Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy

Abstract INTRODUCTION: As conventional treatments currently available for mucositis are not considerably effective,there is a need to implement an adjuvant protocol for the treatment of oral mucositis in patients undergoing radiotherapy and chemotherapy.PURPOSE: To evaluate the effect of Low Level Laser Therapy and Antimicrobial Photodynamic Therapy mediated by curcumin and blue LED as an adjunct treatment of oral mucositis foroncology patients using chemotherapy and or radiotherapy.METHODS: Clinical, randomized study, in a single location, in an oncology service of a general hospital, with a total of 30 patients (over 18 years old) with stable oral mucosa lesions in the process of Chemotherapy and or Radiotherapy. The patients were divided into 3 groups: Control group (treated with nystatin), LLLT group (treated with Low Level Laser Therapy), and the aPDT group (treated with 450 nm blue LED and curcumin photosensitizer).RESULTS: The results showed, by means of intra-group comparisons, that the two experimental treatments promoted yeast reduction of the genus Candida in the last two evaluations (21 days and 30 days), but not in the first two evaluations (7 days and 14 days). The intra-group comparisons showed that the Control and aPDT group showed a significant difference in the degree of mucositis over the four evaluations performed, with the results pointing out that the mucositis worsened in the control group from the 14th day, while reduced in the aPDT group from the 21st day of treatment.CONCLUSION: A reduction in the degree of mucositis and pain score was observed in the LLLT and aPDT groups, with the aPDT group standing out when presenting early clinical improvement in relation to the LLLT group and the control group, thus emphasizing its effectiveness within the desired aspects. Regarding the antimicrobial effect, aPDT showed a greater reduction of yeasts of the genus Candida in the tested parameters.

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Follow-up of pressure ulcer treatment with photodynamic therapy, low level laser therapy and cellulose membrane

Journal of Wound Care ◽

10.12968/jowc.2021.30.4.304 ◽

2021 ◽

Vol 30 (4) ◽

pp. 304-310

Author(s):

Luciano Pereira Rosa ◽

Francine Cristina da Silva ◽

Suzete Carvalho Landulfo Luz ◽

Regiane Lima Vieira ◽

Beatriz Rocha Tanajura ◽

...

Keyword(s):

Photodynamic Therapy ◽

Laser Therapy ◽

Pressure Ulcer ◽

Low Level Laser Therapy ◽

Cellulose Membrane ◽

Low Level ◽

Low Level Laser ◽

Level Laser ◽

Hospitalised Patients

Objective: A pressure ulcer (PU) is an area of tissue trauma caused by continuous and prolonged pressure, often associated with hospitalised patients immobilised due to neurological problems, negatively affecting their quality of life, and burdening the public budget. The aim of this study was to report the follow-up, for 45 weeks, of three patients with neurological lesions due to trauma who subsequently developed PUs, and who were treated with a combination of photodynamic therapy (PDT), low level laser therapy (LLLT) and cellulose membrane (CM). Method: PDT was mediated by the photosensitiser curcumin on a 1.5% emulsion base. Blue LED light at 450 nm was delivered continuously for 12 minutes at an irradiance of 30mW/cm2 and total energy delivered to the tissue was 22J/cm2. LLLT was performed with 660 nm laser, punctuated and continuous, twice a week with parameters: spot size 0.04cm2, power of 40mW, 10 seconds per point, fluence of 10J/cm2 and irradiance of 1000mW/cm2. Results: All PUs had a significant reduction (range: 95.2–100%) of their area after 45 weeks of follow-up and two PUs had complete healing at 20 weeks and 30 weeks. All of the PUs showed a reduction in contamination with the PDT treatments in different proportions. Conclusion: From the results obtained, we conclude that the combination of PDT, LLLT and CM is a promising treatment for PU healing.

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