EFFICACY OF ORAL ZINC SUPPLEMENT AS AN ADJUNCTIVE THERAPY FOR EROSIVE ORAL LICHEN PLANUS (A RANDOMIZED, CONTROLLED CLINICAL TRIAL)

Abstract

BACK GROUND: Oral Lichen planus (OLP) is an autoimmune disorder with a chronic nature where CD8+ cytotoxic T-cells release inflammatory cytokines. Inflammations in OLP persist due to matrix metalloproteinases (MMPs) that have a role in collagen cleavage. Zinc prevents basement membrane disruption through inhibition of MMP-9 activation. AIM OF THE STUDY: Evaluating and comparing clinically the effectiveness of adding systemic oral zinc supplementation to topical corticosteroids and topical corticosteroids alone for erosive OLP (EOLP) treatment, and to measure biochemically salivary MMP-9 levels before and after both treatment modalities. METHODOLOGY: This study was performed on 22 patients have EOLP and divided equally into: Test group; 11 patients received oral zinc picolinate 50 mg as a single morning dose with 0.1% triamcinolone acetonide (TA) oral paste twice daily for 6 weeks. Control group; 11 patients received 0.1% TA orabase twice daily for 6 weeks. Patients were recruited and assessed clinically at baseline, after six and twelve weeks using numerical rating scale (NRS) for pain assessment and Thongprasom et al score for objective assessment of oral lesions. Salivary MMP-9 was evaluated at baseline and after 12 weeks. RESULTS: Test group showed a significant lowering in Thongprasom et al score after 6 weeks, a significant reduction in NRS after 6 and 12 weeks, and a significant reduction in MMP-9 levels from baseline to weeks 12 as compared to control group. CONCLUSIONS: Oral zinc supplementation with topical corticosteroids has promising effects for EOLP.