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Published in: Clinical Rheumatology 3/2018

01-03-2018 | Original Article

Low-level laser therapy for xerostomia in primary Sjögren’s syndrome: a randomized trial

Authors: Tania Fidelix, Adriano Czapkowski, Sergio Azjen, Adagmar Andriolo, Pedro Horvath Neto, Virgínia Trevisani

Published in: Clinical Rheumatology | Issue 3/2018

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Abstract

To evaluate the effectiveness of low-level laser therapy (LLLT) in the treatment of xerostomia in primary Sjögren’s syndrome (SS), a randomized clinical trial of patients with dry mouth symptoms associated with primary SS receiving care at a university hospital was conducted. Sixty-six patients were randomly assigned with a 1:1 allocation ratio to receive LLLT (laser group, n = 33) or placebo treatment (placebo group, n = 33). Patients in the laser group received LLLT twice a week for 6 weeks, for a total of 12 treatment sessions. Laser irradiation was performed with an aluminum-gallium-arsenide laser diode at a wavelength of 808 nm, 100-mW output power, and energy density of 4.0 J/cm2 per irradiation point per session. Placebo treatment was performed following the same protocol used for irradiated patients and using the same laser device to mimic a real irradiation, but with no active laser emission and the tip of the laser probe covered with aluminum foil. The outcomes of interest were xerostomia inventory scores, salivary flow rate, salivary beta-2 microglobulin levels, and salivary sodium and chlorine concentrations. Patients in both groups showed no improvement in xerostomia. Likewise, there was no significant improvement in xerostomia inventory scores (p = 0.301) or salivary flow rate (p = 0.643) in either group. There was no difference in salivary beta-2 microglobulin levels, sodium concentration, and chlorine concentration before and after intervention or between the two groups. The LLLT protocol used in this study effected no improvement in xerostomia or salivary flow rate in patients with primary SS. ClinicalTrials.gov Identifier: NCT02066896
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Literature
1.
go back to reference Yannis A, Drosos AA (2012) Epidemiology. In: Ramos-Casals M, Stone JH, Moutsoupoulos HM (eds) Sjögren’s syndrome: diagnosis and therapeutics. Springer-Verlag, New York, pp 1–9 Yannis A, Drosos AA (2012) Epidemiology. In: Ramos-Casals M, Stone JH, Moutsoupoulos HM (eds) Sjögren’s syndrome: diagnosis and therapeutics. Springer-Verlag, New York, pp 1–9
4.
go back to reference Fox RI, Fox CM (2012) Therapy of oral and cutaneous dryness manifestations in Sjögren’s syndrome. In: Ramos-Casals M, Stone JH, Moutsoupoulos HM (eds) Sjögren’s syndrome: diagnosis and therapeutics. Springer-Verlag, New York, pp 517–545CrossRef Fox RI, Fox CM (2012) Therapy of oral and cutaneous dryness manifestations in Sjögren’s syndrome. In: Ramos-Casals M, Stone JH, Moutsoupoulos HM (eds) Sjögren’s syndrome: diagnosis and therapeutics. Springer-Verlag, New York, pp 517–545CrossRef
5.
go back to reference Vivino FB, Al-Hashimi I, Khan Z, LeVeque FG, Salisbury PL 3rd, Tran-Johnson TK, Muscoplat CC, Trivedi M, Goldlust B, Gallagher SC (1999) Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjogren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92-01 Study Group. Arch Intern Med 159:174–181. https://doi.org/10.1001/archinte.159.2.174 CrossRefPubMed Vivino FB, Al-Hashimi I, Khan Z, LeVeque FG, Salisbury PL 3rd, Tran-Johnson TK, Muscoplat CC, Trivedi M, Goldlust B, Gallagher SC (1999) Pilocarpine tablets for the treatment of dry mouth and dry eye symptoms in patients with Sjogren syndrome: a randomized, placebo-controlled, fixed-dose, multicenter trial. P92-01 Study Group. Arch Intern Med 159:174–181. https://​doi.​org/​10.​1001/​archinte.​159.​2.​174 CrossRefPubMed
12.
go back to reference Vidovic Juras D, Lukac J, Cekic-Arambasin A, Vidovic A, Canjuga I, Sikora M, Carek A, Ledinsky M (2010) Effects of low-level laser treatment on mouth dryness. Coll Antropol 34:1039–1043PubMed Vidovic Juras D, Lukac J, Cekic-Arambasin A, Vidovic A, Canjuga I, Sikora M, Carek A, Ledinsky M (2010) Effects of low-level laser treatment on mouth dryness. Coll Antropol 34:1039–1043PubMed
20.
go back to reference Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH (2002) Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558CrossRefPubMedPubMedCentral Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, Pillemer SR, Talal N, Weisman MH (2002) Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 61:554–558CrossRefPubMedPubMedCentral
21.
go back to reference Daniels TE, Whitcher JP (1994) Association of patterns of labial salivary gland inflammation with keratoconjunctivitis sicca. Analysis of 618 patients with suspected Sjögren’s syndrome. Arthritis Rheum 37:869–877CrossRefPubMed Daniels TE, Whitcher JP (1994) Association of patterns of labial salivary gland inflammation with keratoconjunctivitis sicca. Analysis of 618 patients with suspected Sjögren’s syndrome. Arthritis Rheum 37:869–877CrossRefPubMed
23.
go back to reference Schubert MM, Eduardo FP, Guthrie KA, Franquin JC, Bensadoun RJ, Migliorati CA, Lloid CM, Eduardo CP, Walter NF, Marques MM, Hamdi M (2007) A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation. Support Care Cancer 15:1145–1154. https://doi.org/10.1007/s00520-007-0238-7 CrossRefPubMed Schubert MM, Eduardo FP, Guthrie KA, Franquin JC, Bensadoun RJ, Migliorati CA, Lloid CM, Eduardo CP, Walter NF, Marques MM, Hamdi M (2007) A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation. Support Care Cancer 15:1145–1154. https://​doi.​org/​10.​1007/​s00520-007-0238-7 CrossRefPubMed
24.
go back to reference Taroni P, Pifferi A, Torricelli A, Comelli D, Cubeddu R (2003) In vivo absorption and scattering spectroscopy of biological tissues. Photochem Photobiol Sci 2:124–129CrossRefPubMed Taroni P, Pifferi A, Torricelli A, Comelli D, Cubeddu R (2003) In vivo absorption and scattering spectroscopy of biological tissues. Photochem Photobiol Sci 2:124–129CrossRefPubMed
25.
go back to reference Dawson JB, Barker DJ, Ellis DJ, Grassam E, Cotterill JA, Fisher GW, Feather JW (1980) A theoretical and experimental study of light absorption and scattering by in vivo skin. Phys Med Biol 25:695–709CrossRefPubMed Dawson JB, Barker DJ, Ellis DJ, Grassam E, Cotterill JA, Fisher GW, Feather JW (1980) A theoretical and experimental study of light absorption and scattering by in vivo skin. Phys Med Biol 25:695–709CrossRefPubMed
27.
go back to reference Tuner J, Hode L (1996) Laser therapy in dentistry and medicine. Prima Books, Grángesberg Tuner J, Hode L (1996) Laser therapy in dentistry and medicine. Prima Books, Grángesberg
29.
go back to reference Nielsen KP, Zhao L, Stamnes JJ, Stamnes K, Moan J (2008) The optics of human skin: aspects important for human health. In: Bjatness E (ed) Solar radiation and human health. The Norwegian Academy of Science and Letters, Oslo, pp 35–46 Nielsen KP, Zhao L, Stamnes JJ, Stamnes K, Moan J (2008) The optics of human skin: aspects important for human health. In: Bjatness E (ed) Solar radiation and human health. The Norwegian Academy of Science and Letters, Oslo, pp 35–46
30.
go back to reference Spanemberg JC, Figueiredo MA, Cherubini K, Salum FG (2016) Low-level laser therapy: a review of its applications in the management of oral mucosal disorders. Altern Ther Health Med 22:24–31PubMed Spanemberg JC, Figueiredo MA, Cherubini K, Salum FG (2016) Low-level laser therapy: a review of its applications in the management of oral mucosal disorders. Altern Ther Health Med 22:24–31PubMed
31.
go back to reference Fructuoso JG, Moset JM (1987) Randomized double blind study on biostimulatory effect of laser irradiation of the parotid gland in patients suffering of Sjögren syndrome. Invest Clin Laser 1:18–25 Fructuoso JG, Moset JM (1987) Randomized double blind study on biostimulatory effect of laser irradiation of the parotid gland in patients suffering of Sjögren syndrome. Invest Clin Laser 1:18–25
33.
go back to reference Lopes CO, Mas JRI, Zângaro RA (2006) Prevenção da xerostomia e da mucosite oral induzidas por radioterapia com uso do laser de baixa potência. Radiol Bras 39:131–136CrossRef Lopes CO, Mas JRI, Zângaro RA (2006) Prevenção da xerostomia e da mucosite oral induzidas por radioterapia com uso do laser de baixa potência. Radiol Bras 39:131–136CrossRef
37.
go back to reference Asashima H, Inokuma S, Onoda M, Oritsu M (2013) Cut-off levels of salivary beta2-microglobulin and sodium differentiating patients with Sjogren’s syndrome from those without it and healthy controls. Clin Exp Rheumatol 31:699–703PubMed Asashima H, Inokuma S, Onoda M, Oritsu M (2013) Cut-off levels of salivary beta2-microglobulin and sodium differentiating patients with Sjogren’s syndrome from those without it and healthy controls. Clin Exp Rheumatol 31:699–703PubMed
38.
go back to reference Tishler M, Yaron I, Shirazi I, Yaron M (1997) Saliva: an additional diagnostic tool in Sjogren’s syndrome. Semin Arthritis Rheum 27:173–179CrossRefPubMed Tishler M, Yaron I, Shirazi I, Yaron M (1997) Saliva: an additional diagnostic tool in Sjogren’s syndrome. Semin Arthritis Rheum 27:173–179CrossRefPubMed
40.
go back to reference Nuñez SC (2012) Introdução da terapia laser de baixa potência na clínica odontológica. In: Garcez AS, Ribeiro MS, Nuñez SC (eds) Laser de baixa potência: princípios básicos e aplicações clínicas na odontologia. Elsevier, Rio de Janeiro, pp 81–90 Nuñez SC (2012) Introdução da terapia laser de baixa potência na clínica odontológica. In: Garcez AS, Ribeiro MS, Nuñez SC (eds) Laser de baixa potência: princípios básicos e aplicações clínicas na odontologia. Elsevier, Rio de Janeiro, pp 81–90
Metadata
Title
Low-level laser therapy for xerostomia in primary Sjögren’s syndrome: a randomized trial
Authors
Tania Fidelix
Adriano Czapkowski
Sergio Azjen
Adagmar Andriolo
Pedro Horvath Neto
Virgínia Trevisani
Publication date
01-03-2018
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 3/2018
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-017-3898-9

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