Comparative effectiveness research in photodynamic therapy for oral lichen planus
- Author(s): AlGhamdi, Mohammed Abdulkhalig
- Advisor(s): Chiappelli, Francesco
- et al.
Since there is a lack in knowing the etiology of OLP “Oral Lichen Planus”, there is still a gap in the understanding and subsequently correct management of OLP.
OLP is a chronic immunologic mucocutaneous disease affecting on average 0.5-3% of the population with a significant female predilection, and a potential risk of developing into a carcinoma at advanced stages.
Still used widely among practitioners, steroids appear to remain the most reliable treatment modality among other options including the newer photodynamic therapy “PDT”.
PDT is a minimally invasive procedure, kills damaged cells by the use of oxygen, chemistry and light. Among its many advantages, this modality doesn’t usually result in systemic involvement as in the case of steroids; and it’s done in a series of appointments to monitor results and stage the need for additional therapy accordingly.
The importance of this research stems out of the awareness of an existing gap in the knowledge, and the importance of the lesion by itself with its malignant potential.
The aims of this research are to investigate whether or not PDT poses a better treatment option for OLP in adult patients than topical steroids, and out of the two concentrations of the most frequently prescribed topical corticosteroid, which one is more effective than the other.
The search strategy included search engines and hand searching to obtain systematic reviews and randomized clinical trials relevant to the search question. Independent readers validated the quality of the evidence prior to conducting the acceptable sampling analysis.
For the main hypothesis, the bibliome consisted of four clinical trials, of which only one was yielded by the acceptance sampling process.
For the correlatory hypothesis, the bibliome consisted of one clinical trial, which was retained following the acceptable sampling step.
Qualitative assessment was performed on the findings of both search results and a qualitative consensus was made based on the best available evidence detected.
Laser phototherapy is more effective for treatment of atrophic-erosive oral lichen planus than topical steroids. There is no significant difference between the two concentrations of topical Clobetasol of 0.025% and 0.05% in the treatment of OLP.
Key words: Oral lichen planus, photodynamic therapy, steroids, evidence-based dentistry, CER, Clobetasol.