Fotobiomodulação de lesões gengivais decorrentes de doenças autoimunes: revisão sistemática e meta-análise

Abstract

Several autoimmune diseases can affect the oral cavity, especially oral lichen planus (OLP), mucous membrane pemphigoid (PMM) and pemphigus vulgaris (PV). These diseases can present as gingival lesions and are commonly treated with topical corticosteroids. Because of their adverse effects and injuries refractory to these therapies, other alternatives have been developed, such as photobiomodulation (PBM). Thus, the aim of this study was to evaluate the effects of PBM on these lesions, addressing the following question: “Is PBM effective to treat autoimmune gingival lesions?”. An electronic search was performed until July 2020 in four databases: MEDLINE-PubMed, Embase, Scopus and Web of Science. Seventeen studies were included, of which six were used for the meta-analysis. Women with OLP were the most affected patients, presenting gingival involvement concomitant to other sites, mainly buccal mucosa and tongue. Meta-analysis results showed no significant differences between PBM and topical corticosteroid in pain reduction at baseline and 60-day follow-up; however, Visual Analogue Score (VAS) and Thongprasom clinical scale showed significant reduction when compared before and after PBM at 30 and 60-day follow-up. PBM has become an important tool in the management of autoimmune gingival lesions, showing significant pain reduction and improvement of clinical scores of the lesions after therapy, without showing significant differences when compared to topical corticosteroid. Up to now, there is little strong evidence to assess the efficacy of PBM in autoimmune gingival lesions.