Curcumin-mediated Photodynamic Therapy Versus Photobiomodulation in the Treatment of Oral Erosive Lichen Planus

Background: Oral Lichen Planus (OLP) is a chronic, T-cell-mediated inflammatory disease of the oral mucosa, with the erosive form causing painful ulcerations and erosions, significantly impacting the patient's quality of life and carrying a risk of malignant transformation. While corticosteroids remain the first-line treatment, their long-term use is limited by significant local and systemic side effects. Consequently, there is a critical need for effective, non-invasive and safe alternative therapies. Photodynamic Therapy (PDT) and Photobiomodulation (PBM) have emerged as promising light-based modalities. Curcumin, a natural polyphenol, has gained attention as a safe and effective photosensitizer for PDT due to its anti-inflammatory and antioxidant properties. Aim: This clinical trial aims to evaluate and compare the effect of nano-curcumin formulation incorporated into biodegradable mucoadhesive gel as a photosensitizer for Photodynamic Therapy (PDT) versus Photobiomodulation (PBM) in the treatment of oral erosive lichen planus.

Inclusion Criteria: * Patients diagnosed clinically and histopathologically with erosive oral lichen planus without dysplastic features based on WHO criteria * Patients diagnosed with oral erosive lichen planus refractory to conventional treatment * Patients complaining of painful lesions with pain threshold at a minimum value of 4 on a standard Numerical Rating Scale (NRS) * Therapeutic Washout: Absolute suspension of all localized or systemic corticosteroid / immunosuppressive regimens for at least 4 weeks prior to structural baseline evaluations Exclusion Criteria: * Pregnant or lactating females due to lack of standard safety parameters. * Presence of secondary concurrent multi-system autoimmune pathologies. * Lichenoid reactions: Lesions exhibiting definitive spatial localization to dental amalgam margins or secondary to active drug induction. * Diagnosed systemic photosensitivity syndromes or secondary utilization of systemic photosensitizing therapeutic agents. * Smokers * Bad oral hygiene , severe periodontal disease * Underlying systemic diseases like diabetes , hypertension , cardiac patients , pace makers * Patients with extra oral manifestations