Topical Gel Application and Low Level Laser Therapy on Related Soft Tissue Traumatic Aphthous Ulcers

Keywords:surgical, fiber,  Time:25-03-2016

Traumatic aphthous ulcers (epithelial laceration that usually exposes nerve ending terminals and result in acute and severe pain) [1], are shown on a high percentage on either children or adults during orthodontic treatment [2,3].

Low level laser therapy (LLLT), it´s an international accepted designation defined as laser treatment, in which the outer energy is applied at a low intensity to produce on the tissues non thermal and bio stimulating effects [4]. LLLT has shown to have an increase in proliferation at the cellular level due to several mechanisms [5-20]. Anti-inflammatory properties are based on its decreasing effect on E2 prostaglandin, factor-alpha tumor necrosis, interleukin-1β, cyclooxygenase- 2mRNA and plasmin activator levels [21]. Analgesic properties are associated with its antiinflammatory action and neuronal effect [22-24]. Summing all of the above, LLLT offers a potential solution and has been used in aphthous recurring stomatitis [25-28]. Fitoestimuline Gel® it´s an oral cavity application gel, each 100 g contain aqueous Triticum vulgare extract, 15 g, 2 fenoxietanol 1 g and carbopolcarbé Viano and Santiano [29]. searching for its action mechanism Fitostimuline® was applied over fibroblast and lymphocytes mouse cultures, finding an increase on ARNm and DNA synthesis. The authors concluded that this activity is the base for the action mechanism of the substances that are a part of it, achieving the proper stimulation for tissue regeneration. This study’s objective is to evaluate the effect of LLLT and Fitostimuline Gel® application on pain and healing of orthodontic related traumatic aphthous lesions..

This is a clinical intervention study design, double blind and randomized clinical trial. The initial sample was 350 suitable patients under orthodontic treatment, starting in August 2013 and finishing in May 2014, at the Universidad del Valle (Cali, Colombia) clinics and in a private practice.

Within the appointment in which the patient reported the aphthous lesion G3 and G4 were irradiated with Photon Lase III (AS-GA-Ir) (DMC equipments; Sao Carlos, Brazil) therapeutic laser, with a wavelength of 660 nm, 25 J/cm2, 100 mW, during 14 seconds. Irradiation was made by one operator, applying laser by scanning the lesion 1 mm away two times each of seven seconds. Only one laser application per aphthous lesion was made. G1 and G2 received a placebo application with the laser tip inactive, this in order to create a placebo effect aplication to prevent false effects and mainly to keep the registration process in the visual analog scale as true as possible.