Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

140 questions · 181 findings · 10 reviews · Oral medicine and oral cancer

No studies found 14 · 7.7%GRADE not reported 126 · 69.6%Very low 23 · 12.7%Low 11 · 6.1%Moderate 6 · 3.3%High 1 · 0.6%

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Normalcy of diet (total parenteral nutrition) · Adults with cancer receiving treatment

Keratinocyte growth factor (KGF; palifermin or repifermin),… showed no clear difference in normalcy of diet (total parenteral nutrition) compared with placebo; GRADE not reported.

1 finding from 1 review

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Number of days of treatment with opioid analgesics · Adults with cancer receiving treatment

Keratinocyte growth factor (KGF; palifermin or repifermin),… showed no clear difference in number of days of treatment with opioid analgesics compared with placebo; GRADE not reported.

1 finding from 1 review

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

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

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

Vitamin A or retinoids (systemic or topical; incl. 13-cis-retinoic acid, acitretin) 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
    4 to 12 months
    SoF 1, Safety of the intervention at 4 to 12 months: '3 studies (1 each evaluating topical acitretin, topical 13-cis-retinoic acid, 200,000 IU per week of vitamin A) found no adverse effects. Systemic 13-cis-retinoic…
    4 studies
    GRADE not reported

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

Eating a normally varied diet · People of any age with erosive lichen planus affecting the oral, anogenital, and/or oesophageal regions

The review found no eligible studies for this question.

1 finding from 1 review

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

Restoration of sexual activity · People of any age with erosive lichen planus affecting the oral, anogenital, and/or oesophageal regions

The review found no eligible studies for this question.

1 finding from 1 review

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

Reduction in number of flares · People of any age with erosive lichen planus affecting the oral, anogenital, and/or oesophageal regions

The review found no eligible studies for this question.

1 finding from 1 review

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

Reduction in severity of flares · People of any age with erosive lichen planus affecting the oral, anogenital, and/or oesophageal regions

The review found no eligible studies for this question.

1 finding from 1 review

Hydrocortisone plus hyaluronidase (intralesional) vs Intralesional steroid plus hyaluronidase injections

Maximal mouth opening (interincisal distance) · People of any age with a confirmed diagnosis, by clinical examination and biopsy, of oral submucous fibrosis (OSF)
1 finding from 1 review
  • Singh 2010 (hydrocortisone+hyaluronidase 50 vs triamcinolone+hyaluronidase 50): mouth opening reported categorically (trismus) rather than as continuous data, precluding quantitative analysis; authors found no…
    1 study · 100 participants
    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

Intralesional betamethasone vs intralesional injections of triamcinolone acetonide

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

Intralesional betamethasone may leads to higher clinical resolution compared with intralesional triamcinolone acetonide (low certainty).

1 finding from 1 review

Intralesional betamethasone vs intralesional injections of triamcinolone acetonide

Clinical score (14 days) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment

It is very uncertain whether intralesional betamethasone changes clinical score (14 days) compared with intralesional triamcinolone acetonide (very low certainty).

1 finding from 1 review

Intralesional betamethasone vs intralesional injections of triamcinolone acetonide

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

Intralesional betamethasone showed no clear difference in pain (mean score) compared with intralesional triamcinolone acetonide (low certainty).

1 finding from 1 review

Systemic (oral) betamethasone vs Topical triamcinolone acetonide paste

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

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

1 finding from 1 review

Clobetasol propionate ointment vs Triamcinolone acetonide ointment

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

Clobetasol propionate ointment may leads to higher clinical resolution compared with triamcinolone acetonide ointment (low certainty).

1 finding from 1 review

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell wall preparation) plus standard therapy vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx

Non-specific immunotherapy (recombinant interleukin-2 or BCG cell… showed no clear difference in adverse effects compared with standard therapy alone; GRADE not reported.

9 findings from 1 review
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Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus standard therapy (radiotherapy or chemoradiotherapy) vs Standard therapy alone (radiotherapy or chemoradiotherapy)

Adverse effects · People with squamous cell carcinoma of the oral cavity or oropharynx

Tyrosine kinase inhibitor (erlotinib, gefitinib or lapatinib) plus… led to higher adverse effects compared with standard therapy alone (radiotherapy or chemoradiotherapy); GRADE not reported.

9 findings from 1 review
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