Treatment Of Oral Lichen Planus Research Articles

Photobiomodulation Therapy in the Management of Oral Lichen Planus: A Systematic Review and Meta-Analysis.

Photobiomodulation therapy (PBMT) is a non-invasive and the latest form of therapy used in the treatment of non oncological diseases as well as cancers of various types and locations. The aim of this study was to systematically review and assess the efficacy of PBMT in managing oral lichen planus (OLP) compared to the interventions. A systematic review and meta-analysis were implemented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search using PubMed, Scopus, and Cochrane was conducted to retrieve relevant studies published until June 2023. The outcomes evaluated included the reduction in pain score and clinical severity scores (Prospero No CRD42023428626). A total of eight studies were identified for qualitative synthesis. The pooled analysis incorporating six studies revealed that there are no significant differences for both mean pain score (mean difference [MD] = 0.21, 95% confidence interval [CI] = -0.51, 0.93) as well as clinical score (MD = -0.08, 95% CI = -0.4, 0.25) between PBMT and comparison groups. Subgroup analysis based on corticosteroids as controls showed that there was no significant difference in mean reduction in pain score between PBMT and topical steroids (MD = 0.38, 95% CI = -0.54, 1.31). PBMT is as effective as other interventions in the treatment of OLP, though not superior, and can be a promising alternative treatment for cases resistant to steroids or when steroids are contraindicated. Further studies are recommended to standardize the optimal settings for the treatment of OLP.

Efficacy of antimalarials in oral lichen planus: A systematic review.

To evaluate whether hydroxychloroquine (HCQ) or chloroquine (CQ) are effective for the treatment of oral lichen planus (OLP). A literature search was conducted in four databases. Clinical studies investigating the effect of HCQ/CQ in patients with OLP were included. Eleven studies were included. Four were RCTs and seven quasi-experimental studies. The studies included 390 patients diagnosed with OLP, of which 326 and 7 received HCQ and CQ, respectively. 46 patients received topical dexamethasone, 5 placebo and 6 griseofulvin as controls. Five studies assessed pain, and all of them obtained pain reduction with the use of HCQ. Six studies reported objective clinical improvement of OLP with the use of HCQ. Five studies that used a subjective scale obtained that 24%-100% of the patients achieved a complete/almost complete improvement of OLP lesions and its symptomatology. The most frequent side effects were vision problems, gastric discomfort, rash, nauseas, headaches, skin pigmentation, and elevated kidney function. 17 patients had to withdraw from the studies. Current evidence is scarce to confirm HCQ as a therapeutic option for OLP. More RCTs are needed to compare its efficacy with topical corticosteroids and to evaluate whether HCQ reduces relapses of OLP.

Animal models to study the pathogenesis and novel therapeutics of oral lichen planus.

Oral lichen planus (OLP) is a prevalent oral mucosal disease characterized by an unknown etiology and a complex pathogenesis. Patients with OLP endure a chronic course marked by alternating non-erosive and erosive lesions, with no definitive cure currently available. Particularly challenging is the treatment of recalcitrant erosive OLP, highlighting an urgent need for therapies targeting specific pathogenic pathways. In diseases like OLP, where the etiopathogenesis is intricate and elusive, animal models are indispensable for hypothesis testing and elucidating disease mechanisms. To date, only three animal models for oral lichenoid lesions have been reported in the literature. This Perspective paper evaluates these existing models, along with a novel OLP mouse model introduced at the 3rd International Conference on Oral Mucosal Immunity and Microbiome. The validity of these models is critically assessed, and their potential future applications in advancing our understanding of OLP are discussed.

Evaluation of Turmeric, Ashwagandha, and Aloe Vera in the Management of Oral Lichen Planus Lesion

ABSTRACT Objectives: This study was conducted to evaluate the efficacy of turmeric, ashwagandha, and aloe vera in the management of oral lichen planus (OLP) lesion. Materials and Methods: Thirty patients with histologically confirmed symptomatic OLP with gingival presentation were included in this comparative investigation. Three groups of participants were created: Group I consisted of turmeric; group II included ashwagandha; and group III included aloe vera. For 3 weeks in a row, they were told to apply topical treatments twice a day. The patients were recalled for 4 to evaluate the cessation of symptoms. Result: The participants in all the groups showed a considerable improvement in the burning lesion size and pain after 4 months of follow-up. Conclusion: For the treatment of OLP, turmeric, ashwagandha, and aloe vera can be useful as substitute topical medications, particularly for those who are not responsive to topical corticosteroids.

TYK2 inhibition with deucravacitinib ameliorates erosive oral lichen planus.

Erosive oral lichen planus (OLP) is a challenging disease. This T cell driven disorder frequently shows a treatment unresponsive course and strongly limits patients' quality of life. The disease lacks FDA or EMA approved drugs for its treatment and the efficacy of the commonly administered treatments (i.e. topical and systemic steroids, steroid sparing agents) is often only partial. Although the etiopathogenesis of the disease still needs to be fully elucidated, recent advances helped to identify interferon-ɣ (IFN-ɣ) as a pivotal cytokine in OLP pathogenesis, thus making the interference with its signalling a therapeutic target. Janus kinase (JAK) inhibitors therefore gained relevance for their inhibitory effect on IFN-ɣ signalling. While some drugs such as abrocitinib, upadacitinib, tofacitinib directly interfere with IFN-ɣ signalling through blockade of JAK1 and/or JAK2, deucravacitinib, a selective TYK-2 inhibitor indirectly interferes on IFN-ɣ activation through interference with interleukin (IL)-12, a potent promotor for Th1/IFN-ɣ responses. This mechanism of action makes deucravacitinib a candidate drug for the treatment of OLP. Here we provide initial evidence that deucravacitinib 6 mg daily has a beneficial effect in three patients with oral OLP.

The efficacy of Punica granatum extract gel in the treatment of symptomatic oral lichen planus in an Indian population: A clinical study.

The autoimmune disorder, oral lichen planus (OLP), primarily affects oral mucous membranes. Current drug treatments are only palliative and have serious side effects. Pomegranate has been used as a potential herbal remedy for the treatment of OLP. The study consisted of a sample size of 30 individuals who were diagnosed with symptomatic OLP based on both clinical and histological evidence and were equally assigned to Group A (4% topical Punica granatum seed extract gel, which has been customized for this particular study purpose only) and Group B (0.1% topical steroid). All patients were evaluated for the outcome criteria of pain, burning sensation, and lesion size. In the present study, results were highly statistically significant (P = 0.001) in intragroup observation for both Group A and Group B from baseline to the end of 30 days of follow-up for all three parameters. There was no statistically significant difference between groups for each week of follow-up. P. granatum has been used in very few studies, but this is one of the few where a gel made from P. granatum seed extract is used as an oral gel. In conclusion, it can be said that topical P. granatum extract gel is as good as topical corticosteroids at getting rid of the signs and symptoms of OLP, so it can be used as an alternative treatment.

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

Oral lichen planus (OLP) is a chronic inflammatory condition affecting the oral mucosa. The current reviewinvestigated the potential effectiveness of injectable platelet-rich fibrin (i-PRF) as a treatment for OLP when compared to other interventions. The current review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was implemented across databases such as PubMed, Embase, Scopus, Web of Science, CINAHL, and Google Scholar. The search utilized a combination of Boolean operators (AND, OR) and Medical Subject Headings (MeSH) terms to capture relevant studies. Comparative clinical studies focusing on i-PRF as a treatment for OLPand other interventions were included. Outcomes assessed were pain, surface area of lesions, and patient satisfaction. Review Manager 5.4 was used for statistical analysis. The Risk of Bias 2.0 (RoB 2.0) tool was used to assess the methodological quality of the studies. Three studies were included for the final analysis. The findings indicated that both the i-PRF and comparison treatment groups demonstrated reductions in pain and lesion size. The post-treatment Visual Analogue Scale (VAS) scores showed a decrease in pain intensity, and there was an improvement in lesion extension in the i-PRF-treated sites. The results also revealed increased patient satisfaction with i-PRF treatment. Adverse effects were not reported or specified in the included studies. Quantitative analysis for pain (VAS) showed a mean difference of 0.38 (95% CI: 0.63-1.40), but there was no significant difference between the i-PRF and control groups at p=0.46. Though intragroup differences showed statistically significant differences between pre and post intervention, intergroup differences were not significant for any of the assessed outcomes. The findings from this study suggest that i-PRF holds promise as a potential treatment for OLP. The use of i-PRF resulted in pain reduction, lesion size improvement, and increased patient satisfaction. However, it is important to consider the limitations of the included studies, such as variability in study designs, small sample sizes, and the limited number of studies.

Evidence-based effectiveness of Ozone therapy in the treatment for oral lichen planus - A systematic review.

Oral lichen planus is a common, chronic mucocutaneous condition of uncertain origin. Early treatment of OLP can dramatically reduce the risk of further development, which in turn reduces the risk of developing cancer. Numerous methods can be used to treat OLP. Since the significance of ozone in treating this disease is still uncertain. This systematic review was conducted based on english databases, including PUBMED, SCOPUS, Embase, Ovid, and Journal of Web up to July 2022. We used the search phrases "ozone," "ozone in the treatment of oral lichen planus," "oral lichen planus," and "ozone therapy." Finally, five papers were selected for qualitative analysis. This review included a total of five papers, four of which were clinical trials and one was a longitudinal study. All studies included the erosive form of OLP, also ozone therapy was applied to patients who did not respond to conventional treatment. Ozone showed significant therapeutic effects in terms of reduction in pain and size of the lesion. The signs and symptoms associated with OLP such as burning sensation, lesion size, and scarring all considerably improved with ozone therapy.

Efficacy of Clobetasol Propionate (0.05%), Amlexanox (5%), and Triamcinolone Acetonide (0.1%) in the Treatment of Oral Lichen Planus.

This study aimed to compare the efficiencies of 0.05% clobetasol propionate, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of oral lichen planus (OLP). A total of 120 patients diagnosed with oral lichen planus were equally divided into three groups and treated with 0.05% clobetasol propionate (group A), 0.1% triamcinolone acetonide (group B), and 5% amlexanox (group C) topical medicaments. The patients were evaluated for pain using the visual analog scale (VAS) and erosive lesion. There was a statistically significant decrease in the VAS pain scale score from day 1 to day 15 in all of the tested groups. There was also a reduction in the erosive area on the right and left buccal mucosa on the 15th day with all three tested drugs. Triamcinolone acetonide (0.1%) was effective in reducing the erosive lesions on buccal mucosa when compared with 0.05% clobetasol propionate and 5% amlexanox. Clobetasol propionate, triamcinolone acetonide, and amlexanox were effective in treating OLP patients.

Efficacy and safety of tacrolimus for local steroid-ineffective oral lichen planus

ObjectiveLocal steroid therapy is the first-line treatment for oral lichen planus (OLP); however, steroid-resistant cases are often observed. Local tacrolimus therapy is a good candidate as an effective treatment option for steroid-ineffectiveness. In this study, we retrospectively investigated the efficacy and safety of local tacrolimus for local steroid-ineffective OLP. Materials and methodsTwenty one patients with OLP who visited our clinic between January 2017 and December 2022 and received local tacrolimus therapy were included. We evaluated the clinical type, histopathological features, therapeutic efficacy, and side effects. Therapeutic efficacy was assessed by Reticulation/keratosis, Erythema, and Ulceration scores (REUs) and Numerical Rating Scale (NRS) scores and compared between local steroid and tacrolimus. ResultsWhen we evaluated the clinical characteristics of the patients, red type was predominant (90.5%), and histologically, epithelium thinning was prominent (76.2%). No significant reduction of REUs was observed after steroid treatment (p = 0.227, rate of change score; +0.7%); however, tacrolimus-switching showed a significant effect not only on REUs but also NRS scores (p = 0.0000639, rate of change score; −73.5%). Oral candidiasis (five cases) and irritation (one case) were observed as side effects; however, no patients showed canceration. ConclusionsLocal tacrolimus should be one of the treatment options for steroid-resistant OLP.

Non-Coding RNAs as Potential Targets for Diagnosis and Treatment of Oral Lichen Planus: A Narrative Review.

Oral lichen planus (OLP) is a chronic inflammatory disease that is characterized by the infiltration of T cells into the oral mucosa, causing the apoptosis of basal keratinocytes. OLP is a multifactorial disease of unknown etiology and is not solely caused by the malfunction of a single key gene but rather by various intracellular and extracellular factors. Non-coding RNAs play a critical role in immunological homeostasis and inflammatory response and are found in all cell types and bodily fluids, and their expression is closely regulated to preserve normal physiologies. The dysregulation of non-coding RNAs may be highly implicated in the onset and progression of diverse inflammatory disorders, including OLP. This narrative review summarizes the role of non-coding RNAs in molecular and cellular changes in the oral epithelium during OLP pathogenesis.

Preliminary Assessment of Polysaccharide-Based Emulgels Containing Delta-Aminolevulinic Acid for Oral Lichen planus Treatment.

Photodynamic therapy using delta-aminolevulinic acid is considered a promising option in the treatment of oral lichen planus. In the present work, three emulgel compositions prepared from natural polysaccharide gums, tragacanth, xanthan and gellan, were preliminarily tested for oromucosal delivery of delta-aminolevulinic acid. Apart from cytotoxicity studies in two gingival cell lines, the precise goal was to investigate whether the presence of the drug altered the rheological and mucoadhesive behavior of applied gelling agents and to examine how dilution with saliva fluid influenced the retention of the designed emulgels by oromucosal tissue. Ex vivo mucoadhesive studies revealed that a combination of xanthan and gellan gum enhanced carrier retention by buccal tissue even upon dilution with the saliva. In turn, the incorporation of delta-aminolevulinic acid favored interactions with mucosal tissue, particularly formulations comprised of tragacanth. The designed preparations had no significant impact on the cell viability after a 24 h incubation in the tested concentration range. Cytotoxicity studies demonstrated that tragacanth-based and gellan/xanthan-based emulgels might exert a protective effect on the metabolic activity of human gingival fibroblasts and keratinocytes. Overall, the presented data show the potential of designed emulgels as oromucosal platforms for delta-aminolevulinic acid delivery.

Effect of zinc supplementation as an adjuvant to corticosteroid treatment in patients with oral lichen planus: A systematic review.

Oral lichen planus (OLP) and one of its main presentations, desquamative gingivitis, are common diseases with no definite treatment. Zinc deficiency has a critical role in the pathogenesis of oral mucosal diseases. The current study systematically reviewed the effect of zinc in addition to topical corticosteroids in the treatment of OLP. English articles in PubMed, Web of Sciences, Embase, and Scopus were searched until August 2022. The differences in symptoms were analyzed, including pain, burning sensation, and lesion sizes in patients with lichen planus receiving zinc supplementation as an adjuvant to corticosteroid treatment. A total of 148 articles related to the searched keywords were found. Eventually, two clinical trials were selected. The total population of studied individuals included 60 patients. Due to the high heterogeneity between the studies, meta-analysis was not possible. Administering zinc, in addition to corticosteroids, did not improve the symptoms compared to corticosteroid monotherapy. Considering the limited number of studies and lack of sufficient evidence, it is not currently possible to reach a definite conclusion regarding the effects of zinc on OLP.

Oral Cavity Squamous Cell Carcinomas in Patients with a History of Oral Lichen Planus: Frequency and Outcomes

Oral lichen planus (OLP) is an inflammatory condition which affects the mucous membranes of the oral cavity. While previous studies have described the association between OLP and development of oral cavity cancer, there is currently a paucity of literature examining the impact of this disease on treatment response and prognosis. As such, we present a retrospective cohort study of Oral cavity squamous cell carcinoma (OCSCC) patients with a history of OLP to explore the course of their disease. Using an IRB approved tertiary care registry of head and neck cancer patients, we identified patients with OCSCC who had a prior diagnosis of OLP. The number of new primary tumors, rates of local (LF), regional (RF) and distant failure (DF), as well as overall survival (OS) were assessed using Cox proportional hazards and Kaplan Meier analysis for actuarial survival estimates. Fifty-four patients with OCSCC and OLP were identified with 109 individual OCSCC diagnoses. Patients had a median age of 67 years, were predominantly female (n = 42, 77.8%) and never smokers (n = 29, 53.7%) with a median follow up after diagnosis of OCSCC of 46.5 months. Nine patients (16.7%) had a history of immunosuppression of whom 6 (11.1%) had chronic steroid use for treatment of OLP. Within the cohort, 33 (61.1%) of OLP patients had a single OCSCC, 11 (20.4%) had 2, and 10 (18.5%) had >3 separate tumors develop. The most common oral cavity subsites were oral tongue (n = 42, 38.5%), followed by alveolar ridge (n = 14, 12.8%) and gingiva (n = 13, 11.9%). Papillary SCC subtype was identified in 10.1%. 92.7% of tumors (n = 101) were treated with primary surgery, with 23 (21.1%) receiving adjuvant RT and 10 of those patients receiving concurrent chemotherapy. Among resected patients, pathologic stages were predominantly T1-2 (84.1%) and N0 (50% vs N1 15.6% and N2a-3 34.4%). The mean RT dose was 62 Gy in 32 fractions. Locoregional failure occurred in 24.8% of cancers (n = 27), with local and regional failure occurring in 13.8% (n = 15) and 11% (n = 12) of lesions, respectively. Recurrence free survival at 3 and 5 years was 75% and 70.3%, respectively, with overall survival at 3 and 5 years of 71.1% and 67%, respectively. Patients with OCSCC and a history of OLP are predominantly female and never smokers. The tumors that develop in such patients are often early stage but a proportion of patients appear to be at higher risk of developing multiple malignancies and surveillance of this patient population to identify new tumors is crucial.

Salivary Interleukin-6 Level in Iraqi Patients with Oral Lichen Planus receiving Platelet-Rich Plasma Injections

Background: Interleukin-6 (IL-6) is a cytokine that has several functions, including stimulating growth and inhibiting cell death. It has the potential to operate as a biomarker for the accurate prediction of disease severity and activity, platelets-rich plasma was used in the treatment of oral lichen planus and can change the salivary IL-6 level. Objectives: To study the clinical outcome of intralesional platelets-rich plasma in patients with oral lichen planus and to measure salivary IL-6 levels before and after the treatment with platelets-rich plasma were the aims of this study. Subjects and Methods: In this clinical trial, for each patient a standardized case sheet was filled including demography, social, medical, and medication history. Before receiving, each patient was examined for phenotype, color, size, and site of oral lichen planus lesions. Patient's salivary samples were taken between 8 and 11 a.m. Three to four milliliters of saliva was obtained from each patient. The ELISA kit for IL-6 using sandwich-ELISA technique, to measure salivary IL-6 before and after PRP injections. Results: Thirteen oral lichen planus patients were took part in this study, six males (46.2%) and seven females (53.8%). The patients were between 32 and 91 years of age, with a mean age of 60.2(±13.9) years. All symptomatic and most of the hyperemic ones showed improvement after PRP injections, while the size of the lesions was resistant to change. Mean salivary IL-6 was 44.27 pg/mL (±43.24) before PRP injections and (69.74±59.86 pg/mL) after PRP injections. No significant difference was found, however IL-6 was higher after PRP injections. In relation to color changes after PRP, there was a significant changes in IL-6 level compared with that before PRP injections. Similarly, a significant relation was found between IL-6 level and signs and symptoms; pain and burning sensation. No association was found in salivary IL-6 level in relation to lesion phenotype, size, and location. Conclusion: All symptomatic OLP lesions that were treated with intralesional PRP responded very well, similarly almost all hyperemic lesions turned into normal mucosal color after completing the course of treatment. The majority of OLP lesions showed an increased salivary IL-6 levels after PRP treatment.

A retrospective cohort study of the efficacy of metronidazole in oral lichen planus.

Lichen planus (LP)is an inflammatory dermatosis with mucosal variants, including oral LP (OLP). OLP has a relapsing chronic course and may significantly affect a patient's quality of life. We analysed the efficacy of metronidazole as a treatment for OLP via a retrospective chart review of patients with a diagnosis of OLP seen at our institution over 10 years. Thirty patients with OLP were treated with metronidazole 500 mg twice daily. Most patients (n = 18; 60%) showed improvement with metronidazole, including 10 (33%) who experienced complete resolution of symptoms. Our results were limited by the retrospective nature of the review and the relatively small cohort size. Given the efficacy, mild side-effect profile and the less immunosuppressive nature of metronidazole vs. alternative systemic treatment options, metronidazole is a reasonable option to try in patients with symptomatic OLP who have failed topical treatment options.

Network Pharmacology and Molecular Docking Analysis Exploring the Mechanism of Tripterygium wilfordii in the Treatment of Oral Lichen Planus.

Background: Oral lichen planus (OLP) is an infrequent autoimmune disease of the oral mucosa, which affects up to 2% of the world population. An investigation of Tripterygium wilfordii's mechanism of action for treating OLP was conducted, and a theoretical basis was provided for improving current treatment regimens. Materials and Methods: We used a network pharmacological approach to gain insight into the molecular mechanism of Tripterygium wilfordii in the treatment of OLP. Then, potential protein targets between Tripterygium wilfordii and OLP were analyzed through a drug-target network. This was followed by KEGG enrichment analysis and Gene Ontology (GO) classification. Finally, for molecular docking, AutoDock Vina was used. Results: A protein-protein interaction (PPI) network was constructed by analyzing the common targets of a total of 51 wilfordii-OLP interactions from different databases. The GO and KEGG enrichment analyses showed that the treatment of OLP with Tripterygium wilfordii mainly involves lipopolysaccharide response, bacterial molecular response, positive regulation of cytokine production, and leukocyte proliferation, and the signaling pathways mainly include the AGE-RAGE, NF-κB, Toll-like receptor, IL-17, HIF-1, and TNF signaling pathways. The molecular docking results showed that β-sitosterol, kaempferol, hederagenin, and triptolide have a higher affinity for AKT1, TNF, CASP3, and PTGS2, respectively. Based on the CytoNCA analysis of common targets, 19 key targets, including AKT1, TNF, VEGFA, STAT3, CXCL8, PTGS2, TP53, and CASP3, and their connections were identified. Conclusions: Preliminarily, this study reveals that Tripterygium wilfordii interferes with OLP by interacting with multiple targets through multiple accesses, as validated by molecular docking.

Treatment of Oral Lichen Planus: A Systematic Review

Objective: Oral Lichen Planus (OLP) treatment or clinical management is challenging. This systematic review aims to discuss the main therapy used in the management of OLP and the efficacy of every type of treatment to improve the quality of patient life. Methodology: We discussed the publications on the clinical management of oral lichen planus on the PubMed database. Only randomized controlled trials (RCT) conducted in humans were considered. We included randomized controlled trials (RCT) published from 2005/1/1 to 2021/5/28 with symptomatic, clinically, or histologically diagnosed OLP. We compared different active treatments or between active treatment and placebo. Results: Twenty randomized controlled trials involving 931 patient samples were included in the analysis. For the short time treatment (on average 2-8 weeks) of OLP, TCI, including Tacrolimus, pimecrolimus, and Ciclosporin, were similar to TCS, including Clobetasol, triamcinolone in efficacy. Tacrolimus–Triamcinolone resulted in similar outcomes. In addition, Tacrolimus and Ciclosporin showed a statistically higher incidence of local adverse events than triamcinolone and Clobetasol. A few systemic adverse events occurred in the tacrolimus and ciclosporin groups, but they were not serious. Conclusion: Triamcinolone acetonide 0.1% should be the first drug of choice when selecting TCS, and Tacrolimus 0.1% should be the drug of choice when selecting TCI. J Bangladesh Coll Phys Surg 2023; 41: 219-233

3D printed mucoadhesive orodispersible films manufactured by direct powder extrusion for personalized clobetasol propionate based paediatric therapies

The aim of this work is the development and production by Direct Powder Extrusion (DPE) 3D printing technique of novel oral mucoadhesive films delivering Clobetasol propionate (CBS), useful in paediatric treatment of Oral Lichen Planus (OLP), a rare chronic disease. The DPE 3D printing of these dosage forms can allow the reduction of frequency regimen, the therapy personalization, and reduction of oral cavity administration discomfort. To obtain suitable mucoadhesive films, different polymeric materials, namely hydroxypropylmethylcellulose or polyethylene oxide blended with chitosan (CS), were tested and hydroxypropyl-β-cyclodextrin was added to increase the CBS solubility. The formulations were tested in terms of mechanical, physico-chemical, and in vitro biopharmaceutical properties. The film showed a tenacious structure, with drug chemical-physical characteristics enhancement due to its partial amorphization during the printing stage and owing to cyclodextrins multicomponent complex formation. The presence of CS enhanced the mucoadhesive properties leading to a significant increase of drug exposure time on the mucosa. Finally, the printed films permeation and retention studies through porcine mucosae showed a marked retention of the drug inside the epithelium, avoiding drug systemic absorption. Therefore, DPE-printed films could represent a suitable technique for the preparation of mucoadhesive film potentially usable for paediatric therapy including OLP.

ANXIETY AND DEPRESSION AS POTENTIAL PSYCHOPATHOLOGICAL FACTORS FOR ORAL LICHEN PLANUS

Objective The present study aimed to evaluate the possible relationship between oral lichen planus (OLP) and symptoms of depression and anxiety, as well as combined therapeutic approaches in the treatment of OLP. Study Design Searches were performed in PubMed (Medline), BVS (Lilacs), and Cochrane library databases to identify relevant scientific articles using the following search terms: "oral lichen planus", "depression", "anxiety" and "treatment", in such a way that 33 publications were initially found. After application of inclusion and exclusion criteria, a total of 16 articles were selected for the main body reading. Results According to the analyzed literature, potential relationship between OLP and depression and anxiety was suggested, although there were divergences between the different studies. Currently, there is still no consensus on a gold-standard treatment for these lesions, even emphasizing the use of alternative therapies that have demonstrated some efficacy. In addition, recidivism is notable among patients with OLP, since psychological factors hypothetically affect healing during treatment. Conclusion The emergence of OLP lesions can be related to psychopathological risk factors such as depression and anxiety and, even if they are not standardized, alternative therapies are effective, while each case of OLP has its peculiarity. The present study aimed to evaluate the possible relationship between oral lichen planus (OLP) and symptoms of depression and anxiety, as well as combined therapeutic approaches in the treatment of OLP. Searches were performed in PubMed (Medline), BVS (Lilacs), and Cochrane library databases to identify relevant scientific articles using the following search terms: "oral lichen planus", "depression", "anxiety" and "treatment", in such a way that 33 publications were initially found. After application of inclusion and exclusion criteria, a total of 16 articles were selected for the main body reading. According to the analyzed literature, potential relationship between OLP and depression and anxiety was suggested, although there were divergences between the different studies. Currently, there is still no consensus on a gold-standard treatment for these lesions, even emphasizing the use of alternative therapies that have demonstrated some efficacy. In addition, recidivism is notable among patients with OLP, since psychological factors hypothetically affect healing during treatment. The emergence of OLP lesions can be related to psychopathological risk factors such as depression and anxiety and, even if they are not standardized, alternative therapies are effective, while each case of OLP has its peculiarity.