Diode laser versus topical triamcinolone acetonide agent in the pain reduction of minor recurrent aphthous stomatitis

Abstract

Background: Recurrent aphthous stomatitis (RAS) is characterized by the painful ulcerations of the oral mucosa, which impacts on the patient swallowing, so an effective therapeutic strategy mostly addresses the pain reduction as well as ulcer healing process; however, no specific therapeutic modality has been validated as gold standard therapy yet. Objective: The objective of the study was to determine the efficacy of 810-nm diode low-level laser therapy (LLLT) and compare with the application of topical triamcinolone acetonide in Orabase agent in respect to pain threshold reduction in patients with minor RAS. Patients and Methods: Twenty patients with minor recurrent aphthous stomatitis were enrolled in the study and were randomly divided into two equal groups: Group “A” treated with 810-nm diode LLLT, with an estimated energy density of 30–37.5 J/cm2, and Group “B” treated with topical triamcinolone acetonide; a questionnaire was handed to all these patients and it was returned back after 7 days to record their pain perception threshold on the Visual Analog Scale (VAS) score on daily basis. Results: The mean VAS pain score of the laser group was 6.94 ± 0.32 initially and was decreased significantly to 2.14 ± 0.47 on day 3, with P = 0.001; while the mean VAS pain score of the triamcinolone group was 7.13 ± 0.38 initially and was decreased significantly to 2.16 ± 0.14 on day 3, with P = 0.001. However, in the intergroup comparison, the mean value of VAS pain perception threshold in the laser group (2.98 ± 0.32) was significantly lower than that of the triamcinolone group (3.40 ± 0.14) from day 1 to day 3, with P = 0.012. Conclusions: Both low-level diode laser and triamcinolone therapies showed a significant early and lasting pain threshold reduction in patients with minor RAS; however, in comparison between the two modalities, it goes more statically significant in favor of the low-level diode laser therapy up to day 3.