A Comparative Evaluation of Clinical Efficacy of Topical application of Propolis with triamcinolone acetonide in the management of symptomatic oral lichen planus: A Randomized Controlled Trial

Oral lichen planus (OLP) is a chronic autoimmune disease causing inflammation on mucocutaneous area. The world prevalence for this lesion is 1.01%, more commonly found in women than men with a 2:1 ratio, respectively, and more common in age 30-60 years. OLP has been classified as an oral potentially malignant disorder with a malignant transformation rate ranging from 0 to 12.5% in different studies10 The etiology of this lesion remains unclear until today. However, few possible etiologies have been identified, such as hypersensitivity reaction, autoimmune reaction, psychological stress, and the still-debated viral infection. The widely recognized and generally accepted feature of OLP is related to its possible association with some psychological disorders, among which are anxiety, depression, and stress. As the exact causative factor for OLP is a matter of conflict, the failure to achieve appropriate or exact treatment for it may be the reason for its incomplete regression. The first line of treatment for OLP has been corticosteroids, but because of their adverse effects1 However, continuous and prolonged use is associated with many systemic adverse effects such as bad taste, nausea, facial swellings, SHORT STUDY SYNOPSIS OF PROPOSED TOPIC dryness, mucosal atrophy, candidal infection, granuloma formation, hypersensitivity reactions, delayed wound healing and in later stages; hypothalamus pituitary adrenal suppression ; alternative therapeutic approaches are being carried out. Recently, use of natural drugs, such as propolis, has gained considerable interest. Propolis is a resinous sticky substance produced naturally by bees, and it consists of the exudates of plants mixed with enzymes, wax, and pollen. The term “propolis” is Greek in origin and, in the context of bees, means “defense of the hive.” As the term suggests, propolis is used by bees for hive protection against bacteria, viruses, fungi, and parasites1. It is collected by the honey bees from the sap, leaves, and buds of plants, and then mixed with secreted beeswax. It has been used in folk medicine for thousands of years and is also known as Russian penicillin1. Propolis being very high in bioflavonoid content has antioxidant, antibacterial, antifungal, antiviral, immunomodulatory and anti-inflammatory properties. These properties have prompted investigators to check its efficacy on various oral diseases, namely oral lichen planus (LP), oral candidiasis, recurrent aphthous stomatitis, radiation mucositis16, denture stomatitis, and herpes labialis Furthermore, there is growing interest within the dental field in the use of natural medicinal products with inherent antimicrobial activity, such as propolis. it not only represents a promising alternative antimicrobial agent but also has a range of favorable biological activities, making its use in preventing or treating various dental and oral conditions1. “This Study aims to provide an overview of the applications of propolis in the symptoms of OLP and highlighting its clinical effectiveness and identifying research gaps that need to be addressed”