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

Öz

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. 

Anahtar Kelimeler

• 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

Öz

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. 

Anahtar Kelimeler

• Corticosteroid
• Lichen Planus
• Mucosa
• Platelet Rich Fibrine

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