Treatment options for oral Leukoplakia: a review

Aim: the aim of this work was to highlight the most important findings regarding treatment options for oral leucoplakia, a white lesion with a potentially malignant evolution. There are several forms of oral leukoplakia with a various rate of malignant transformation, related to alcohol and tobacco consumption, gender, population, lesion size and type and level of dysplasia. Methods: two databases (Medline via PubMed, Web of Science) were searched up to July 2022 and the most relevant papers on the topic were selected. Hand search was carried out too focusing on new and promising techniques regarding oral leukoplakia management options. Only papers written in English or Spanish were included in the research. Results: the management options for oral leukoplakia are varied and diverse, they may involve a regime of observation with use of new and promising salivary biomarkers, a topical or systemic use of drugs, a surgical approach including laser ablation or a non-surgical approach using photodynamic therapy (PDT). There is a rising interest in PDT, which proved to be an interesting minimally invasive approach for oral leukoplakia, reducing lesions size or removing the lesion in its totality, de-pending on the histopathological stage of the lesions and other variables linked to the type of PDT and the number of sessions. PDT works through the interaction between a light source and a chemical dye or photosensitizer in the presence of oxygen resulting in the formation of reactive oxygen species (ROS), which cause oxidative damage. Conclusions: despite promising results, longer clinical trials are required in order to define a protocol, evaluate potential side effects of PDT and demonstrate its effectiveness.