Efficacy of injectable platelet-rich fibrin in the erosive oral lichen planus: a split-mouth, randomized, controlled clinical trial (original) (raw)
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2021
Objectives: Oral lichen planus could be a doubtless malignant autoimmune disease, characterized by burning and pain that reduces the standard of patient's life. Treatment of OLP remains a significant challenge despite the recent advances in understanding the immunopathogenesis. The properties of Platelet-rich plasma suggested its application in clinical practice for treatment of OLP patients that do not respond to conventional therapy. This study aims to evaluate the effectiveness of intralesional Platelet rich Plasma in treatment of Erosive lichen planus. Materials and methods: The study sample consisted of 10 patients of erosive OLP among which were given intralesional PRP. All the patients were given weekly injections for 4 weeks. The two fundamentals variables used for assessment of the patient is pain control and healing of the lesion. Each visit consists of measuring the target lesion size and pain evaluation by Visual analogue scale (VAS) . Results: No serious adverse rea...
Alexandria Dental Journal, 2019
INTRODUCTION: Oral lichen planus is a common chronic inflammatory muco-cutaneous disease. Although the cause of oral lichen planus is not well known, T-lymphocyte infiltrate suggests a cell mediated immunological damage to basal cell layer of the epithelium. Its suggested treatment is topical corticosteroid. A promising new treatment for oral lichen planus [OLP] is the topical application of hyaluronic acid [HA], which has shown beneficial effect on wound healing. OBJECTIVES: to evaluate the effect of hyaluronic acid gel in the treatment of erosive oral lichen planus in comparison with topically applied corticosteroids. MATERIALS AND METHODS: a randomized, parallel, controlled clinical study was conducted on twenty patients who were randomly divided into two groups. Group I received topical application of corticosteroid (triamcinolone acetonide) 4-5 daily, for 28 days and Group II was similarly treated using hyaluronic acid 0.2% gel. Subjective symptom and Visual Analogue Scale (VAS) were recorded at base line, after 10 days and at 3 months. The objective sign clinical score was recorded at baseline, 1 and 3 months post-treatment. RESULTS: Both groups showed decrease in the lesion size and symptoms of OLP. The HA treated group showed a significantly higher decrease in the pain score in comparison to the corticosteroid treated group. Regarding the healing score, the corticosteroid group showed superior results than that shown with the HA. CONCLUSIONS: HA 0.2% gel is effective in the treatment of OLP, it resulted in a decrease in symptoms and signs of the disease. HA resulted in more control of pain when compared to topical corticosteroid.
Interventions for treating oral lichen planus
The Cochrane library, 2011
Pain (VAS), clinical score (weighted area) Volz 2008 24 Germany Group A: 10 (10) Group B: 10 (10) Group A: pimecrolimus cream 1%, twice daily, for 30 days Group B: placebo, twice daily, for 30 days Pain (VAS), clinical score (composite score), adverse effects Voute 1993 17 Netherlands Group A: 20 (20) Group B: 20 (209) Group A: fluocinonide in adhesive cream (0AE025%) at least 6 times a day, for 9 weeks Group B: placebo at least 6 times a day, for 9 weeks Pain (5-grade score), clinical score (5-grade score) Wei 2003 40 China Group A: 37 (37) Group B: 20 (20) Group A: alternative use of Mycostatin (nystatin) paste and dexamethasone paste (twice daily each), for 6 weeks Group B: dexamethasone paste (four times daily each), for 6 weeks Clinical score (4-grade score) Xiong 2009 39 China Group A: 31 (28) Group B: 25 (25) Group A: Bacillus Calmette-Guérin polysaccharide nucleic acid, 0AE5 mL intralesional injection every other day, until either erosive lesion disappeared or for 2 weeks. Total 6 injections Group B: triamcinolone acetonide 10 mg (0AE25 mL from solution 40 mg mL)1) mixed 0AE25 mL 2% lidocaine solution, intralesional injection, once a week, for 2 weeks. Total 2 injections Pain (VAS), clinical score (erosive area), adverse reactions
Contemporary Clinical Dentistry, 2015
Aim: Oral lichen planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of selenium combined with Vitamins A, C & E (Selenium-ACE) in the treatment of erosive-ulcerative OLP as an adjunctive to topical corticosteroids plus antifungal agent. Subjects and Methods: Thirty patients with a confirmed clinical and histopathologic diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of three groups and treated as follows: (I) Topical corticosteroids, (II) topical corticosteroids plus antifungal, and (III) SE-ACE combined with topical corticosteroids plus antifungal. The patients were followed for 6 weeks. The pain and severity of the lesions were recorded at the initial and follow-up visits. All recorded data were analyzed using paired t-test and ANOVA test. A P ≤ 0.05 was considered significant. Results: The experimental groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period, but there was no significant difference between the first two Groups I and II. However, healing of lesions and improvement of pain sensation was effective in Group III since a significant difference was found favoring Group III over both Groups I and II. Conclusion: No significant difference was found in treating erosive-ulcerative lesions of OLP by topical corticosteroids alone or combined with antifungal. However, when using SE-ACE in combination with topical corticosteroids plus antifungal, this approach may be effective in managing ulcerative lesions of OLP; but more research with a larger sample size and a longer evaluation period may be recommended.
INTERNATIONAL JOURNAL OF ORAL HEALTH AND MEDICAL RESEARCH, 2020
Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder.OLP is classified as reticular, papular, plaque-like, atrophic, erosive, bullous, and erythematous types. The atrophic, erosive, and bullous forms are generally associated with symptoms ranging from a mild burning sensation to severe pain. Its prevalence has been reported between 1% and 18.2%. Malignant transformation seems to be more likely in erosive lesions, possibly due to the exposure of the deeper epithelial layers to oral environmental carcinogens. Oral lesions of OLP are difficult to control and are often refractory to conventional therapies such as topical corticosteroids. The latter is widely accepted as the primary treatment of choice. The greatest disadvantage of topical therapy of OLP lesions is the lack of sufficient mucosal adherence. In addition, one-third of erythematous OLP patients treated with topical corticosteroids develop secondary candidiasis, which mandates to be treated. Another disadvantage of prolonged use of these drugs is tachyphylaxis, a decrease in their biological effectiveness. Considering the resistance to topical treatments in some patients affected with erythematous OLP and other disadvantages, several studies have found an alternative effective treatment of erythematous oral lichen planus, which is low-level laser therapy (LLLT). The LLLT (LLLT 630-nm diode laser) has proven minimal side effects such as rapid hemostasis, immediate relief, and healing process acceleration. Studies have revealed that the association of local application of steroids and LLLT give a better efficient outcome. The aim of our paper is to demonstrate, through a clinical case report, the effectiveness of the combination of local corticosteroids and LLLT in treating erythematous OLP.
Egyptian Dental Journal
Trial design: The study is a randomized clinical placebo-controlled trial in parallel groups 1:1 allocation ratio. Methods: 30 patients with erosive oral lichen planus were randomly assigned to receive either platelet lysate mucoadhesive gel or placebo vehicle gel 3 times per day for 4 weeks. Outcomes: Assessment of outcomes included a visual analog scale (VAS) for pain as a primary outcome, and the secondary outcomes included improvement in the clinical picture according to Thongprasom sign score and any side effects of treatment. Results: Results had shown a significant reduction of both pain and clinical scores in both groups at 2, 3, and 4 weeks and at 3 months of follow-up and a significant difference in pain and clinical scores between the intervention and control group at each visit as well as at 3 months follow up in which the intervention had greater pain reduction and clinical improvement. Conclusion: Platelet lysate mucoadhesive gel is a promising material for managing erosive OLP and could be considered a suitable, safe, and easy alternative to other hemo-derived products. However, further larger randomized controlled trials are recommended.
Journal of the European Academy of Dermatology and Venereology, 2013
BackgroundOral lichen planus (OLP) is a chronic inflammatory disease, affecting nearly 1–2% of the population; Proposed therapies are usually symptomatic and numerous drugs have been used, but recently, it has been published that there is insufficient evidence to support the effectiveness of any specific treatment as being superior. To the best of our knowledge, direct evaluation of the efficacy of topically applied pimecrolimus and tacrolimus in the treatment of atrophic‐erosive OLP, refractory to topical steroids, is still lacking.ObjectivesTo assess the efficacy and safety of topical calcineurin inhibitors for unresponsive OLP. An 8 week randomized, double‐blind controlled trial, followed by a 6 month follow‐up period. Patients were treated with either pimecrolimus 1% cream or tacrolimus 0.1% ointment, both mixed with an equivalent amount of 4% hydroxyethyl cellulose gel. The medications were to be applied twice daily for 2 months. Each patient was examined at the beginning of th...
Healthcare, 2021
Photobiomodulation (PBM) therapy is a promising approach for the management of inflammatory conditions and autoimmune lesions, such as oral lichen planus (OLP). The aim of this retrospective study was to assess the effectiveness of PBM in the management of painful and erosive/ulcerative OLP and to compare it with the standard of care that is the topical application of corticosteroids. 96 patients were included with erosive and painful OLP. 48 patients received PBM therapy and 48 received corticosteroids. Data was collected retrospectively on pain using the visual analogue scale; clinical aspects of lesions were assessed with the REU score, and the recurrence rate was noted. One session of PBM therapy with a helium-neon red light (635 nm) was carried out every 48 h for 6 weeks. Treatments were mainly made in contact mode, using a fiber with a diameter of 600 µm (0.6 mm). The output power of the laser beam was calibrated by a power meter. A delivered power of 0.1 W was used for 40 s i...
International journal of basic and clinical pharmacology, 2023
Platelet-rich plasma (PRP) is a simple, efficient, and minimally invasive method of obtaining a natural concentration of autologous growth factors (GFs). Generation of PRP involves centrifugation of autologous blood to separate and extract the plasma and buffy coat portion of the blood, which contain high concentrations of platelets. PRP has established use in the fields of dentistry, dermatology, plastic and maxillofacial surgery, acute trauma, cosmetic surgery, and veterinary medicine. The rationale for the widespread use of PRP in the healing process of such varied tissue types resides in the fact that platelets represent an easily accessible reservoir of critical