Treatment of oral lichen planus by surgical excision and acellular dermal matrix grafting: Eleven case reports and review of literature

Abstract

BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disorder, and it can affect normal oral function. The conventional treatments for OLP are not always effective, and relapse easily occurs. Therefore, treatment of OLP is difficult and challenging. In this study, we evaluated over a long period the clinical efficacy of surgical excision and acellular dermal matrix (ADM) grafting in patients with refractory OLP. CASE SUMMARY Eleven patients with refractory OLP underwent a standardized protocol of surgical excision and ADM grafting. The condition of the area of the grafted wound, the intraoperative maximum mouth opening, pain, and clinical healing were assessed at postoperative follow-up visits. All patients had a flat surgical area with similar mucosal tissue coverage and local scar formation. Patients had no irritation and pain in their mucous membranes when eating acidic and spicy food. All patients’ mouth openings returned to normal within 2-6 mo after surgery. During follow-up, none of the patients had recurrence of OLP after surgery. The longest follow-up was 11 yr and the shortest was 6 mo, and none of the patients relapsed during follow-up. CONCLUSION Surgical excision and ADM grafting could be an effective method to treat refractory OLP.

Integrative approach in managing oral lichen planus

“…Free gingival and soft tissue are also being used for managing the localized lesions of erosive OLP. 13…”

Humoral immune disorders affect clinical outcomes of oral lichen planus

“…Currently, corticosteroids, hydroxychloroquine (HC), and immunosuppressive drugs are the principal first‐line treatments for OLP (Conrotto et al, 2006). Additionally, low‐level laser, monotherapy, biomolecules, photodynamic therapy, and surgery have all been utilized, but their results vary widely, and there is currently no treatment that is particularly effective and well‐known (Fu et al, 2021; Khater & Khattab, 2020; Lavaee & Shadmanpour, 2019; Pinas et al, 2018; Solimani et al, 2019). A large number of evidence‐based medical evidence confirms that effective molecular typing is the basis for guiding precise treatment (Heim et al, 2018; Ma et al, 2022).…”