title: Efficacy of photodynamic therapy in the management of oral premalignant lesions. A systematic review.
abstract: OBJECTIVE
  The aim was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral premalignant lesions.
  
  
  METHODS
  The addressed focused question was "Is PDT effective in the management of oral premalignant lesions?" PubMed/Medline, Google-Scholar, EMBASE and ISI Web of Knowledge databases were searched from 1984 till June 2014 using different combinations of the following keywords: photodynamic therapy; oral premalignant lesions; leukoplakia; erythroplakia; erythro-leukoplakia; verrucous hyperplasia; and submucous fibrosis. Review articles, experimental studies, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were not sought. The pattern of the present study was customized to mainly summarize the relevant information.
  
  
  RESULTS
  Thirteen studies were included. In these studies, the number of patients ranged between 5 patients and 147 individuals with mean ages ranging between 51 years and 62.2 years. Oral premalignant lesions, which were investigated were leukoplakia, erythroplakia, erythro-leukoplakia and verrucous hyperplasia. Reported number of premalignant lesions ranged between 5 and 225. Laser wavelength, duration of irradiation and power density were 585-660nm, 60s to 16.6min and 100-150mW/cm(2), respectively. Aminolevulinic acid, chlorine-e6, meta-tetrahydroxyphenylchlorin and photofrin were used as photosensitizer. The frequency of PDT application ranged between once and 12 times. Complete, partial and no response to PDT was shown by 27-100%, 5-50% and 0-25% of pre-malignant lesions, respectively. The recurrence rate of pre-malignant lesions was up to 36%.
  
  
  CONCLUSIONS
  PDT is effective in the overall management of oral premalignant lesions.
authors.affiliation: Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Fahim
authors.initials: F
authors.lastname: Vohra
authors.affiliation: Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11541, Saudi Arabia.
authors.forename: Abdulaziz A
authors.initials: AA
authors.lastname: Al-Kheraif
authors.affiliation: Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden.
authors.forename: Talat
authors.initials: T
authors.lastname: Qadri
authors.affiliation: Department of Restorative Dentistry, Universiti Teknologi MARA, Shah Alam, Malaysia.
authors.forename: Mohamed Ibrahim Abu
authors.initials: MI
authors.lastname: Hassan
authors.affiliation: Department of Laser Dentistry, RWTH Aachen University, Aachen, Germany; Department of Dentistry, Lifecare Hospital, Abu Dhabi, United Arab Emirates.
authors.forename: Asma
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Department of Oral Medicine, King's College London and WHO Collaborating Centre for Oral Cancer and Precancer, London, United Kingdom.
authors.forename: Saman
authors.initials: S
authors.lastname: Warnakulasuriya
authors.affiliation: Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA. Electronic address: fawjav@gmail.com.
authors.forename: Fawad
authors.initials: F
authors.lastname: Javed
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D010778:Photochemotherapy / Q000706:statistics & numerical data*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011230:Precancerous Conditions / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents
keywords: Erythro-leukoplakia; Erythroplakia; Leukoplakia; Oral premalignant lesion; Photodynamic therapy; Verrucous hyperplasia