PMC10351595_01
A 24-year-old male with RAS. (A and B) Ulcers at first visit on the right upper labial mucosa and left buccal mucosa. (C and D) Application of PBM to ulcers. (E and F) Lesion at the third visit (day 21) showed an improvement.
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Intraoral examination revealed two rounded confluent ulcers on the right upper labial mucosa and one ulcer on the left buccal mucosa, 8-10 mm in diameter, covered by whitish pseudomembranous and surrounded by an erythematous halo with a regular border (Figure 1A and B). The patient was treated for PBM using a 976 nm diode laser (Figure 1C and D). The lesions showed a significant improvement at a follow-up of 21 days after treatment (Figure 1E and F).
PMC10351595_02
A 38-year-old woman with chronic oral ulcer. (A) Ulcer on left labial and buccal mucosa. (B) Toluidine blue examination: no malignancy possibilities. (C) On the next visit (2 months), ulcer condition after histopathological biopsy along with stricture release procedure. (D) Ulcer on the right buccal mucosa. (E) Application of PBM to ulcers. (F) Lesion condition in the fourth visit (day 28) showed cicatricial/fibrotic tissue formation.
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Intraoral examination revealed an oval, concave ulcer, 10 mm in diameter, with an irregular border, and granulation on palpation on the left labial mucosa, the ulcer on the left buccal mucosa was difficult to evaluate (Figure 2A). Toluidine blue examination did not indicate malignancy (Figure 2B). There was cicatricial/fibrotic tissue formation on the healed lesion (Figure 2C). Intraoral examination revealed an oval, concave ulcer, 11 mm in diameter, with an irregular border, and granulation on palpation on the right buccal mucosa (Figure 2D). The patient was treated for PBM using 976 nm diode laser (Figure 2E). There was significant improvement of the lesions and pain reduction after the fourth visit (day 28) (Figure 2F).
(A and B) Histopathological examination results: PMN inflammatory cells and lymphocyte inflammatory cells (indicated by a black arrow on (A), plasma cells, accompanied by proliferation and dilatation of blood vessels, salivary gland acini, and tubular ductile (with 100x magnification) (indicated by a black arrow on (B). (C) Panoramic radiograph: no abnormalities. (D) USG Thyroid: within normal range, lymph node enlargement as high as level IIb colli dextra (E and F) head CT-scan (with contrast): did not show bone destruction, mass, and intracranial lesion, lymph node enlargement as high as level IIb colli dextra.
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The thyroid ultrasonography and head CT-scan showed no abnormalities and no possibility of metastasis (Figure 3D-F). Panoramic radiograph findings showed root radix 15, 16, 38, 45 and root radix with periapical abscess 48 (Figure 3C). The histopathological examination of the previous ulcer did not indicate malignancy, and the condition leads to non-specific chronic sialadenitis at the inferior of labial mucosa and the buccal mucosa sinistra (Figure 3A and B).
PMC10351595_03
A 16-year-old man with TUGSE. (A) Ulcer on the right labial mucosa (B) Ulcer condition at the second visit (day 7) (C) Application of PBM to ulcers. (D) The fourth visit (day 21): ulcer lesion showed an improvement.
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Intraoral examination revealed an oval, concave ulcer, 10 mm in diameter, with an irregular border, and granulation on palpation (Figure 4A). Intraoral findings revealed an oval, concave ulcer, 8 mm in diameter, with an irregular border, and granulation on palpation (Figure 4B). The patient was treated with PBM using a 976 nm diode laser (Figure 4C). The lesion was improved after three sessions of PBM (day 21) (Figure 4D; Table 3).
PMC10351595_04
A 63-year-old woman with PHN. (A) Dry crusts on the right portion of the face, preceded by multiple vesicles with an erythematous area (picture taken by the patient). (B) The condition on the first visit: extraoral findings showed multiple blackish-brown patches. (C) Intraoral findings showed multiple ulcers on the right portion of labial mucosa (picture taken by the patient). (D)The condition on the first visit: intraoral findings showed no lesion.
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Two weeks before, it had been preceded by multiple vesicles, redness, and lump on the right face accompanied with painful multiple ulcers on the right side of the oral cavity (the patient gave us the clinical picture that was taken by herself; Figure 5A and C). Extraoral findings revealed multiple blackish-brown patches, varying in size from 3 to 10 mm, with a diffuse and irregular border on the right side of the face (Figure 5B). Intraoral findings showed no abnormalities on the mucosal surface, root radix on 15, 14, 12, 11, 22, and edentulous area from 35 to 37, 45 to 47 (Figure 5D).
The PBM procedure. Laser irradiation following the dermatomal pattern (A) nearby trigeminal ganglion, (B) along with ophthalmic nerve (V1), (C) along with maxillary nerve (V2), and (D) along with mandibular nerve (V3).
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The patient felt immediate pain reduction with the VAS score after PBM was 4 (Figure 6).