The effect of epigallocatechin gallate (extracted from green tea) loaded nanostructured lipid carriers on the treatment of oral lichen planus

Abstract

Introduction: Considering the role of lichen planus in creating oral precancerous lesions and the tendency of people to use herbal medicines, the present study aims to investigate the effect of epigallocatechin gallate (extracted from green tea) loaded nanostructured lipid carriers to increase the bioavailability of the drug on the treatment of oral lichen planus in Patients referred to Tabriz Dental Faculty were examined. Method: The present study is a three-blind randomized controlled trial that was conducted on 46 patients with lichen planus referred to Tabriz Dental Faculty between 1402-1403. The participants were allocated to two groups with equal proportion through random block and after Allocation Concealment. For one group of patients, mouthwash containing EGCG and for the other group, mouthwash containing EGCG loaded in NLC, the characteristics of prepared nanoparticles, including their morphology and cytotoxicity, were evaluated; It was used three times a day. Thongprasom scoring system was used to evaluate clinical signs and VAS (Visual Analog Scale) scale was used for pain intensity, and the size of lesions and pain intensity on the first day of visit were compared with two and four weeks later. Also, patients were examined four weeks later in terms of improvement in clinical manifestations. Chi-square test was used to report data qualitatively, t-test was used to report data quantitatively before the intervention (pain level and clinical symptoms), and ANOVA-RM test was used to examine within-groups and differences between group Result: Intra-group comparison for clinical signs showed that the mean Thongprasom score in the EGCG group at 2 and 4 weeks after the intervention and in the EGCG+NLC group, 4 weeks after the intervention, had a statistically significant difference (p<0.001). Also, there was a statistically significant difference in the average Thongprasom score of EGCG and EGCG+NLC groups at three time points (p < 0.001) and (p = 0.003), so that Thongprasom scores decreased over time in both groups. The mean score of Thongprasom between the two groups did not have a statistically significant difference over time (P=0.903). Intra-group comparison (EGCG group and EGCG+NLC group) for pain intensity showed that the average pain score at each time point (2 and 4 weeks after the intervention) compared to the baseline level, had a statistically significant difference in both groups (p < 0.001). It was also determined by repeated measurement within the group that there was a statistically significant difference in the average of EGCG and EGCG+NLC groups at three time points (p<0.001). In both groups, the pain scores decreased over time, but the changes in the EGCG+NLC group were greater to the extent that there was a statistically significant difference in the intergroup test at both time points. Based on the ANOVA test with repeated measurement over time, it was found that the average pain score between the two groups had a statistically significant difference (P<0.043). Most of the participants in both groups reported the recovery rate at a relative level, and there were three people who did not respond to treatment in the epigallocatechin gallate group, but in the group of epigallocatechin gallate loaded in nanostructured lipid carriers, no response to treatment was reported (P=0.271) Conclusion: The use of mouthwash containing epigallocatechin gallate loaded in nanostructured lipid carriers had an effective role in reducing the pain of lesions as well as reducing clinical symptoms. Considering the effectiveness of mouthwash containing loaded epigallocatechin gallate in reducing pain and burning compared to mouthwash containing epigallocatechin gallate alone, it is significantly recommended as a preferable intervention in reducing the pain of lesions.