Does oral lichen planus aggravate the state of periodontal disease? A systematic review and meta-analysis

Antimicrobial photodynamic therapy in the nonsurgical treatment of periodontitis in patients with HIV infection: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.

The Effect of Dexlansoprazole on Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis evaluated the efficacy of dexlansoprazole (a proton pump inhibitor-PPI) in resolving heartburn, reflux, and other symptoms and complications resulting from gastroesophageal reflux disease (GERD). The study followed PRISMA 2020 and was registered in PROSPERO (CRD42020206513). The search strategy used MeSH and free terms appropriately adapted for each database. Only randomized clinical trials (RCTs) were included. The Cochrane tool (RoB 2.0) was used to assess the risk of bias, and the certainty of evidence was rated using GRADE. Ten RCTs were included. Dexlansoprazole outperformed the placebo and other PPIs in the resolution of heartburn and reflux symptoms in patients with GERD, with benefits during and after treatment, especially in those with moderate and severe symptoms. The meta-analyses indicated that dexlansoprazole at doses of 30 and 60 mg had more 24 h heartburn-free days and nights compared to the placebo medications; no difference was reported between dexlansoprazole at doses of 30 and 60 mg in heartburn-free nights. A low bias risk and a moderate certainty of evidence were observed. This review confirms the therapeutic effect of dexlansoprazole (placebo-controlled) and its improvements in GERD symptoms compared to another PPI. However, the interpretation of the results should be carried out cautiously due to the small number of included studies and other reported limitations.

Risk factors for the development of oral precancerous lesions in a cohort of 293 oral lichen planus patients with or without chronic periodontitis in southern Taiwan

Background/purpose

Oral lichen planus (OLP) may contribute to the risk of chronic periodontitis, and no reports have shown whether OLP patients with periodontitis have a greater risk of oral precancerous lesions, Candida infection or other clinicopathological diseases. This study aimed to assess the risk factors for the development of oral precancerous lesions in a cohort of 293 OLP patients with or without chronic periodontitis in southern Taiwan.

Materials and methods

The current study recruited 293 OLP patients without preexisting periodontitis at a tertiary institution from 1995 to 2018. The patients were divided into two groups based on the presence or absence of periodontitis. The study compared various clinical and pathological characteristics between the two groups, and also estimated the odds ratio (OR) and the 10-year cumulative risk of chronic periodontitis in OLP patients using logistic regression models and Kaplan‒Meier analysis methods, respectively.

Results

After adjusting for age and gender, the significant contributors to oral precancerous lesions in OLP patients (P < 0.05) were periodontal disease (OR = 2.24) and the male gender (OR = 7.52). Betel nut consumption (OR = 2.61), smoking (OR = 2.46), and candidiasis infection (OR = 3.02) also showed significant associations. Older OLP patients had a lower lesion risk, while a longer OLP duration heightened the periodontal disease likelihood.

Conclusion

The present study demonstrated that coexisting periodontal disease increases the likelihood of developing precancerous lesions in patients with OLP. Periodontal management with oral hygiene care and quitting betel nut consumption and smoking can reduce the risk.

Disease severity scoring systems in mucosal lichen planus: A systematic review

Several scoring systems have been developed to evaluate disease severity in mucosal lichen planus, but only a few have been validated to ensure reproducible and accurate assessment of disease severity. The current systematic review was undertaken to identify clinical severity scoring systems in mucosal lichen planus that have undergone validity or reliability testing and to describe their operating characteristics. We performed a bibliographic search in five databases from their inception to October 2022 for severity scoring systems in mucosal lichen planus that have undergone validity or reliability tests. Quality assessment was conducted using the Joanna Briggs Institute Critical Appraisal tools. We have included 118 studies and identified 11 clinical severity scoring systems for oral lichen planus that have undergone validity or reliability testing. Of these, the most reported were the Thongprasom score, the Oral Disease Severity Score (ODSS) and the REU (Reticular/hyperkeratotic, Erosive/erythematous, Ulcerative) scoring systems. We did not identify clinical scoring systems for extraoral mucosal lichen planus that have undergone validity or reliability testing. The ODSS and REU scoring systems have undergone the highest number of validation attempts and reliability assessments for oral lichen planus respectively. However, we have identified numerous factors that have hampered the universal adoption of a standardised scoring system. There is a need for the development and validation of scoring systems for extraoral mucosal lichen planus.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.

Desquamative Gingivitis, Oral Hygiene, and Autoimmune Oral Diseases: A Scoping Review

Desquamative gingivitis is a clinical condition with a chronic course, not specific to a particular disease, characterized by intense erythema, scaling, vesicles, and/or blisters that may involve both the marginal free gingiva (MG) and the neighboring adherent gingiva (AG). This scoping review aimed to investigate whether there is a correlation between oral hygiene and gingival lesions induced by autoimmune diseases of the oral cavity and whether periodontal disease can negatively influence a clinical picture of desquamative gingivitis due to an immune disorder of the oral cavity. Case series studies and randomized controlled trials were considered for this scoping review; studies that did not comply with the inclusion criteria were excluded. A total of seven studies were selected for this review. The PRISMA-ScR (preferred reporting items for scoping reviews) consensus has been followed. Based on the included studies, it is possible to state that improvement in disease and patient-reported outcomes may be the result of appropriate oral hygiene education when patients are found to have autoimmune diseases with gingival manifestations.

Gingival lichen planus: A clinical and pathological study

BACKGROUND

Oral lichen planus (OLP) is a common immune-mediated chronic inflammatory disease affecting the oral mucosa. It is most likely to occur in adults, particularly in women. The most commonly affected areas are the buccal mucosa, tongue and gingiva, either alone or in combination. The aim of this study was to analyse the clinicopathological characteristics of gingival lichen planus in a series of patients diagnosed between 2000 and 2019.

MATERIALS AND METHOD

Files of 190 patients with histopathologically confirmed gingival lichen planus were retrieved from the archives of the Laboratory of Oral and Maxillofacial Pathology of the Geneva University Hospitals. We analysed the demographic characteristics of the patients, the location, clinical presentation and histopathological characteristics of the lesions, and the presence of symptoms.

RESULTS

The majority of the patients were women (74.2%). The age ranged between 12 and 88 years of age, with a mean of 58.6 years. 79 cases (41.6%) of gingival lichen planus were confined to the gingiva. In the remaining cases, the gingival lesions were associated with other localisations, mostly the buccal mucosa and the tongue, as well as other intraoral and extra-oral sites. 38.7% of the patients presented mixed form of OLP, 27.8% keratotic form and 22.4% erythematous/erosive form. The mixed and the erythematous/erosive forms were the most symptomatic lesions. The majority of gingival lichen planus were active atrophic. A total of seven malignant transformation were found (3.7% of the cases).

CONCLUSION

Gingival lichen planus is a chronic disease that can have many different clinical and histological presentations. Long-term regular follow-up of gingival lichen planus is recommended to detect signs of malignant transformation.

Study on the Effects of Orthodontics on Anterior Tooth Displacement in Patients

Objective

The purpose of this study was to investigate the therapeutic effect of orthodontic treatment on anterior tooth displacement caused by periodontal disease.

Methods

A prospective study was performed in 86 patients with anterior tooth displacement caused by periodontal disease. These patients were divided into the experimental group and the control group according to the intervention methods. For the control group, patients were treated with conventional therapy. The experimental group used straight wire orthodontic technique for orthodontic treatment on the basis of conventional treatment. Comparisons were performed between two groups in term of bleeding index, alveolar bone height, anterior tooth coverage, periodontal pocket depth, probing depth, clinical crown length, tooth root length, inflammatory cytokines levels, and orthodontic satisfaction.

Results

Comparison of bleeding index, alveolar bone height, anterior tooth coverage, periodontal pocket depth, probing depth, clinical crown length, tooth root length, and inflammatory cytokines levels between two groups before treatment indicated that there were no statistical differences (all P > 0.05). After treatment, bleeding index, alveolar bone height, anterior tooth coverage, periodontal pocket depth, probing depth, clinical crown length, and serum levels of IL-6 and TNF-α in the experimental group were lower than those in the control group (all P < 0.05), while the serum level of IL-2 in the experimental group was more than that in the control group (P < 0.05). Also, there was no difference for tooth root length between two groups. Moreover, compared with the control group, orthodontic satisfaction in the experimental group was significantly increased.

Conclusion

The efficacy of orthodontic treatment in patients with anterior tooth displacement caused by periodontal disease is higher than that of only using conventional therapy, as it helps improve their periodontal health, alveolar bone height, clinical crown length, inflammatory factor levels, and orthodontic satisfaction of patients.