"Exploring the Link Between Oral Lichen Planus and Xerostomia: A Systematic Literature Review"

Abstract

Introduction: Oral lichen planus (OLP) is a chronic disorder affecting the oral mucosa, potentially associated with xerostomia, either independently or concurrently. Research suggests that approximately 45% of patients with erythematous and ulcerative OLP may experience dry mouth sensations. The aim of this systematic review is to assess the current literature regarding the potential relationship or co-occurrence of xerostomia with OLP. Understanding this association is imperative for the development of comprehensive management strategies and the improvement of patient outcomes.

Method and material: The study followed the PRISMA 2020 checklist and included human studies, specifically investigating xerostomia in patients with OLP. After screening 897 articles, 9 studies were selected based on predefined criteria Quality assessment was conducted using the Cochrane risk of bias tools: ROB 2 for RCTs and ROBINS-I for non-randomized studies Scale was conducted to evaluate potential biases in study design, selection, and outcomes.

Result: A systematic review of nine studies (1960-2023) examining xerostomia in OLP patients found a significant reduction in unstimulated salivary flow rates in many cases. Although evidence links xerostomia with OLP, a definitive causal relationship remains unestablished. Some studies highlighted Candida infection, altered saliva protein expression, and inflammation-related nerve damage as contributing factors to dry mouth in OLP patients.

Discussion and conclusion: This systematic review examines the potential relationship between OLP and xerostomia, focusing on factors such as salivary flow, histopathological changes, and immune-related mechanisms. While some studies suggest a link between OLP and reduced saliva production, no definitive causal relationship has been established. The review identified significant research gaps, including inconsistent methodologies and a lack of standardized criteria. Future studies should explore different OLP forms, receptor interactions, immune responses, and neuropeptides to gain a better understanding of xerostomia's etiopathogenesis and improve management strategies for OLP patients.

Keywords: autoimmune disorder; dry mouth; etiopathogenesis; hyposalivation; oral lichen planus; xerostomia.

Figure 1

Flow diagram based on PRISMA 2020, which included searches of databases, registers, and other sources.

Figure 2

ROBINS‐I diagram shows a comprehensive summary of bias assessment. It includes the review authors' critical evaluations of the methodological quality in non‐randomized studies for each study included in the review.