Efficacy and Safety of Photodynamic Therapy Versus Corticosteroids in the Management of Oral Lichen Planus: A Systematic Review

Abstract

Background: Usually causing great pain and a decrease in quality of life, oral lichen planus (OLP) is a chronic inflammatory condition invading the mucous membranes of the oral cavity. Although topical corticosteroids remain the gold standard for treatment, interest in alternative therapies such photodynamic therapy (PDT) comes from worries about long-term side effects. The effectiveness and safety of PDT over corticosteroids in controlling OLP is assessed in this systematic study.

Methods: Electronic databases including PubMed, Cochrane Library, Scopus, and Web of Science were searched holistically. We used keywords including "Oral Lichen Planus," "Photodynamic Therapy," "Corticosteroids," and "OLP Management." Randomized controlled trials (RCTs), cohort studies, and comparative clinical trials evaluating PDT and corticosteroids for OLP treatment constituted among the inclusion criteria. Following PRISMA criteria, the methodological quality of the research was evaluated using statistical analysis, sample size, study design, and follow-up period.

Results: Comprising 842 patients, 19 studies in all fulfilled the inclusion criteria. Having an effectiveness range of 78–85%, corticosteroids showed a fast decrease in lesion size and symptom alleviation. With other studies noting slower beginning but steady symptom management, PDT demonstrated similar efficacy. Superior clinical results came from combination treatment including PDT with corticosteroids. For both treatments, recurrence rates ranged from 9% to 15%; side effects were negligible, except in rare PDT cases when some discomfort was noted. Emerging as a potential complement with long-lasting effects and less negative effects is Photo Bio Modulation Therapy (PBMT).

Conclusion: Ultimately, especially for patients with contraindications to long-term steroid therapy, PDT offers a reasonable substitute for corticosteroids for OLP management. Variations in PDT techniques and insufficient long-term follow-up data, however, emphasize the need of uniform treatment guidelines and more extensive, multicenter RCTs to create definite recommendations.