To assess the effectiveness of photobiomodulation therapy for managing oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS), including their outcomes and patient satisfaction with the safety profile.
Method:
A systematic review was conducted by searching electronic databases like PubMed Central, PubMed, Cochrane, CrossRef, Google Scholar, and Embase. Articles published until June 2025 were reviewed using MeSH (Medical Subject Heading) and various combinations of the keywords: oral lichen planus, Recurrent Aphthous Stomatitis, photobiomodulation therapy, and conventional drug therapy. We considered two different outcomes, such as pain and the size of the lesion. Due to the heterogeneity of the data, we did not conduct any statistical analysis.
Result:
Initially, 560 publications were selected for this review article, and after analyzing all these, only 12 articles fulfilled the inclusion and exclusion criteria. In all those studies, the laser wavelength, power output, and duration of irradiation changed between 630–980 m, 20–30 mW, and 10 sec–15 min have been described. Topical medications used in the comparative group were amlexanox, triamcinolone acetonide, granofurin, and socosenyl. Our findings showed that the photobiomodulation laser group is more effective for decreasing the pain and lesion size of RAS and OLP in comparison with the topical medication group.
Conclusion:
We can conclude that photobiomodulation therapy was better for treating RAS and OLP with greater healing, patient satisfaction, and lower recurrence rate in comparison with other topical drug therapies.
DarshanDD, KumarCN, KumarAD, ManikantanNS, BalakrishnanD, UthkalMP. Clinical study to know the efficacy of Amlexanox5% with other topical antiseptic, analgesic and anesthetic agents in treating minor RAS. J Int Oral Health2014;6:5–11.
2.
ValeFA, MoreiraMS, de AlmeidaFC, RamalhoKM. Low-level laser therapy in the treatment of recurrent aphthous ulcers: A systematic review. ScientificWorldJournal2015;2015:150412; doi: 10.1155/2015/150412
3.
CaputoBV, FilhoGAN, dos SantosCC, OkidaY, GiovaniEM. Laser therapy of recurrent aphthous ulcer in patient with HIV infection. Case Rep Med2012;2012:695642.
4.
SuterVGA, SjölundS, BornsteinMM. Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: A systematic review. Lasers Med Sci2017;32(4):953–963; doi: 10.1007/s10103-017-2184-z
5.
ChattopadhyayA, ShettyKV. Recurrent aphthous stomatitis. Otolaryngol Clin North Am2011;44(1):79–88, v.
6.
DavatchiF, Tehrani-BanihashemiA, JamshidiAR, et al.The prevalence of oral aphthosis in a normal population in Iran: A WHO-ILAR COPCORD study. Arch Iran Med2008;11:207–209.
7.
McCulloughMJ, Abdel-HafethS, ScullyC. Recurrent aphthous stomatitis revisited; clinical features, associations, and new association with infant feeding practices? J Oral Pathol Med2007;36(10):615–620.
8.
SlebiodaZ, SzponarE, KowalskaA. Etiopathogenesis of recurrent aphthous stomatitis and the role of immunologic aspects: Literature review. Arch Immunol Ther Exp (Warsz)2014;62(3):205–215.
9.
Al-OmiriMK, KarasnehJ, AlhijawiMM, ZwiriAM, ScullyC, LynchE. Recurrent aphthous stomatitis (RAS): a preliminary within-subject study of quality of life, oral health impacts and personality profiles. J Oral Pathol Med2015;44(4):278–283.
10.
Belenguer-GuallarI, Jiménez-SorianoY, Claramunt-LozanoA. Treatment of recurrent aphthous stomatitis. A literature review. J Clin Exp Dent2014;6(2):e168–e174.
LiangMW, NeohCY. Oral aphthosis: Management gaps and recent advances. Ann Acad Med Singap2012;41(10):463–470.
15.
BladowskiM, Konarska-ChoroszuchaH, ChoroszuchaT. Comparison of treatment results of recurrent aphthous stomatitis (RAS) with low-and high-power laser irradiation vs a pharmaceutical method (5-year study). The J of Oral Laser Appli2004;4(3):191–209.
16.
BrownRS, BottomleyWK. Combination immunosuppressant and topical steroid therapy for treatment of recurrent major aphthae. A case report. Oral Surg Oral Med Oral Pathol1990;69(1):42–44; doi: 10.1016/0030-4220(90)90266-u
17.
ShaferW, HineM, LevyNA. Textbook of Oral Pathology, W. B. Saunders, Philadelphia (USA), 1983.
18.
BottomleyWK, RosenbergS. Clinical′s guide to treatment of common oral conditions. Am Aca of Oral Me (Chicago, III, USA)1987.
19.
PalopoliJ, WaxmanJ. Recurrent aphthous stomatitis and vitamin B12 deficiency. South Med J1990;83(4):475–477.
ParasharP. Oral Lichen Planus. Otolaryngol Clin North Am2011;44(1):89–107, vi.
22.
DillenburgCS, MartinsMA, MuneratoMC, et al.Efficacy of laser phototherapy in comparison to topical clobetasol for the treatment of oral lichen planus: A randomized controlled trial. J Biomed Opt2014;19(6):068002; doi: 10.1117/1.JBO.19.6.068002
DerikvandN, GhasemiSS, MoharamiM, ShafieiE, ChiniforushN. Management of oral lichen planus by 980 nm diode laser. J Lasers Med Sci2017;8(3):150–154; doi: 10.15171/jlms.2017.27
25.
van der WaalI. Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects. Med Oral Patol Oral Cir Bucal2009;14(7):E310–E314.
26.
ThongprasomK, DhanuthaiK. Steroids in the treatment of lichen planus: A review. J Oral Sci2008;50(4):377–385.
27.
BombeccariGP, GuzziG, TettamantiM, et al.Oral lichen planus and malignant transformation: A longitudinal cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2011;112(3):328–334; doi: 10.1016/j.tripleo.2011.04.009
28.
AgrawalN, DangoreS, BhowateR, AgrawalS, RecheA. Comparative efficacy of laser and topical corticosteroid in the management of aphthous stomatitis. J Datta Meghe Inst Med Sci Univ2019;14(3):155–161.
29.
BhatS, SujathaDA. clinical evaluation of 5% amlexanox oral paste in the treatment of minor recurrent aphthous ulcers and comparison with the placebo paste: A randomized, vehicle controlled, parallel, single center clinical trial. Indian J Dent Res2013;24(5):593–598.
30.
HusseinH, ZakyA, NadimM, ElbarbaryA. Low-level diode laser therapy (LLLT) versus topical corticosteroids in the management of recurrent Aphthous stomatitis patients. A randomized controlled trial. Ad Dent J2021;3(4):200–210.
31.
ŚlebiodaZ, Dorocka-BobkowskaB. Low-level laser therapy in the treatment of recurrent aphthous stomatitis and oral lichen planus: A literature review. Postepy Dermatol Alergol2020;37(4):475–481; doi: 10.5114/ada.2020.98258
32.
Al-MaweriSA, KalakondaB, Al-SoneidarWA, Al-ShamiriHM, AlakhaliMS, AlaizariN. Efficacy of low-level laser therapy in management of symptomatic oral lichen planus: A systematic review. Lasers Med Sci2017;32(6):1429–1437; doi: 10.1007/s10103-017-2233-7
33.
JainR, MhapuskarA, HiremuttD, KaleI, KalyanpurK, BhadaniH. Comparison of efficacy of combination therapy (Low Level Laser Therapy (LLLT) and topical steroid) with topical steroid therapy only in patients with symptomatic oral lichen planus – In vivo study. J of Indian Aca of Oral Med and Radio2021;33(3):286–293; doi: 10.4103/jiaomr.jiaomr_126_21
34.
Al-MaweriSA, JavedF, KalakondaB, AlAizariNA, Al-SoneidarW, Al-AkwaA. Efficacy of low-level laser therapy in the treatment of burning mouth syndrome: A systematic review. Photodiagnosis Photodyn Ther2017;17:188–193; doi: 10.1016/j.pdpdt.2016.11.017
35.
PandeshwarP, RoaMD, DasR, ShastrySP, KaulR, SrinivasreddyMB. Photobiomodulation in oral medicine: A review. J Investig Clin Dent2016;7(2):114–126; doi: 10.1111/jicd.12148
36.
AbduljabbarT, JavedF, ShahA, SamerMS, VohraF, AkramZ. Role of lasers as an adjunct to scaling and root planning in patients with type 2 diabetes mellitus: A systematic review. Lasers Med Sci2017;32(2):449–459; doi: 10.1007/s10103-016-2086-5
37.
CafaroA, ArduinoPG, MassoliniG, RomagnoliE, BroccolettiR. Clinical evaluation of the efficiency of low-level laser therapy for oral lichen planus: A prospective case series. Lasers Med Sci2014;29(1):185–190; doi: 10.1007/s10103-013-1313-6
38.
Khaleel AhmedM, JaferM, NayeemM, et al.Low-level laser therapy and topical medications for treating Aphthous ulcers: A systematic review. J Multidiscip Healthc2020;13:1595–1605; doi: 10.2147/JMDH.S281495
39.
ArkseyH, O’MalleyL. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol2005;8(1):19–32.
40.
HazeemMI, RajabMS, BadeiaRA. Treatment of recurrent aphthous stomatitis with 940 nm diode laser. Tikrit J Dental Sci2013;1:77–82.
41.
AggarwalH, SinghMP, NaharP, MathurH, GvS. Efficacy of low-level laser therapy in treatment of recurrent aphthous ulcers - a sham controlled, split mouth follows up study. J Clin Diagn Res2014;8(2):218–221; doi: 10.7860/JCDR/2014/7639.4064
42.
AlbrektsonM, HedströmL, BerghH. Recurrent aphthous stomatitis and pain management with low-level laser therapy: A randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol2014;117(5):590–594; doi: 10.1016/j.oooo.2014.01.228
43.
LalabonovaH, DaskalovH. Clinical assessment of the therapeutic effect of low-level laser therapy on chronic recurrent aphthous stomatitis. Biotechnol Biotechnol Equip2014;28(5):929–933; doi: 10.1080/13102818.2014.966526
44.
BabuB, UppadaUK, TarakjiB, HussainKA, AzzeghaibiSN, AlzoghaibiI. Versatility of diode lasers in low-level laser therapy for the management of recurrent aphthous stomatitis. J Orofac Sci2015;7(1):49–53.
45.
PatilK, BhattacharyaPT, GuledgudMV. Effectiveness of 904 nm gallium arsenide diode laser in treatment of oral lichen planus: Report of two cases. J Dent Lasers2015;9(2):110–113.
46.
TandonC, KashyapA, AamirM, et al.Low level laser therapy for treatment of lichen planus: An original research. J Adv Med Dent Sci Res2022;10(1):69–72.
47.
ManandharS, PrasanthT, SatishaTS, GuptaN, KumarP. Comparative evaluation of management of oral lichen planus using three different modalities: A clinical study. IP Int J PeriodontolImplantol2022;7(3):113–121.
48.
ManchandaY, RathiSK, JoshiA, DasS. Oral lichen planus: An updated review of etiopathogenesis, clinical presentation, and management. Indian Dermatol Online J2024;15(1):8–23.
49.
TaylorDN, WinfieldT, WyndS. Low-level laser light therapy dosage variables vs treatment efficacy of Neuromusculoskeletal conditions: A scoping review. J Chiropr Med2020;19(2):119–127; doi: 10.1016/j.jcm.2020.06.002
50.
EbrahimH, et al.Comparison between the effect of 810nm and 940nm diode laser irradiation on histopathological changes in iatrogenic oral ulcers: An animal study. J Dent Shiraj Univ Med Sci2021;22(4):267–272; doi: 10.3076/DENTJODS.2021.86623.1202
51.
Rigi LadizMA, MirzaeiA, HendiSS, et al.Effect of photobiomodulation with 810nm and 940nm diode lasers on human gingival fibroblasts. Dent Med Probl2020;57(4):369–376.
52.
EbrahimH, et al.The comparison of 940 nm and 810 nm diode laser effects on the repair of inferior alveolar sensory nerve injury: A clinical trail. J Dent Shiraz Univ Med Sci2024;25(3):215–222; doi: 10.30476/dentjods.2023.97393.2013
53.
AggarwalH, SingG, KumarP. Diode laser verversustopicalcorticosteroidsin the treatment of recurrent aphthous stomatitis: A clinical and pain assessment study. J Clin Diagn Res2017;11(2):ZC98–ZC101.
54.
Bello-SilvaMs, de FreitasPM, AranhaAC, Lage-MarquesJL. Laow-level laser therapy for recurrent aphthous ulcers: Arandomi, placebo-controlled clinical trial. Clin Oral Investing2010):353–360.
55.
SattayutS, BuranaromN, VonthonglorT. Diode Laser as anadjunctive treatment for oral lichen Planus: A randomized control trial. Lasers Med Sci2020;35(4):931–938.
56.
FattahM, SalahA. Efficacy of diode laser in the management of oral lichen planus: A systematic review. Int J of Ad Research2017;5:650–657; doi: 10.21474/IJAR01/5373
57.
PakfetratA, FalakiF, AhrariF, BidadS. Removal of refractory erosive-atrophic lichen planus by the CO2 laser. Oral Health Dent Manag2014;13(3):595–599.
58.
MozafariH, FarhadzadehK, RezaeiF. A study of the effects of CO2 laser therapy on oral lichen planus (OLP). J Appl Environ Biol Sci2015;5(9S):114–118.
59.
SaibeneAM, RossoC, CastellarinP, et al.Managing benign and malignant oral lesions with carbon dioxide laser: Indications, techniques, and outcomes for outpatient surgery. Surg J (N Y).2019;5(3):e69–e75.
60.
CloitreA, RosaRW, ArriveE, FricainJC. Outcome of CO2 laser vaporisation for oral potentially malignant disorders treatment. Med Oral Patol Oral Cir Bucal2018;23(2):e237–e247.
61.
NasrySA, El ShenawyHM, MostafaD, AmmarNM. Different modalities for treatment of recurrent aphthous stomatitis. A randomized clinical trial. J Clin Exp Dent2016;8(5):e517–e522.
62.
DeSouzaTO, MartinsMA, BussadoriSK, FernandesKP, TanjiEY, Mesquita FerrariRA. Clinical evaluation of low-level laser treatment for recurring aphthous stomatitis. Photomed Laser Surg2010;28(2):S85–S88.
63.
KhademiH, ShiraniA, NikegbalF. Evaluation of low level laser therapy in recurrent aphthous stomatitis. Shiraz Univ Dent. J2009;10(2):160–162.
64.
BasiratM. The effect of low power lasers in healing of oral ulcers. J Lasers Med Sci2012;3(2):79–83.
65.
MückeT, GentzI, KanatasA, et al.Clinical trial analyzing the impact of continuous defocused CO2 laser vaporisation on the malignant transformation of erosive oral lichen planus. J Craniomaxillofac Surg2015;43(8):1567–1570.
66.
DalirsaniZ, SeyyediSA. Treatment of Plaque-like oral lichen planus with CO2 laser. Indian J Dermatol2021;66(6):698–703.
67.
Al-MohayaMA, Al-MalikAM. Excision of oral pyogenic granuloma in a diabetic patient with 940nm diode laser. Saudi Med J2016;37(12):1395–1400; doi: 10.15537/smj.2016.12.15941
68.
ArasMH, GöregenM, GüngörmüşM, AkgülHM. Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia. Photomed Laser Surg2010;28(2):173–177; doi: 10.1089/pho.2009.2498
69.
BeulahJM, DeepthiA, Gracelin MuruganK, DeepakJH. Efficacy of carbon dioxide laser in treating oral lichen planus-A scoping review. J Clin of Diagn Res2023;17(3):ZE01–ZE07.
70.
HabibT, KhondkerL, KabirH, et al.Managementoforal lichen planus by the application of carbon dioxide laser: A systematic review. JPTCP2024;31(5):110–121; doi: 10.53555/jptcp.v31i5.5954
