Oral mucositis, aphtae

Indication		Joule cm2	Frequency	Treeatments week
Oral mucositis aphtae		2 - 6	Nogier A/F	2-3
	X	apply the laser with skin contact and dental applicator.

Treatment of mucositois and aphtae etc. is very promising, it is as well recommend as a standard treatment during chemo therapy. In order find the cause of the oral dsorder, always include the condition of the digestion system (stomach, small and large intestine) in your diagnostic evaluations.

The immune system of the patient must be supported as well.
C.Migliorati, C.Massumoto, F.P.Eduardo, K.P.Müller, T.C.Carrieri, P.Haypek, C.P.Eduardo Hospital Sírio Libanes and SOL - Sociedade de Odontologie a Laser, Sao Paulo, Brasil

Purpose: Oral mucositis is a severe and therapy limiting stomatotoxic side effect caused by systemic high-dose chemotherapy (CT) and by conditioning regimen for Bone Marrow Transplantation (BMT). This initial clinical observational study evaluated the possible efficacy of low energy lasertherapy in the treatment of oral mucositis.

Material and Methods: Eleven patients from the Oncology Center of the Hospital Sirio Libanes in São Paulo - Brazil, with a variety of oncological diseases, and who were going to receive either CT (2) or BMT (9) were treated with the Mucolaser™ (GaAlAs laser - MM Optics São Carlos - Brazil). All patients had the oral cavity examined by an oral medicine expert before the beginning of the oncological treatment. On the first day of the CT of Conditioning Regimen, the entire oral mucosa was laser-treated with continuous emission of the infrared light, which had 780nm wavelength, and output power of 60 mW, resulting in a final energy density of 2J/cm2. The tip of the laser device lightly touched the oral mucosa for about 35 minutes. Daily sessions were performed for an average of 10 applications for each patient. Mucositis was clinically evaluated based on the WHO scale and pain was measured by using a visual analogue scale.

Results: In general the patients tolerated the procedure well. In some cases days of application were missed because of nausea or vomiting, but there were no toxic effects related with the laser. Ten of the 11 patients developed mucositis varying from grade I -IV of the WHO classification. None of the patients had maximum pain score (10). Patients requested that lasertherapy was performed because of the immediate pain relief.

Conclusion: The authors of the present paper believe that low energy lasertherapy may play a role in the control of pain in oral mucositis. In order to evaluate prevention of mucositis and acceleration of the healing we have initiated a randomized controlled study.

Congress for Oral laser Therapy, Vienna 2001

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