Photodynamic therapy for oral potentially malignant disorders

Abstract

To assess the impact of photodynamic therapy (PDT) parameters in the management of oral potentially malignant disorders (OPMDs). We conducted a systematic review and meta-analysis of studies that assessed the curative effect of PDT published in PubMed and Embase until Dec 2018. Random or fixed effects models for pooled estimates calculation were used. A pooled estimate calculation revealed that lesion size decreased by 1.38 cm² (95% CI: 0.39-2.36) after PDT, and the overall complete response (CR) was 0.52 (95% CI: 0.36-0.68), while partial response (PR) reached 0.82 (95% CI: 0.74-0.88). Subgroup analyses revealed that the lesion response (CR: 0.21 [95% CI: 0.12-0.33]) of oral lichen planus was worse than that of other disease entities. 20% aminolevulinic acid was more effective than other photosensitizers, with the overall CR was 0.68 (95% CI: 0.42-0.86), while the PR was 0.88 (95% CI: 0.76-0.94). Topical use of photosensitizers can yield desirable results, while gargling methylene blue yields poor response (0.82 [95% CI: 0.75-0.88] vs. 0.59 [95% CI: 0.44-0.72], respectively). PDT is an effective treatment modality in the management of OPMDs, the overall efficacy of which is influenced by several factors.

Keywords: Meta-analysis; Oral potentially malignant disorders; Photodynamic therapy; Systematic review.