Evaluation Of Pulsed Erbium: Yttrium Aluminum Garnet Laser In Treatment Of Erosive Oral Lichen Planus

Objective: To evaluate the clinical efficacy of pulsed Er: Yttrium Aluminum Garnet(Er: YAG)laser and triamcinolone acetonide ointment(TA)in the treatment of erosive oral lichen planus(OLP),evaluate the therapeutic effect of pulsed Er: YAG laser on erosive OLP,to explore the feasibility of Er: YAG laser treatment of erosive OLP,and to provide new ideas for the treatment of erosive OLP in clinical practice.Methods: Forty patients who were clinically and histopathologically diagnosed with OLP from December 2021 to November 2022 at the Department of Periodontal Mucosa of Dalian Stomatological Hospital were selected,and all lesions were accompanied by erosion.And the included patients were randomly divided into two groups: Er: YAG group and TA group,with 20 cases in each group.Er: YAG group was the laser treatment group.Pulsed Er: YAG laser was used to treat erosion lesions,once a week,until the erosion area disappeared completely,with a total of no more than 10 times.TA group was treated with triamcinolone acetonide ointment applied locally to treat mucosal erosion,3 times a day,until the erosion area disappeared completely,no more than 30 days.The VAS(pain assessment),mean lesion area,clinical sign score,and functional score of patients in both groups were evaluated at the baseline,at the 1st week,2nd week,1st month,and 3rd month after treatment,respectively,the treatment efficiency of patients in both groups was evaluated at 1st month and 3rd month after treatment,and the recurrence rate of cured patients in both groups was evaluated at 3rd month.Results: No adverse effects were observed during the treatment period in both groups.And the pain level,mean lesion area,clinical signs score and functional score decreased in both groups after treatment.The VAS score in the Er: YAG group was 1.50±0.946 at 1st week after treatment,which was significantly lower than that in the TA group,which was 2.10±0.912,(P=0.049,P<0.05),and the difference was statistically significant.There was no statistical difference in VAS score between the two groups at 2nd week,1st month and 3rd month after treatment,(P=0.192,P=0.201,P=0.718,P>0.05).The mean lesion area in the Er: YAG group was 0.31±0.549 at 2nd week after treatment,which was statistically significantly higher than that in the TA group,which was 0.07±0.223,(P=0.043,P<0.05),and there was no statistical difference in the mean lesion area between the two groups at 1st week,1st month and 3rd month after treatment,(P=0.121,P=0.820,P=0.862,P>0.05).There was no statistically significant difference in the clinical sign scores between the two groups at each stage,(P=0.231,P=0.076,P=0.271,P=0.341,P>0.05).When comparing the functional scores of the two groups at each stage,the Er: YAG group was lower than the TA group,(P=0.015,P=0.017,P=0.007,P=0.009,P<0.05),and the difference was statistically significant.At the 1st month after treatment,the effective rate was 85% in the Er: YAG group and 80% in the TA group,(P=0.677,P>0.05),and the difference was not statistically significant.At the 3rd month after treatment,the effective rate was 85% in the laser group and 70% in the TA group(P=0.256,P>0.05),and the difference was not statistically significant.At the 3rd month after treatment,the recurrence rate was 9.09% in the laser group and 27.27% in the TA group(P=0.269,P>0.05),and the difference was not statistically significant.Conclusions: The overall effectiveness of the pulsed Er: YAG laser for the treatment of erosive OLP was not significantly different compared to triamcinolone acetonide ointment.The pulsed Er: YAG laser was superior to triamcinolone acetonide ointment in short-term pain relief and functional improvement,and triamcinolone acetonide ointment was superior to the pulsed Er: YAG laser in promoting healing of erosive lesions.This study proved that the pulsed Er: YAG laser is feasible for the treatment of erosive OLP,and there is no risk of fungal infection,drug component allergy,drug dependence,etc.It can be used as a direct treatment for erosive OLP or an adjunct to drug therapy in clinical practice,providing new ideas for the treatment of erosive OLP.