Efficacy of Platelet-Rich Plasma Therapy in Oral Lichen Planus: A Systematic Review

Add-On Technologies That Aim to Improve Oocyte Quality and Embryo Implantation Potential

Advancements in assisted reproductive technologies (ARTs) have led to the development of various add-on techniques aimed at improving oocyte quality and enhancing embryo implantation potential. These techniques target critical stages of both oocyte and embryo physiology, including oocyte growth and maturation, fertilization, chromosomal status, and embryo development. Key approaches involve the optimization of in vitro fertilization (IVF) protocols, recruiting capable follicles giving rise to dynamic oocytes to evolve, culture media supplementation, preimplantation genetic testing (PGT), and mitochondrial replacement therapy (MRT), all of which are designed to enhance oocyte competence through its function and metabolism. The use of PGT has been promising in selecting embryos suitable for transfer, thus optimizing implantation success. Emerging technologies, such as platelet-rich plasma treatment (PRP), time-lapse imaging (TLI), and hyaluronan-rich (HA) culture media, claim to improve ovarian rejuvenation and uterine receptivity, embryo selection, as well as embryo implantation potential, respectively. Evidence for certain add-on approaches remains limited, but ongoing research suggests that the use of such treatments may lead to increased clinical pregnancies and live birth rates, especially in poor-prognosis patients. The present review describes the current state of the add-on innovations, their mechanisms of action, as well as their possibilities to increase ART success rates.

How to explain the beneficial effects of platelet-rich plasma

Platelet-rich plasma (PRP) is the platelet and leukocyte-containing plasmatic fraction of anticoagulated autologous blood. While evidence supporting the clinical use of PRP in dentistry is low, PRP is widely used in sports medicine, orthopedics, and dermatology. Its beneficial activity is commonly attributed to the growth factors released from platelets accumulating in PRP; however, evidence is indirect and not comprehensive. There is thus a demand to revisit PRP with respect to basic and translational science. This review is to (i) recapitulate protocols and tools to prepare PRP; (ii) to discuss the cellular and molecular composition of PRP with a focus on platelets, leukocytes, and the fibrin-rich extracellular matrix of coagulated plasma; and finally (iii) to discuss potential beneficial effects of PRP on a cellular and molecular level with an outlook on its current use in dentistry and other medical fields.

A Decadal Bibliometric Analysis on the Therapeutic Strategies in Oral Lichen Planus

Background and Aims

Oral Lichen Planus (OLP) is a common chronic inflammatory autoimmune illness that mostly affects the oral mucosa but may also affect other mucous membrane. It has higher prevalence in female patients of fourth to sixth decade of life with reticular being the commonest clinical variant. Clinical assessment, patient history, biopsy findings, and immunofluorescence were used to diagnose OLP. This study aimed to assess research publication trends in therapeutic strategies in the treatment of OLP, examining publication growth, country and institution contributions, and collaborative networks.

Methods

Using the Dimensions and Lens.org databases with Boolean operators combined the keywords a total of 40,046 peer-reviewed international publications were initially assessed. The article was selected from 2014 to December 2023. Through rigorous application of inclusion and exclusion criteria using an advanced search, a subset of 134 papers emerged to meet the high relevance standards. This subset, constituting a representative sample, was selected for in-depth bibliometric analysis.

Results and Conclusion

The result shows a clear upward trend in the number of publications, with a notable increase in 2018. After 2018, there is decrease in the number of publications, but it has an upward trend, reaching a peak of 215 in 2022. Chaitanya Nallan CSK leads the list of authors with four publications and a respectable total citation count of 12. Cairo University is the leading institution in this data set, with the 8 number of publications and 11 citations. The analysis revealed that at the top of the list is the "Egyptian Dental Journal" from Egypt, with six publications, four citations, and a link strength of two. In the second position is "BMC Oral Health" from the United Kingdom, with five publications, one citation, and a link strength of three. This study offers valuable insights for future research, clinical practice, and policy decisions.

Drug-Induced Oral Erythema Multiforme: A Report of a Rare Case

Erythema multiforme (EM) is an acute-onset, self-limiting inflammatory condition affecting the skin and mucous membranes. It exhibits a range of skin lesions, which is why it is referred to as "multiforme." Oral lesions, usually inflammatory and frequently marked by rapidly rupturing vesicles and bullae, often constitute a significant clinical feature. The exact etiology is obscure; however, it may be caused by multiple triggering factors. The most well-established connection is with a previous herpes simplex virus infection, while a smaller percentage of cases (<10%) are linked to drug use. Based on mucosal involvement, the condition is classified into two types: EM minor and EM major. Stevens-Johnson syndrome and toxic epidermal necrolysis (Lyell's disease) are now recognized as separate clinical conditions. EM usually exhibits a self-limiting course, with lesions typically improving within a few weeks. Avoiding triggers and using steroid therapy can be effective treatments. This paper documents a rare case of drug-induced oral EM featuring characteristic lip and intraoral lesions. The patient developed painful oral ulcers and difficulty in swallowing after taking azithromycin for a sore throat and fever. Clinical examination revealed multiple, hemorrhagic encrustations on the lips, along with ulcers on the right buccal mucosa and vesicular eruptions on the palate. The acute onset of multiple oral ulcers associated with a recent drug intake led to a diagnosis of drug-induced oral EM. Treatment included systemic prednisolone, topical triamcinolone paste, and supportive oral care. No recurrence was observed during the six-month follow-up.

Translational Research in Oral Lichen Planus: From Laboratory Discoveries to Clinical Applications

Oral lichen planus (OLP) is a chronic inflammatory condition that affects the oral mucous membrane, causing discomfort and pain for millions of people worldwide. Challenges in managing OLP include its chronic nature, varied clinical manifestations, poor patient compliance, and potential for malignant transformation. Recent breakthroughs in the therapy of OLP have opened up new paths for dental practitioners, yet persistent difficulties require attention. Topical calcineurin inhibitors, photodynamic treatment, and biologics have all demonstrated success in relieving symptoms and delaying disease progression. Furthermore, advances in understanding OLP's immunopathogenesis have revealed new targets for targeted treatments, raising hopes for more tailored therapy methods. However, obstacles remain, particularly in the area of long-term treatment and the danger of malignant transformation, needing close monitoring and interdisciplinary teamwork. This review will attempt to explore all of the therapeutic strategies for treating OLP that have been addressed in the literature.

Oral Lichen Planus: A Narrative Review Navigating Etiologies, Clinical Manifestations, Diagnostics, and Therapeutic Approaches

Background/Objectives: Oral Lichen Planus (OLP) is a common immune-mediated inflammatory disorder affecting the oral mucosa, impacting 0.5% to 2% of the global population, primarily middle-aged women. Immunological dysregulation is a key factor in OLP's pathogenesis, involving CD4+ T helper and CD8+ T cytotoxic cells. The World Health Organization (WHO) classifies OLP as a potentially malignant disorder, with a risk of oral squamous cell carcinoma (OSCC) developing in up to 2% of lesions. This narrative review aims to provide a comprehensive overview of the etiopathogenesis, clinical manifestations, diagnostic criteria, and therapeutic strategies for OLP, informing clinical practice and guiding future research. Methods: A review of the literature from the PubMed and Google Scholar databases was conducted up to December 2023, focusing on studies addressing the etiopathogenesis, diagnosis, clinical manifestations, and treatment of OLP. Results: OLP's pathogenesis is driven by immune dysregulation, with CD4+ and CD8+ cells playing crucial roles. Clinically, OLP presents as reticular, erosive, bullous, and plaque-like lesions. Diagnosis relies on clinical examination, histopathology, and direct immunofluorescence. Recent advancements in diagnostic markers and imaging techniques have improved detection and monitoring. Treatment primarily involves corticosteroids, but novel therapies such as curcumin, retinoids, and laser therapy are increasingly used for their effectiveness and reduced side effects. These treatments show promise in symptom reduction and recurrence prevention, although long-term data are needed. Conclusions: Regular screenings and biopsies are essential due to OLP's likelihood of malignant transformation. This study urges further investigation into long-term results, improved diagnostic techniques, and evidence-based treatment regimens.

Successful Pregnancy Following Platelet-Rich Plasma Intraovarian Injection and In Vitro Maturation of Oocytes in a 47-Year-Old Woman: A Case Report

In vitro maturation (IVM) of oocytes represents an assisted reproductive technique that involves the minimal or absence of ovarian stimulation and is beneficial to specific groups of patients. It is based on the collection of immature cumulus-oocyte complexes (COCs) from antral follicles, which are cultured in vitro until they reach the metaphase II (MII) stage. Once maturation is completed, IVM oocytes are normally fertilized, as during a conventional IVF protocol. On the other hand, ovarian rejuvenation through the intraovarian platelet-rich plasma (PRP) injection represents an innovative procedure intended to restore ovarian fertility and development, and it is used to enhance ovarian stimulation outcomes. Here, we report a case of a 47-year-old woman who underwent an assisted reproductive technology cycle (ART) with PRP injection and IVM, which resulted in a successful pregnancy.

Evaluation of clinical and demographical finding in patients with oral lichen planus: A retrospective cross sectional study

OBJECTIVE

Aim: To learn more about Oral Lichen Planus Iraqi patients, including their background information, symptoms, and prognosis.

PATIENTS AND METHODS

Materials and Methods: From the Oral and Maxillofacial Pathology Department, College of Dentistry, Baghdad University, we retrospectively reviewed the medical records of 68 patients with a histologically confirmed clinical diagnosis of oral lichen planus and subsequently contacted the patients by phone to evaluate their prognosis.

RESULTS

Results: Females were more likely than males to experience severe pain; the reticular form of Oral Lichen Planus was the most prevalent at 38.2%, but the erosive type was more prevalent among females. Only 53 of 68 patients responded to phone calls. More than 37% of those respondents reported involvement at a second location intra-orally following the first oral manifestation, and 20% had extraoral Lichen Planus, and approximately 22.6% of them observed changes in the morphology and behavior of the lesion after a brief period of time, while 26.4% experienced complete remission.

CONCLUSION

Conclusions: Females were more likely to have oral lichen planus. Females and elderly persons were more likely to have severe pain than other. The lesion must be monitored for symptomatic flare-ups over time.

Platelet-Rich Plasma (PRP) in Dermatology: Cellular and Molecular Mechanisms of Action

Platelet-rich plasma (PRP) therapy has gained attention in the scientific field due to its potential regenerative effects and great benefit-risk ratio. This review extensively explores the most studied mechanisms of this therapy according to the etiopathogenesis of skin diseases: cellular proliferation, matrix formation, regulation of inflammation, angiogenesis, collagen synthesis, and the remodeling of new tissue. Moreover, it draws on newly reported and lesser-known effects of PRP: its anti-apoptotic effects, immunological suppression, decrease in melanin synthesis, anti-microbial effects, overexpression of miR-155, antioxidant effects, and their involved pathways. This work aims to provide a complete update for understanding PRP's benefits and clinical relevance in wound healing, alopecia, pigmentary disorders, scars, rejuvenation, lichen sclerosus, and other inflammatory dermatoses, based on the current evidence. Furthermore, recent reports with novel indications for PRP therapy are highlighted, and new potential pathways correlated with the pathogenesis of skin diseases are explored.

Effect of platelet concentrates for pain and symptom management in oral lichen planus: an evidence-based systematic review

BACKGROUND

Platelet Concentrate (PC) injection therapy has shown potential as a local therapy for oral lichen planus (OLP). However, its safety and efficacy have not yet been fully established. Our research compared the efficacy of PC with topical steroid treatment in alleviating pain and symptoms related to OLP. We aims to present evidence-based alternatives that dentists can use to improve patient outcomes while reducing potential side effects.

METHODS

We conducted a systematic search of five electronic databases up to April 2023, including Embase, Cochrane Central Register of Controlled Trials, PubMed, OVID Medline, and WanFang, to evaluate PCs' efficacy compared to topical corticosteroid therapy for OLP. The literature quality was assessed using the Cochrane ROB tool. A fixed-effects model was used to determine the Weighted Mean Difference (WMD) and Mean Difference (MD) at a 95% confidence interval (CI) for pain severity and other relevant clinical indicators.

RESULTS

The comparison between topical corticosteroid therapy and PCs showed no significant difference for pain relief (WMD = -0.07, CI = 95% -0.34 to 0.19), symptom improvement (MD = -0.21, CI = 95% -0.55 to 0.13), or the severity of included lesions measured by REU scores (MD = -0.25, CI = 95% -0.32 to 0.82).

CONCLUSIONS

Locally injected PC have been found efficient in managing oral lichen planus, indicating that they are a promising alternative option to steroid therapy for OLP patients, particularly those who have not responded favorably to steroid therapy. However, further research is needed to establish determining the recurrence rate and long-term adverse effects.

TRIAL REGISTRATION

The systematic review protocol has been registered in advance with the PROSPERO database (CRD42023415372).