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Roccon A, Cavallin F, Zanette G, Bacci C. Single session of laser photobiomodulation for symptom management of oral lichen planus: a retrospective study. Lasers Med Sci 2023; 38:43. [PMID: 36656450 PMCID: PMC9849837 DOI: 10.1007/s10103-023-03706-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023]
Abstract
This study aimed to evaluate the effectiveness of a single session of laser photobiomodulation (PBM) with flat top handpiece in reducing painful symptoms in patients with Oral Lichen Planus (OLP). The clinical charts of 20 patients of the Dental Clinic of University of Padua (Italy) who underwent a single laser PBM to manage OLP symptomatology were retrospectively analyzed. A 980 nm diode laser and a flat top handpiece with a 1-cm2 spot area were employed to perform the PBM with a single session protocol. VAS pain scores were assessed before and after the laser PBM, the day after, and on the 7th and 30th days after the treatment. No adverse effects occurred within 30 days after treatment. The mean VAS-pain score was 3.8 (SD 2.3) before PBM; 2.6 (SD 2.0) after PBM; 1.9 (SD 2.2) on day 1; 2.0 (SD 2.3) on day 7; and 1.5 (SD 2.2) on day 30. VAS pain decreased significantly over time (p < 0.0001). A single session of laser PBM may be safe and effective in reducing pain for symptomatic OLP patients. Further investigations are required to include placebo or topical corticosteroids as comparators.
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Affiliation(s)
- Andrea Roccon
- Department of Neurosciences, Section of Clinical Dentistry, University of Padua, via Giustiniani, 2, Padova, Italy.
| | | | - Gastone Zanette
- Department of Neurosciences, Section of Clinical Dentistry, University of Padua, via Giustiniani, 2, Padova, Italy
| | - Christian Bacci
- Department of Neurosciences, Section of Clinical Dentistry, University of Padua, via Giustiniani, 2, Padova, Italy
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Bao J, Chen C, Yan J, Wen Y, Bian J, Xu M, Liang Q, He Q. Antioxidant therapy for patients with oral lichen planus: A systematic review and meta-analysis. Front Pharmacol 2022; 13:1030893. [PMID: 36438849 PMCID: PMC9684670 DOI: 10.3389/fphar.2022.1030893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/28/2022] [Indexed: 09/21/2023] Open
Abstract
Aims: This study aimed to systematically review the efficacy and safety of antioxidants for patients with Oral lichen planus (OLP). Methods: Databases, including PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar, were searched up to 30 April 2022, for randomized controlled trials on the antioxidant therapy of OLP. The following endpoints were analyzed: pain score, clinical score, pain resolution rate, clinical resolution rate, and adverse effects. Results: A total of 19 studies met the inclusion criteria, and 17 studies with 704 patients were included in the meta-analysis. The findings showed that antioxidant therapy could significantly reduce the pain score [standardized mean difference -0.72 (-1.36, -0.07), P = 0.03, I2 = 87%, PI2 < 0.00001] and clinical score [SMD -2.06 (-3.06, -1.06), P < 0.0001, I2 = 94%, PI2 < 0.00001] of patients with OLP and improve the pain resolution rate [risk ratio (RR) 1.15 (1.01, 1.31), P = 0.04, I2 = 45%, PI2 = 0.09] and clinical resolution rate [RR 1.40 (1.10, 1.78), P = 0.006, I2 = 72%, PI2 = 0.002]. Conclusion: The study demonstrated that antioxidant therapy was beneficial for patients with OLP, and antioxidants might be used to treat OLP. Systematic Review Registration: https://clinicaltrials.gov/, identifier CRD4202233715.
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Affiliation(s)
- Jie Bao
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chu Chen
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiayu Yan
- School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Stomatology, Sichuan Integrated Traditional and Western Medicine Hospital, Chengdu, China
- School of Stomatology, North Sichuan Medical College, Nanchong, China
| | - Yueqiang Wen
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiamin Bian
- School of Stomatology, North Sichuan Medical College, Nanchong, China
| | - Mengting Xu
- Department of Stomatology, Sichuan Integrated Traditional and Western Medicine Hospital, Chengdu, China
| | - Qin Liang
- Department of Stomatology, Pengzhou Hospital of Traditional Chinese Medicine, Pengzhou, China
| | - Qingmei He
- Department of Neurological, Chongqing Shi Yong Chuan Hospital of Traditional Chinese Medicine, Chongqing, China
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A Case Report of Dental Implants and Site Augmentation in a Patient with Erosive Lichen Planus. Case Rep Dent 2022; 2022:9508580. [PMID: 35615492 PMCID: PMC9126713 DOI: 10.1155/2022/9508580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
Lichen planus (LP) is an autoimmune inflammatory disease that affects oral mucosal tissue, leading to complications in patients treated with dental implant therapy. This case report discusses the clinical management of a patient diagnosed with an erosive type of LP. After disease management, the patient was treated with dental implants in the upper and lower jaws with augmentation procedures around the implants. All implants were loaded after a three-month period of healing. Slight bone loss was observed in the upper premolar area following an exaggerated soft tissue response to the augmentation procedure. Within one year of implant placement, no additional complications were encountered.
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Sandhu S, Klein BA, Al-Hadlaq M, Chirravur P, Bajonaid A, Xu Y, Intini R, Hussein M, Vacharotayangul P, Sroussi H, Treister N, Sonis S. Oral lichen planus: comparative efficacy and treatment costs-a systematic review. BMC Oral Health 2022; 22:161. [PMID: 35524296 PMCID: PMC9074269 DOI: 10.1186/s12903-022-02168-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/11/2022] [Indexed: 12/22/2022] Open
Abstract
Objective To compare the reported efficacy and costs of available interventions used for the management of oral lichen planus (OLP). Materials and methods A systematic literature search was performed from database inception until March 2021 in MEDLINE via PubMed and the Cochrane library following PRISMA guidelines. Only randomized controlled trials (RCT) comparing an active intervention with placebo or different active interventions for OLP management were considered.
Results Seventy (70) RCTs were included. The majority of evidence suggested efficacy of topical steroids (dexamethasone, clobetasol, fluocinonide, triamcinolone), topical calcineurin inhibitors (tacrolimus, pimecrolimus, cyclosporine), topical retinoids, intra-lesional triamcinolone, aloe-vera gel, photodynamic therapy, and low-level laser therapies for OLP management. Based on the estimated cost per month and evidence for efficacy and side-effects, topical steroids (fluocinonide > dexamethasone > clobetasol > triamcinolone) appear to be more cost-effective than topical calcineurin inhibitors (tacrolimus > pimecrolimus > cyclosporine) followed by intra-lesional triamcinolone. Conclusion Of common treatment regimens for OLP, topical steroids appear to be the most economical and efficacious option followed by topical calcineurin inhibitors. Large-scale multi-modality, prospective trials in which head-to-head comparisons interventions are compared are required to definitely assess the cost-effectiveness of OLP treatments. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02168-4.
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Affiliation(s)
- Shaiba Sandhu
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA. .,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA. .,Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Brittany A Klein
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Malak Al-Hadlaq
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Prazwala Chirravur
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Amal Bajonaid
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Yuanming Xu
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Rossella Intini
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Mai Hussein
- Harvard Medical School, Boston, MA, USA.,Ministry of Health and Population, Cairo, Egypt
| | - Piamkamon Vacharotayangul
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Herve Sroussi
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital/ Dana Farber Cancer Institute, Boston, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, USA
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Therapies with Antioxidant Potential in Psoriasis, Vitiligo, and Lichen Planus. Antioxidants (Basel) 2021; 10:antiox10071087. [PMID: 34356320 PMCID: PMC8301010 DOI: 10.3390/antiox10071087] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 12/17/2022] Open
Abstract
Oxidative stress plays an important pathogenetic role in many chronic inflammatory diseases, including those of dermatological interest. In particular, regarding psoriasis, vitiligo, and lichen planus, excess reactive oxygen species and a decline in endogenous antioxidant systems are observed. In this regard, treatments with antioxidant properties could be appropriate therapeutic options. To date, clinical trials in dermatology on these treatments are limited. We reviewed the available studies on the efficacy of antioxidant therapies in psoriasis, vitiligo, and lichen planus. The role of herbal derivatives, vitamins, and trace elements was analyzed. The antioxidant properties of conventional therapies were also evaluated. Data from the literature suggest that antioxidants might be useful, but available studies on this topic are limited, heterogeneous, not completely standardized, and on small populations. Furthermore, in most cases, antioxidants alone are unable to induce significant clinical changes, except perhaps in mild forms, and must be used in conjunction with standard drug treatments to achieve measurable results. Further studies need to be conducted, considering larger populations and using internationally validated scales, in order to compare the results and clinical efficacy.
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New markers of oxidative stress in lichen planus and the influence of hepatitis C virus infection - a pilot study. ACTA ACUST UNITED AC 2021; 59:359-368. [PMID: 33951354 DOI: 10.2478/rjim-2021-0017] [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: 11/22/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Lichen planus (LP) is a mucocutaneous T-cell mediated disorder of unknown etiology. There is growing evidence that oxidative stress is an important player in the pathogenesis of LP. Therefore, we have investigated oxidative stress markers in LP and the influence of hepatitis C virus (HCV) infection, a frequently associated condition, on oxidative stress in LP patients. METHOD We have determined the serum levels of 4- hydroxynonenal (4-HNE) and symmetric dimethylarginine (SDMA), as markers of oxidative stress, and total antioxidant capacity (TAC), as a marker of the antioxidant defence, in 4 groups: group A - HCV positive patients with LP (n=12), group B - HCV positive patients without LP (n=12), group C - HCV negative patients with LP (n=31) and group D - control group (n=26). RESULTS In LP patients, we have identified an increased level of lipid peroxidation (4-HNE - group A - 8.41±1.11 µg/mL, group B - 7.97±2.17 µg/mL, group C - 7.81±1.96 µg/mL and group D - 6.15±1.17 µg/mL) and alterations in arginine methylation (SDMA - group A - 1.10±0.24 µmol/L, group B - 1.03±0.16 µmol/L, group C - 0.84±0.19 µmol/L and group D - 0.50±0.06 µmol/L) associated with a diminished antioxidant defence (TAC - group A - 234,50±49,96, µmol/L group B - 255,83±41,41 µmol/L, group C - 269,83±43,33 µmol/L and group D - 316,46 ±29,33 µmol/L), processes augmented by the association with HCV infection. CONCLUSION There is an imbalance between oxidants and antioxidants in patients with LP, an imbalance that is augmented by the presence of HCV infection. SDMA could be regarded as a novel biomarker of oxidative stress among these patients. To the best of our knowledge this is the first study to investigate the influence of HCV infection on oxidative stress in LP patients.
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Ioannides D, Vakirlis E, Kemeny L, Marinovic B, Massone C, Murphy R, Nast A, Ronnevig J, Ruzicka T, Cooper S, Trüeb R, Pujol Vallverdú R, Wolf R, Neumann M. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol 2020; 34:1403-1414. [DOI: 10.1111/jdv.16464] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/31/2020] [Indexed: 12/15/2022]
Affiliation(s)
- D. Ioannides
- Department of Dermatology and Venereology Aristotle University of Thessaloniki Medical School Thessaloniki Greece
| | - E. Vakirlis
- Department of Dermatology and Venereology Aristotle University of Thessaloniki Medical School Thessaloniki Greece
| | - L. Kemeny
- Department of Dermatology and Allergology University of Szeged Szeged Hungary
| | - B. Marinovic
- Department of Dermatology and Venereology University Hospital Center and School of Medicine Zagreb Zagreb Croatia
| | - C. Massone
- Department of Dermatology Medical University of Graz Graz Austria
| | - R. Murphy
- Department of Dermatology Nottingham University Hospital Nottingham UK
| | - A. Nast
- Department of Dermatology, Venereology and Allergy Division of Evidence‐Based Medicine Charité ‐ Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin and Berlin Institute of Health Berlin Germany
| | | | - T. Ruzicka
- Department of Dermatology and Allergology LMU Munich Germany
| | - S.M. Cooper
- Department of Dermatology Oxford University Hospitals NHS Trust and University of Oxford Oxford UK
| | - R.M. Trüeb
- Center for Dermatology and Hair Diseases Wallisellen Switzerland
| | | | - R. Wolf
- Department of Dermatology and Allergology LMU Munich Germany
| | - M. Neumann
- Department of Dermatology Erasmus MC Rotterdam The Netherlands
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Oberti L, Alberta L, Massimo P, Francesco C, Dorina L. Clinical Management of Oral Lichen Planus: A Systematic Review. Mini Rev Med Chem 2019; 19:1049-1059. [DOI: 10.2174/1389557519666190301144157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 02/12/2019] [Accepted: 02/22/2019] [Indexed: 12/17/2022]
Abstract
Aim:
The clinical management of OLP represents a considerable challenge for the oral physician.
The aim of this review is to assess the main intervention used in the management of OLP and
the efficacy of every type of treatment.
Materials & Methods:
We searched and analyzed PubMed database for articles on OLP management.
Only randomized controlled trials, comparing an active treatment with placebo, or between different
active treatments, were considered in this systematic review. Only patients with symptomatic
OLP were included and interventions of all types were considered (topical treatment, systemic drugs,
non pharmacological intervention).
Results:
A total of 25 randomized controlled trials were examined and included in this review. Steroids
are the most frequently employed drug in the treatment of OLP and their efficacy and safety are demonstrated.
Also calcineurin inhibitors and photo-dynamic therapy are used in different studies for OLP
management, with positive results.
Conclusion:
Topical steroids remain the first-line treatment for symptomatic OLP, however, many different
pharmacological and non-pharmacological therapies would represent a valid alternative for its
management, but, nowadays they require further investigations.
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Affiliation(s)
- Luca Oberti
- Department of Medicine and Surgery, Centre of Neuroscience of Milan, University of Milano-Bicocca, 20126 Milan, Italy
| | - Lucchese Alberta
- Multidisciplinary Department of Medical and Dental Specialties, University of Campania- Luigi Vanvitelli, 80138 Naples, Italy
| | - Petruzzi Massimo
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy
| | - Carinci Francesco
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Lauritano Dorina
- Department of Medicine and Surgery, Centre of Neuroscience of Milan, University of Milano-Bicocca, 20126 Milan, Italy
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Yang XY, Li XZ, Zhang SN. Metabolomics analysis of oral mucosa reveals profile perturbation in reticular oral lichen planus. Clin Chim Acta 2018; 487:28-32. [PMID: 30218656 DOI: 10.1016/j.cca.2018.09.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 08/06/2018] [Accepted: 09/11/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory mucosal disorder and potentially oral premalignant lesion affecting the stratified squamous epithelia. In OLP, reticular type is the most common clinical form of the disease. However, little is known about it. Metabolomics analysis may help to investigate the disease pathogenesis and to improve clinical treatment. METHODS Liquid chromatography (LC)-mass spectrometry (MS) system, XCMS software, SIMCA software, and OSI / SMMS software were integrated to identify differentially expressed metabolites for the pathways and pathology analysis. RESULTS Totally, 21 modulated metabolites were identified, whose dysregulations affected 30 metabolic pathways. Through an impact-value screen (impact-value>0.1), 8 pathways were selected as the significantly dysregulated pathways. Pathological network showed that these metabolites participated in 5 pathological processes, that is, inflammatory lesion, DNA damage and repair disorder, apoptosis process, oxidative stress injury, and abnormal energy expenditure. CONCLUSION The study revealed the metabolic perturbation of oral mucosa in reticular OLP, which may provide an important reference for the understanding of the pathogenesis of the disease and the discovery of therapeutic targets.
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Affiliation(s)
- Xu-Yan Yang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, PR China
| | - Xu-Zhao Li
- Pharmacy School, Guiyang University of Chinese Medicine, Guiyang 550025, PR China.
| | - Shuai-Nan Zhang
- Pharmacy School, Guiyang University of Chinese Medicine, Guiyang 550025, PR China.
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Divakar NM. Topical tocopherol for the treatment of reticular oral lichen planus: Randomized, double-blind crossover study - A query. Oral Dis 2018; 24:1140. [DOI: 10.1111/odi.12720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- NM Divakar
- Department of Oral Medicine and Radiology; KMCT Dental College; Manassery Mukkam Calicut India
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