Efficacy of low-level laser therapy compared to steroid therapy in the treatment of oral lichen planus: A systematic review.

BACKGROUND Low-level laser therapy (LLLT) has been proposed as a potential treatment strategy for the treatment of oral lichen planus (OLP). The aim of this systematic review was to assess the efficacy of LLLT, in comparison with corticosteroid therapy, in the treatment of OLP. MATERIALS AND METHODS This systematic review aimed to address the following focused question: "Does LLLT yield better clinical outcomes than corticosteroid therapy in the treatment of OLP?" Indexed databases were searched up to and including April 2017. Clinical trials in humans diagnosed clinically and/or histologically with OLP allocated to test (LLLT) versus control (steroid therapy) groups were included. RESULTS Five clinical studies were included. The risk of bias was considered high in four studies and moderate in one study. Laser wavelengths, power, spot size, and duration of laser exposure ranged between 630 and 970 nm, 10-3000 mW, 0.2-1.0 cm2 , and 6-480 seconds, respectively. The follow-up period ranged from 4 to 48 weeks. All included studies reporting clinical scores showed that LLLT was effective in the treatment of OLP in adult patients at follow-up. Three studies showed significantly higher improvements with topical use of corticosteroids compared to LLLT, while one study showed significant improvement with LLLT. One study showed comparable outcomes between LLLT and corticosteroid application. CONCLUSION It remains debatable whether LLLT is more effective as compared to corticosteroids in the treatment of OLP, given that the scientific evidence is weak. These findings are preliminary and further randomized clinical trials are recommended.