Oral Lichen Planus Clinical Trial
Official title:
Free Soft Tissue Graft in Treatment of Oral Lichen Planus
Oral lichen planus is a common chronic mucocutaneous disease with various clinical forms.
Erosive-ulcerative forms usually cause symptoms of pain and discomfort. The most important
complication of OLP is development of oral squamous cell carcinoma, although this is a very
controversial matter. various treatments have been suggested for OLP but their results are
unsatisfactory. Through the experiences of the investigators, corticosteroids (in any
form)is not a wise option for treating OLP and has many side effects . More over,
immunosuppressive therapy did not influence the risk for oral cancer. The purpose of the
study is to determine the efficacy of free soft tissue graft in the treatment of
precancerous and symptomatic lesions of OLP. Removal of the lesions up to submucosa has been
done. The graft sliced from healthy mucosa also up to submucosa. Then graft will be sutured
in position.
According to other authors, basal epithelial layers of the graft remain intact and represent
the focus of re-epithelization. New epithelial cells migrate over the basal membrane and
appear to guide it by proliferation, will generate new epithelium. The wound is
re-epithelialized by proliferation of surrounding healthy epithelial cell, therefore, not
contaminated by modified antigens of the cell membrane that are theoretically responsible
for lymphocyte aggression. The healthy graft remains free of lesions and appears clinically
healthy.
Oral lesions in OLP are chronic ,rarely undergo spontaneous remission, are potentially
premalignant and are often a source of morbidity. recent study does not support that non
reticular OLP are more predisposed to malignant change. Moreover , immunosuppressive therapy
did not influence the risk for oral cancer. in general ,all treatment should be aimed at
eliminating precancerous lesions ,alleviating symptoms ,and potentially decreasing the risk
of malignant transformation. Although the cause of OLP is unknown , it is generally
considered to be an immunologically mediated process that microscopically resembles a
hypersensitivity reaction .it is characterized by an intense T cell infiltrate localized to
epithelium-connective tissue interface. the purpose of the study is to determined the
efficacy of free soft tissue graft in treatment of precancerous and symptomatic lesions of
OLP. so removal of the lesions up to submucosa will be done. the graft sliced from healthy
mucosa also up to submucosa . then graft will be sutured in position.
According to other authors, basal epithelial layers of the graft remain intact and represent
the focus of reepithelialization. new epithelial cell migrate over the basal membrane and
appear to guide it and by proliferation ,will generate new epithelium. so the wound is
re-epithelialized by proliferation of surrounding healthy epithelial cell, therefore, not
contaminated by modified antigens of the cell membrane that are theoretically responsible
for lymphocyte aggression so the healthy graft remains free of lesions and appears
clinically healthy.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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