Findings

What do systematic reviews say?

1,218 questions · 1,325 findings · 34 reviews · Oral medicine and oral cancer

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No studies found 164 · 12.4%GRADE not reported 841 · 63.5%Very low 209 · 15.8%Low 72 · 5.4%Moderate 38 · 2.9%High 1 · 0.1%

Light-based detection and/or oral spectroscopy (e.g. ViziLite, VELscope, Microlux DL, Identafi 3000) vs Surgical or punch biopsy with histological assessment

Sensitivity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous oral lesions

1 finding from 1 review

Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically evident… 2021 · Cochrane All outcomes
Sensitivity 0.87 [0.78, 0.93]
23 studies
Low

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

Sensitivity (COE alone arm) · Oral cavity cancer or potentially malignant disorder symptom-free individuals with tobacco habits

1 finding from 1 review

Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
Sensitivity 0.50 [0.12, 0.88]
1 study · 3895 participants
Moderate

COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone

Sensitivity · Oral cavity cancer or potentially malignant disorder symptom-free individuals with tobacco habits

1 finding from 1 review

Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
Sensitivity 0.40 [0.05, 0.85]
1 study · 4080 participants
Moderate

Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

Sensitivity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance programme, or screened…

1 finding from 1 review

Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
Summary of findings 2 (no pooled analysis): sensitivity 0.18 (95% CI 0.13 to 0.24), 0.09 (95% CI 0.04 to 0.15), 0.43 (95% CI 0.24 to 0.63), and 0.33 (95% CI 0.10 to 0.65) across the 4 studies. Prevalence 0.6% to 63.6%.…
4 studies · 35059 participants
Very low

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

Sensitivity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance programme, or screened…

1 finding from 1 review

Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
Summary of findings 1 (no pooled analysis): for the 7 studies with low prevalence (<=10%) sensitivity ranged from 0.50 (95% CI 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); for the 3 higher-prevalence studies…
10 studies · 25568 participants
Low

Fluticasone propionate spray vs Betamethasone sodium phosphate mouthwash

Pain / clinical response (not analysable) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
Hegarty 2002: cross-over data not suitable for quantitative analysis
1 study
GRADE not reported

Topical triamcinolone acetonide vs pimecrolimus 1%

Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide showed no clear difference in adverse effects compared with topical pimecrolimus; GRADE not reported.

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
end of treatment
RR 0.21 [0.01, 4.10]
1 study · 35 participants
GRADE not reported

Clobetasol propionate plus miconazole (adjunctive antifungal) vs Clobetasol propionate plus placebo

Candidosis (adverse effect) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
Lodi 2007: 5 cases of candidosis among 15 participants without antifungal vs 0 with adjunctive miconazole (low-certainty)
1 study · 35 participants
Low

Topical triamcinolone acetonide vs Topical tacrolimus

Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide may leads to lower adverse effects compared with topical tacrolimus (low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
3-8 weeks
RR 0.47 [0.22, 0.99]
2 studies · 58 participants
Low

Topical triamcinolone acetonide vs Topical curcumin

Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide may leads to lower pain (mean score) compared with topical curcumin (low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
MD -0.64 [-1.19, -0.10]
2 studies · 100 participants
Low

Topical clobetasol propionate vs Topical ciclosporin

Pain resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether topical clobetasol propionate changes pain resolution compared with topical ciclosporin (very low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
3-8 weeks
RR 2.11 [0.76, 5.86]
1 study · 39 participants
Very low

Topical clobetasol propionate vs Topical tacrolimus

Pain (mean VAS score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical clobetasol propionate showed no clear difference in pain (mean VAS score) compared with topical tacrolimus; GRADE not reported.

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
end of treatment
MD 0.08 [-0.33, 0.49]
1 study · 68 participants
GRADE not reported

Topical clobetasol propionate vs Topical tacrolimus

Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether topical clobetasol propionate changes clinical resolution compared with topical tacrolimus (very low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
3-8 weeks
RR 0.61 [0.38, 0.99]
2 studies · 52 participants
Very low

Oral prednisone plus curcuminoids (adjunctive) vs Oral prednisone plus placebo

Reduction in pain · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
Chainani-Wu 2007: no difference between adjunctive curcuminoids and placebo (recruitment stopped after interim analysis)
1 study · 28 participants
GRADE not reported

Topical triamcinolone acetonide vs Intralesional BCG-polysaccharide nucleic acid (BCG-PSN)

Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide showed no clear difference in pain (mean score) compared with intralesional BCG-polysaccharide nucleic acid (BCG-PSN); GRADE not reported.

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
MD 0.59 [-0.15, 1.33]
1 study · 53 participants
GRADE not reported

Topical betamethasone 0.1% gel vs pimecrolimus 1%

Pain / clinical response (not analysable) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
Ezzatt 2019 (betamethasone 0.1% gel vs pimecrolimus 1% gel): effectiveness data not reported in a way that allowed quantitative analysis
1 study
GRADE not reported

Systemic (oral) betamethasone vs Topical triamcinolone acetonide paste

Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether systemic (oral) betamethasone changes clinical score compared with topical triamcinolone acetonide paste (very low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
MD 1.13 [0.09, 2.17]
1 study · 46 participants
Very low

Topical triamcinolone acetonide vs Photodynamic therapy

Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical triamcinolone acetonide may leads to higher clinical score compared with photodynamic therapy (low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
MD 1.52 [0.17, 2.87]
1 study · 20 participants
Low

Topical corticosteroids vs placebo

Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

Topical corticosteroid showed no clear difference in clinical score compared with placebo (low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
end of treatment
MD -0.38 [-0.89, 0.14]
1 study · 32 participants
Low

Topical triamcinolone acetonide vs Topical tacrolimus

Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether topical triamcinolone acetonide changes clinical resolution compared with topical tacrolimus (very low certainty).

1 finding from 1 review

Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
3-8 weeks
RR 0.86 [0.55, 1.35]
2 studies · 60 participants
Very low