***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Symptomatic oral lichen planus ( OLP ) has been palliated with a wide spectrum of topical and systemic therapies . Although the majority of management strategies include corticosteroids , few have been evaluated in r and omized controlled trials . OBJECTIVE We investigated the acceptability and efficacy of topical fluticasone propionate spray ( FP ) and betamethasone sodium phosphate mouthrinse ( BSP ) upon the signs and symptoms of OLP , assessing patient quality of life changes as a consequence of these therapies . METHODS We implemented a r and omized , crossover study in which each drug was administered for a period of 6 weeks with an intervening washout period of 2 weeks at an outpatient oral medicine unit in London , United Kingdom . We treated 48 patients with biopsy-proven symptomatic OLP , and 44 patients ( 92 % ) completed the study . The dosage was 50 microg two dose unit sprays and BSP 500 microg , each 4 times daily . Symptomatic improvement was evaluated by means of a visual analogue scale ( VAS ) , the McGill pain score , the Oral Health Impact Profile ( OHIP ) , and Oral Health Quality of Life ( OHQoL ) question naires . The total surface area of the lesions , including all white , erythematous , and ulcerative lesions was measured at each visit . The efficacy , ease of application , and adverse effects associated with each medication were recorded . RESULTS Both FP and BSP mouthwash caused both a statistically significant reduction in painful symptoms as measured by the VAS and improvement in quality of life as measured by the OHIP and OHoQL indices . There was no significant difference between the two corticosteroids in their efficacy in reducing painful symptoms ( measured by the VAS ) or in their effect on patient quality of life . Both FP and BSP significantly reduced the surface area of oral lesions . However , FP was statistically significantly better than BSP in reducing lesion surface area . There was no statistically significant difference between the patient-assessed effects of the 2 therapies . CONCLUSIONS FP and BSP are both effective in the short-term clinical management of symptomatic OLP . FP is more acceptable to patients than BSP because of the convenience of the spray form OBJECTIVE Our purpose was to investigate the efficacy and safety of 0.1 % topical tacrolimus in erosive or ulcerative oral lichen planus . METHODS This was an open-label , noncomparative study conducted in an outpatient oral medicine unit in London , United Kingdom . The study covered an 8-week period with a 22-week follow-up after cessation of therapy . Nineteen patients , aged 28 to 87 years with biopsy-proven oral lichen planus refractory to , or dependent on , systemic immunosuppressive agents , were enrolled . Seventeen patients ( 89 % ) completed the study . Application of 0.1 % tacrolimus was administered to all symptomatic oral mucosal lesions . Clinical review took place 1 , 3 , 5 , 7 , and 8 weeks after commencing therapy . Alleviation of symptoms was evaluated by using a visual analogue scale as well as the McGill Pain and Oral Health Impact profile question naires . The extent of the oral mucosal erosion or ulceration was directly measured by the same clinician at all visits . Safety assessment s included monitoring of adverse events , complete blood cell count , renal and hepatic clinical chemistry , and tacrolimus blood concentrations . RESULTS Tacrolimus caused a statistically significant improvement in symptoms within 1 week of commencement of therapy . A mean decrease of 73.3 % occurred in the area of ulceration over the 8-week study period . Local irritation ( in 6 subjects , 35 % ) was the most commonly reported adverse effect . Laboratory values showed no significant changes with time . Therapeutic levels of tacrolimus  were demonstrated in 8 subjects but were unrelated to the extent of oral mucosal involvement . Thirteen of 17 patients suffered a relapse of oral lichen planus within 2 to 15 weeks of cessation of tacrolimus therapy . CONCLUSION Topical tacrolimus is effective therapy for erosive or ulcerative oral lichen planus Background Economic evaluations to inform decisions about allocation of health re sources are scarce in Low and Middle Income Countries , including in Sri Lanka . This is in part due to a lack of country-specific utility weights , which are necessary to derive appropriate Quality Adjusted Life Years . The EQ-5D-3L , a generic multi-attribute instrument ( MAUI ) , is most widely used to measure and value health states in high income countries ; nevertheless , the sensitivity of generic MAUIs has been criticised in some conditions such as cancer . This article describes a protocol to produce both a generic EQ-5D-3L and cancer specific EORTC-8D utility index in Sri Lanka . Method EQ-5D-3L and EORTC-8D health states will be valued using the Time Trade-Off technique , by a representative population sample ( n = 780 invited ) identified using stratified multi-stage cluster sampling with probability proportionate to size method . Households will be r and omly selected within 30 clusters across four districts ; one adult ( ≥18 years ) within each household will be selected using the Kish grid method . Data will be collected via face-to-face interview , with a Time Trade-Off board employed as a visual aid . Of the 243 EQ-5D-3L and 81,290 EORTC-8D health states , 196 and 84 respectively will be directly valued . In EQ-5D-3L , all health states that combine level 3 on mobility with either level 1 on usual activities or self-care were excluded . Each participant will first complete the EQ-5D-3L , rank and value 14 EQ-5D-3L states ( plus the worst health state and “ immediate death ” ) , and then rank and value seven EORTC-8D states ( plus “ immediate death ” ) . Participant demographic and health characteristics will be also collected . Regression models will be fitted to estimate utility indices for EQ-5D-3L and EORTC-8D health states for Sri Lanka . The dependent variable will be the utility value . Different specifications of independent variables will be derived from the ordinal EQ-5D-3L to test for the best-fitting model . Discussion In Sri Lanka , a LMIC health state valuation will have to be carried out using face to face interview instead of online methods . The proposed study will provide the first country-specific health state valuations for Sri Lanka , and one of the first valuations to be completed in a South Asian Country UNLABELLED Implant overdentures and conventional prostheses have been compared in several trials using a variety of functional and oral health-related quality of life ( OHQOL ) outcomes . In this paper , we describe the impact of implant overdentures on general and OHQOL in seniors . OBJECTIVES To compare the oral health-related and general quality of life of seniors ( aged 65 - 75 years ) who received either m and ibular implant overdentures or conventional dentures .  METHODS Sixty edentulous patients were recruited . Thirty received m and ibular overdentures retained by two implants ( IOD ) and a conventional maxillary denture , the other 30 subjects received new maxillary and m and ibular conventional complete dentures ( CD ) . All completed the 20-item version of the Oral Health Impact Profile ( OHIP-20 ) before treatment , then at two and 6 months after delivery of the dentures . The SF-36 general health question naire was completed at baseline and 6 months only . RESULTS Pretreatment and 6-month data from 55 subjects were analyzed . Those who received the IODs had significantly better OHIP-20 total scores at 6 months . Results for IOD subjects were also superior in the functional limitation , physical pain , physical disability and psychological disability subscales . While no significant between group difference was found on the SF-36 health survey , significant pre-post-treatment differences within the IOD group were detected for the role emotional , vitality and the social function scales . CONCLUSIONS M and ibular overdentures retained by two implants provide elderly patients with better OHQOL . General health-related quality of life improved in the implant group BACKGROUND Lichen planus is a common chronic inflammatory mucocutaneous disease , affecting 0.1 % to 4 % of the general population . There is no published r and omized active control clinical trial on pimecrolimus for the treatment of oral lichen planus ( OLP ) . OBJECTIVE The purpose of this study was to compare the efficacy and safety of pimecrolimus 1 % cream with triamcinolone acetonide 0.1 % paste in treating OLP . METHODS In this investigator-blinded parallel-group r and omized clinical trial , 40 patients were r and omly assigned in two equal groups to receive either pimecrolimus 1 % cream or triamcinolone acetonide 0.1 % paste 4 times daily for a total of 2 months and followed up for another 2 months . The patients were assessed for painful symptoms measured by visual analog scale , the Oral Health Impact Profile score , and objective clinical score . Nonparametric tests were used to assess the main outcomes . Intention-to-treat analysis was used . RESULTS Eighteen patients in pimecrolimus group and 17 patients in triamcinolone group finished the 4-month trial course . Both pimecrolimus and triamcinolone groups showed significant improvement in all measured efficacy end points throughout the visits . There was no significant difference between changes from baseline median values of pimecrolimus and triamcinolone groups after treatment termination in terms of visual analog scale score ( -9.8 + /- 11.3 vs -8.4 + /- 18.3 , P = .70 ) , Oral Health Impact Profile score ( -1.5 + /- 2.6 vs -1.6 + /- 2.1 , P = .38 ) , and clinical score ( -0.7 + /- 0.6 vs -0.8 + /- 0.7 , P = .86 ) , respectively . Two patients in pimecrolimus group experienced prominent but transient burning sensation whereas none of the patients in triamcinolone group had any prominent adverse event ( P = .24 ) . LIMITATIONS Blood levels in pimecrolimus group were not measured and carcinogenicity of pimecrolimus , especially in its long-term use for OLP , is yet to be determined . CONCLUSION This study showed that patients with OLP may benefit from both topical pimecrolimus and triamcinolone acetonide therapy with minimal side effects . Further studies should be conducted to assess the maintenance effects and long-term safety of both drugs ( Cochrane skin group identifier : CSG TrialNo . 22 ) Background : Dermatologists see patients with oral mucosal conditions . Objectives : To evaluate oral health-related quality of life ( OHRQoL ) and the burden of disease of dermatological patients with oral mucosal diseases . Methods : All consecutive patients ( April 2005 to November 2006 ) coming to the oral health care unit of the IDI-IRCCS in Rome were asked to complete oral health-specific ( 14-item Oral Health Impact Profile , OHIP-14 ) , generic health status ( 12-item Short Form of Medical Outcome Study , SF-12 ) and general psychological ( 12-item General Health Question naire , GHQ-12 ) question naires . Physicians and patients gave a global assessment of severity of disease on a 5-point scale . Results : 206 patients participated . Recurrent aphthous stomatitis ( RAS ) had the highest impact on OHRQoL. Women had poorer OHRQoL both on physical and mental scales of the SF-12 . 33.7 % of patients were GHQ-positive with women showing a much higher prevalence than men ( 39.7 vs. 20.3 % ) . OHIP-14 high scores were observed in RAS , followed by oral lichen planus and burning mouth syndrome . Patients whose condition was ‘ underestimated ’ by the physicians had the worst OHRQoL and psychological status . Conclusions : Administration of specific and generic question naires provides a detailed picture of the impact of oral diseases on patients , which adds information that may be useful in clinical practice . The possible contribution of such tools should be assessed in a r and omized controlled trial The aim of this study was to describe prospect ively quality of life and mood in patients with oral or oropharyngeal cancer treated with surgery + /- radiotherapy . Seventy-five patients completed the EORTC Core Question naire , the EORTC Head and Neck Cancer module and the Center for Epidemiologic Studies ' Depression Scale before treatment and 6 and 12 months later . There was a significant deterioration of physical functioning , fatigue and almost all head and neck symptoms except pain , which improved . Patients with stage III/IV and patients receiving combined treatment had significantly worse physical symptoms compared to patients with stage I/II and patients treated with surgery only , respectively . Before and after treatment there was a high level of depressive symptomatology . However , after treatment a gradual improvement in emotional functioning occurred . Surgical treatment for oral or oropharyngeal cancer results in significant deterioration of physical functioning and symptoms during the first year , especially when combined with radiotherapy . Despite this , there is an improvement of emotional functioning after treatment , probably as a result of adaptation and coping processes OBJECTIVE To test the reliability and responsiveness of the Chronic Oral Mucosal Diseases Question naire ( COMDQ ) , in measuring the quality of life ( QofL ) in patients with chronic oral mucosal conditions . METHODS A r and om sample of 160 patients with the following chronic oral mucosal conditions , recurrent aphthous stomatitis , 
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The findings differ but , overall , do not provide evidence that patients with OPMDs have a poorer QoL compared with healthy patients .