Martins Aragão L.M. et al. - Photobiomodulation in the Treatment of Oral Lichen Planus: A Systematic Review and Meta-Analysis

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A systematic review of 15 clinical trials reports that photobiomodulation slightly reduces pain associated with oral lichen planus compared with conventional pharmacological treatment. However, the authors found no significant effect on disease severity or anxiety scores.

What this study measured

Oral lichen planus is a chronic inflammatory disease of the oral mucosa with an autoimmune component, characterized by pain, irritation, and sometimes bleeding and ulceration. The standard of care involves topical corticosteroids, often over the long term, which carries a risk of adverse effects. The team led by Lívia Maria Martins Aragão at the Federal University of Ceará in Brazil evaluated photobiomodulation as a noninvasive alternative. Seven databases were searched through March 1, 2025: PubMed, LILACS, Livivo, Scopus, Embase, Web of Science, and EBSCO. Eligible studies were human clinical trials—whether randomized or not—comparing photobiomodulation to conventional pharmacological treatment. Of the 4,118 references identified, 15 studies were included, with an assessment of risk of bias using Cochrane tools and certainty of evidence according to GRADE. The abstract does not mention a PROSPERO registration.

Key Findings

The results are mixed: there was an improvement in symptoms and wound healing, but no effect on markers of severity or emotional well-being. The authors themselves describe the reduction in pain as mild.

4,118 references identified, 15 studies included
Pain: Slight reduction compared to conventional treatment
Disease severity: no significant difference
Anxiety scores: no significant difference
Complete mucosal healing: higher rates with photobiomodulation
Recurrence of lesions: lower rates in erosive forms
No adverse effects were reported in the included studies

How photobiomodulation works for this indication

The proposed mechanism remains hypothetical. Red or near-infrared light would be absorbed by mitochondrial cytochrome c oxidase, which would transiently increase ATP production in mucosal cells. This boost in energy could support the proliferation of keratinocytes and fibroblasts, thereby promoting the healing of erosive areas. Modulation of oxidative stress and pro-inflammatory cytokines is also suggested as a mechanism for pain relief in a disease where a chronic lymphocytic infiltrate sustains local inflammation. These hypotheses were not tested in the studies analyzed.

Limits You Should Know

The journal accepts both randomized and non-randomized trials, which automatically lowers the level of evidence. The published abstract provides neither quantified effect sizes nor confidence intervals: the actual magnitude of the benefit for pain cannot be assessed. The GRADE certainty was assessed, but the level assigned for each criterion is not detailed. With 15 studies and protocols that vary widely from one center to another, clinical heterogeneity is likely significant. The authors themselves conclude that higher-quality randomized trials are still needed.

What This Means in Practice

These data position photobiomodulation as a plausible complementary option, especially in erosive forms where healing and recurrence are the main concerns. It is not a substitute for prescribed topical corticosteroid therapy or specialized follow-up, as oral lichen planus requires regular monitoring of the oral mucosa. The abstract does not specify wavelengths, energy densities, or the number of sessions; therefore, no protocol can be recommended based on this publication.

Frequently Asked Questions

Can photobiomodulation replace cortisone in the treatment of oral lichen planus?

No, and this review does not suggest that. It shows a slight reduction in pain and an increase in complete healing, but no significant effect on the severity of the disease. Oral lichen planus requires medical follow-up and treatment planned in consultation with a healthcare professional.

Is photobiomodulation safe for the oral mucosa?

In the studies compiled here, no adverse effects were reported, and the authors describe the approach as noninvasive and well tolerated. This analysis is based on only 15 studies, which is still insufficient to detect rare events.

How many sessions does it take to see results?

The abstract does not specify the number of sessions, the wavelengths, or the doses used in the included trials. No protocol can be inferred from it, a shortcoming that is regularly highlighted in the literature on photobiomodulation.

Reference

Martins Aragão LM, Julião Costa GA, da Silva JF, Fontes Borges Franco MM, de Barros Silva PG, Lima Mota MR. Analysis of the efficacy of photobiomodulation therapy in the treatment of oral lichen planus: A systematic review and meta-analysis of randomized and non-randomized clinical trials. Journal of Clinical and Experimental Dentistry, 2026. PMID 42542826. View the study on PubMed

This summary is provided for informational purposes only and does not constitute medical advice. Photobiomodulation is not a substitute for prescribed treatment. Consult a healthcare professional.