Effect of Diode Laser combined with Hyaluronic Acid Gel in Treatment of Recurrent Aphthous Stomatitis in Children: Randomized Clinical Trial

Background: Recurrent Aphthous Stomatitis (RAS) is a painful rounded ulcer characteristic by erythematous margin and pseudo yellowish- gray membrane in its center. All forms of RAS have bad effects on quality of life that interfere with daily activities. Hyaluronic acid has essential part in tissue hydrodynamics, cell migration, proliferation and differentiation. It shows an anti-inflammatory role so; it prevents tissue destruction and helps in tissue healing. Low level laser therapy is recognized with various terminologies such as “biostimulator,” and “cold laser,” It has role in the management of RAS, it has a wide spectrum of clinical applications which include herpes labialis, angular cheilitis, trismus, paresthesia, dentin hypersensitivity, temporomandibular joint pain, and in the postoperative phase.
Materials and Method: Forty five normal healthy males and females children aged from (4-10 years) suffering from aphthous lesions were used in this study. Children were examined in Outpatient clinic pediatric Dentistry Department, Faculty of Dentistry, Suez canal University by a clinician. Each patient had one minor RAS of less than 72 h duration or two nearby minor aphthous lesions of less than 72 h at the same side of oral cavity. Patients were evenly divided into three groups (15 patients in each) with the method of simple randomization, Patients of group I were treated with topical application of hyaluronic acid gel , those of group II were treated with diode laser and group III patients were treated with diode laser followed by topical application of hyaluronic acid gel. The patients were evaluated at (0, 2nd, 4th and 6th) days, for measuring ulcer size and pain score.
Results: At the 2nd, 4th and 6th days there was statistical significance decrease in mean size of the ulcer of group III when compared to both groups (I) and (II) . On other hands, at days 2 and 6 there was statistical significance decrease in mean of pain score in group III when compared to group I. There was also statistical significance decrease in mean of pain score in group II when compared to group I at the 4th day of evaluation.
Conclusion: Hyaluronic acid gel combined with diode laser are effective in treatment of RAS.