Investigating the effect of melatonin combined with betamethasone mouthwash compared to betamethasone mouthwash alone in the treatment of ulcerative oral lichen planus

Abstract

Objective: Oral lichen planus is a chronic inflammatory disease that affects the mucous membrane of the oral cavity. The treatment of oral lichen planus is to control the symptoms of the disease, and corticosteroids, including steroid mouthwashes, are common drugs for its treatment. Melatonin protects cells with an anti-inflammatory effect by stimulating the immune system response and also acts as an antioxidant. In addition, melatonin also plays a role in modulating and regulating the immune system. So, melatonin can have therapeutic applications as an important factor in autoimmune disorders such as Sjogren's syndrome, periodontal diseases, aphthous ulcers and lichen planus. According to the new studies conducted in the field of the use of antioxidants in the treatment of lichen planus, the purpose of this study is to investigate the effect of melatonin drug in the treatment of oral lichen planus.

Materials and methods: Patients with oral lichen planus who had no underlying disease were examined in two groups of 16 people. For one group of patients, melatonin tablets were used along with the combined mouthwash of MG aluminum and betamethasone, and in the other group, only the combined mouthwash of MG aluminum and betamethasone was used. The patients were examined before the intervention and 4 and 9 weeks after using the treatment, and the amount of pain and burning and the size of the lesions were evaluated. Independent T-test (in case of normal) or Mann-Whitney test (abnormal) were used to compare the average intensity of pain and burning and the size of the lesion between the two groups. Analysis of variance with repeated measures was used for intra-group comparison of variables and K-squared test was used to compare categorical and qualitative variables such as gender in the study groups. The significance level in all tests was considered less than 5%.

Results: The mean age in the intervention group was 55 and in the control group was 54, and most of the participants in both groups were women. In both groups, a significant reduction in lesion size and pain scale was observed after treatment. There was no statistically significant difference in any of the time intervals measured in terms of lesion size between the two groups (p>0.05). Regarding the amount of pain, there was a significant difference between the two groups in the measurement intervals of the first time and 4 weeks later (p=0.049), but there was no statistically significant difference in the measurement interval of 9 weeks later (p=0.449).

Conclusion: Both betamethasone mouthwash and betamethasone mouthwash with melatonin can be effective in improving oral lichen planus lesions, but there was no difference between the two interventions in terms of improving the size of the lesion and the level of pain.