Laser surgical treatment of chronic graft-versus-host disease (cGvHD)-induced buccal mucosal sclerosis

Oral sclerotic chronic graft-versus-host-disease (cGvHD) represents a distinctive phenotype of cGvHD which causes severe disability and morbidity due to impaired oral hygiene and food intake, jaw pain, tightness and discomfort. As it is a rare presentation, there is little published evidence on its management. Here, the case of a patient suffering from stage-2 oral sclerotic cGvHD treated with a bilateral surgical release of fibrous bands performed using a blue light-emitting diode laser (λ=445±5 nm) is presented. This was followed by maintenance of the mouth opening through a specifically designed resin intraoral device. After the laser-assisted surgical procedure, the patient did not experience any bleeding, pain or discomfort, and the mouth opening was increased from 12 mm to 20 mm. Over a 6-month follow-up period, the patient increased and stabilized the mouth opening from 20 mm to 25 mm helping to maintain and improve oral hygiene together with overall comfort and quality of life.