Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran.
Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
BMC Oral Health. 2024 Jun 8;24(1):674. doi: 10.1186/s12903-024-04443-y.
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. This systematic review investigated the effects of autologous platelet concentrates compared to topical steroids in treating symptomatic oral lichen planus patients.
A systematic literature search was performed in PubMed, Web of Science, Scopus, Embase, and Cochrane for randomized controlled trials. Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines were observed for article selection. 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.
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 (SMD = 0.17 (95% CI: -0.47 to 0.81); I = 63.6%). The SMD of Thongprasom score in patients receiving autologous platelet concentrates was lower than the corticosteroid groups, with no significant effect size (SMD= -2.88 (95% CI: -5.51 to -0.25); I = 91.7%). Therefore, there was no statistically significant difference between the autologous platelet concentrates and topical steroids regarding pain and clinical score.
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.
口腔扁平苔藓是一种慢性、潜在恶性的口腔黏膜疾病。皮质类固醇被用作口腔扁平苔藓患者的一线治疗药物；然而，它们有许多副作用。血小板浓缩物（富血小板血浆和富血小板纤维蛋白）是自体生物活性物质。本系统评价研究了与局部皮质类固醇相比，自体血小板浓缩物治疗有症状的口腔扁平苔藓患者的效果。
在 PubMed、Web of Science、Scopus、Embase 和 Cochrane 中进行了系统的文献检索，以查找随机对照试验。文章选择遵循系统评价和荟萃分析的 Preferred Reporting Items 指南。为了进行研究合并，使用随机效应模型的标准化均数差进行荟萃分析，以估计治疗口腔扁平苔藓的汇总效应大小。
共纳入 6 项研究，共纳入 109 例口腔扁平苔藓患者。两种治疗方法均在治疗结束时和随访时从基线开始，在结局参数（病变大小、疼痛评分、Thongprasom 评分）上均有统计学显著改善。两组患者疼痛下降的汇总估计 SMD 无显著差异（SMD=0.17（95%CI：-0.47 至 0.81）；I=63.6%）。接受自体血小板浓缩物治疗的患者的 Thongprasom 评分 SMD 低于皮质类固醇组，但无显著效应量（SMD=-2.88（95%CI：-5.51 至 -0.25）；I=91.7%）。因此，在疼痛和临床评分方面，自体血小板浓缩物和局部皮质类固醇之间无统计学显著差异。
自体血小板浓缩物和局部皮质类固醇均能减小口腔扁平苔藓患者的病变大小、Thongprasom 评分和疼痛，但两种治疗方法之间的差异无统计学意义。因此，自体血小板浓缩物可被视为局部皮质类固醇的替代治疗方法。
