EROZİV ORAL LİKEN PLANUS’TA ENJEKTE EDİLEBİLEN TROMBOSİTTEN ZENGİN FİBRİN: ÇİFT KÖR, BÖLÜNMÜŞ AĞIZ, RANDOMİZE KONTROLLÜ PİLOT ÇALIŞMA

Year 2020, Volume: 27 Issue: 4, 483 - 490, 25.12.2020

Ebru Sağlam Zeliha Betül Özsağır Tuğba Ünver Ali Toprak Suzan Bayer Alınca Mustafa Tunalı

https://doi.org/10.17343/sdutfd.599210

Abstract

Amaç: Bu
çalışmanın amacı, enjekte edilebilen trombositten zengin fibrin'nin  (i-PRF) eroziv liken planus (EOLP) lezyonları
üzerindeki klinik etkisini değerlendirmek ve kortikosteroid tedavisi ile
karşılaştırmaktır.

Gereç ve Yöntem: Yanak
mukozasında çift taraflı EOLP bulunan 13 sistemik sağlıklı hastanın yanak
mukozalarının bir tarafına i-PRF, diğer tarafına intralezyonel kortikosteroid enjeksiyonu
yapılmıştır. Enjeksiyonlar 15 gün araya 4 seans tekrarlanmıştır. Sübjektif
değerlendirme belirteci olarak görsel analog skala (VAS), objektif
değerlendirme belirteci olarak Thongprasom skorları kullanılmıştır. Skorlamalar
tedaviden önce, son enjeksiyon seansından hemen sonra, tedavi sonrası 1. ay ve
tedavi sonrası 2. ay kontrol seanslarında yapılmıştır.

Bulgular: Gruplar
arası karşılaştırmada, başlangıç ve kontrol seanslarında VAS-Ağrı ,
VAS-Memnuniyet ve Thongprasom skorlarında istatistiksel olarak anlamlı bir fark
bulunamamıştır. Grup içi karşılaştırmalarda hem i-PRF uygulanan grupta (VAS-Ağrı
83,46 ± 16,25'ten 7,69 ± 9,92'ye düştü (p <0,001), VAS-Memnuniyet 26,54 ±
19,73'ten 87,31 ± 9,71'e yükseldi (p <0,001), Thongprasom skorları 4,85 ±
0,37'den 2,08 ± 1,04'e düştü (p = 0,001)), hem de kortikosteroid uygulanan
grupta (VAS-Ağrı 83,46 ± 16,25'ten 10,77 ± 14,27'ye düştü (p <0,001), VAS-Memnuniyet
26,54 ± 19,72'den 84,23 ± 13,52'ye yükseldi (p <0,001), Thongprasom skorları
4,54 ± 0,52'den 2,00 ± 1,22’e düştü (p = 0,001))  VAS-Ağrı ve Thongprasom skorlarının ortalama
değerlerinde istatistiksel olarak anlamlı bir düşüş görülürken, VAS-Memnuniyet
skorlarının ortalamasında  istatistiksel
olarak anlamlı bir artış gözlenmiştir.
Sonuç: Bu pilot çalışma, i-PRF enjeksiyonunun EOLP lezyonların tedavisinde
altın standart kabul edilen kortikosteroid enjeksiyonuna benzer derecede etkili
olabileceğini göstermiştir. 

Keywords

Kortikosteroid, Liken Planus, Mukoza, Trombositten Zengin Fibrin

INJECTABLE PLATELET RICH FIBRIN IN EROSIVE ORAL LICHEN PLANUS: A DOUBLE-BLIND, SPLIT- MOUTH, RANDOMIZED CONTROLLED PILOT STUDY

Abstract

Objective: The purpose of this study was to evaluate the clinical
effect of injectable platelet-rich fibrin (i-PRF) at erosive lichen planus
(EOLP) lesions and compare with corticosteroid therapy.

Material and Method: In 13 systemically healthy patients with bilateral
EOLP in the buccal mucosa, i-PRF was injected on one side of the buccal mucosa
and intralesional corticosteroid injection on the other side. The injections
were repeated 4 sessions with 15 days interval. Visual analog scale (VAS) was used
as subjective evaluation marker and Thongprasom scale were used as objective
evaluation marker. Scores were performed before the treatment, immediately
after the last injection session, at 1^st month post-treatment and at
2^nd months post-treatment control sessions.

Results: In the comparison between the groups, no statistically significant
difference was found in the VAS-Pain, VAS-Satisfaction and Thongprasom scores
at the baseline and control sessions. Intragroup comparisons were showed a
statistically significant decrease in mean values of both VAS-Pain and
Thongprasom scores, and a statistically significant increase in
VAS-Satisfaction scores in both i-PRF  group
(VAS-Pain decreased from 83,46 ± 16,25 to 7,69 ± 9,92 (p <0,001), Thongprasom
scale decreased from 4,85 ± 0,37 to 2,08 ± 1,04 (p = 0,001)) and VAS-Satisfaction
increased from 26,54 ± 19,73 to 87,31 ± 9 (p <0,001), and corticosteroid  group (VAS-Pain decreased from 83,46 ± 16,25
to 10,77 ± 14,27 (p <0,001), Thongprasom scale decreased from 4,54 ± 0,52 to
2,00 ± 1,22 (p = 0,001) and VAS-Satisfaction increased from 26,54 ± 19,72 to
84,23 ± 13,52 (p <0,001)). There was a statistically significant decrease in
the mean values of VAS-Pain and Thongprasom scores, while a statistically
significant increase was observed in the mean VAS-Satisfaction scores.

Conclusion: This
pilot study showed that i-PRF infection could be as effective as corticosteroid
injection, the gold standard in the treatment of EOLP lesions. 

Keywords

Corticosteroid, Lichen Planus, Mucosa, Platelet Rich Fibrine

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