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激光图案化微凝固术(LPM)治疗口腔扁平苔藓继发的剥脱性龈炎:一项随机对照试验性临床试验(LPM试验)

Laser patterned microcoagulation (LPM) in the management of desquamative gingivitis secondary to oral lichen planus: A randomized controlled pilot clinical trial (LPM TRIAL).

作者信息

Reddy Saravanan Sampoornam Pape, Singh Harjeet, Francis Delfin Lovelina, Harish Ruchi, Rathi Manish, Karmakar Shaswata, Manohar Balaji, Chopra Sukhbir Singh

机构信息

Army Dental Centre (Research & Referral), Army Hospital Research and Referral, New Delhi, India, 110010.

3 Corps Dental Unit, Dimapur, India.

出版信息

Lasers Med Sci. 2025 Apr 11;40(1):188. doi: 10.1007/s10103-025-04454-3.

Abstract

The application of laser patterned microcoagulation (LPM) for the management of desquamative gingivitis secondary to oral lichen planus (OLP) was investigated. This single-centre, randomized, sham-controlled, single-blinded, parallel-arm pilot clinical trial included 30 patients diagnosed with OLP manifesting only as desquamative gingivitis. Permuted block randomization was performed. LPM was performed in the test group and sham treatment was provided to the control group along with 0.1% triamcinolone acetonide application. Diode laser with 940nm wavelength with a tip diameter of 400μm and power 0.5 W was utilized in pulsed contact mode for 250 ms to induce thermal injury zones. Five joules of energy were delivered at a fluence of 4kJ/Cm2 at the tip. LPM led to a significant reduction in the number and size of gingival lesions in the test group. Compared to the control group (4.07 ± 0.80), pain reduction was significant in the test group (6.4 ± 0.51, p = 0.000). Oral diseases severity score for pain at three months in test group (1.87 ± 0.64) was significantly lesser than in control (2.47 ± 0.64, p = 0.021) and Thongprasom's score at six months was 0.33 ± 0.49 in test and 1.33 ± 0.49 in control group (p = 0.000). LPM was well-tolerated by all patients, with no significant adverse effects. This study provides evidence of the effectiveness and safety of LPM as a novel treatment modality for the management of desquamative lesions of OLP suggesting accelerated healing and reduced inflammation.

摘要

研究了激光图案化微凝固术(LPM)在治疗口腔扁平苔藓(OLP)继发的剥脱性龈炎中的应用。这项单中心、随机、假对照、单盲、平行组试点临床试验纳入了30例仅表现为剥脱性龈炎的OLP确诊患者。采用置换区组随机化。试验组进行LPM,对照组进行假治疗并应用0.1%曲安奈德。使用波长940nm、尖端直径400μm、功率0.5W的二极管激光,以脉冲接触模式照射250ms,以诱导热损伤区。在尖端以4kJ/Cm2的能量密度传递5焦耳能量。LPM使试验组牙龈病变的数量和大小显著减少。与对照组(4.07±0.80)相比,试验组的疼痛减轻显著(6.4±0.51,p = 0.000)。试验组三个月时疼痛的口腔疾病严重程度评分(1.87±0.64)显著低于对照组(2.47±0.64,p = 0.021),试验组六个月时的Thongprasom评分为0.33±0.49,对照组为1.33±0.49(p = 0.000)。所有患者对LPM耐受性良好,无显著不良反应。本研究提供了证据,证明LPM作为一种治疗OLP剥脱性病变的新型治疗方式具有有效性和安全性,提示愈合加速且炎症减轻。

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