Comparison of the effect of platelet-rich factor with corticosteroids in treatment of Oral Lichen Planus Patients: A systematic review

Abstract

Objective: Oral lichen planus is a chronic and potentially malignant disorder of oral mucosa. Corticosteroids are used as first-line therapy for oral lichen planus patients; however, they have many side effects. Platelet concentrates (platelet-rich plasma and platelet-rich fibrin) are autologous bioactive materials which have higher growth factors than normal amounts necessary for tissue regeneration and repair. Several studies have investigated the effects of these products on oral lichen planus compared to topical steroids, but their results are not homogenous. Therefore, this systematic review and meta-analysis was conducted to compare the effects of autologous platelet-rich products in the treatment of oral lichen planus with topical steroids..

Materials and methods: A systematic literature search was performed in PubMed, Web of Science, Scopus, Embase, and Cochrane for randomized controlled trials till December 30, 2023. Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines were observed for article selection. The outcome parameters were change in lesion size, change in pain and change in clinical score. For the pooling of studies, meta-analysis using Standardized Mean Differences by random effects model was carried out to estimate summary effect sizes for the treatment of oral lichen planus.

Results: By searching the mentioned databases, 210 articles were obtained. After screening and reviewing the texts, a total of six studies, incorporating 109 oral lichen planus patients, were involved. Both treatment modalities showed a statistically significant improvement in the outcome parameters (lesion size, pain score, Thongprasom score) from the baseline to the end of treatment and further to the follow-up visits. There was no significant difference in the pooled estimate SMD of pain decline in patients of the two groups. The SMD of Thongprasom score in patients receiving autologous platelet concentrates was lower than the corticosteroid groups, with no significant effect size. Therefore, there was no statistically significant difference between the autologous platelet concentrates and topical steroids regarding pain and clinical score.

Conclusion: Autologous platelet concentrates, and topical steroids decreased the size of lesions, Thongprasom scale, and pain in oral lichen planus patients, but the difference between the two treatments was not statistically significant. Thus, autologous platelet concentrates could be considered as an alternative treatment to topical steroids.