A comparative study between oral zinc therapy with or without steroid application in symptomatic oral lichen planus: a randomized controlled trial

Abstract

Objectives Lichen planus is an autoimmune inflammatory disease affecting the buccal mucosa, tongue, and gingiva. As a result of its effect on matrix metalloproteinase, zinc is useful for treating the lesions and preventing their recurrences. This study aimed to compare the efficacy of a combination of oral zinc acetate 50 mg tablets and the 0.1% triamcinolone acetonide Orabase with Orabase alone in the healing process of symptomatic oral lichen planus (OLP). Study Design Forty patients attending the Department of Oral Medicine were randomly included in the study and were categorized into 2 groups, group A and group B. Group A (control group) and group B (case group) each comprised 20 patients with clinically and histopathologically confirmed OLP and symptoms of burning sensation. Group A received the 0.1% triamcinolone acetonide Orabase 2 times daily. Group B received 50 mg zinc acetate tablets plus Ora-base 2 times daily for 8 weeks. Orabase was discontinued after 1 week of application in the case group, whereas zinc acetate tablets were continued throughout the treatment period. The follow-up period was 2 months. Lesion size and burning sensation were measured by using the Thongprasom scale and the visual analogue scale (VAS) at initial and weekly visits till cessation of treatment. Results A decrease in pain intensity from the first visit to the follow-up visit was statistically significant in both groups (P = .000). Group B showed higher mean pain intensity from the initial visit to the follow-up visit compared with group A. Mean difference between the first and follow-up visits in the study group showed that there was a gradual decrease in pain intensity, whereas the control group showed minimal difference compared with the study group; the difference was not statistically significant (P = .498). There was statistically significant gradual decrease in lesion size till the follow-up period in both groups (P = .000). Conclusions Oral zinc therapy was found to be an adjunct in reducing burning sensation and lesion size in symptomatic OLP. Lichen planus is an autoimmune inflammatory disease affecting the buccal mucosa, tongue, and gingiva. As a result of its effect on matrix metalloproteinase, zinc is useful for treating the lesions and preventing their recurrences. This study aimed to compare the efficacy of a combination of oral zinc acetate 50 mg tablets and the 0.1% triamcinolone acetonide Orabase with Orabase alone in the healing process of symptomatic oral lichen planus (OLP). Forty patients attending the Department of Oral Medicine were randomly included in the study and were categorized into 2 groups, group A and group B. Group A (control group) and group B (case group) each comprised 20 patients with clinically and histopathologically confirmed OLP and symptoms of burning sensation. Group A received the 0.1% triamcinolone acetonide Orabase 2 times daily. Group B received 50 mg zinc acetate tablets plus Ora-base 2 times daily for 8 weeks. Orabase was discontinued after 1 week of application in the case group, whereas zinc acetate tablets were continued throughout the treatment period. The follow-up period was 2 months. Lesion size and burning sensation were measured by using the Thongprasom scale and the visual analogue scale (VAS) at initial and weekly visits till cessation of treatment. A decrease in pain intensity from the first visit to the follow-up visit was statistically significant in both groups (P = .000). Group B showed higher mean pain intensity from the initial visit to the follow-up visit compared with group A. Mean difference between the first and follow-up visits in the study group showed that there was a gradual decrease in pain intensity, whereas the control group showed minimal difference compared with the study group; the difference was not statistically significant (P = .498). There was statistically significant gradual decrease in lesion size till the follow-up period in both groups (P = .000). Oral zinc therapy was found to be an adjunct in reducing burning sensation and lesion size in symptomatic OLP.