Preprint Article Version 1 This version is not peer-reviewed

Photobiomodulation Therapy in the Management of Burning Mouth Syndrome: Morphological Variations in the Capillary Bed

Version 1 : Received: 23 July 2020 / Approved: 26 July 2020 / Online: 26 July 2020 (15:26:40 CEST)

How to cite: Scardina, G.A.; Casella, S.; Bilello, G.; Messina, P. Photobiomodulation Therapy in the Management of Burning Mouth Syndrome: Morphological Variations in the Capillary Bed. Preprints 2020, 2020070635 (doi: 10.20944/preprints202007.0635.v1). Scardina, G.A.; Casella, S.; Bilello, G.; Messina, P. Photobiomodulation Therapy in the Management of Burning Mouth Syndrome: Morphological Variations in the Capillary Bed. Preprints 2020, 2020070635 (doi: 10.20944/preprints202007.0635.v1).

Abstract

Burning Mouth Syndrome (BMS) is an idiopathic condition that manifests itself primarily with the onset of burning sensation. The aim of the research was to perform Photobiomodulation Therapy (PBM) using a diode laser on the oral mucosa of BMS patients, followed by an objective evaluation of the morphological changes in the vascular bed underlying the mucosa using polarized light videocapillaroscopy. A group of 40 patients were included in the study. The patients were randomly divided into two groups (using simple randomization): 20 patients were assigned to the laser group and 20 patients were assigned to the placebo group. Each patient of the laser group received 8 irradiations (with 4 Watt of power, wavelength 800nm, energy 1200 Joules, irradiation time for 300 seconds of time, energy density 50J/cm2 , 60 mW continuous wave laser, irradiance 180mW/cm2 ), twice a week, blinded to the type of irradiation administered, for four consecutive weeks. The patients in the placebo group underwent the same sessions as the others, the only difference being the non-emission of the laser. An initial check of the vascular bed was performed with a polarized light videocapillaroscope. This was followed by treatment with a therapeutic diode laser and a subsequent check with a videocapillaroscope. It was possible to observe that in the group of patients that underwent laser therapy, there was a lasting improvement in symptoms. The capillary oral bed in the placebo groups did not show any statistically significant difference (P>0.05). In the laser group we observed: in the buccal mucosa the diameter of the capillary had a reduction of 3μm; in the upper lip mucosa a reduction of 3μm; in the lower lip mucosa, there was a reduction of 3μm; in the dorsal lingual surface, there was a reduction of 2 μm. An increase in capillary length was also obtained in all irradiated regions in the laser group patients (P < 0.05). PBM induces microcirculatory changes that are still present at a distance of time, such as an improvement in the clinical picture. The improvement in the symptoms has been correlated to the reduction of the capillary diameter. Placebo effect only leads to a temporary improvement in symptoms that are unrelated to changes in the microcirculatory pattern.

Subject Areas

burning mouth syndrome; photobiomodulation therapy; capillaroscopy

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