Recurrence in oral lichen planus: a systematic review and meta-analysis

Oral lichen planus (OLP) is a chronic immune-mediated disorder characterized by a complicated aetiology and the potential for malignant transformation. This meta-analysis aims to investigate the relationship between the recurrence of OLP and the treatment strategies employed. Studies of the recurrence rate following OLP treatment were searched using the PubMed, Embase, Web of Science, Scopus, and Cochrane Library databases until June 2025. The effect and corresponding 95% confidence interval (CI) for the recurrence rate were analysed using Stata version 18.0. Subgroup analyses were conducted based on the treatment strategy, geographic region, study type, follow-up duration, and definition of recurrence. A meta-regression analysis was performed to determine the correlation between follow-up duration and OLP recurrence. A total of 28 studies encompassing 1347 patients with OLP were included. The results showed that the pooled recurrence rate was 27% (CI 0.20–0.34, I2 = 82.1%, p < 0.001), with the effects of the different treatments observed in decreasing order as follows: calcineurin inhibitor (43%, CI 0.03–0.57, I2 = 0.0%, p = 0.0627) > sterol (40%, CI 0.32–0.49, I2 = 74.4%, p < 0.001) > photobiomodulation (PBM) therapy (16%, CI 0.09–0.24, I2 = 51.2%, p = 0.068) > platelet-rich products (PRPs) therapy (10%, CI −0.09–0.29, I2 = 0.0%, p < 0.001). Compared with the recurrence rate observed after other treatment strategies, the recurrence rate after treatment with PRPs was the lowest, while the recurrence rate after treatment with calcineurin inhibitors was the highest, followed by that after treatment with PBM and sterols. The pooled recurrence rate of OLP was 27%. PRPs and PBM may be promising therapeutic options for reducing recurrence rates. GRADE assessments revealed that PBM is supported by low-certainty evidence, sterols, PRPs, and calcineurin inhibitors are supported by very low-certainty evidence. Nevertheless, additional rigorous studies are needed to validate these findings and establish the most effective treatment strategy for patients with OLP. Based on these results, a better treatment plan can be developed, and the recurrence rate of OLP after treatment can be predicted and monitored.