Dexamethasone solution and dexamethasone in Mucolox for the treatment of oral lichen planus: a preliminary study

Villa, Alessandro; Sankar, Vidya; Bassani, Gus; Johnson, Lisa Bennett; Sroussi, Hervé

doi:10.1016/j.oooo.2020.02.014

Cited by 10 publications

(18 citation statements)

References 15 publications

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“…Two‐thousand seven‐hundred and fifteen articles were retrieved with the search strategy and two from the cross‐references. Out of 2717, 55 studies 13–67 were included in the systematic review encompassing 2831 patients. Three studies did not report their outcomes amenable for calculating the pooled estimates.…”

Section: Resultsmentioning

confidence: 99%

Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

Sridharan

Sivaramakrishnan

2021

Australian Dental Journal

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Background Corticosteroids, calcineurin inhibitors, vitamin D, photodynamic therapy, herbal drugs are some of the interventions tried in clinical trials for treating oral lichen planus. We carried out the present network meta‐analysis to compare the above‐mentioned interventions. Methods Electronic databases were searched for randomized clinical trials evaluating interventions in patients with symptomatic oral lichen planus. Clinical resolution, clinical score, pain resolution, pain score, and adverse effects were the outcomes evaluated. Results Fifty‐five (2831 patients) trials were included. Corticosteroids (OR: 13.6; 95% CI: 1.2, 155.4), pimecrolimus (OR: 14.7; 95% CI: 1.7, 125), purslane (OR: 18.4; 95% CI: 3.5, 97), and ozonized water/corticosteroids (OR: 52; 95% CI: 1.4, 1882.6) had better rates of clinical resolution compared to placebo. Corticosteroids (OR: 3.18; 95% CI: 1.2, 8.43), ozonized water/corticosteroids (OR: 9.9; 95% CI: 2.7, 36.2), aloe vera (OR: 13; 95%: 1.5, 111.8), pimecrolimus (OR: 18.8; 95% CI: 2, 177.4) and hyaluronic acid (OR: 24.8; 95% CI: 1.3, 457.6) were significantly associated with superior rates of pain resolution compared to placebo. Pimecrolimus and cyclosporine were associated with significantly higher risk of adverse effects than placebo. Conclusion Topical corticosteroids were the most effective drug class for treating oral lichen planus.

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Section: Resultsmentioning

confidence: 99%

Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

Sridharan

Sivaramakrishnan

2021

Australian Dental Journal

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“…Self‐formulated and compounded dexamethasone mouth rinses were compared in two studies. In the Villa et al study (Villa et al., 2020), dexamethasone 0.1 mg/ml solution in Mucolox (mucoadhesive polymer) was compared to dexamethasone 0.1 mg/ml solution alone, while in the Hambly et al study (Hambly et al., 2017) a self‐formulated mouth rinse composed of 0.5 mg dexamethasone tablet crushed and mixed with up to 20 ml water was compared to a compounded mouth rinse of dexamethasone (0.5 mg/2 ml). Although there were no statistically significant differences between the 2 groups in the overall self‐reported responses in the first study, and the treatments for both groups were effective at lowering the REU scores, the group on Mucolox solution had statistically better outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…Bias due to missing outcome data was evaluated as low for all the studies. Bias in measurement of the outcome was assessed as raising some concerns for 2 studies (Mirza et al., 2018; Villa et al., 2020), and as low for the remaining six studies (Bakhtiari et al., 2017; Fu et al., 2012; Hambly et al., 2017; Jajarm et al., 2015; Javadzadeh et al., 2008; Wu et al., 2010). Bias related to the selection of the reported results were estimated as low for all the studies reviewed.…”

Section: Resultsmentioning

confidence: 99%

The effectiveness of topical forms of dexamethasone in the treatment of oral lichen planus— A systematic review

2021

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The goal of this systematic review was to assess the efficacy of dexamethasone compared to other treatments in oral lichen planus (OLP). The literature search used the following inclusion criteria: randomized controlled trials (RCT) comparing dexamethasone and other treatment strategies in patients with OLP. The outcome measures included relief of symptoms, decrement of erosive area size, and changes in quality of life. A computer and manual search was performed in Pubmed, Web of Science, and Cochrane Library up to January 31, 2021. The risk of bias was measured with the Revised Cochrane risk‐of‐bias tool for randomized trials. Eight trials with 131 study participants and 132 controls were identified. The following interventions were compared dexamethasone mouthwash, and 5% methylene blue‐mediated photodynamic therapy, low‐level laser therapy, amlexanox, clobetasol mouthwash, ketoconazole with amitriptyline, and thalidomide 1% paste. The therapeutic outcomes were more advantageous for dexamethasone in comparison with photodynamic therapy (PDT) (2 RCT) and low‐level laser therapy (LLLT). Comparable effects were observed for dexamethasone, amlexanox, thalidomide, and PDT (1 RCT). Clobetasol showed more effective action than dexamethasone. Given the small sample sizes, heterogeneity and the few studies included, there is limited evidence to support the selection of treatment for OLP.

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“…To our knowledge, this is the first study to analyze the permeability of dexamethasone through oral tissues by an in silico predictive model, which indicated that dexamethasone has promising characteristics for topical intra-alveolar administration. Some topical formulations of dexamethasone have been recommended to treat oral lesions, such as recurrent aphthous ulcerations ( 23 ), oral lichen planus ( 24 ), and oral vesicular lesions ( 25 ). In the studies by Majid and Mahmood ( 26 ) and Saravanan et al .…”

Section: Discussionmentioning

confidence: 99%

Effect of the intra-alveolar administration of dexamethasone on swelling, trismus, and pain after impacted lower third molar extraction: a randomized, double-blind clinical trial

Marques¹,

Branco-de-Almeida²,

Marques³

et al. 2022

Med Oral

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Background To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction. Material and Methods The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student’s t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides. Results There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times ( p >0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration. Conclusions Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars. Key words: Molar, third, tooth, impacted, oral surgical procedures, dexamethasone.

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Dexamethasone solution and dexamethasone in Mucolox for the treatment of oral lichen planus: a preliminary study

Cited by 10 publications

References 15 publications

Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

The effectiveness of topical forms of dexamethasone in the treatment of oral lichen planus— A systematic review

Effect of the intra-alveolar administration of dexamethasone on swelling, trismus, and pain after impacted lower third molar extraction: a randomized, double-blind clinical trial

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