OBJECTIVE

This systematic review synthesizes existing empirical evidence on the efficacy and safety of pharmacological treatment options for desquamative gingivitis (DG), in order to establish evidence-based clinical recommendations on DG clinical management.

METHODS

A comprehensive literature search was conducted across seven databases to retrieve literature records published from 1990 to 2023, followed by manual searches of reference lists of the included articles. Studies assessing pharmacological interventions for DG with relevant clinical outcomes were included. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Relevant data, including those on clinical improvement and adverse events, were extracted and synthesised to determine the efficacy and safety of the pharmacological agents used in the included articles.

RESULTS

Out of the yielded 624 records and the manual search, 15 studies met the inclusion criteria, comprising randomized controlled trials (RCTs), non-randomized trials and cohort studies. MMAT scores ranged from 5 to 7, with a mean score of 5.57. Clobetasol (53.33%) and tacrolimus (26.67%) were the most frequently studied agents, both demonstrating significant reductions in pain and lesion severity. Emerging therapies, such as platelet-rich plasma and bio-adhesive gels containing propolis and nano-vitamin formulations, showed promising results, particularly as adjunctive treatments. Quality of life (QoL) assessments was limited, with only one study employing a validated tool (OHIP-14). Recurrence rates were inconsistently reported with no reported relapses in clobetasol-treated groups during short-term follow-up. Safety profiles differed across pharmacological agents with topical treatments exhibiting mild and transient adverse effects. Systemic agents exhibited a higher risk profile, including candidiasis and haemolysis.

CONCLUSIONS

Clobetasol and tacrolimus remain first-line therapies for DG, supported by their efficacy and manageable safety profiles. Platelet-rich plasma and nano-vitamin-based therapies offer potential alternatives but require further validation. Given the variability in treatment protocols, standardized guidelines and long-term studies are needed to optimize the clinical management.

CLINICAL TRIAL NUMBER

Not applicable.