Comparative efficacy of photodynamic therapy versus triamcinolone in symptomatic oral lichen planus: IL-1Beta, IL-6, TNF-Alpha, and MDA biomarker analysis.

BACKGROUND AND OBJECTIVES: Oral lichen planus (OLP) is a chronic inflammatory, autoimmune, and potentially malignant disorder of the oral mucosa. Photobiomodulation (PBM) aids tissue repair, while photodynamic therapy (PDT) selectively targets diseased cells and modulates cytokines. This study compares the effectiveness of PDT (660 nm) and triamcinolone acetonide 0.1% in managing symptomatic OLP. It evaluates their impact on serum and salivary biomarkers (IL-1Beta, IL-6, TNF-alpha, and MDA) at baseline and at 3 months and correlates these markers with pain and clinical scores (VAS and RAE) to determine their therapeutic efficacy.

MATERIALS AND METHODS: A randomized controlled trial on 28 OLP patients compared two treatments: Group I received 0.1% TA (3 times/day for 1 month); Group II underwent PDT with 1% toluidine blue and 660 nm diode laser (100 mW, 60 sec/cm², 2 times/week for 1 month). Pain with VAS and lesion size with RAE were assessed at baseline and 1, 2, and 3 months. Biomarkers were evaluated using ELISA and thiobarbituric acid tests.

RESULTS: Both treatments significantly reduced pain and lesion size. PDT demonstrated greater pain reduction than TA and slightly more lesion size reduction, though not statistically significant. Biomarkers showed no significant changes except a correlation between salivary IL-1β and VAS in the TA group.

CONCLUSION: PDT and TA effectively managed pain and lesion size in OLP, with PDT showing a trend toward greater improvement. PDT is a promising alternative for OLP management.