Efficacy of injectable platelet‐rich fibrin in the treatment of symptomatic oral lichen planus

Abstract

Objectives: The use of autologous platelet concentrates has shown growing evidence as a promising therapy. We conducted a split-mouth study to evaluate the effectiveness of injectable platelet-rich fibrin (PRF) compared with triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). Materials and methods:This split-mouth randomized trial included 12 patients with symptomatic, bilateral OLP lesions. The participants were randomly allocated to receive a 1-ml intralesional PRF injection on one side of the buccal mucosa and a 0.5-ml TA injection on the counterpart side. The application was performed once a week for 4 weeks. The outcomes were measured using a visual analog scale score, REU score, and lesion areas.Results: Both injectable TA and PRF were effective in the management of oral lichen planus. After 4 weeks of treatment, there was an average reduction in the VAS score (68.5% i-PRF, 91% TA) and an average reduction in the REU score (74% i-PRF, 91% TA). There were no statistically significant differences between the two treatment methods (p > 0.05).Conclusions: Intralesional injection with TA showed more effectiveness than i-PRF in the management of OPL lesions. Although, i-PRF cannot be considered a first-line treatment option, it showed promising alternative therapy choice with no side effects.

Regenerative potential of platelet concentrates in chronic oral mucosal 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...…”

“… 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.…”

What can we learn from treatments of oral lichen planus?

“…In recent years, scholars have found PRF local injections to be comparable to tretinoin (TA) in relieving OLP pain, suggesting a role in EOLP pain control ( Bennardo et al., 2021 ). However, one study found that TA showed better treatment results on the visual pain analog scale (VAS) and semi-quantitative REU (reticulo-erosion-ulcer) scores when both were injected at the same lesion site ( Al-Hallak et al., 2023 ). Platelet-rich fibrin (i-PRF) and CS for EOLP both reduce pain and lesion size, but i-PRF is less expensive ( Saglam et al., 2021 ).…”

Effectiveness of Injectable Platelet-Rich Fibrin in the Treatment of Oral Lichen Planus: A Systematic Review and Meta-Analysis

“…Studies showed a tendency for lesions to manifest in the fourth and fifth decades. While the studies of Al-Hallak et al [ 21 ] and Bennardo et al [ 22 ] compared i-PRF with triamcinolone acetonide (TA), Saglam et al [ 23 ] compared i-PRF with methylprednisolone acetate (MPA). The Thongprasom score was calculated to assess the surface area of the lesion in studies by Bennardo et al [ 22 ] and Saglam et al [ 23 ].…”