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Zheng T, Liu C, Wang Y, Zhou R, Wu D, Tan J, Zhu K. Efficacy and safety of topical clobetasol propionate in comparison with alternative treatments in oral lichen planus: an updated systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1391754. [PMID: 38854667 PMCID: PMC11162109 DOI: 10.3389/fmed.2024.1391754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
Background Oral lichen planus (OLP) is a relatively common chronic T cell-mediated disease characterized by pain and inflammation. Clobetasol propionate (CLO) is the first-line drug in the treatment of OLP. The meta-analysis aimed to evaluate the efficacy and safety of CLO for treating patients with OLP. Methods PubMed, Embase and Web of Science were systematically searched from the database inception date up to August 2023. There were no restrictions on language or date of publication. The outcomes of our interest were as follows: improvement of clinical signs and/or symptoms, total lesion size, relapse and adverse events. Results A total of 17 RCTs evaluating the effects of CLO were included in this study. The results revealed no significant difference in the clinical score (WMD = 0.14, 95% CI: -0.39, 0.66; p = 0.609) and pain score (WMD = 0.17, 95% CI: -0.44, 0.79; p = 0.582) between CLO and other treatments. However, clinical resolution (RR = 1.61, 95% CI: 1.17, 2.22; p = 0.003) and symptoms improvement (RR = 1.80, 95% CI: 1.17, 2.77; p = 0.008) were significantly different between CLO and other treatments. Moreover, there was a significant reduction in the total lesion size with CLO treatment (WMD = -0.58, 95% CI: -1.03, -0.13; p = 0.011). In addition, CLO showed no statistical incidence of adverse events (RR = 1.46, 95% CI: 0.86, 2.50; p = 0.161) and relapse (RR = 1.56, 95% CI: 0.66, 3.71; p = 0.314) than other therapies. Conclusion This systematic review and meta-analysis of 17 randomized clinical trials supported the long-term application of CLO as an effective regimen in OLP patients.
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Affiliation(s)
- Tao Zheng
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - ChengYong Liu
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - YeTong Wang
- School of Stomatology, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Rong Zhou
- Changsha Hospital for Maternal and Child Health Care, Changsha, Hunan, China
| | - Dan Wu
- Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jin Tan
- Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - KeKe Zhu
- Department of Stomatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
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Arboleda LPA, Pereira TCE, Epstein JB, Migliorati CA, Warnakulasuriya S, Diniz-Freitas M, Lopes MA, Santos-Silva AR. Clinical and Psychosocial Impact of Communication about Oral Potentially Malignant Disorders: A Scoping Review. Dent J (Basel) 2023; 11:209. [PMID: 37754329 PMCID: PMC10530221 DOI: 10.3390/dj11090209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
Delivering bad news has been widely studied in cancer, thus, this scoping review aims to identify the available evidence concerning the communication of oral potentially malignant disorders (OPMDs) and their clinical and psychosocial impacts. A search was performed using electronic databases (Medline/PubMed, Scopus, Embase, and Web of Science) and one grey literature database (Google Scholar). Studies focused on communicating the diagnosis of OPMDs and the patients' perceptions were included. Study selection and data extraction were performed by two authors in a two-phase process. Five publications were included in the qualitative analysis. Differences regarding the study design, population, OPMDs assessed, and outcomes of professional-patient communication were found in each study. Protocols for OPMD communication have not yet been reported and there is a need to standardize strategies as communication skills may provide better clinical outcomes for patients diagnosed with potentially malignant disorders. Although future studies are needed, a brief list recommending the aspects that must be communicated is proposed.
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Affiliation(s)
- Lady P. A. Arboleda
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, SP, Brazil; (L.P.A.A.); (T.C.E.P.); (M.A.L.)
- Graduate Program, A.C. Camargo Cancer Center, São Paulo 01508-020, SP, Brazil
| | - Thaís C. E. Pereira
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, SP, Brazil; (L.P.A.A.); (T.C.E.P.); (M.A.L.)
| | - Joel B. Epstein
- Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Health System, Los Angeles, CA 90048, USA;
- Division of Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA 91010, USA
| | - Cesar A. Migliorati
- Department of Oral & Maxillofacial Diagnostic Sciences, College of Dentistry, University of Florida, Gainesville, FL 32603, USA;
| | - Saman Warnakulasuriya
- WHO Collaborating Centre for Oral Cancer and Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, Londos WC2R 2LS, UK;
| | - Márcio Diniz-Freitas
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Marcio A. Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, SP, Brazil; (L.P.A.A.); (T.C.E.P.); (M.A.L.)
| | - Alan R. Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, SP, Brazil; (L.P.A.A.); (T.C.E.P.); (M.A.L.)
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Frydrych AM, van Schaijik B, Parsons R, Kujan O. Changes in quality of life over time in patients diagnosed with oral leukoplakia: A prospective longitudinal study. J Oral Pathol Med 2023; 52:226-231. [PMID: 36799652 DOI: 10.1111/jop.13415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/07/2022] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Oral leukoplakia (OL) is one of the most prevalent oral potentially malignant disorders (OPMD). Although there is emerging evidence that quality of life (QoL) is impaired in subjects with OL; studies to date are based on single and heterogenous point-in-time assessments. The aim of this study was to ascertain if QoL scores change over time in individuals diagnosed with OL. METHODS Forty-one individuals with OL were administered the Short Generic Health Questionnaire (SF-12) and the discipline-specific Oral Potentially Malignant Disorder Questionnaire (OPMDQ) at four points in time: at the time of clinical diagnosis, at the post-biopsy review (confirmed diagnosis), and at 3- and 6-month follow-up appointments. Responses were compared between the four time points. RESULTS No significant differences were observed in the SF-12 questionnaire scores over time. However, a general improvement in the participants' life quality was evident over the 6-month period under investigation in the domains of psychological and social well-being (p = 0.0027) and effect of treatment on daily life (p = 0.0317) as well as in the total score (p = 0.0005) of the OPMDQ. Age, gender, medical status, tobacco/alcohol use, lesion site, size, the presence of dysplasia and treatment did not impact QoL scores over time. CONCLUSIONS QoL scores of OL subjects may improve with time. Our results suggest that studies examining QoL in individuals with OL should be controlled for time at which the participants are surveyed.
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Affiliation(s)
| | - Bede van Schaijik
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | | | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
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Ashshi RA, Stanbouly D, Maisano PG, Alaraik AF, Chuang SK, Takako TI, Stoopler ET, Le AD, Sollecito TP, Shanti RM. Quality of life in patients with oral potentially malignant disorders: oral lichen planus and oral epithelial dysplasia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:363-371. [PMID: 36549944 DOI: 10.1016/j.oooo.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate and compare quality of life (QoL) parameters in patients with oral potential malignant disorders (OPMDs), namely, oral lichen planus (OLP) and oral epithelial dysplasia (OED). STUDY DESIGN A cross-sectional study was completed at the oral maxillofacial surgery/oral medicine practices at University of Pennsylvania. Patients with clinical and histopathologic confirmation of OLP or OED from January to June 2021 were included in the study. The primary predictor variable was the OPMD type. The primary outcome variable was the score of 3 separate surveys: the Chronic Oral Mucosal Disease Questionnaire-26 (COMDQ-26), Oral Potential Malignant Disorder QoL Questionnaire (OPMDQoL), and Hospital Anxiety and Depression Scale. Multiple linear regression was used to determine independent predictors of increased/decreased questionnaire scores. RESULTS The final study sample consisted of 100 patients:53 patients had OLP (53.0%), 39 patients had OED (39.0%), and 8 patients had OLP with OED (8.0%). Relative to OED, OLP added 15.7 points to the COMDQ-26 survey score (P < .001). Relative to OED, OLP added 8.9 points to the OPMDQoL survey score (P = .003). CONCLUSIONS Oral lichen planus shows significantly poorer QoL specifically within the COMD-26 and OPMDQoL questionnaires, compared with OED. Additionally, patients with OPMDs aged 40 to 64 years were independently associated with higher COMD-26 scores compared with older patients (>65 years).
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Affiliation(s)
- Rawan A Ashshi
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Dani Stanbouly
- School of Dental Medicine, University of Columbia, New York, NY
| | - Pietro G Maisano
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ayman F Alaraik
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sung-Kiang Chuang
- Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Tanaka I Takako
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Eric T Stoopler
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| | - Anh D Le
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
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Serafini G, De Biase A, Lamazza L, Mazzucchi G, Lollobrigida M. Efficacy of Topical Treatments for the Management of Symptomatic Oral Lichen Planus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1202. [PMID: 36673955 PMCID: PMC9859481 DOI: 10.3390/ijerph20021202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Oral lichen planus (OLP) is a chronic mucosal inflammatory disease associated with T-cell-mediated immunological dysfunction. Symptomatic OLP is a painful condition, and complete healing is often not achieved. The aim of this systematic review was to assess the effectiveness of topical drugs, medications, and other interventions compared to placebo or to other treatments in pain reduction and clinical resolution in adult patients with symptomatic OLP. A detailed electronic literature search was performed through the MEDLINE (PubMed) database between 1 January 2005 and 30 September 2022. Eligible studies were selected based on the inclusion criteria, and a quality assessment was conducted. From 649 titles, 121 articles were selected as abstracts, 75 papers were assessed as full text, along with 15 other papers obtained through a manual search. A total of 15 RCTs were finally included in the review process. Because of the significant heterogeneity in the study design of the included studies, no meta-analysis of the data could be performed. Topical corticosteroids represent the first-line treatment in the management of symptomatic OLP due to their efficacy and minimal adverse effects. Calcineurin inhibitors seem to be equally effective and are indicated in recalcitrant cases, extensive lesions, patients susceptible to oral candidiasis, or cases unresponsive to corticosteroids. Other treatments, such as aloe vera, chamomile, isotretinoin, ozone, and laser therapy, could be beneficial as adjunct therapies in association with first-line treatments.
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Affiliation(s)
- Giorgio Serafini
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
| | | | - Luca Lamazza
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
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Li XJ, Li Y, Meng Y, Pu XQ, Qin JW, Xie R, Wang W, Liu Z, Jiang L, Ju XJ, Chu LY. Composite dissolvable microneedle patch for therapy of oral mucosal diseases. BIOMATERIALS ADVANCES 2022; 139:213001. [PMID: 35882148 DOI: 10.1016/j.bioadv.2022.213001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 06/15/2023]
Abstract
A composite microneedle patch (MN patch) is developed for oral transmucosal administration. To improve the oral transmucosal drug delivery efficiency, the composite MN patch is designed to consist of an array of 100 dissolvable microneedles (MNs) with drug-loaded tips and a backing layer. The MNs are composed of two parts, the hyaluronic acid (HA) tip part and the polyvinylpyrrolidone (PVP) base part. Due to the small size and sufficient mechanical strength, the HA-PVP MNs can painlessly penetrate the oral mucosa barrier and deliver drugs directly to the basal layer or submucosa. Betamethasone sodium phosphate (BSP), as the model drug, is concentrated in the HA tip parts to avoid the drug waste caused by mucosa elasticity. Considering the special moist environment and saliva flow in the mouth, a double-layer backing layer composed of a poly(vinyl alcohol) (PVA) adhesive layer and an ethyl cellulose (EC) waterproof layer is designed and constructed, which could reduce the saliva flow effects. The in vitro and in vivo results demonstrate that the MN patch could achieve rapid and efficient BSP release in oral mucosa due to the rapid dissolution of HA. The proposed MN patch provides a novel strategy for the therapy of oral mucosal diseases.
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Affiliation(s)
- Xin-Jiao Li
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Yao Li
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Yang Meng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xing-Qun Pu
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Jia-Wang Qin
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Rui Xie
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Wei Wang
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Zhuang Liu
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
| | - Lu Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Xiao-Jie Ju
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China.
| | - Liang-Yin Chu
- School of Chemical Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, PR China
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Quality of Life in Oral Submucous Fibrosis: A Systematic Review. J Maxillofac Oral Surg 2022; 21:14-24. [PMID: 35400917 PMCID: PMC8934822 DOI: 10.1007/s12663-020-01507-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022] Open
Abstract
Backgrounds Oral submucous fibrosis (OSMF) is a chronic, insidious disease and is said to have a multifactorial origin with varied clinical manifestation of repeated oral ulcers, intolerance to spicy food, mucosal blanching resulting in stiffness of the oral mucosa and formation of taut bands leading to reduced mouth opening. We designed this study to systematically review the literature on QOL in OSMF and hope to make recommendations for future course of QOL assessment in OSMF. Methods An electronic bibliographic search of studies was done from year 1900-2019 using specified keywords. The following databases were searched: PubMed, Ovid, Google Scholar and manual search were done from references of relevant articles. Of the screened 156 articles, finally 10 studies were included after screening for inclusion/exclusion criteria. Quality assessment of studies was completed using the Effective Public Health Practice Project (EPHPP) criteria for quantitative studies. Results Most instruments used in the studies were not disease specific for OSMF except one study. Six types of questionnaires were used. The heterogeneity in study population, study designs, QOL instruments and outcome measures made it difficult for a comparison. Therefore, a quantification analysis was not possible. Also pure OSMF data without the involvement of other lesions were less in number. Conclusions OSMF not only physically debilitates a patient, it has its repercussions on the social, physical, psychological domains as well. Another aspect is that apart from trismus, which is the most common and evident symptom associated with OSMF, a substantial part of the suffering that ensues is also because of the ulcerations, burning sensation and worsening of dental health. Another focus was the association of worse QOL with a higher grade of disease, longer and higher tobacco abuse contact duration. This review is unable to give a confident answer to the evidence on QOL in OSMF but definitely showers light on the evident lack of robust data on the same. Robust Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation methodological and adequately powered studies on assessing QOL in OSMF using only a reliable disease specific questionnaire is the need of the hour. Clinical Trial Registration PROSPERO Registration: CRD42018102874.
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Memon AB, Rahman AAU, Channar KA, Zafar MS, Kumar N. Assessing the Quality of Life of Oral Submucous Fibrosis Patients: A Cross-Sectional Study Using the WHOQOL-BREF Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189498. [PMID: 34574424 PMCID: PMC8464822 DOI: 10.3390/ijerph18189498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 12/20/2022]
Abstract
The aim of the present study was to evaluate the quality of life (QoL) of oral submucous fibrosis (OSMF) patients using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. This cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro. We used the consecutive sampling technique to recruit patients who were clinically diagnosed with OSMF (n = 112). Data were collected using the WHOQOL-BREF questionnaire, which contains a total of 26 questions. The first two questions, related to overall QoL and overall health status, were evaluated separately. The remaining questions (3-26), which represented four domains-physical, psychological, social, and environmental health-were evaluated separately. Patients were asked questions in their native language (Urdu). The relationship between these four domains of life was evaluated with gender, age categories, functional staging, and habit duration using the independent t-test to determine statistical significance. Cronbach's Alpha was used to assess the reliability of the WHOQOL-BREF domains. The overall QoL of the OSMF patients was considerably poor, and the majority of the patients were unsatisfied with their oral health status. The age variable significantly affected the scores of all domains except for social relationships, whereas habit duration and functional staging of OSMF did not significantly affect the scores of all domains. The domains of the WHOQOL-BREF questionnaire (translated into the Urdu language) showed good reliability, except for social relationships.
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Affiliation(s)
- Abdul Bari Memon
- Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan; (A.B.M.); (A.A.U.R.)
| | - Aneela Atta Ur Rahman
- Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan; (A.B.M.); (A.A.U.R.)
- Faculty of Community Medicine and Public Health Sciences, Shaheed Mohtarama Benazir Bhutto Medical University, Larkana 77150, Pakistan
| | - Kashif Ali Channar
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah, Al Munawwarah 41311, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | - Naresh Kumar
- Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan; (A.B.M.); (A.A.U.R.)
- Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi 74200, Pakistan
- Correspondence: ; Tel.: +92-333-2818500
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Su Z, Hu J, Cheng B, Tao X. Efficacy and safety of topical administration of tacrolimus in oral lichen planus: An updated systematic review and meta-analysis of randomized controlled trials. J Oral Pathol Med 2021; 51:63-73. [PMID: 34133803 DOI: 10.1111/jop.13217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/08/2021] [Accepted: 06/04/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Symptomatic oral lichen planus is a common chronic T-cell-mediated disorder characterized by pain and inflammation. The meta-analysis aimed to compare and evaluate the effects and safety of tacrolimus for treating patients with symptomatic oral lichen planus. METHODS A comprehensive literature review was performed, including PubMed, the Cochrane Library, Embase, and Web of Science published up to and including December 2020. ClinicalTrials.gov was searched for ongoing trials. There were no restrictions on language or date of publication. Using the Cochrane Collaboration tool, we assessed the risk of bias for randomized controlled trials and estimated the proportion of between-trial heterogeneity. RESULTS A total of 9 RCTs evaluating the effects of tacrolimus were included in this study. The results revealed no significant difference in clinical resolution and relapse between tacrolimus and corticosteroids. However, tacrolimus may be more likely to cause mild adverse effects. In particular, clinical resolution was not significantly different between tacrolimus and clobetasol propionate, and between tacrolimus and triamcinolone acetonide, while tacrolimus was more likely to cause adverse effects than triamcinolone acetonide and clobetasol propionate. Moreover, there was no significant difference in pain resolution between tacrolimus and clobetasol. Furthermore, adverse effects were not significantly different between tacrolimus and pimecrolimus. CONCLUSIONS This systematic review and meta-analysis of 9 clinical trials supported the short-term application of tacrolimus as an effective regimen in OLP patients resistant to other topical and systemic therapies. Furthermore, the adverse effects of tacrolimus were minor and transient and did not affect tacrolimus' continued application.
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Affiliation(s)
- Zhangci Su
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Jiaqi Hu
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Bin Cheng
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoan Tao
- Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Kumar K, Khandpur M, Khandpur S, Mehrotra D, Chandra Tiwari S, Kumar S. Quality of life among Oral Potentially Malignant Disorder (OPMD) patients: A prospective study. J Oral Biol Craniofac Res 2020; 11:88-91. [PMID: 33384918 DOI: 10.1016/j.jobcr.2020.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 11/06/2020] [Indexed: 11/29/2022] Open
Abstract
Objective The purpose of this study was to evaluate the quality of life among the Oral Potentially Malignant Disorder (OPMD) patients during diagnosis, at one month and 3 months after intervention (surgical or conservative). Methods The University of Washington Quality of Life version (4UWQOL v4) and World Health Organization (WHO-BREF) were repeatedly administered on 54 OPMD patients. Results The results of Friedman's ANOVA showed a statistically significant change in the mean scores for pain, activity, speech, shoulder, taste, saliva, mood, and anxiety domains of UWQOL with time, (p-value <0.05); while physical health, social relationships, environment domains of WHO- BREF have shown significant changes in their respective mean scores. Conclusion The assessment of Quality of Life (QOL) should routinely be done by the clinicians. If the clinicians start considering the QOL as the primary outcome of a treatment protocol, it will enhance patients' identity, well-being, and personality.
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Affiliation(s)
- Kapila Kumar
- Department of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, UP, India
| | - Mani Khandpur
- Department of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, UP, India
| | - Sukhanshi Khandpur
- Department of Molecular Medicine & Biotechnology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, UP, India
| | - Divya Mehrotra
- Department of Oral & Maxillofacial Surgery, King George's Medical University, Lucknow, UP, India
| | - Sarvada Chandra Tiwari
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, UP, India
| | - Sumit Kumar
- Department of Health Research- Multidisciplinary Research Unit (DHR-MRU), King George's Medical University, Lucknow, UP, India
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11
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Lodi G, Manfredi M, Mercadante V, Murphy R, Carrozzo M. Interventions for treating oral lichen planus: corticosteroid therapies. Cochrane Database Syst Rev 2020; 2:CD001168. [PMID: 32108333 PMCID: PMC7047223 DOI: 10.1002/14651858.cd001168.pub3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a relatively common chronic T cell-mediated disease, which can cause significant pain, particularly in its erosive or ulcerative forms. As pain is the indication for treatment of OLP, pain resolution is the primary outcome for this review. This review is an update of a version last published in 2011, but focuses on the evidence for corticosteroid treatment only. A second review considering non-corticosteroid treatments is in progress. OBJECTIVES To assess the effects and safety of corticosteroids, in any formulation, for treating people with symptoms of oral lichen planus. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 25 February 2019: Cochrane Oral Health's Trials Register, CENTRAL (2019, Issue 1), MEDLINE Ovid, and Embase Ovid. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. There were no restrictions on language or date of publication. SELECTION CRITERIA We considered randomised controlled clinical trials (RCTs) of any local or systemic corticosteroid treatment compared with a placebo, a calcineurin inhibitor, another corticosteroid, any other local or systemic (or both) drug, or the same corticosteroid plus an adjunctive treatment. DATA COLLECTION AND ANALYSIS Three review authors independently scanned the titles and abstracts of all reports identified, and assessed risk of bias using the Cochrane tool and extracted data from included studies. For dichotomous outcomes, we expressed the estimates of effects of an intervention as risk ratios (RR), with 95% confidence intervals (CI). For continuous outcomes, we used mean differences (MD) and 95% CI. The statistical unit of analysis was the participant. We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE. MAIN RESULTS We included 35 studies (1474 participants) in this review. We assessed seven studies at low risk of bias overall, 11 at unclear and the remaining 17 studies at high risk of bias. We present results for our main outcomes, pain and clinical resolution measured at the end of the treatment course (between one week and six months), and adverse effects. The limited evidence available for comparisons between different corticosteroids, and corticosteroids versus alternative or adjunctive treatments is presented in the full review. Corticosteroids versus placebo Three studies evaluated the effectiveness and safety of topical corticosteroids in an adhesive base compared to placebo. We were able to combine two studies in meta-analyses, one evaluating clobetasol propionate and the other flucinonide. We found low-certainty evidence that pain may be more likely to be resolved when using a topical corticosteroid rather than a placebo (RR 1.91, 95% CI 1.08 to 3.36; 2 studies, 72 participants; I² = 0%). The results for clinical effect of treatment and adverse effects were inconclusive (clinical resolution: RR 6.00, 95% CI 0.76 to 47.58; 2 studies, 72 participants; I² = 0%; very low-certainty evidence; adverse effects RR 1.48, 95% 0.48 to 4.56; 3 studies, 88 participants, I² = 0%, very low-certainty evidence). Corticosteroids versus calcineurin inhibitors Three studies compared topical clobetasol propionate versus topical tacrolimus. We found very low-certainty evidence regarding any difference between tacrolimus and clobetasol for the outcomes pain resolution (RR 0.45, 95% CI 0.24 to 0.88; 2 studies, 100 participants; I² = 80%), clinical resolution (RR 0.61, 95% CI 0.38 to 0.99; 2 studies, 52 participants; I² = 95%) and adverse effects (RR 0.05, 95% CI 0.00 to 0.83; 2 studies, 100 participants; very low-certainty evidence) . One study (39 participants) compared topical clobetasol and ciclosporin, and provided only very low-certainty evidence regarding the rate of clinical resolution with clobetasol (RR 3.16, 95% CI 1.00 to 9.93), pain resolution (RR 2.11, 95% CI 0.76 to 5.86) and adverse effects (RR 6.32, 95% CI 0.84 to 47.69). Two studies (60 participants) that compared triamcinolone and tacrolimus found uncertain evidence regarding the rate of clinical resolution (RR 0.86, 95% CI 0.55 to 1.35; very low-certainty evidence) and that there may be a lower rate of adverse effects in the triamcinolone group (RR 0.47, 95% CI 0.22 to 0.99; low-certainty evidence). These studies did not report on pain resolution. AUTHORS' CONCLUSIONS Corticosteroids have been first line for the treatment of OLP. This review found that these drugs, delivered topically as adhesive gels or similar preparations, may be more effective than placebo for reducing the pain of symptomatic OLP; however, with the small number of studies and participants, our confidence in the reliability of this finding is low. The results for clinical response were inconclusive, and we are uncertain about adverse effects. Very low-certainty evidence suggests that calcineurin inhibitors, specifically tacrolimus, may be more effective at resolving pain than corticosteroids, although there is some uncertainty about adverse effects and clinical response to tacrolimus showed conflicting results.
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Affiliation(s)
- Giovanni Lodi
- University of MilanDepartment of Biomedical, Surgical and Dental SciencesVia Beldiletto 1/3MilanItaly20142
| | - Maddalena Manfredi
- University of ParmaPolo Clinico di Odontostomatologia, SBiBiT DepartmentVia Gramsci, 14ParmaItaly43100
| | - Valeria Mercadante
- University College of LondonEastman Dental Institute256 Gray's Inn RoadLondonUKWC1X 8LD
| | - Ruth Murphy
- Sheffield Children's NHS Foundation TrustDepartment of Dermatology, Sheffield Children's HospitalSheffieldUKS10 2JF
| | - Marco Carrozzo
- University of Newcastle upon TyneDepartment of Oral Medicine, School of Dental SciencesFramlington PlaceNewcastle upon TyneUKNE2 4BW
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Min Ang X, Chi Khang Au P, Kwok K, Yeon Park K, Kujan O, Frydrych AM, Farah CS. Quality of life in patients with oral leukoplakia. J Oral Pathol Med 2019; 48:574-580. [PMID: 31172584 DOI: 10.1111/jop.12897] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Oral leukoplakia (OL) is the most common oral potentially malignant disorder, yet despite its chronic and potentially disabling nature, the literature concerning impacts of OL on quality of life (QoL) is limited. This study aimed to evaluate QoL in subjects with OL compared to controls using QoL questionnaires. METHODS Fifty individuals with OL and 50 controls matched for age, gender, smoking, and alcohol use were administered the Short Generic Health Questionnaire (SF-12) and the discipline-specific Oral Potentially Malignant Disorder Questionnaire (OPMDQ). Responses were compared between the two groups. RESULTS Subjects with OL reported poorer QoL scores compared to controls in two domains "Role limitations due to physical problems" and "Pain" of the SF-12 questionnaire, and in two domains "Difficulty with diagnosis" and "Effect of treatment on daily life" and in the overall scores of the OPMDQ. Females reported poorer QoL in the overall OPMD QoL score and in the domains of "Physical and function limitation" and "Psychological and social well-being," while older individuals in the domains of "Physical and function limitation" and "Effect of treatment on daily life." Non-alcohol drinkers and subjects with dysplastic or non-homogeneous OLs also reported poorer QoL scores. CONCLUSIONS Quality of life assessments provide useful insight into the impact of OL on an individual's life and opportunity to improve clinical care.
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Affiliation(s)
- Xin Min Ang
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Phil Chi Khang Au
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Kevin Kwok
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Ka Yeon Park
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Omar Kujan
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Agnieszka M Frydrych
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia
| | - Camile S Farah
- UWA Dental School, University of Western Australia, Nedlands, Western Australia, Australia.,Australian Centre for Oral Oncology Research & Education, Nedlands, Western Australia, Australia
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Farah CS, Pollaers K, Frydrych A. Management of Premalignant Disease of the Oral Mucosa. HEAD AND NECK CANCER CLINICS 2019. [DOI: 10.1007/978-981-13-2931-9_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Gondivkar SM, Bhowate RR, Gadbail AR, Sarode SC, Patil S. Quality of life and oral potentially malignant disorders: Critical appraisal and prospects. World J Clin Oncol 2018; 9:56-59. [PMID: 30148068 PMCID: PMC6107473 DOI: 10.5306/wjco.v9.i4.56] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/08/2018] [Accepted: 06/28/2018] [Indexed: 02/06/2023] Open
Abstract
Quality of life (QoL) is a vital and often required health outcome measure that is relevant to patient care. A healthy oral cavity enables person to perform daily activities without any limitations. However, any disturbance may result in impaired QoL. The oral health-remains an essential element of people’s health and well-being. In recent years, the tradition of clinical practice and research has been changed by incorporating QoL assessment, as it helps in assessment of patients’ needs and monitoring treatment responses. Oral potentially malignant disorders (OPMDs) are a group of chronic disorders including oral leukoplakia (OL), oral lichen planus and oral submucous fibrosis (OSF). It is evident that patients with OPMDs experience significant health-related symptoms, functional limitations and psycho-social impairment, compromising their QoL. Moreover, the worsening of QoL has been associated with advanced stages of OPMDs. Despite of increasing number of OPMD cases in recent decades, limited literature is available regarding QoL in this population. Although, there is higher prevalence of habit-related OPMDs, particularly OSF and OL in Southern Asian countries, only a few studies have been performed in these populations. Moreover, these studies administered generic QoL instruments, which offer less sensitivity to clinical changes. However, condition-specific instruments are more sensitive and allows better measurement of QoL. As the impacts of different conditions on OHRQoL may vary, the development and validation of a QoL instrument specific to each clinical entity of OPMDs is currently needed.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur 440003, India
| | - Rahul R Bhowate
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College and Hospital, Wardha 442001, India
| | - Amol R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College and Hospital, Nagpur 440003, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411017, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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Gondivkar SM, Bhowate RR, Gadbail AR, Gondivkar RS, Sarode SC, Sarode GS, Patil S. Impact of oral submucous fibrosis on oral health-related quality of life: A condition-specific OHRQoL-OSF instrument analysis. Oral Dis 2018; 24:1442-1448. [DOI: 10.1111/odi.12921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/08/2018] [Accepted: 06/17/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Shailesh M. Gondivkar
- Department of Oral Medicine & Radiology; Government Dental College & Hospital; Nagpur Maharashtra India
| | - Rahul R. Bhowate
- Department of Oral Medicine & Radiology; Sharad Pawar Dental College & Hospital; Wardha Maharashtra India
| | - Amol R. Gadbail
- Department of Dentistry; Indira Gandhi Government Medical College & Hospital; Nagpur Maharashtra India
| | | | - Sachin C. Sarode
- Department of Oral Pathology & Microbiology; Dr. D.Y. Patil Dental College & Hospital; Dr. D. Y. Patil Vidyapeeth; Pune Maharashtra India
| | - Gargi S. Sarode
- Department of Oral Pathology & Microbiology; Dr. D.Y. Patil Dental College & Hospital; Dr. D. Y. Patil Vidyapeeth; Pune Maharashtra India
| | - Shankargouda Patil
- Division of Oral Pathology; Department of Maxillofacial Surgery and Diagnostic Sciences; College of Dentistry; Jazan University; Jazan Saudi Arabia
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Gondivkar SM, Bhowate RR, Gadbail AR, Gaikwad RN, Gondivkar RS, Sarode SC, Sarode GS. Development and validation of oral health-related quality of life measure in oral submucous fibrosis. Oral Dis 2018; 24:1020-1028. [PMID: 29570905 DOI: 10.1111/odi.12857] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 01/30/2018] [Accepted: 03/10/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to develop and assess the validity and reliability of disease-specific oral health-related quality of life (OHRQoL) instrument for oral submucous fibrosis (OSF). MATERIALS AND METHODS Items for the OHRQoL-OSF were generated from personal interviews and focus group discussions, the existing questionnaires, reviews of literature and inputs from expert's panel. Item reduction was performed by clinical impact method followed by pretesting of the developed questionnaire. The validity and reliability of the instrument were then examined. RESULTS Forty-five items were generated from qualitative data and item pooling from various sources. After item reduction, 17 items were finalized with four domain-structure having Eigenvalues greater than 1. OHRQoL-OSF was shown to be valid in distinguishing patients with varying degrees of OSF severity. For the concurrent validity, the observed impact of OSF based on OHRQoL-OSF significantly correlated with Oral Health Impact Profile and global self-ratings of oral health and overall well-being. OHRQoL-OSF and all its domains demonstrated good internal consistency reliability with Cronbach's alpha ˃0.7 and excellent test-retest reliability (ICC = 0.96). CONCLUSION The first disease-specific OHRQoL-OSF instrument appeared to be highly reliable and valid measure for assessing impact of OSF on life quality.
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Affiliation(s)
- S M Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - R R Bhowate
- Department of Oral Medicine & Radiology, SharadPawar Dental College & Hospital, Wardha, Maharashtra, India
| | - A R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India
| | - R N Gaikwad
- Community Oral Health and Epidemiology Department, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
| | | | - S C Sarode
- Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. PatilVidyapeeth, Pune, Maharashtra, India
| | - G S Sarode
- Department of Oral Pathology & Microbiology, Dr. D.Y. Patil Dental College & Hospital, Dr. D.Y. PatilVidyapeeth, Pune, Maharashtra, India
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Gondivkar SM, Gadbail AR, Gondivkar RS, Sarode SC, Sarode GS, Patil S. Impact of oral potentially malignant disorders on quality of life: a systematic review. Future Oncol 2018; 14:995-1010. [PMID: 29561169 DOI: 10.2217/fon-2017-0577] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Although oral potentially malignant disorders (OPMDs) are relatively common and potentially debilitating, literature on quality of life (QoL) in these patients is scanty. The purpose of this paper is to systematically review the literature on QoL in patients with OPMDs. A total of 210 titles were retrieved from electronic and manual databases searched from 1960 until September 2017. Out of these, 25 met our strict inclusion criteria as per the preferred reporting items for systematic reviews and meta-analyses guidelines. Most studies have assessed QoL in patients with oral lichen planus, reports of which cannot be generalized to all patients with OPMD. The findings of the studies differ but, overall, do not provide evidence that OPMD patients have a poorer QoL than healthy subjects.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Amol R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India
| | - Rima S Gondivkar
- 301, Aarti Regency, Mahalakshmi Nagar, Manewada Road, Nagpur, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology & Microbiology, Dr DY Patil Dental College & Hospital, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Gondivkar SM, Bhowate RR, Gadbail AR, Sarode SC, Gondivkar RS, Yuwanati M, Patil S. Quality of Life-related "Patient-reported Outcome Measures" in Oral Submucous Fibrosis Patients. J Contemp Dent Pract 2018. [PMID: 29603708 DOI: 10.5005/jp-journals-10024-2262] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIM The aim of this study was to explore the patients' perspectives about the impact of oral submucous fibrosis (OSF) on life quality. MATERIALS AND METHODS Thirty clinically diagnosed OSF patients with a wide degree of disease severity and diverse range of sociodemographic profile were included in this study. Fourteen participants were interviewed and four focus group discussions were conducted in nonclinical settings. The audio recordings were anonymized, transcribed, and translated in English from Marathi language. Data were analyzed using an in-depth narrative thematic analysis method. RESULTS Four main themes evolved from the interviews: (1) discomfort and functional impairment; (2) psychological wellness; (3) physical wellness, and (4) social wellness. Majority of the participants discussed about discomfort and functional impairment. Participants also reported greater impact of OSF on psychological and social wellness. CONCLUSION This study demonstrated the impact of OSF on different aspects of participant's life. "Discomfort and functional impairment" was noticed to be the most recognized theme by our participants. However, OSF also has impacts on other important domains, namely psychological, social, and physical wellness. CLINICAL SIGNIFICANCE The patient-reported outcome (PRO) measure (PROM) reflects an integral aspect of general health and well-being and thus can be used to elucidate the impact of OSF on the quality of life (QoL) of affected individuals. These patients' perspectives should be taken into consideration along with thorough clinical examination to decide and effectively manage the overall health care needs of the OSF patients.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India, Phone: +919604121273 e-mail:
| | - Rahul R Bhowate
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College & Hospital, Wardha, Maharashtra, India
| | - Amol R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Pune Maharashtra, India
| | - Rima S Gondivkar
- Private Practitioner, Mahalakshmi Nagar, Nagpur, Maharashtra India
| | - Monal Yuwanati
- Department of Oral Pathology and Microbiology, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
| | - Shankargouda Patil
- Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University Jazan, Kingdom of Saudi Arabia
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Abstract
Oral potentially malignant disorders (OPMDs) refer to epithelial lesions and conditions with an increased risk for malignant transformation; oral leukoplakia is the most commonly encountered. Overall, OPMDs have a low risk for malignant transformation, yet the challenge is the difficulty to reliably identify and predict which patients with OPMDs are at the highest risk for malignant transformation. Future research is needed to elucidate the molecular aspects of OPMDs, to improve current diagnostic strategies, leading to personalized management.
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Tadakamadla J, Kumar S, Lalloo R, Gandhi Babu DB, Johnson NW. Impact of oral potentially malignant disorders on quality of life. J Oral Pathol Med 2017; 47:60-65. [PMID: 28766765 DOI: 10.1111/jop.12620] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients. METHODS Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF-12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF-12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS). RESULTS A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, "physical impairment and functional limitations" than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased. CONCLUSIONS OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL.
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Affiliation(s)
- Jyothi Tadakamadla
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
| | - Santhosh Kumar
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, St Lucia, Qld, Australia
| | - Dara Balaji Gandhi Babu
- Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, Telangana, India
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Qld, Australia
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Thomson PJ. Potentially malignant disorders-The case for intervention. J Oral Pathol Med 2017; 46:883-887. [DOI: 10.1111/jop.12626] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2017] [Indexed: 12/18/2022]
Affiliation(s)
- P. J. Thomson
- Oral & Maxillofacial Surgery; School of Dentistry; University of Queensland; Oral Health Centre; QLD Australia
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Biological functions of melatonin in relation to pathogenesis of oral lichen planus. Med Hypotheses 2017; 104:40-44. [DOI: 10.1016/j.mehy.2017.05.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/20/2017] [Accepted: 05/24/2017] [Indexed: 12/21/2022]
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Tadakamadla J, Kumar S, Lalloo R, Johnson NW. Qualitative analysis of the impact of Oral Potentially Malignant Disorders on daily life activities. PLoS One 2017; 12:e0175531. [PMID: 28410381 PMCID: PMC5391936 DOI: 10.1371/journal.pone.0175531] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/28/2017] [Indexed: 01/11/2023] Open
Abstract
Objective To evaluate the impact of Oral Potentially Malignant Disorders (OPMD) on daily life activities. Materials and methods Patients diagnosed with Oral Leukoplakia, Oral submucous fibrosis and Oral Lichen Planus attending the Oral Medicine clinic of Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, India were invited to participate. Eighteen interviews and three focus groups were conducted in a non-clinical setting. Voice recordings were transcribed and translated from Telugu to English. Data coding was performed using the NVivo software. Results Sample size for this qualitative study comprised 32 patients. Four main themes emerged: (1) difficulties with diagnosis and knowledge about the condition, (2) physical impairment and functional limitations, (3) psychological and social wellbeing and (4) effects of treatment on daily life. In a majority of the patients, most of the interview time was spent discussing physical impairment and functional limitations. Patients also reported their mouth condition having a debilitating effect on their psychological well-being and social interactions. Conclusions ‘Physical impairment and functional limitations’ was the most important theme for many of the patients. However, the impacts of OPMD also extended beyond physical impairment and functional limitations to aspects of daily living, notably psychological and social wellbeing.
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Affiliation(s)
- Jyothi Tadakamadla
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
- * E-mail:
| | - Santhosh Kumar
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Newell W. Johnson
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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Pakpour AH, Lin C, Kumar S, Fridlund B, Jansson H. Predictors of oral health‐related quality of life in Iranian adolescents: A prospective study. ACTA ACUST UNITED AC 2017; 9. [DOI: 10.1111/jicd.12264] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/06/2017] [Indexed: 01/07/2023]
Affiliation(s)
- Amir H. Pakpour
- Social Determinants of Health Research CenterQazvin University of Medical Sciences Qazvin Iran
- Department of NursingSchool of Health and WelfareJönköping University Jönköping Sweden
- Department of Natural Science and BiomedicineSchool of Health and WelfareJönköping University Jönköping Sweden
| | - Chung‐Ying Lin
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic University Hung Hom Hong Kong
| | - Santhosh Kumar
- Griffith Health InstituteSchool of Dentistry and Oral Health Gold Coast QLD Australia
| | - Bengt Fridlund
- School of Health and WelfareJönköping University Jönköping Sweden
| | - Henrik Jansson
- Department of Natural Science and BiomedicineSchool of Health and WelfareJönköping University Jönköping Sweden
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Tadakamadla J, Kumar S, Lalloo R, Johnson NW. Development and validation of a quality-of-life questionnaire for patients with oral potentially malignant disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:338-349. [DOI: 10.1016/j.oooo.2016.10.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 10/05/2016] [Accepted: 10/29/2016] [Indexed: 01/02/2023]
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Luengtrakoon K, Wannakasemsuk W, Vichitrananda V, Klanrit P, Hormdee D, Noisombut R, Chaiyarit P. Increased melatonin in oral mucosal tissue of oral lichen planus (OLP) patients: A possible link between melatonin and its role in oral mucosal inflammation. Arch Oral Biol 2017; 78:13-19. [PMID: 28189880 DOI: 10.1016/j.archoralbio.2017.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/03/2017] [Accepted: 02/05/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The existence of extra-pineal melatonin has been observed in various tissues. No prior studies of melatonin in human oral mucosal tissue under the condition of chronic inflammation have been reported. The aim of this study was to investigate the presence of melatonin in oral mucosal tissue of patients with oral lichen planus (OLP) which was considered as a chronic inflammatory immune-mediated disease causing oral mucosal damage and ulcerations. MATERIALS AND METHODS Sections from formalin-fixed and paraffin-embedded oral mucosal tissue of OLP patients (n=30), and control subjects (n=30) were used in this study. Immunohistochemical staining was performed and the semiquantitative scoring system was used to assess the levels of arylalkylamine-N-acetyltransferase (AANAT: a rate-limiting enzyme in the biosynthesis pathway of melatonin), melatonin, and melatonin receptor 1 (MT1) in oral mucosa of OLP patients and normal oral mucosa of control subjects. RESULTS AANAT, melatonin, and MT1were detected in oral mucosal tissue of OLP patients and control subjects. Immunostaining scores of AANAT, melatonin, and MT1 in oral mucosal tissue of OLP patients were significantly higher than those in control subjects (p=0.002, p<0.001, and p=0.031, respectively). CONCLUSIONS Increased levels of AANAT, melatonin, and MT1 in the inflamed oral mucosal tissue of OLP patients imply that chronic inflammation may induce the local biosynthesis of melatonin via AANAT, and may enhance the action of melatonin via MT1.
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Affiliation(s)
- Kirawut Luengtrakoon
- Dental Hospital, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Poramaporn Klanrit
- Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University, Khon Kaen, Thailand; Department of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Doosadee Hormdee
- Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University, Khon Kaen, Thailand; Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Rajda Noisombut
- Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Ponlatham Chaiyarit
- Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University, Khon Kaen, Thailand; Department of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.
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Kularatna S, Whitty JA, Johnson NW, Jayasinghe R, Scuffham PA. A comparison of health state utility values associated with oral potentially malignant disorders and oral cancer in Sri Lanka assessed using the EQ-5D-3 L and the EORTC-8D. Health Qual Life Outcomes 2016; 14:101. [PMID: 27402015 PMCID: PMC4940840 DOI: 10.1186/s12955-016-0502-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 06/29/2016] [Indexed: 11/22/2022] Open
Abstract
Background It has been suggested that the EQ-5D-3 L preference-based measure of health outcome lacks sensitivity to discriminate between health states in cancer patients. An alternative approach is to use a disease (cancer) specific preference-based measure, such as the EORTC-8D. A limited number of comparisons have been made between generic and disease specific preference-based measures. The aim of this study was to compare the utility scores from the EQ-5D-3 L and the EORTC-8D in a group of patients with oral cancer or with oral potentially malignant disorders (OPMD). Methods Patients (n = 151) with OPMD or oral cancer were recruited consecutively from six hospitals in Sri Lanka. All participants completed both the EQ-5D-3 L and the EORTC's QLQC-30 instrument. The Sri Lankan EQ-5D-3 L and EORTC-8D scoring algorithms were employed to estimate utility scores. The utility scores from the two instruments were compared for discrimination, responsiveness and correlation. Results There were significant differences across the two utility scores. The EQ-5D-3 L showed better discrimination than EORTC-8D with higher effect sizes. There were higher ceiling effects observed in the EQ-5D-3 L. There was poor correlation between the dimensions of the two instruments except for the mobility and physical functions. Conclusion The two instruments captured different aspects of quality of life. The EQ-5D-3 L demonstrated better discrimination than the EORTC-8D. In mild conditions EORTC-8D was more responsive and we recommend further validation of this instrument in diverse cancer conditions.
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Affiliation(s)
- Sanjeewa Kularatna
- Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University , 170 Kessels Road, Nathan, 4111, Queensland, Australia. .,Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
| | - Jennifer A Whitty
- Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University , 170 Kessels Road, Nathan, 4111, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia.,School of Pharmacy, The University of Queensland, Queensland, Australia
| | - Newell W Johnson
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Ruwan Jayasinghe
- Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Paul A Scuffham
- Centre for Applied Health Economics, School of Medicine, Nathan Campus, Griffith University , 170 Kessels Road, Nathan, 4111, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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Ferreira AM, de Souza Lucena EE, de Oliveira TC, da Silveira ÉJD, de Oliveira PT, de Lima KC. Prevalence and factors associated with oral potentially malignant disorders in Brazil's rural workers. Oral Dis 2016; 22:536-42. [DOI: 10.1111/odi.12488] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 01/17/2023]
Affiliation(s)
- AM Ferreira
- Sciences Health Post-Graduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - EE de Souza Lucena
- Dentistry Department; State′s University of Rio Grande do Norte; Caicó RN Brazil
| | - TC de Oliveira
- Health Collective Post-Graduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - ÉJD da Silveira
- Oral Pathology Post-Graduate Program; Dentistry Department; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - PT de Oliveira
- Oral Pathology Post-Graduate Program; Dentistry Department; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - KC de Lima
- Health Collective Post-Graduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
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