Forums › Laser Treatment Tips and Techniques › Soft Tissue Procedures › How to treat this
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Samuel MossSpectatorHey,
I have a patient who has recurrent episodes of erosive lichen planus that occurs on her left buccal mucosa. She reports that it is very painful. I saw Stu show how he treats it with a CO2 laser. I have and erbium and Periolase 7 Nd:yag laser. My question: Has anyone treated erosive lichen planus with any success using either of these 2 lasers? If so, what settings, parameters, treatment times, etc. were employed?
Thank any of you in advance,
Mossman
Robert Gregg DDSSpectatorHi Sam,
These are tough lesion to treat.
I have treated them with a FRP Nd:YAG, but I think CO2 would be better. No laser “cures” these….yet.
I would try using the erbium w/o water defocused and with “light” air. See if you can remove the surface epithelium and get down to the basement membrane and put an thin eschar. Try a test area and document the location so you can track results.
Let us know.
Bob
Samuel MossSpectatorBob,
Thanks for answering my question on both forums. That’s what I’m going to do.
Your are a wonderful mentor.
Your friend,
Mossman
kellyjblodgettdmdSpectatorHey, Sam! Another consideration since you have the advantage of having 2 wavelengths is to employ the both. Perhaps do what Bob suggested using the Er for surface ablation, and finish w/ the Nd:YAG in a LLLT fashion. I have used 10Hz x 100mJ at a distance of 3-5cm which should simply help w/ biostimulation.
Adding the Nd:YAG certainly can’t do any harm (I don’t thing – grin).
Kelly
Kenneth LukSpectatorA lady had been suffering from erosive lichen planus for over a yr. She had seen oral surgeon, been hospitalised for a week on steroid treatment, chinese herbal medicine….. you name it, she’s tried it. She couldn’t eat , brush her teeth without pain and bleeding.
She was referred to me by a colleague recently. I tried out LLLT with 980nm and the symptoms gradually improve and now she can eat and brush her teeth without any bleeding nor pain.
The symptoms however relapsed slightly after a month. At the time , I had the Erbium Yag for trial. I lased the surface of the lesion. She came back after one week and the area healed very well. She was over the moon with the laser treatment as the visits were short and painless.
Ken -
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