochrane risk of bias tool was used to assess the quality of the included studies. A meta-analysis was performed regarding visual analog scale (VAS) scores, Thongprasom sign scores, lesion size, response to treatment, and exacerbation of lesions after therapy. The clinical severity was analyzed qualitatively. Five RCTs consisting of 180 samples fulfilled the inclusion and exclusion criteria. All parameters of VAS score, Thongprasom sign score, lesion size, and response to treatment were statistically non-significant. Our results indicate that both MB-PDT and corticosteroid therapy are effective for the management of OLP. Moreover, MB-PDT is an effective alternative treatment option for OLP when corticosteroids are contraindicated. However, conclusive evidence cannot be ascertained owing to the heterogeneity among the studies.

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References

  1. Jajarm HH, Falaki F, Sanatkhani M, Ahmadzadeh M, Ahrari F, Shafaee H. A comparative study of toluidine blue-mediated photodynamic therapy versus topical corticosteroids in the treatment of erosive-atrophic oral lichen planus: a randomized clinical controlled trial. Lasers Med Sci 2015; 30: 1475-80. https://doi.org/10.1007/s10103-014-1694-1
  2. He Y, Deng J, Zhao Y, Tao H, Dan H, Xu H, et al. Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis. BMC Oral Health 2020; 20: 302. https://doi.org/10.1186/s12903-020-01260-x
  3. Panta P, Andhavarapu A, Patil S. A holistic intervention for oral lichen planus. J Contemp Dent Pract 2019; 20: 765-7. https://doi.org/10.5005/jp-journals-10024-2635
  4. Sadaksharam J, Nayaki KP, Selvam NP. Treatment of oral lichen planus with methylene blue mediated photodynamic therapy - a clinical study. Photodermatol Photoimmunol Photomed 2012; 28: 97-101. https://doi.org/10.1111/j.1600-0781.2012.00647.x
  5. Saleh W, Tageldin S, Khashaba E, Darwish M, Elnagdy S, Khashaba O. Could photodynamic therapy be utilized as a treatment modality for oral lichen planus? Photodiagnosis Photodyn Ther 2020; 30: 101677. https://doi.org/10.1016/j.pdpdt.2020.101677
  6. Prasanna SW, Ingle E, Aruna PR, Pravada C, Koteeswaran D, Ganesan S. Photodynamic therapy of oral leukoplakia and oral lichen planus using methylene blue: a pilot study. J Innov Opt Health Sci 2015; 8: 1540005. https://doi.org/10.1142/S1793545815400052
  7. Lavaee F, Shadmanpour M. Comparison of the effect of photodynamic therapy and topical corticosteroid on oral lichen planus lesions. Oral Dis 2019; 25: 1954-63. https://doi.org/10.1111/odi.13188
  8. Maloth KN, Velpula N, Kodangal S, Sangmesh M, Vellamchetla K, Ugrappa S, et al. Photodynamic therapy - a non-invasive treatment modality for precancerous lesions. J Lasers Med Sci 2016; 7: 30-6. https://doi.org/10.15171/jlms.2016.07
  9. Akram Z, Javed FD, Hosein M, Al-Qahtani MA, Alshehri F, Alzahrani AI, et al. Photodynamic therapy in the treatment of symptomatic oral lichen planus: a systematic review. Photodermatol Photoimmunol Photomed 2018; 34: 167-74. https://doi.org/10.1111/phpp.12371
  10. Mirza S, Rehman N, Alrahlah A, Alamri WR, Vohra F. Efficacy of photodynamic therapy or low level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus. Photodiagnosis Photodyn Ther 2018; 21: 404-8. https://doi.org/10.1016/j.pdpdt.2018.02.001
  11. Sabry MA, El-Housiny Saafan AM, El-Shenawy HM, Hussine AA, Abd El-Aziz DM, Abdel Fadeel DA. Effect of photodynamic therapy on pain control in patients with erosive / atrophic oral lichen planus. Eurasian J Biosci 2020: 14; 7455-60.
  12. Singh AR, Rai A, Aftab M, Jain S, Singh M. Efficacy of steroidal vs non-steroidal agents in oral lichen planus: a randomised, open-label study. J Laryngol Otol 2017; 131: 69-76. https://doi.org/10.1017/S0022215116009658
  13. Bakhtiari S, Azari-Marhabi S, Mojahedi SM, Namdari M, Rankohi ZE, Jafari S. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus. Photodiagnosis Photodyn Ther 2017; 20: 159-64. https://doi.org/10.1016/j.pdpdt.2017.06.002
  14. Sobaniec S, Bernaczyk P, Pietruski J, Cholewa M, Skurska A, Dolinska E, et al. Clinical assessment of the efficacy of photodynamic therapy in the treatment of oral lichen planus. Lasers Med Sci 2013; 28: 311-6. https://doi.org/10.1007/s10103-012-1153-9
  15. Mostafa D, Moussa E, Alnouaem M. Evaluation of photodynamic therapy in treatment of oral erosive lichen planus in comparison with topically applied corticosteroids. Photodiagnosis Photodyn Ther 2017; 19: 56-66. https://doi.org/10.1016/j.pdpdt.2017.04.014
  16. Cosgarea R, Pollmann R, Sharif J, Schmidt T, Stein R, Bodea A, et al. Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study. Sci Rep 2020; 10: 1667. https://doi.org/10.1038/s41598-020-58548-9
  17. Salva KA. Photodynamic therapy: unapproved uses, dosages, or indications. Clin Dermatol 2002; 20: 571-81. https://doi.org/10.1016/S0738-081X(02)00266-3
  18. Jajarm HH, Asadi R, Bardideh E, Shafaee H, Khazaei Y, Emadzadeh M. The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus-a systematic review and meta-analysis. Photodiagnosis and photodynamic therapy. 2018; 23: 254-60. https://doi.org/10.1016/j.pdpdt.2018.07.001
  19. Sterne JAC, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898.
  20. Zborowski J, Kida D, Szarwaryn A, Nartowski K, Rak P, Jurczyszyn K, et al. A comparison of clinical efficiency of photodynamic therapy and topical corticosteroid in treatment of oral lichen planus: a split-mouth randomised controlled study. J Clin Med 2021; 10: 3673. https://doi.org/10.3390/jcm10163673
  21. Jurczyszyn K, Trzeciakowski W, Kozakiewicz M, Kida D, Malec K, Karolewicz B, et al. Fractal dimension and texture analysis of lesion autofluorescence in the evaluation of oral lichen planus treatment effectiveness. Materials 2021; 14: 5448. https://doi.org/10.3390/ma14185448
  22. Kubler AC. Photodynamic therapy. Med Laser Appl 2005; 20: 37-45. https://doi.org/10.1016/j.mla.2005.02.001
  23. Konopka K, Goslinski T. Photodynamic therapy in dentistry. J Dent Res 2007; 86: 694-707. https://doi.org/10.1177/154405910708600803
  24. Kvaal SI, Angell-Petersen E, Warloe T. Photodynamic treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115: 62-70. https://doi.org/10.1016/j.oooo.2012.08.448
  25. Sadaksharam J, Nayaki KP, Selvam NP. Treatment of oral lichen planus with methylene blue mediated photodynamic therapy-a clinical study. Photodermatol Photoimmunol Photomed 2012; 28: 97-101. https://doi.org/10.1111/j.1600-0781.2012.00647.x
  26. Aghahosseini F, Arbabi-Kalati F, Fashtami LA, Djavid GE, Fateh M, Beitollahi JM. Methylene blue-mediated photodynamic therapy: A possible alternative treatment for oral lichen planus. Lasers Surg Med 2006; 38: 33-8. https://doi.org/10.1002/lsm.20278
  27. Chen Y, Zheng W, Li Y, Zhong J, Ji J, Shen P. Apoptosis induced by methylene-blue-mediated photodynamic therapy in melanomas and the involvement of mitochondrial dysfunction revealed by proteomics. Cancer Sci 2008; 99: 2019-27. https://doi.org/10.1111/j.1349-7006.2008.00910.x
  28. Tardivo JP, Del Giglio A, de Oliveira CS, Gabrielli DS, Junqueira HC, Tada DB, et al. Methylene blue in photodynamic therapy: From basic mechanisms to clinical applications. Photodiagnosis Photodynamic Therapy 2005; 2: 175-91. https://doi.org/10.1016/S1572-1000(05)00097-9
  29. Gollnick SO, Owczarczak B, Maier P. Photodynamic therapy and anti-tumor immunity. Lasers Surg Med 2006; 38: 509-15. https://doi.org/10.1002/lsm.20362
  30. Al-Maweri SA, Ashraf S, Kalakonda B, Halboub E, Petro W, AlAizari NA. Efficacy of photodynamic therapy in the treatment of symptomatic oral lichen planus: a systematic review. J Oral Pathol Med 2018; 47: 326-32. https://doi.org/10.1111/jop.12684