Clinical Evaluation Of The Efficiency of Intralesional Injection Of Autologous Platelet Rich Plasma In Treatment Of Erosive Oral Lichen planus.

Abstract

Oral lichen planus (OLP) could be a doubtless malignant autoimmune disease, characterized by burning and pain that reduces the standard of patient's life. Treatment of OLP remains a significant challenge despite the recent advances in understanding the immunopathogenesis.The properties of Platelet-rich plasma suggested its application in clinical practice for treatment of OLP patients that do not respond to conventional therapy. This study aims to evaluate the effectiveness of intralesional Platelet rich Plasma (PRP) in treatment of Erosive lichen planus. Materials and methods:The study sample consisted of 10 patients of erosive OLP among which were given intralesional PRP. All the patients were given weekly injections for 4 weeks. The two fundamentals variables used for assessment of the patient is pain control and healing of the lesion. Each visit consists of measuring the target lesion size and pain evaluation by visual analogue scale (VAS) .Results: No serious adverse reaction was obtained in patients during the 4 weeks of treatment.The result was satisfactory with a significant reduction in patient symptoms. Reduction in terms of size and inflammation was observed. Conclusion:This methodology of using intralesional PRP showed to be effective in decreasing the symptoms and improvement in clinical signs of OLP, which was resistant to conventional therapy.

Effect of platelet concentrates for pain and symptom management in oral lichen planus: an evidence-based systematic review

“…Furthermore, the Hijazi study [ 20 ] suggested that although PRP had a slower clinical response than TA injections, both treatments exhibited similar complete remission rates, with no significant differences observed in pain score, Sign score, or lesion area remission. The observed differences could be attributed to variations in the duration of release and peak time of GFs reported across studies [ 36 , 37 ].The UE Shinnawi study [ 38 ] also supports this notion, showing a clear improvement in symptoms with blood derivatives after the first two weeks of treatment. Several other studies have assessed the efficacy of injection PCs in managing refractory erosive OLP patients who showed no response to corticosteroid treatment [ 39 ].…”

Regenerative potential of platelet concentrates in chronic oral mucosal lesions

“… 36 Likewise, intralesional PRP injections in cases with recalcitrant erosive OLP for 4–8 weeks showed a significant reduction in pain, ulcer size, and erythema. 37 , 38 , 39 , 40 , 41 In addition, a randomized clinical trial showed that PRF injections in OLP resulted in a significant reduction of lesion size, pain score, and decreased mean values of oral health impact profile scale, which were comparable to corticosteroid injections. 42 , 43 , 44 Overall, clinical studies suggest that applying PCs either topically or intralesional for an average of eight weeks would be a valid treatment option for recalcitrant OLP lesions.…”

“… Lesion Type of PCs Effect of PCs Ref. Oral lichen planus PRF membrane PRF resulted in a decrease in lesions' size within 3 weeks of treatment 36 Platelet solution PC improved quality of life and decreased pain 35 PRP Complete regression of the lesion after 4 weeks 41 PRP 90% of patients reported complete resolution of erythema 40 PRP Significant reduction in pain, size of the lesion and inflammation 37 i-PRF i-PRF reduced the lesion size by 59.8% and reduced the VAS scores by 47.6% 65 i-PRF i-PRF reduced pain and lesion's size 44 PRP PRP reduced pain and size of the ulcers 39 i-PRF i-PRF reduced VAS scores and lesion size by 68.5% and 74%, respectively 42 PRP Significant decrease in lesion size and pain score 38 Oral mucositis Platelet lysate Healing was good-to-complete in 5 out of 7 cases 50 Platelet gel Platelet gel resulted in improvement of oral mucosa, revealing restitutio ad integrum 46 Platelet gel PC resulted in improved quality of life and pa...…”