Interventions for the management of Oral lichen planus: A review of the conventional and novel therapies

Abstract

Objective

This narrative review focuses on the rationale & role of conventional and newer therapies in the management of Oral lichen planus with emphasis on randomized controlled trials reported over 2 decades.

Materials and methods

Literature search was conducted to identify randomized controlled trials for management of OLP from 1/1/1995 to 31/12/2015; Medline, and Cochrane databases complemented with manual search was used. Primary outcome as resolution of pain was evaluated with analysis of clinical resolution of erythema and ulceration as secondary outcome.

Results

The search provided 260 abstracts, of which 70 full text articles were included. Majority of trials used topical steroids with very few trials on newer therapies. It was found that topical steroids are effective for symptomatic management of OLP with equal efficacy shown by topical calcineurin inhibitors and retinoids. However, the side effect of transient burning sensation with relapse was more with calcineurin inhibitors.

Conclusion

Although the newer therapies offer advantage over steroids for management of OLP in recalcitrant cases, extensive lesions and cases unresponsive to steroids, but sufficient clinical data on their use is still lacking. Hence, more RCTs with large sample size, adequate treatment duration and long term follow up is required for clinical utility.

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