{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:05:29Z","timestamp":1793829929145,"version":"4.6.1"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,5,27]],"date-time":"2019-05-27T00:00:00Z","timestamp":1558915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objective: Cortisol, as the main human glucocorticoid, is considered to be a biological marker of stress and anxiety. Since it is known that oral lichen planus (OLP) can appear and worsen during stressful events, cortisol levels have been previously studied in OLP patients. The present meta-analysis aims to assess the salivary concentration of cortisol in OLP patients compared to healthy controls. Materials and methods: Web of Science, PubMed, Cochrane Library, and Scopus databases were searched up to October 2018. The RevMan 5.3 software was used with the mean difference (MD) and 95% confidence intervals (CIs). The CMA 2.0 Software was used to evaluate the publication bias, sensitivity analysis, and meta-regression as possible sources of heterogeneity. Results: 10 studies were analyzed and a total of 269 OLP patients and 268 controls were included. The pooled MD of the salivary levels of cortisol in OLP patients compared with controls was 4.27 ng\/mL (95% CI: 2.33, 6.21; P &lt; 0.0001), thus, the salivary level of cortisol in OLP patients was significantly higher than in controls. In Indian-based population studies, a significant difference in the salivary cortisol levels in OLP patients compared with controls was detected (MD = 5.62 ng\/mL; 95% CI: 2.67, 8.56; P = 0.0002). In addition, a significant difference in the salivary cortisol levels in the OLP patients compared with the controls was obtained in studies performed with enzyme-linked immunosorbent assay (ELISA) method (MD = 5.33 ng\/mL; 95% CI: 2.72, 7.93; P &lt; 0.0001). Conclusion: We suggest that supportive psychological treatment together with the conventional therapy could increase patients\u2019 capability to prevent stress, anxiety, and depression.<\/jats:p>","DOI":"10.3390\/medicina55050213","type":"journal-article","created":{"date-parts":[[2019,5,27]],"date-time":"2019-05-27T11:19:27Z","timestamp":1558955967000},"page":"213","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Evaluation of the Salivary Level of Cortisol in Patients with Oral Lichen Planus: A Meta-Analysis"],"prefix":"10.3390","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3314-8613","authenticated-orcid":false,"given":"Pia","family":"Lopez-Jornet","sequence":"first","affiliation":[{"name":"Facultad de Medicina y Odontologia Universidad de Murcia, Hospital Morales Meseguer, Clinica Odontologic Adv Marques Velez s\/n, 30008 Murcia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4537-3014","authenticated-orcid":false,"given":"Elisa","family":"Zavattaro","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Translational Medicine, University of Eastern Piedmont \u201cAmedeo Avogadro\u201d, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid Reza","family":"Mozaffari","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah 6713954658, Iran"},{"name":"Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazaher","family":"Ramezani","sequence":"additional","affiliation":[{"name":"Molecular Pathology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah 6714415153, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3586-3012","authenticated-orcid":false,"given":"Masoud","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran"},{"name":"Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,27]]},"reference":[{"key":"ref_1","first-page":"43","article-title":"Salivary Cortisol as a Diagnostic Marker in Oral Lichen Planus","volume":"7","author":"Kaur","year":"2015","journal-title":"J. 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