Evaluation of the Effect of Low-Level Laser Therapy Versus Photodynamic Therapy on the Level of Serum IL-17 and Salivary IL-4 in Patients Suffering from Erosive/Atrophic Oral Lichen Planus: A Case Control Study

Abstract

Background: One of the most common treatment modalities of oral lichen planus (OLP) is topical corticosteroids (TCS). However, it has several side effects which are harmful to the patients. One such promising treatment modality is low level laser therapy (LLLT) as well as photodynamic therapy (PDT) which are considered safe and reliable in reducing the painful symptoms of the disease with minimal side effects. The inflammatory mediators; cytokines as (IL- 4 & IL- 17) were found to play a crucial role in the pathogenesis of atrophic/erosive OLP. Objective: The aim of this study is to investigate and compare the effect of PDT, LLLT & TCS by measuring the pain scale VAS, IL- 4 in saliva and IL- 17 in serum to detect the response of OLP patients to these different modalities. Methods: The study was conducted on 30 patients divided into 3 groups. Each group received either of 3 treatments; PDT, LLLT or TCS, then VAS, salivary IL-4 and serum IL-17 were measured by ELISA at base line, immediately after the first session, at 2 and 4 months from base line to detect the efficiency of each type of treatment. Results: The use of PDT and LLLT were effective and superior to TCS in treatment of OLP in adult patients. Cytokines were reduced in the 3 groups and VAS was markedly reduced by LLLT. No correlation was found between any of the used parameters, this shows that each one of the parameters was efficient on its own in monitoring the effectiveness of the three treatment modalities used. Conclusions: the use of LLLT and PDT was effective in treatment of OLP in adult patients.