Abstract
Hyaluronic acid (HA) has anti-inflammatory and anti-edematous effects and, thus, could be promising in the treatment of oral lichen planus (OLP). The aim of the study was to evaluate the effects of topical hyaluronic acid, compared to placebo, on salivary levels of calprotectin, interleukin-6 (IL-6), and bacteria, as well as clinical and subjective parameters. Fourteen patients with confirmed OLP were included. After random selection, patients started with either 0.2% hyaluronic acid or a placebo gel for 6 weeks. Following a wash-out period, the groups changed the application. Whole saliva, clinical parameters, and questionnaires were evaluated before and after the intervention, as well as after the crossover phase. Salivary calprotectin, IL-6, and inflammation-related bacteria were determined by ELISA and PCR, respectively. There were no significant differences in clinical or subjective outcome parameters, salivary levels of IL-6, calprotectin, or bacteria after the application of hyaluronic acid, compared to placebo. However, only nine patients completed the study, as five out of seven patients starting with placebo were lost to follow-up. Significant effects of HA on inflammatory mediators and clinical parameters in OLP patients could not be proven, although a trend in clinical severity improvement could be observed.
Highlights
Oral lichen planus (OLP) affects around 2% of the adult population, with a higher prevalence in women [1]
Baseline amount of saliva was 1.0 ± 0.8 g, which increased by 0.3 ± 0.5 g in the Hyaluronic acid (HA) group and
Due to its beneficial properties for tissue regeneration and wound healing, topical HA has been shown to be a useful adjuvant in the treatment of gingivitis and chronic periodontitis, as well as during the postoperative period for faster healing and to reduce patients’ discomfort [22]
Summary
Oral lichen planus (OLP) affects around 2% of the adult population, with a higher prevalence in women [1]. OLP is considered an inflammatory mucocutaneous disease; the mechanisms are not entirely clarified. A genetic (HLA-DR2) background and infection as a predisposing or provoking factor are considered to be involved in the pathogenesis of OLP [3]. Patients often suffer from pain or burning sensations, and from psychosocial impairment linked to anxiety and the burden of a chronic, and potentially malignant, disease, even if the malignant transformation is only in a small subset of OLP patients (around 1.1%) [4]. Erosive oral mucosal conditions radically affect oral health-related quality of life, and are accompanied by a high frequency of psychological problems [2]. Pathognomonic reticular lesions (Wickham striae) are usually discovered incidentally during routine intraoral examination, and are mostly asymptomatic
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