Low Level Laser Therapy and Omega-3 in the Management of Recurrent Aphthous Sto matitis

Introduction: In view of the importance and prevalence of Recurrent Aphthous Stomatitis
(RAS) there is an urgent need for searching about an effective therapy that is less expensive, easy
to use and readily available with no side effects. Low Level Laser Therapy (LLLT ) and Omega-3
were considered as possible treatment options of RAS.
Aim of the work: The aim of the current study was to compare the usefulness of LLLT with or
without omega-3 versus omega-3 alone in treatment of RAS and evaluate the immune-modulatory
effect of systemically administered omega-3.
Materials and method: 45 patients were suffering from RAS were randomly assigned into
either GӀ: (LLL T), GӀӀ: (omega-3) and GӀӀӀ: (omega-3 plus LLL T). The comparison was assessed
clinically via calculating: The reduction in ulcer surface area by using Visual Basic Program, the
effectiveness indices (EI ) of pain improvement at day 1 and day five, average duration of ulcer
episodes, and the number of new ulcer outbreaks at base line and then monthly for the following 6
months. Immunologically via: Measuring the amount of IL2, determination of CD4+CD25+ high T
regulatory cells in blood samples at base line (BL), 3 and 6 months.
Results: GӀ showed significant reduction in ulcer surface area and significant decrease in pain
sensation, without significant change in all other parameters. GӀӀ showed no significant change
in the degree of pain sensation in spite of reduction in ulcer surface area in addition to significant
change in all other parameters. GӀӀӀ showed significant improvement in all clinical parameters
which is compatible with the changes occurred in the immunologic parameters. At BL no
significant deference was observed in between the three groups. For the follow up measurements:
The reduction in ulcer surface area and (EI ) of pain improvement showed significant difference
comparing GӀӀ with GӀ and GӀӀӀ in favor of the last mentioned two groups with no difference
in between both of them, regarding the monthly clinical variables and immunologic parameters
showed significant difference comparing GӀ with GӀӀ and GӀӀӀ in favor of the GӀӀ and GӀӀӀ with no
difference in between both of them.
Conclusions: Using LLLT with omega - 3 fatty acid in management of RAS gave the most
favorable clinical and immunologic results. The used Visual Basic Program was effective in
calculating the difference of ulcers surface areas and the digital data enabled fair statistical analysis.