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Evidence found and GRADE certainty

550 questions · 606 findings · 25 reviews · Oral medicine and oral cancer

No studies found 62 · 10.2%GRADE not reported 428 · 70.6%Very low 69 · 11.4%Low 30 · 5%Moderate 16 · 2.6%High 1 · 0.2%

NSAIDs (ketorolac oral rinse; systemic celecoxib) vs placebo or no treatment

Clinical resolution (oral lesion not completely resolved) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 3, Clinical resolution (not completely resolved) at 3 months: '1 study evaluated systemic treatment and 1 evaluated topical treatment. Neither found benefit for NSAIDs.' No GRADE. Effects text: celecoxib…
    2 studies
    GRADE not reported

Vitamin A or retinoids (systemic or topical; incl. 13-cis-retinoic acid, acitretin) vs placebo or no treatment

Malignant transformation (oral cancer development) · People with a diagnosis of oral leukoplakia

It is very uncertain whether vitamin A or retinoids (systemic or topical; incl. 13-cis-retinoic… changes oral cancer development compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Topical bleomycin vs placebo or no treatment

Clinical resolution (oral lesion not completely resolved) · People with a diagnosis of oral leukoplakia

It is very uncertain whether topical bleomycin changes clinical resolution (oral lesion not completely resolved) compared with placebo or no treatment (very low certainty).

1 finding from 1 review

NSAIDs (ketorolac oral rinse; systemic celecoxib) vs placebo or no treatment

Safety of the intervention (adverse effects) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 3, Safety of the intervention over 3 months: systemic celecoxib (1 study) - 32 intervention participants reported 56 adverse effects, 20 placebo participants reported 20; 4 grade 3 events; 2 discontinued. Ketorolac…
    2 studies
    GRADE not reported

NSAIDs (ketorolac oral rinse; systemic celecoxib) vs placebo or no treatment

Improvement of histological features (not improved) · People with a diagnosis of oral leukoplakia

The review found no eligible studies for this question.

1 finding from 1 review

Topical bleomycin vs placebo or no treatment

Safety of the intervention (adverse effects) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • Interventions for treating oral leukoplakia to prevent oral cancer 2016 · Cochrane All outcomes
    up to 3 months
    SoF 5, Safety of the intervention up to 3 months: 'All patients in the bleomycin group developed erythema with erosion by the end of the applications, whereas erythema developed in the placebo group. Discomfort was…
    1 study
    GRADE not reported

Vitamin A or retinoids (systemic or topical; incl. 13-cis-retinoic acid, acitretin) vs placebo or no treatment

Clinical resolution (oral lesion not completely resolved) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • Interventions for treating oral leukoplakia to prevent oral cancer 2016 · Cochrane All outcomes
    4 to 12 months
    SoF 1, Clinical resolution (not completely resolved) at 4 to 12 months: 'Studies could not be combined in meta-analysis. One study evaluated topical treatment and did not find evidence of benefit; 3 studies of systemic…
    4 studies
    GRADE not reported

Herbal extracts (tea components; Chinese herbal mixture; freeze-dried black raspberry gel) vs placebo or no treatment

Clinical resolution (oral lesion not completely resolved) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 4, Clinical resolution (not completely resolved) at 3 to 6 months: '3 studies (freeze-dried black raspberry gel, green tea extract capsules, mixed tea) did not find evidence of benefit.' No GRADE. Effects text:…
    4 studies
    GRADE not reported

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Improvement of histological features (not improved) · People with a diagnosis of oral leukoplakia

Systemic beta carotene or carotenoids (incl. lycopene) may leads to lower improvement of histological features (not improved) compared with placebo or no treatment (low certainty).

1 finding from 1 review

Bowman-Birk inhibitor vs placebo or no treatment

Improvement of histological features (not improved) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 6, Histological changes: 'Not measured'. Effects text: data on histological changes from Armstrong 2013 were not available for analysis, but study authors reported no statistically significant differences in…
    1 study
    GRADE not reported

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Malignant transformation (oral cancer development) · People with a diagnosis of oral leukoplakia

It is very uncertain whether systemic beta carotene or carotenoids (incl. lycopene) changes oral cancer development compared with placebo or no treatment (very low certainty).

1 finding from 1 review

Herbal extracts (tea components; Chinese herbal mixture; freeze-dried black raspberry gel) vs placebo or no treatment

Malignant transformation (oral cancer development) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 4 (Herbal extracts vs placebo), Cancer development: SoF cell 'Not measured'. Effects text: cancer development was among the outcomes in Tsao 2009 (green tea extract) but it was not possible to analyse the data…
    1 study
    GRADE not reported

Vitamin A or retinoids (systemic or topical; incl. 13-cis-retinoic acid, acitretin) vs placebo or no treatment

Improvement of histological features (not improved) · People with a diagnosis of oral leukoplakia

Vitamin A or retinoids (systemic or topical; incl. 13-cis-retinoic… probably leads to lower improvement of histological features (not improved) compared with placebo or no treatment (moderate certainty).

1 finding from 1 review

Systemic beta carotene or carotenoids (incl. lycopene) vs placebo or no treatment

Safety of the intervention (adverse effects) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • Interventions for treating oral leukoplakia to prevent oral cancer 2016 · Cochrane All outcomes
    5 to 12 months
    SoF 2, Safety of the intervention at 5 to 12 months: 'Systemic beta carotene did not cause any adverse effects in 1 study supplementing 10 mg/d (Nagao), and caused adverse effects of varying severity in 9% of…
    3 studies
    GRADE not reported

NSAIDs (ketorolac oral rinse; systemic celecoxib) vs placebo or no treatment

Malignant transformation (oral cancer development) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 3 (NSAIDs vs placebo), Cancer development: SoF cell 'Not measured'. Effects text: cancer development was among outcomes in Papadimitrakopoulou 2008 (celecoxib) but did not occur in either arm, probably because of…
    1 study
    GRADE not reported

Bowman-Birk inhibitor vs placebo or no treatment

Malignant transformation (oral cancer development) · People with a diagnosis of oral leukoplakia

The review found no eligible studies for this question.

1 finding from 1 review

Herbal extracts (tea components; Chinese herbal mixture; freeze-dried black raspberry gel) vs placebo or no treatment

Improvement of histological features (not improved) · People with a diagnosis of oral leukoplakia
1 finding from 1 review
  • SoF 4, Histological changes (not improved) at 3 months: '2 studies (green tea extract capsules and freeze-dried raspberry gel) did not find evidence of benefit.' No GRADE. Effects text: Mallery raspberry RR 0.97…
    2 studies
    GRADE not reported

Surgical removal of the lesion (surgical excision, laser surgery, cryotherapy) vs Placebo or no treatment

Outcome not reported · People with a diagnosis of oral leukoplakia

The review found no eligible studies for this question.

1 finding from 1 review
  • 'We did not identify any RCTs that compared surgical treatments with placebo or no treatment.' Three surgical RCTs were found (Chee 2013, Lopez-Jornet 2013, Schwarz 2005) but all excluded because they did not include a…
    Studies not reported
    No studies found