Management of Oral Leukoplakia – A Systematic Umbrella Review of Global Evidence

Objective: To summarize the global evidence related to various interventions for treating Oral Leukoplakia. Introduction: Oral leukoplakia is a common oral potentially malignant lesion that precedes the development of oral cancer. The main aim of any treatment is to prevent the malignant transformation. This umbrella review updates the global evidence of different medicinal treatment available for Oral Leukoplakia. Methods: The databases searched were Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, Scopus. The key terms used were leukoplakia, oral leukoplakias, Proliferative verrucous leukoplakia, interventions, management, chemoprevention, laser, photodynamic, topical agents. JBI Sumari software was used to screen and appraise the articles along with data extraction and data synthesis. Results: A total of 670 citations were identified through the electronic search. Out of which 61 systematic reviews were recognized. Following removal of duplicates, 47 records were retrieved. The full texts of 13 papers were retrieved for further examination with 9 systematic reviews meeting the inclusion criteria and therefore included in this umbrella review. Study overlap calculation was conducted and pooled results showed that the treatments available for oral leukoplakia has little effect on clinical response and malignant transformation rate. Conclusions: Currently we do not have evidence of a treatment that is preventing oral leukoplakia from converting to oral cancer. Treatments such as vitamin A and beta carotene may be effective in reducing clinical size of oral lesions. More long-term studies are required for surgical management, lasers and photodynamic therapy.