Avaliação da dor, aspecto clínico e citocinas salivares em pacientes com líquen plano oral submetidos à fotobiomodulação: estudo clínico, aleatorizado e duplo- cego

Abstract

Oral lichen planus (OLP) is a chronic, mucocutaneous inflammatory disease mediated by T lymphocytes and pro and anti-inflammatory cytokines such as IL-6, IL-1β, IL-17, TNF-α and IL-10. It presents painful symptoms and changes in the clinical aspect of the oral mucosa. Conventional treatment is by corticosteroid. Photobiomodulation (PBM) emerges as an alternative to classic treatment (corticosteroids), which generally offers side effects to the patient such as kidney problems, hypertension, diabetes, among other deleterious effects. This research was conducted by a randomized, double-blind clinical study. Patients were evaluated by clinical and histopathological exams, and those who tested positive on both exams were included in these research and randomized into two groups, the Control Group treated with corticosteroids (0.05% clobetasol propionate), 3 times a day for 30 consecutive days and with laser off to mask photobiomodulation and other laser-treated PBM Group (660nm, 100mW, 177J / cm2, 5s, 0.5J per point) twice a week for 30 days consecutive and placebo gel 3 times daily during treatment to mask corticotherapy. Pain was assessed using the Visual Analog Scale and clinical aspect was assessed by baseline score, weekly during treatment and at the end. Saliva samples were collected at the beginning and end of treatment and salivary concentrations of IL-6, IL-1β, IL-17, TNF-α and IL-10 were evaluated by ELISA. Both PBM and corticosteroids were effective in reducing pain and improving the clinical aspect of OLP lesions, and in both treatments the clinical aspect evolved to reticular form in the vast majority of cases. The concentration of cytokine IL-1β presented significant P value, while the concentration of the others, the P value was not significant. Additionally, there was a positive correlation between the high IL-1β concentration and the worst clinical score of OLP lesions. No salivary cytokine modulation was observed in either group at the beginning or end of treatment. PBM was as effective as corticosteroids in the treatment of OLP, with the advantage of no adverse effects.