Comparison of platelet rich plasma and injectable steroids in the treatment of oral lichen planus: A systematic review and meta-analysis

Oral lichen planus (OLP) is the common acute or chronic, potentially malignant disorder of the oral mucosa. Steroids the primary treatment for OLP; however, their chemical composition often leads to significant side effects. Platelet-rich plasma (PRP), an autologous biologically active material has been explored as an alternative treatment option. This systematic review evaluates the effects of autologous platelet-rich plasma compared to injectable steroids for treatment of OLP. A comprehensive search for randomized controlled trials were conducted in PubMed, Web of Science, Google Scholar, and Scopus using search terms such as "oral lichen planus and corticosteroids and platelet rich plasma injection," "oral lichen planus and corticosteroids," "oral lichen planus and corticosteroids and PRP," "oral lichen planus and PRP," "OLP and PRP and steroid." Articles selection followed the Preferred Reporting Items for Systematic Reviews and meta-analysis guidelines. A meta-analysis was performed to group studies and determine summary effect estimates. A total of nine Randomized Controlled Trials (RCT) involving 266OLP patients were included in the analysis. Both treatment methods demonstrated a statistically significant improvements in outcome parameters including lesion size, pain scores, and burning sensations from baseline to the end of treatment and during follow-up visits. Patients treated with autologous PRP reported lower levels of pain and burning sensations compared to those treated with corticosteroids. A significant difference was observed between the two treatments with PRP showing greater effectiveness in alleviating pain and burning sensation than injectable steroids. Both platelet-rich plasma and injectable steroids effectively reduce lesion size and pain in OLP patients as measured by the Visual Analog Scale (VAS). However, the difference in efficacy between the two treatments was not statistically significant. Nonetheless, platelet-rich plasma can be considered promising alternative treatment to injectable steroids.