Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know

Shavit, Eran; Klieb, Hagen; Shear, Neil H.

doi:10.12688/f1000research.18713.1

Cited by 23 publications

(30 citation statements)

References 62 publications

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“…A review on dental amalgam-associated oral lichenoid lesions (OLLs) and oral lichen planus (OLP) found that approximately one-third of patients experienced complete resolution, another one-third experienced partial resolution, and the remaining third had no resolution of OLP upon removal of the amalgam [ 8 ]. For patients with OLP, 89.2% of patients with positive patch tests and 78.9% of patients with negative patch tests experienced improvement with removal of the amalgam.…”

Section: Discussionmentioning

confidence: 99%

Gold Dental Implant-Induced Oral Lichen Planus

Rasul¹,

Anderson²,

Bergholz³

et al. 2022

Cureus

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Lichen planus is a chronic inflammatory cutaneous and mucosal disease mostly affecting middle-aged individuals. The etiology of lichen planus is unknown, but current literature suggests that it is an altered immune response characterized by dysregulated T-cell activation and subsequent inflammation which can be associated with conditions like allergic contact dermatitis and hepatitis C. Additionally, heavy metals like lead, tin, arsenic, and bismuth can create inflammatory and allergic reactions that can predispose to the formation of lichen planus. This report examines the case of a 64-year-old female with longstanding oral lichenoid lesions with superimposed Wickham's striae, allergic skin reactions to several medications, and a history of receiving gold-containing dental implants. As a result of her history and subsequent allergy testing, she was found to have a gold allergy. The constant mucosal irritation from her dental implants likely was associated with the development of her oral lesions, which were confirmed to be oral lichen planus. She was recommended to apply triamcinolone 0.1% ointment to her oral lesions and to follow up with her dentist for evaluation of her filings. Further, it was recommended she replaces the dental crowns with compounds lacking gold to decrease the persistent irritation. This case represents the first such instance of gold dental fillings directly having an appreciable role in the development of oral lichen planus.

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Section: Discussionmentioning

confidence: 99%

Gold Dental Implant-Induced Oral Lichen Planus

Rasul¹,

Anderson²,

Bergholz³

et al. 2022

Cureus

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“…Treatment goals include reducing pain, healing ulcerative lesions, reducing the risk of cancer of the oral cavity, prolonging asymptomatic periods, and maintaining good oral hygiene and dental status [ 85 ].…”

Section: Lichen Planus (Lp)mentioning

confidence: 99%

“…In patients with OLP, establishing a bacterial plaque control program improved not only the frequency of gingival bleeding, but also the painful symptoms of the lesions and the general activity of the disease [ 50 , 85 ]. Figure 5 illustrates a treatment algorithm for the management of desquamative gingivitis due to lichen planus.…”

Section: Lichen Planus (Lp)mentioning

confidence: 99%

Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment

et al. 2022

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Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prognosis and treatment vary according to the cause. DG may inflict significant oral discomfort, which is why patients typically present to the dentist for a first consultation, rendering it important for these specialists to be informed about this condition. Our paper aims to review the ethiopatogenesis and diagnostic approach of DG, focusing on the most common underlying disorders (autoimmune bullous dermatoses and lichen planus) and on the management of these patients. Potential etiological agents leading to an inflammatory immune response in the oral mucosa and DG appearance include genetic predisposition, metabolic, neuropsychiatric, infectious factors, medication, dental materials, graft-versus-host reaction and autoimmunity. A thorough anamnesis, a careful clinical examination, paraclinical explorations including histopathological exam and direct immunofluorescence are necessary to formulate an appropriate diagnosis. Proper and prompt management of these patients lead to a better prognosis and improved quality of life, and must include management in the dental office with sanitizing the oral cavity, instructing the patient for rigorous oral hygiene, periodic follow-up for bacterial plaque detection and removal, as well as topical and systemic therapy depending on the underlying disorder, based on treatment algorithms. A multidisciplinary approach for the diagnosis and follow-up of DG in the context of pemphigus vulgaris, bullous pemphigoid, cicatricial pemhigoid or lichen planus is necessary, including consultations with dermatologists, oral medicine specialists and dentists.

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“…La etiología del LPO aún se desconoce y su patogenia no está del todo aclarada. Se sabe que corresponde a una respuesta inmune celular, que inducirían una respuesta inflamatoria crónica y apoptosis de queratinocitos de la mucosa oral (Shavit et al, 2020). Esta falta de conocimiento ha desencadenado múltiples controversias y el surgimiento de nuevas teorías que han intentado explicar su etiopatogenia (Aguirre-Urizar et al, 2020).…”

Section: Introductionunclassified

Inmunoglobulinas en la Etiopatogenia del Liquen Plano Oral; La Evidencia Carece de Confiabilidad. Revisión Sistemática Exploratoria

Hernández

Sánchez

2021

Int. J. Odontostomat.

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RESUMEN:El liquen plano oral es una enfermedad inflamatoria crónica mucocutánea, de etiología desconocida y se asocia principalmente a una respuesta de inmunidad celular. En los años 70, se comienza a involucrar a las inmunoglobulinas en la etiopatogenia de la enfermedad y hasta la fecha la evidencia científica nos ofrece información reducida, muy variada y con resultados discutibles que hacen necesario una detallada evaluación de esta. Hemos encontrado poca investigación (32 artículos desde 1974 hasta el 2020) y la importancia relativa de las revistas donde han sido publicado los estudios es miscelánea (cuartiles 1, 2 ,3, 4 y no indexadas). Los artículos científicos presentan baja calidad metodológica en el 75% (24 artículos). El 25% restante, presenta calidad media (7 artículos) y de estos, solo el 9 % (3 artículos) encontraron diferencia en la presencia de inmunoglobulinas entre los grupos de casos y controles, y un solo artículo presenta calidad metodológica alta (3 %), pero sus resultados indican que no hay información suficiente. Nuestros resultados revelan que la evidencia científica existente en cuanto a la participación de inmunoglobulinas en la etiopatogenia del liquen plano oral carece de confiabilidad por presentar calidad metodológica de baja calidad. Proponemos dejar de pensar en esta posibilidad o bien mejorar sustancialmente la metodología empleada en los futuros estudios.

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Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know

Cited by 23 publications

References 62 publications

Gold Dental Implant-Induced Oral Lichen Planus

Gold Dental Implant-Induced Oral Lichen Planus

Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus—Challenges in the Diagnosis and Treatment

Inmunoglobulinas en la Etiopatogenia del Liquen Plano Oral; La Evidencia Carece de Confiabilidad. Revisión Sistemática Exploratoria

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