title: The effect of diode laser and topical steroid on serum level of TNF-alpha in oral lichen planus patients.
abstract: BACKGROUND
  Oral lichen planus (OLP) is a common chronic inflammatory mucosal disease with a multifactorial etiology. It is a T-cell mediated autoimmune disease in which the cytotoxic CD8+T cells trigger apoptosis of the basal cells of oral epithelium. Various treatment regimens have been employed for management of symptomatic OLP. This study was carried out to evaluate the effect of topical steroids as well as laser on the clinical signs and symptoms detected by reticular, atrophic, erosive score (RAE score) and tumor necrosis factor- α (TNF-α) level in the serum of patients with symptomatic OLP.
  
  
  METHODS
  The study was conducted on twenty-four patients (18 females and 6 males) with symptomatic OLP that were allocated into two groups. Each included twelve patients. The first group treated either with diode laser (970nm SIROLaser Advance class IIIb, SIRONA The Dental Company, Germany) twice weekly with maximum of ten sessions while the second group were treated with topical corticosteroids (0.1% triamcinolone acetonide orabase, Kenacort-A Orabase Pomad, DEVA HOLDING A.Ș, Istanbul, Turkey) for four weeks.
  
  
  RESULTS
  Corticosteroids group showed less clinical signs and symptoms of reticular, atrophic, erosive RAE score (p=0.02) and TNF-α serum level (p=0.028) than diode laser group with no reported therapy side effects or complications in any of the treated patients.
  
  
  CONCLUSIONS
  Topical steroids reduce pain, reticular, atrophic, erosive RAE score and TNF-α serum level more than laser treatment. Moreover, laser treatment can be used as an alternative treatment when steroids are contraindicated for the treatment of symptomatic OLP.Key words:Oral lichen planus, diode laser, topical steroid, RAE score, TNF-α.
authors.affiliation: Prof, Dr. Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University.
authors.forename: Nagwa-Abdelhamid
authors.initials: NA
authors.lastname: Othman
authors.affiliation: Prof, Dr. Department of Biochemistry, Faculty of Medicine, Cairo University.
authors.forename: Olfat-Gamil
authors.initials: OG
authors.lastname: Shaker
authors.affiliation: Associate, Prof, Dr. Department of Surgery and Oral Medicine, National Research Center.
authors.forename: Hanaa-Mohamed
authors.initials: HM
authors.lastname: Elshenawy
authors.affiliation: Associate, Prof,Dr. Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University.
authors.forename: Wessam
authors.initials: W
authors.lastname: Abd-Elmoniem
authors.affiliation: PhD. Department of Surgery and Oral Medicine, National Research Center.
authors.forename: Amany-Mohy
authors.initials: AM
authors.lastname: Eldin
authors.affiliation: PhD. Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University.
authors.forename: Mariam-Yehia
authors.initials: MY
authors.lastname: Fakhr