Evaluation of the therapeutic effect of topical calcipotriol versus topical tretinoin in treatment of oral Leukoplakia and their effect on clinical improvement and salivary level of MMP-9, IL-6 and TGF-β: A Randomized Clinical Trial

Abstract

Background: Leukoplakia is the most common potentially malignant lesion of the oral cavity. The main objective in treatment of oral leukoplakia is to prevent malignant transformation. Retinoids and vitamin D analogues have anti-keratinizing and immunomodulatory properties and proven effectiveness in the treatment of leukoplakia.Aim of the study: the aim of this clinical trial was to compare the effectiveness of topical calcipotriol versus topical tretinoin in treatment of oral leukoplakia regarding changes in clinical score as well as salivary IL-6, TGF- β and MMP-9 levels.Methodology: 40 patients with oral leukoplakia were randomly assigned into two groups. Group 1: (n=20) patients were treated with topical calcipotriol gel applied twice daily for 4 weeks. Group 2: (n=20) patients were treated with topical tretinoin cream applied twice daily for 4 weeks. Clinical improvement as well as salivary level of TGF-β, IL-6 and MMP-9 was evaluated 4 weeks after treatment and compared to baseline values.Results: Both treatments resulted in clinical improvement with no significant differences between groups. However, calcipotriol produced a highly statistically significant reduction in salivary IL-6 and MMP-9 compared to tretinoin while both treatments caused significant reduction in salivary TGF-β with no significant difference.Conclusion: Calcipotriol could be considered a promising therapeutic alternative with fewer side effects for the treatment of oral leukoplakia.