Prof. Dr. Reem Hanna, BDS, PhD, MSc, PG DipSed, PG DipHE, PG Cert.AP, FAHE, FIADFE
Professor Dr. Reem Hanna is a faculty member at Department of Surgical Sciences and Integrated Diagnostics, University of Genoa (UniGe), where she teaches on Academic Master Degree Programme in Laser Dentistry. She is an Associate Specialist in Department of Oral Surgery at King’s College Hospital in London, UK and an Honorary Associate Professor at UCL-Eastman Dental Institute in London, UK, where she is academic coordinator and lead of Fellowship Courses in Laser Dentistry. Prof. Hanna is a Fellow Academy of Higher Education, UK and International academy of Dento-Facial Esthetic, New York. She achieved her PhD in Photomedicine from UniGe in 2020 with distinction. Prof. Hanna is an Executive Board Member of British Medical Laser Association (BMLA) and Chair of BMLA Scientific Committee and Photobiomodulation Working Group. Prof. Hanna is a senior educator, clinician and experienced researcher. She lectures nationally and internationally on the use of photobiomodulation, antimicrobial photodynamic therapy and surgical lasers for various oral applications and diseases. She has been invited to present her work at several international conferences, as an invited keynote presenter. Prof. Hanna has received publications in over 34 peer reviewed papers on the use of photobiomodulation, aPDT and surgical lasers in various medical and oral applications and wrote two chapters in two books on Photobiomodulation Therapy in wound healing and in management of oral complications induced by head and neck cancer Treatments. In March 2022, Prof. Hanna received” Life Achievement Award” from European Medical Laser Association for recognising her valuable contributions to the laser community.

Title: Oral Neuropathic Pain Management with Photobiomodulation Therapy: A Prospective Analgesic Pharmacotherapy-Paralleled Feasibility Trial

Neuropathic pain (NP) can be challenging to treat effectively as analgesic pharmacotherapy (MED) can reduce pain, but the majority of patients do not experience complete pain relief. Our pilot approach is to assess the feasibility and efficacy of an evidence-based photobiomodulation (PBM) intervention protocol. This would be as an alternative to paralleled standard analgesic MED for modulating NP intensity-related physical function and quality of life (QoL) prospectively in a mixed neurological primary burning mouth syndrome and oral iatrogenic neuropathy study population (n = 28). The study group assignments and outcome evaluation strategy/location depended on the individual patient preferences and convenience rather than on randomisation.
Our prospective parallel study aimed to evaluate the possible pre/post-benefit of PBM and to allow for a first qualitative comparison with MED, various patient-reported outcome measures (PROMs) based on Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT-II) were used for up to a nine-month follow-up period in both intervention groups (PBM and MED). The PBM protocol applied to the PBM group was as follows: λ810 nm, 200 mW, 0.088 cm2, 30 s/point, 9 trigger and affected points, twice a week for five consecutive weeks, whereas the MED protocol followed the NICE guidelines. Our results showed that despite the severe and persistent nature of the symptoms of 57.50 ± 47.93 months at baseline in the PBM group, a notably rapid reduction in PISmax on VAS from 7.6 at baseline (T0) to 3.9 at one-month post-treatment (T3) could be achieved. On the other hand, mean PISmax was only reduced from 8.2 at baseline to 6.8 at T3 in the MED group. Our positive PBM findings furthermore support more patients’ benefits in improving QoL and functional activities, which were considerably impaired by NP such as: eating, drinking and tasting, whereas the analgesic medication regimens did not. No adverse events were observed in both groups. To the best knowledge of the authors, our study is the first to investigate PBM efficacy as a monotherapy compared to the gold standard analgesic pharmacotherapy. Our positive data proves statistically significant improvements in patients’ self-reported NP, functionality, psychological profile and QoL at mid- and end-treatment, as well as throughout the follow-up time points (one, three, six and nine months) and sustained up to nine months in the PBM group, compared to the MED group. Our study, for the first time, proves the efficacy and safety of PBM as a potent analgesic in oral NP and as a valid alternative to the gold standard pharmacotherapy approach. Furthermore, we observed long- term pain relief and functional benefits that indicate that PBM modulates NP pathology in a pro-regenerative manner, presumably via antioxidant mechanisms.