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Aljohani K, Alqarni A, Harte M, Alghamdi R, Alzahrani S, Albuquerque R. Oral Potentially Malignant Disorders and Oral Cancer in Saudi Arabia: An Epidemiological Review of the Literature. J Clin Med 2024; 13:1376. [PMID: 38592216 PMCID: PMC10932327 DOI: 10.3390/jcm13051376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Oral potentially malignant disorders (OPMDs) are a group of chronic oral mucosal diseases associated with an increased risk of malignant transformation. Multiple studies have investigated the prevalence of these conditions in multiple regions; however, there are limited data about the prevalence of OPMDs in the Kingdom of Saudi Arabia (KSA). This paper aims to review the prevalence of OPMDs in the KSA, to ensure better understanding of the population risk and propose a more standardised approach to the diagnosis and management of this group across the KSA. In addition, this review will discuss the prevalence of oral cancer in the KSA, considering independent risk factors for oral cancer development. Methods: Electronic databases including PubMed, Medline, Medscape, ScienceDirect, StatPearls, BMC Oral Health and the Cochrane Library were searched with the keywords "Oral Potentially Malignant Disorders"; "Saudi Arabia"; and "Oral Cancer". Identified articles were reviewed independently by 2 reviewers against defined inclusion and exclusion criteria. Results: 16 studies were included in this review. The prevalence of OPMDs in KSA varies significantly depending on age, gender, social habits, background disease and dental status. Conclusions: This review highlights the need for up-to-date data on the prevalence, distribution, and characteristics of OPMDs in KSA. The diverse prevalence rates and distinct characteristics of various OPMDs emphasise the necessity for targeted preventive measures. As the data on OPMDs in KSA remains limited, future research efforts should prioritise the establishment of comprehensive epidemiological studies to inform effective public health interventions in this region.
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Affiliation(s)
- Khalid Aljohani
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ali Alqarni
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Taif 21944, Saudi Arabia;
| | - Molly Harte
- Department of Oral Medicine, Guy’s and St Thomas NHS Foundation Trust, Faculty of Dentistry, Oral Craniofacial Sciences, King’s College London, London SE1 8WA, UK; (M.H.); (R.A.)
| | - Rawia Alghamdi
- Independent Researcher, Jeddah 22335, Saudi Arabia; (R.A.); (S.A.)
| | - Saja Alzahrani
- Independent Researcher, Jeddah 22335, Saudi Arabia; (R.A.); (S.A.)
| | - Rui Albuquerque
- Department of Oral Medicine, Guy’s and St Thomas NHS Foundation Trust, Faculty of Dentistry, Oral Craniofacial Sciences, King’s College London, London SE1 8WA, UK; (M.H.); (R.A.)
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Parlatescu I, Tovaru S, Tofan C, Perlea P, Milanesi E, Dobre M, Mihai LL. Gingival Manifestations in Oral Chronic Autoimmune Bullous Diseases: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:167. [PMID: 38256427 PMCID: PMC10818461 DOI: 10.3390/medicina60010167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Desquamative gingivitis (DG) is a clinical term indicating "peeling gums" and is associated with different oral manifestations. In this study, we aimed to assess the association between DG and autoimmune blistering mucocutaneous diseases (ABMD) with oral manifestations. Materials and Methods: A retrospective study including 88 patients diagnosed between 1998 and 2019 with ABMD (intraepithelial and subepithelial autoimmune blistering diseases) was performed at the Oral Medicine Department, Faculty of Dentistry, "Carol Davila" University of Medicine and Pharmacy in Bucharest. For each patient, the sociodemographic and anamnestic data, as well as clinical features of oral lesions (location), histological evaluation, and direct immunofluorescence data were collected. Results: Most of the patients involved in the study were female (78.4%). In total, 34 patients (38.63%) were diagnosed with subepithelial autoimmune diseases (SAD) and 54 (61.36%) had intraepithelial autoimmune diseases (IAD). Differences in the anatomic distribution of oral involvement were found between SAD and IAD. The presence of DG was significantly more common in patients with SAD compared to those with a diagnosis of IAD. Conclusions: Specific anatomical locations of the oral lesions are significantly associated with different subtypes of ABMD, with gingiva and hard palate mucosa being more involved in SAD and the soft palate and buccal mucosa in IAD. Desquamative gingivitis is a clinical sign that raises diagnostic challenges for several conditions in oral medicine.
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Affiliation(s)
- Ioanina Parlatescu
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.P.); (S.T.); (P.P.)
| | - Serban Tovaru
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.P.); (S.T.); (P.P.)
| | - Cristina Tofan
- Private Dental Practice, Dimitrie Cantemir Street, no 11, bl. 8, ap. 46, 040233 Bucharest, Romania
| | - Paula Perlea
- Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (I.P.); (S.T.); (P.P.)
| | - Elena Milanesi
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Victor Babeș National Institute of Pathology, 050096 Bucharest, Romania;
| | - Maria Dobre
- Victor Babeș National Institute of Pathology, 050096 Bucharest, Romania;
| | - Laurenta Lelia Mihai
- Faculty of Dental Medicine, “Titu Maiorescu” University of Bucharest, 031593 Bucharest, Romania;
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Torrezani A, Gallo CDB, Motta ACF, Siqueira CS, Rabelo GD, Júnior CAL. Desquamative gingivitis treatment with topical tacrolimus applied to a custom tray: an open trial regarding its efficacy on patients' symptoms. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:30-36. [PMID: 37919196 DOI: 10.1016/j.oooo.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate the efficacy of topical tacrolimus offered on a custom tray to treat desquamative gingivitis (DG). STUDY DESIGN Eighteen patients with symptomatic DG related to oral lichen planus (OLP) or mucous membrane pemphigoid (MMP) were selected, of which 13 completed the study. Periodontal treatment was followed by the fabrication of a custom silicone tray to apply a tacrolimus gel formulation (0.1%). Clinical evaluation (complaint of pain and burning - visual analog scale from 0 to 10; and the presence of erythema, desquamation, vesicle/blister, erosion, ulcer, and bleeding) was performed by the same examiner on day 1, and every 15 days for 90 days. RESULTS Total remission was found in 4 patients (30.76%). Partial remission was found in 69.24% of the patients, classified with an excellent (30.76%), good (30.76%), and regular (7.69%) recovery, respectively. There was a reduction of about 60% in pain and 65% in burning sensation complaints. Wilcoxon test revealed significant differences between pre- and post-treatment pain and burning sensation symptoms (P < .01). CONCLUSION Topical application of 0.1% tacrolimus gel was effective in the treatment of DG in controlling pain and burning sensation, leading to the clinical remission of gingival lesions in patients with OLP and MMP.
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Affiliation(s)
- Anna Torrezani
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Camila de Barros Gallo
- Stomatology Department, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Ana Carolina Fragoso Motta
- Stomatology, Public Health & Forensic Department, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Gustavo Davi Rabelo
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Sciuca AM, Toader MP, Stelea CG, Maftei GA, Ciurcanu OE, Stefanescu OM, Onofrei BA, Popa C. Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus-Challenges in the Diagnosis and Treatment. Diagnostics (Basel) 2022; 12:1754. [PMID: 35885656 PMCID: PMC9322493 DOI: 10.3390/diagnostics12071754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
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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Affiliation(s)
- Ana Maria Sciuca
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Mihaela Paula Toader
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Carmen Gabriela Stelea
- Discipline of Oral Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (O.E.C.); (O.M.S.)
| | - George Alexandru Maftei
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Oana Elena Ciurcanu
- Discipline of Oral Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (O.E.C.); (O.M.S.)
| | - Ovidiu Mihail Stefanescu
- Discipline of Oral Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (O.E.C.); (O.M.S.)
| | - Bianca-Andreea Onofrei
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Cristina Popa
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
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Shikino K, Hanazawa N, Noda K, Ikusaka M. Gingival telangiectases due to dermatomyositis. J Gen Fam Med 2021; 22:49-50. [PMID: 33457157 PMCID: PMC7796783 DOI: 10.1002/jgf2.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kiyoshi Shikino
- Department of General Medicine Chiba University Hospital Chiba Japan
| | - Nao Hanazawa
- Department of General Medicine Chiba University Hospital Chiba Japan
| | - Kazutaka Noda
- Department of General Medicine Chiba University Hospital Chiba Japan
| | - Masatomi Ikusaka
- Department of General Medicine Chiba University Hospital Chiba Japan
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DALTABAN Ö, ÖZÇENTİK A, AKMAN-KARAKAŞ A, ÜSTÜN K, HATİPOĞLU M, UZUN S. Clinical Analysis of Desquamative Gingivitis Related Oral Mucocutaneous Diseases. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.779519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Shaqman M, Hamdan A, Karadsheh O, Sawair F, Hassona Y. Desquamative gingivitis: a challenging diagnosis for clinicians. Br Dent J 2020; 229:26-30. [PMID: 32651518 DOI: 10.1038/s41415-020-1848-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Diagnosis of underlying causes for desquamative gingivitis (DG) is often delayed in clinical settings, but little is known about factors influencing its delayed diagnosis. We investigated the diagnostic patterns and associated factors in a cohort of patients presenting primarily with DG.Materials and methods A total of 41 patients presenting primarily with DG were interviewed to evaluate professional and patient diagnostic delays. Severity of DG was evaluated using the desquamative gingivitis clinical score (DGCS) proposed by Arduino <i>et al.</i> (2017).Results The study sample was composed of 29 females and 12 males. On average, patients waited 10.8 ± 10 months (range 4-20 months) before seeking their first professional consultation (that is, patient delay). Less severe disease and female gender were significantly associated with longer patient delay. Patients consulted an average of 4.1 ± 2 healthcare professionals (range two to six) before a definitive diagnosis was reached, with an average professional delay of 7.3 ± 5 months (range 2-11 months). Professional delay was positively correlated with the number of professional consultations (r = 0.69) and absence of other oral mucosal lesions or extraoral involvement.Conclusions Considerable diagnostic delay is a feature of the natural history of DG. Increased patient knowledge and professional awareness regarding DG symptoms and diagnostic measures is needed to reduce diagnostic delay and improve patients' experience with this disease.
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Affiliation(s)
- Murad Shaqman
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan.
| | - Ahmad Hamdan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Omar Karadsheh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
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Bilodeau EA, Lalla RV. Recurrent oral ulceration: Etiology, classification, management, and diagnostic algorithm. Periodontol 2000 2019; 80:49-60. [PMID: 31090148 DOI: 10.1111/prd.12262] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Recurrent oral ulcerations are manifestations of a heterogeneous set of both general and more-or-less specific oral diseases due to numerous potential etiologies, including, but not limited to, infections, medications, autoimmune disease, and other systemic disease. This review discusses the pathogenesis, clinical presentation, diagnosis, and management of the common causes of recurrent oral ulceration. The following types/etiologies of recurrent oral ulceration are covered: traumatic ulceration, chemical ulceration, recurrent aphthous stomatitis, medication-related ulceration, infectious ulceration, mucocutaneous disease, and autoimmune/systemic disease. A diagnostic algorithm for recurrent oral ulceration is also presented.
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Affiliation(s)
- Elizabeth A Bilodeau
- Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Rajesh V Lalla
- Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
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Bianco L, Romano F, Maggiora M, Bongiovanni L, Guzzi N, Curmei E, Arduino PG, Aimetti M. Effect of sonic versus manual supervised toothbrushing on both clinical and biochemical profiles of patients with desquamative gingivitis associated with oral lichen planus: A randomized controlled trial. Int J Dent Hyg 2018; 17:161-169. [PMID: 30507032 DOI: 10.1111/idh.12377] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/07/2018] [Accepted: 11/27/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this randomized, parallel-design, clinical trial was to investigate the effectiveness of an intensive plaque control programme with sonic versus manual toothbrushing on clinical outcomes and gingival crevicular fluid (GCF) levels of matrix metalloproteinases (MMP) in desquamative gingivitis (DG) patients. METHODS A total of 32 patients affected by DG secondary to oral lichen planus (OLP) were consecutively recruited and randomly assigned to a test (n = 16) and control (n = 16) group. Both groups were enrolled in an intensive control programme comprising supragingival scaling and polishing, and brush-specific instructions for a period of 8 weeks. The treatment of interest (test) was the use of a sonic-powered toothbrush, and the standard treatment (control) was the utilization of a soft-bristle manual toothbrush for twice-daily home oral hygiene procedures. Periodontal parameters, patient-centred outcomes, MMP-1 and MMP-9 GCF levels were evaluated at baseline and 8 weeks after starting the programme. RESULTS The plaque control programme resulted in statistically significant reduction in periodontal parameters with consequent improvement in the clinical features, painful symptoms and severity of DG lesions in both groups (all P < 0.001). When a sonic toothbrush was used, there was a more significant decrease in clinical indices, mucosal disease scores and GCF levels of MMP-1 and MMP-9. CONCLUSIONS This clinical trial reported the effectiveness of a combined protocol based on professional oral hygiene and supervised toothbrushing in OLP patients with DG. The daily use of a sonic toothbrush would seem to perform better in the short term.
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Affiliation(s)
- Laura Bianco
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Marina Maggiora
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Loretta Bongiovanni
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Nicoletta Guzzi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Elena Curmei
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Paolo Giacomo Arduino
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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Sami N. Recalcitrant Oral Pemphigus Vulgaris Treated With Rituximab. Clin Adv Periodontics 2018. [DOI: 10.1002/cap.10033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Naveed Sami
- Department of Dermatology; University of Alabama-Birmingham; Birmingham AL
- Department of Medicine; University of Central Florida; Orlando FL
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11
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Effect of a structured plaque control on MMP-1 and MMP-9 crevicular levels in patients with desquamative gingivitis associated with oral lichen planus. Clin Oral Investig 2018; 23:2651-2658. [PMID: 30327948 DOI: 10.1007/s00784-018-2704-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES No data are available in the literature on the extent to which the immune host-response and bacterial-elicited inflammation separately contributes to the increase in gingival crevicular fluid (GCF) levels of inflammatory biomarkers in patients affected by desquamative gingivitis (DG) secondary to oral lichen planus (OLP). The aim of this study was to investigate the effect of a structured plaque control intervention on GCF levels of MMP-1 and MMP-9 in OLP patients with DG and to compare them with those of non-OLP patients. MATERIALS AND METHODS The study population consisted of 18 unrelated Caucasian patients with DG, while 18 periodontally healthy subjects were recruited for the control group. Periodontal parameters and GCF biomarker amounts were evaluated at baseline and 2 months after a structured plaque control intervention, comprising professional oral hygiene sessions, manual toothbrushing, and interdental cleaning advice, only for DG patients. Determination of MMP-1 and MMP-9 levels was carried out by means of an enzyme-linked immunosorbent assay. RESULTS Plaque control program led to improvement in all examined clinical parameters and resulted in significant decrease in GCF total amount and concentration of MMP-1 and MMP-9 in comparison to baseline (p < 0.001). However, MMP-1 and MMP-9 levels in DG patients were still significantly higher than those in the healthy control group (p < 0.01). CONCLUSIONS These findings would seem to support an intrinsic upregulated expression of MMPs in DG patients that is exacerbated by bacterial plaque. CLINICAL RELEVANCE The present outcomes provide further scientific grounds for the importance of strict professional oral hygiene sessions in DG patients.
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Lopes de Oliveira LM, Batista LHC, Neto APDS, Silva LB, Cimões R, Leão JC, Cintra ML, Ribeiro CMB. Oral Lichenoid Lesion Manifesting as Desquamative Gingivitis: Unlikely Association? Case Report. Open Dent J 2018; 12:679-686. [PMID: 30369977 PMCID: PMC6182885 DOI: 10.2174/1745017901814010679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/19/2018] [Accepted: 09/03/2018] [Indexed: 01/13/2023] Open
Abstract
Introduction: The aim of this report is to present a clinical case of oral lichenoid lesions associated with amalgam restorations with the presence of desquamative gingivitis for a nine months follow up period. Case Report: The histopathologic characteristics and direct immunofluorescence were compatible with Oral Lichenoid Lesion (LLO). Diagnosis was based on a synthesis of all available information, including medical history, clinical examination, histopathology and the results of specific tests, such as the patch test, which confirmed allergy to thimerosal, an organic compound of mercury. Discussion: The replacement of amalgam restorations has brought improvements to the instrument, as evidenced by the disappearance of desquamative gingivitis, aspect erythematosus and erosive lesions. The fading does not complete the same, however, indicates the need to continue has been under continuous observation, the patient, having in view the possibility of the existence of an underlying lichen planus.
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Affiliation(s)
- Lívia Maria Lopes de Oliveira
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | | | | | - Luciano Barreto Silva
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Renata Cimões
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Jair Carneiro Leão
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Maria Leticia Cintra
- Medical Sciences College, University of Campinas - FCM UNICAMP, Campinas, Brazil
| | - Camila Maria Béder Ribeiro
- Department of Pathology, Faculty of Dentistry, Cesmac University Center, Cônego Machado, 918, Farol CEP: 57051-160, Maceió, Alagoas, Brazil
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Mester A, Lucaciu O, Ciobanu L, Apostu D, Ilea A, Campian RS. Clinical features and management of oral lichen planus (OLP) with emphasis on the management of hepatitis C virus (HCV)-related OLP. Bosn J Basic Med Sci 2018; 18:217-223. [PMID: 29984679 DOI: 10.17305/bjbms.2018.3133] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 12/20/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease characterized by the occurrence of multiple, symmetrical lesions in the oral cavity. Hepatitis C virus (HCV) infection has been suggested as an etiological factor in OLP. The purpose of this review was to summarize the current literature regarding the treatment of OLP in patients with HCV infection. An electronic search of the PubMed database was conducted until January 2018, using the following keywords: OLP, HCV, corticosteroids, retinoids, immunomodulatory agents, surgical interventions, photochemotherapy, laser therapy, interferon, ribavirin, and direct-acting antivirals. We selected the articles focusing on the clinical features and treatment management of OLP in patients with/without HCV infection. Topical corticosteroids are considered the first-line treatment in OLP. Calcineurin inhibitors or retinoids can be beneficial for recalcitrant OLP lesions. Systemic therapy should be used in the case of extensive and refractory lesions that involve extraoral sites. Surgical intervention is recommended for isolated lesions. In patients with HCV, monotherapy with interferon (IFN)-α may either improve, aggravate or trigger OLP lesions, while combined IFN-α and ribavirin therapy does not significantly influence the progression of lesions. Direct-acting antiviral (DAA) therapy appears to be a promising approach in patients with HCV-related OLP, as it can improve symptoms of both liver disease and OLP, with fewer side effects. Nevertheless, for clinical utility of DAAs in OLP patients, further studies with larger sample sizes, adequate treatment duration, and long term follow-up are required.
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Affiliation(s)
- Alexandru Mester
- Department of Oral Rehabilitation, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
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Porter SR, Mercadante V, Fedele S. Oral manifestations of systemic disease. Br Dent J 2018; 223:683-691. [PMID: 29123296 DOI: 10.1038/sj.bdj.2017.884] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 12/17/2022]
Abstract
While the majority of disorders of the mouth are centred upon the direct action of plaque, the oral tissues can be subject to change or damage as a consequence of disease that predominantly affects other body systems. Such oral manifestations of systemic disease can be highly variable in both frequency and presentation. As lifespan increases and medical care becomes ever more complex and effective it is likely that the numbers of individuals with oral manifestations of systemic disease will continue to rise. The present article provides a succinct review of oral manifestations of systemic disease. In view of this article being part of a wider BDJ themed issue on the subject of oral medicine, this review focuses upon oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease.
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Affiliation(s)
- S R Porter
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD
| | - V Mercadante
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD
| | - S Fedele
- UCL Eastman Dental Institute, 256 Gray's Inn Road, London, WC1X 8LD.,UCL NIHR Biomedical Research Centre
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15
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Rahman SU, Mosca RC, Govindool Reddy S, Nunez SC, Andreana S, Mang TS, Arany PR. Learning from clinical phenotypes: Low-dose biophotonics therapies in oral diseases. Oral Dis 2018; 24:261-276. [DOI: 10.1111/odi.12796] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 01/03/2023]
Affiliation(s)
- SU Rahman
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - RC Mosca
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
- Energetic and Nuclear Research Institute; Radiation Technology Center; São Paulo Brazil
| | - S Govindool Reddy
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - SC Nunez
- Biomedical Engineering and Bioengineering; Universidade Brasil; São Paulo Brazil
| | - S Andreana
- Restorative and Implant Dentistry; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - TS Mang
- Oral and Maxillofacial Surgery; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - PR Arany
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
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16
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Affiliation(s)
- Paolo G Arduino
- Department of Surgical Sciences, CIR-Dental School, University of Turin, Via Nizza 230, Turin 10100, Italy.
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17
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Arduino PG, Romano F, Sasia D, Broccoletti R, Ricceri F, Barbui AM, Brossa S, Cipriani R, Cricenti L, Cabras M, Aimetti M. Subgingival Microbiota in White Patients With Desquamative Gingivitis: A Cross-Sectional Study. J Periodontol 2017; 88:643-650. [DOI: 10.1902/jop.2017.160745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Paolo G. Arduino
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
| | - Federica Romano
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
| | - Danilo Sasia
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service Azienda Sanitaria Locale Torino 3, Grugliasco, Italy
| | - Anna Maria Barbui
- Division of Microbiology and Virology, Azienda Ospedaliero University, Città della Salute e della Scienza – Molinette Hospital, Turin, Italy
| | - Silvia Brossa
- Division of Microbiology and Virology, Azienda Ospedaliero University, Città della Salute e della Scienza – Molinette Hospital, Turin, Italy
| | - Raffaella Cipriani
- Division of Microbiology and Virology, Azienda Ospedaliero University, Città della Salute e della Scienza – Molinette Hospital, Turin, Italy
| | - Luca Cricenti
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
| | - Marco Cabras
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, Center for Interdepartmental Research – Dental School, University of Turin, Turin, Italy
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18
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Arduino PG, Broccoletti R, Carbone M, Conrotto D, Pettigiani E, Giacometti S, Gambino A, Elia A, Carrozzo M. Describing the gingival involvement in a sample of 182 Italian predominantly oral mucous membrane pemphigoid patients: A retrospective series. Med Oral Patol Oral Cir Bucal 2017; 22:e149-e152. [PMID: 28160581 PMCID: PMC5359700 DOI: 10.4317/medoral.21431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 01/23/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The oral cavity has been frequently described as the only site of involvement or as the first manifestation of mucous membrane pemphigoid (MMP), being the gingival tissues often involved, but usually this has been effusively detailed in limited case series. This is a retrospective evaluation of the gingival involvement in 182 Italian patients with oral MMP. MATERIAL AND METHODS The diagnosis of MMP was established by both clinical morphology and direct immunofluorescence finding. Patient information (age, gender, risk factors and medical status) and parameters of manifestation (lesions' distribution, site and type) were detailed. RESULTS The mean age was 62 years for women (n=137) and 67 years for men (n=45). Patients had several sites of oral involvement; the gingiva was the most common one, affecting 151 patients (82.96%; 119 f - 32 m). Female subjects had more possibilities to develop gingival lesions than male patients (P = 0.005). Sixty-five patients (35.7%; 58 f - 7 m) had pure gingival involvement. Patients with lower gingival involvement statistically had more complaints (P = 0.006). CONCLUSIONS This report is one of the largest about predominantly oral MMP cases, detailing the very frequent gingival involvement; this could be crucial not only for oral medicine specialists but also for primary dental healthcare personnel and for periodontists.
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Affiliation(s)
- P-G Arduino
- Department of Surgical Sciences; CIR - Dental School, School of Medicine, University of Turin, Via Nizza 230, 10126 Turin, Italy,
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19
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Monea M, Hănțoiu T, Stoica A, Vlad R, Sitaru A. Original Research. The Influence of Desquamative Gingivitis on Periodontal Health. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background: Desquamative gingivitis (DG) is a non-plaque-induced, blistering and painful condition occurring most frequently on the labial aspect of the attached gingiva of anterior teeth. The incidence of DG is highest around 50 years of age, and usually indicates the presence of oral or systemic diseases. The purpose of our study was to determine the impact of DG on periodontal health by recording the plaque index, gingival index and gingival bleeding index in a group of patients with DG, compared to healthy controls. Materials and methods: Recordings of specific indices were performed in a group of 26 patients with DG and compared with 24 healthy individuals. These were followed by radiographic examinations in order to assess the loss of marginal alveolar bone. Results: The results showed that patients with DG had a statistically significant increase in periodontal indices, with more gingival inflammation and plaque retention compared to the control group (p <0.05). The highest scores for gingival inflammation were recorded in patients with DG, but on radiographic evaluation the difference was related only to gender, men being more affected by alveolar bone loss in both groups (p <0.05). Conclusions: The incidence and severity of gingival inflammation proved to be higher in patients with DG, which calls for better preventive and maintenance treatment protocols in this group of patients. Early diagnosis and initial-phase periodontal treatment are very important in preventing further tissue breakdown.
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Affiliation(s)
- Monica Monea
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Tudor Hănțoiu
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Alexandra Stoica
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Ramona Vlad
- Master student, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
| | - Alexandru Sitaru
- Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540039, Tîrgu Mureș, Romania
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20
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Hamburger J. Orofacial manifestations in patients with inflammatory rheumatic diseases. Best Pract Res Clin Rheumatol 2016; 30:826-850. [PMID: 27964791 DOI: 10.1016/j.berh.2016.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/19/2016] [Indexed: 11/16/2022]
Abstract
The main orofacial manifestation of the inflammatory rheumatic diseases is that of Sjögren's syndrome. In addition, there is a constellation of orofacial manifestations of the inflammatory rheumatic diseases, many of which are extra-articular with some constituting presenting signs of the underlying rheumatic disease. This review will discuss the orofacial manifestations in a variety of connective tissue diseases and will also allude to the oral adverse drug reactions that may occur as a consequence of therapy.
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Affiliation(s)
- John Hamburger
- Birmingham Behçet's Syndrome Centre of Excellence, Sheldon Block, Birmingham and Midland Eye Centre, City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
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21
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Arduino PG, Broccoletti R, Sciannameo V, Scully C. A practical clinical recording system for cases of desquamative gingivitis. Br J Dermatol 2016; 177:299-301. [PMID: 27639053 DOI: 10.1111/bjd.15075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- P G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - R Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - V Sciannameo
- Unit of Epidemiology, Regional Health Service ASL TO3, Turin, Italy
| | - C Scully
- WHO Collaborating Centre for Oral Health-General Health and University College London, London, U.K
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22
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Chang JYF, Chiang CP, Wang YP, Wu YC, Chen HM, Sun A. Antigastric parietal cell and antithyroid autoantibodies in patients with desquamative gingivitis. J Oral Pathol Med 2016; 46:307-312. [DOI: 10.1111/jop.12490] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 01/09/2023]
Affiliation(s)
- Julia Yu-Fong Chang
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
- Graduate Institute of Clinical Dentistry and Graduate Institute of Oral Biology; School of Dentistry; National Taiwan University; Taipei Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
- Graduate Institute of Clinical Dentistry and Graduate Institute of Oral Biology; School of Dentistry; National Taiwan University; Taipei Taiwan
| | - Yi-Ping Wang
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
- Graduate Institute of Clinical Dentistry and Graduate Institute of Oral Biology; School of Dentistry; National Taiwan University; Taipei Taiwan
| | - Yang-Che Wu
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Hsin-Ming Chen
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
- Graduate Institute of Clinical Dentistry and Graduate Institute of Oral Biology; School of Dentistry; National Taiwan University; Taipei Taiwan
| | - Andy Sun
- Department of Dentistry; National Taiwan University Hospital; College of Medicine; National Taiwan University; Taipei Taiwan
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23
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Karagoz G, Bektas-Kayhan K, Unur M. Desquamative gingivitis: A review. J Istanb Univ Fac Dent 2016; 50:54-60. [PMID: 28955567 PMCID: PMC5573533 DOI: 10.17096/jiufd.57228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 06/19/2014] [Indexed: 11/30/2022] Open
Abstract
Desquamative gingivitis (DG) is characterized by
the erythematous gingiva, desquamation and erosion
of the gingival epithelium, and blister formation. It is
a common clinical manifestation in several diseases.
Contact allergic reactions to various oral hygiene
products and chemical agents have also been reported
to represent as DG. The management of DG has been
a major problem, largely because the etiology of the
disease has been elusive. In this paper, we aimed to
review the current literature on the pathogenesis,
diagnosis management and prognosis of DG.
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Affiliation(s)
- Gizem Karagoz
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Turkey
| | - Kivanc Bektas-Kayhan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Turkey
| | - Meral Unur
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Turkey
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24
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Herrera D, Alonso B, de Arriba L, Santa Cruz I, Serrano C, Sanz M. Acute periodontal lesions. Periodontol 2000 2015; 65:149-77. [PMID: 24738591 DOI: 10.1111/prd.12022] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/30/2022]
Abstract
This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case.
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25
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Buajeeb W, Okuma N, Thanakun S, Laothumthut T. Direct Immunofluorescence in Oral Lichen Planus. J Clin Diagn Res 2015; 9:ZC34-7. [PMID: 26436043 DOI: 10.7860/jcdr/2015/13510.6312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/01/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Oral lichen planus (OLP) is a common immune-mediated oral mucosal disease. Diagnosis of OLP depends mainly on both clinical and histopathological features. Direct immunofluorescence (DIF) is a useful investigation method to distinguish between similar lesions and to confirm diagnosis in cases of uncharacterized features. AIM The purpose of this study was to evaluate the prevalence and pattern of DIF in a group of Thai patients with OLP. MATERIALS AND METHODS Records of clinically and histologically diagnosed OLP patients attending the Oral Medicine Clinic, Faculty of Dentistry, Mahidol University, Bangkok, Thailand were consecutively reviewed for DIF results. The DIF patterns in these patients were analysed. RESULTS There were 82 atrophic and/or erosive OLP patients with a mean age of 51.6 years. Male to female ratio was 1:5. Of these, 82.9% showed positive DIF. Buccal mucosa was superior to the gingiva and palate in terms of sensitivity for DIF. All specimens except one (98.5%) demonstrated deposition of fibrinogen at the basement membrane zone (BMZ) in a shaggy pattern. The most common DIF pattern was shaggy fibrinogen at BMZ with IgM deposition on the colloid bodies (CB) (35.3%) followed by shaggy fibrinogen along BMZ (27.9%). CONCLUSION The prevalence of positive DIF in Thai OLP patients was 82.9%. The most common finding was shaggy fibrinogen at BMZ. The typical pattern was shaggy fibrinogen along BMZ with or without positive IgM at CB. DIF pattern could be evaluated for the diagnosis of OLP lacking clinical and/or histopathological characteristic features.
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Affiliation(s)
- Waranun Buajeeb
- Associate Professor, Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University , Bangkok, Thailand
| | - Nis Okuma
- Instructor, Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University , Bangkok, Thailand
| | - Supanee Thanakun
- Associate Professor, Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University , Bangkok, Thailand
| | - Titikarn Laothumthut
- Assistant Professor, Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University , Bangkok, Thailand
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26
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Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14:930-51. [PMID: 26117595 DOI: 10.1016/j.autrev.2015.06.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023]
Abstract
A group of autoimmune diseases is characterised by autoantibodies against epithelial adhesion structures and/or tissue-tropic lymphocytes driving inflammatory processes resulting in specific pathology at the mucosal surfaces and the skin. The most frequent site of mucosal involvement in autoimmune diseases is the oral cavity. Broadly, these diseases include conditions affecting the cell-cell adhesion causing intra-epithelial blistering and those where autoantibodies or infiltration lymphocytes cause a loss of cell-matrix adhesion or interface inflammation. Clinically, patients present with blistering, erosions and ulcers that may affect the skin as well as further mucosal surfaces of the eyes, nose and genitalia. While the autoimmune disease may be suspected based on clinical manifestations, demonstration of tissue-bound and circulating autoantibodies, or lymphocytic infiltrates, by various methods including histological examination, direct and indirect immunofluorescence microscopy, immunoblotting and quantitative immunoassay is a prerequisite for definitive diagnosis. Given the frequency of oral involvement and the fact that oral mucosa is the initially affected site in many cases, the informed practitioner should be well acquainted with diagnostic and therapeutic aspects of autoimmune dermatosis with oral involvement. This paper reviews the pathogenesis and clinical presentation of these conditions in the oral cavity with a specific emphasis on their differential diagnosis and current management approaches.
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Affiliation(s)
- Mayson B Mustafa
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; Oral medicine section, Department of Oral and Maxillofacial Surgery, University of Khartoum, Faculty of Dentistry, Khartoum, Sudan
| | | | - Bruce R Smoller
- Department of Pathology, University of Rochester, School of Medicine and Dentistry, USA
| | - Cassian Sitaru
- Department of Dermatology, University of Freiburg, Hauptstrasse 7, 79104 Freiburg, Germany; BIOSS Centre for Biological Signalling Studies, Signalhaus Freiburg, Schänzlestr. 18, 79104 Freiburg, Germany.
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27
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Endo H, Aoki S, Ito T, Rees TD, Allen EP, Kuyama K, Yamamoto H. Letter to the editor: authors' response. J Periodontol 2015; 86:609-10. [PMID: 25904067 DOI: 10.1902/jop.2015.140722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hiroyasu Endo
- Department of Oral Diagnosis, Nihon University, School of Dentistry at Matsudo, Matsudo, Japan
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28
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Stone SJ, Heasman PA, Staines KS, McCracken GI. The impact of structured plaque control for patients with gingival manifestations of oral lichen planus: a randomized controlled study. J Clin Periodontol 2015; 42:356-62. [DOI: 10.1111/jcpe.12385] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Simon J. Stone
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | - Peter A. Heasman
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | - Konrad S. Staines
- School of Oral and Dental Sciences; University of Bristol; Bristol UK
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29
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Endo H, Rees TD, Allen EP, Kuyama K, Aoki S, Yamamoto H, Ito T. A Stab-and-Roll Biopsy Technique to Maintain Gingival Epithelium for Desquamative Gingivitis. J Periodontol 2014; 85:802-9. [DOI: 10.1902/jop.2014.130428] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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30
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Di Zenzo G, Carrozzo M, Chan LS. Urban legend series: mucous membrane pemphigoid. Oral Dis 2013; 20:35-54. [DOI: 10.1111/odi.12193] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 09/17/2013] [Accepted: 10/02/2013] [Indexed: 11/28/2022]
Affiliation(s)
- G Di Zenzo
- Molecular and Cell Biology Laboratory; Istituto Dermopatico dell'Immacolata; IDI-IRCCS; Rome Italy
| | - M Carrozzo
- Department of Oral Medicine; Centre for Oral Health Research; Newcastle University; Newcastle upon Tyne UK
| | - LS Chan
- Department of Dermatology and Immunology/Microbiology; University of Illinois College of Medicine; Chicago IL USA
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31
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Lo Russo L, Gallo C, Pellegrino G, Lo Muzio L, Pizzo G, Campisi G, Di Fede O. Periodontal clinical and microbiological data in desquamative gingivitis patients. Clin Oral Investig 2013; 18:917-25. [PMID: 23900791 DOI: 10.1007/s00784-013-1038-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 07/02/2013] [Indexed: 02/05/2023]
Affiliation(s)
- Lucio Lo Russo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy,
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32
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Stone SJ, McCracken GI, Heasman PA, Staines KS, Pennington M. Cost-effectiveness of personalized plaque control for managing the gingival manifestations of oral lichen planus: a randomized controlled study. J Clin Periodontol 2013; 40:859-67. [PMID: 23800196 DOI: 10.1111/jcpe.12126] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2013] [Indexed: 10/26/2022]
Abstract
AIM To undertake cost-effectiveness and cost-benefit analyses of an intervention to improve oral health in patients presenting with the gingival manifestations of oral lichen planus (OLP). MATERIALS & METHODS Eighty-two patients were recruited to a 20-week randomized controlled trial. The intervention was personalized plaque control comprising powered tooth brushing and inter-dental cleaning advice. The primary outcome measure was the oral health impact profile (OHIP) with secondary outcomes of pain, plaque index, mucosal disease score and cost-effectiveness. Private cost data and stated willingness-to-pay (WTP) values for treatment were obtained from intervention patients at 20 weeks. RESULTS Overall, 81% of intervention patients showed improvement in both plaque index and mucosal disease score at 20 weeks compared to 30% of controls that continued with their usual plaque control regimen. All intervention group patients stated a positive WTP value. The mean net value of the treatment was £172 compared to the incremental cost of the treatment estimated at £122.75. The cost-effectiveness analysis resulted in an incremental cost-effectiveness ratio of £13 per OHIP point. CONCLUSIONS The tailored plaque control programme was more effective than control in treating the gingival manifestations of oral lichen planus. The programme is cost effective for modest values placed on a point on the OHIP scale and patients generally valued the treatment in excess of the cost.
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Affiliation(s)
- Simon J Stone
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
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33
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Suresh L, Neiders ME. Definitive and Differential Diagnosis of Desquamative Gingivitis Through Direct Immunofluorescence Studies. J Periodontol 2012; 83:1270-8. [DOI: 10.1902/jop.2012.110627] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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34
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain C. [Immunological diseases of buccal localisation]. Med Clin (Barc) 2012; 140:88-92. [PMID: 22989674 DOI: 10.1016/j.medcli.2012.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/04/2012] [Accepted: 06/14/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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Comparison of periodontal status in gingival oral lichen planus patients and healthy subjects. Dermatol Res Pract 2012; 2012:561232. [PMID: 22570646 PMCID: PMC3337596 DOI: 10.1155/2012/561232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 03/05/2012] [Indexed: 12/02/2022] Open
Abstract
Background and Objective. Oral lichen planus (OLP) is a common chronic mucocutaneous disease. OLP can occur in different oral sites such as gingiva. The purpose of study was to evaluate the periodontal status of OLP patients with desquamative gingivitis (DG) and compare it with that of healthy control. Methods. This study was case-control. 32 patients with gingival OLP as a case group and 32 healthy subjects as a control group were selected. The periodontal status of all subjects including plaque index (PI), bleeding on probing (BOP), and clinical attachment level (CAL) was evaluated in both groups. Finally data were analyzed by t-test. Results. The mean values of periodontal parameters were observed to be higher in case group compared with control group, and this was significant (P < 0.05). Conclusion. Our results showed that periodontal status is worse in gingival OLP if compared with healthy controls.
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Woo SB. Diseases of the oral mucosa. MCKEE'S PATHOLOGY OF THE SKIN 2012:362-436. [DOI: 10.1016/b978-1-4160-5649-2.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Woo SB. Immune-Mediated, Autoimmune, and Granulomatous Conditions. ORAL PATHOLOGY 2012:150-184. [DOI: 10.1016/b978-1-4377-2226-0.00008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Carvalho CHPD, Santos BRMD, Vieira CDC, Lima EDNDA, Santos PPDA, Freitas RDA. Estudo epidemiológico das doenças dermatológicas imunologicamente mediadas na cavidade oral. An Bras Dermatol 2011; 86:905-9. [DOI: 10.1590/s0365-05962011000500007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Accepted: 10/17/2010] [Indexed: 02/02/2023] Open
Abstract
FUNDAMENTO: As doenças dermatológicas imunologicamente mediadas compõem diversas patologias que apresentam formas variadas de manifestação no organismo. OBJETIVO: Foi proposição desta pesquisa, estabelecer a prevalência das principais doenças dermatológicas imunologicamente mediadas que apresentam manifestação oral. MÉTODOS: Foram avaliados laudos histopatológicos de 10.292 casos arquivados no Serviço de Anatomia Patológica da Disciplina de Patologia Oral da Universidade Federal do Rio Grande do Norte, no período de 1988 a 2009. Dos casos diagnosticados como algum tipo de doença em estudo, coletaram-se dados clínicos como sexo, idade, raça, sítio anatômico e sintomatologia das doenças. RESULTADOS: Do total de casos registrados, no serviço supracitado, 82 (0,8%) corresponderam a doenças dermato lógicas imunologicamente mediadas com manifestação na cavidade oral. As doenças encontradas neste estudo foram: líquen plano oral, pênfigo vulgar e penfigoide benigno das membranas mucosas, sendo o líquen plano oral a lesão mais prevalente, representando 68,05% dos casos analisados, dos quais 64,3% apresentavam-se em mu lheres, sendo a mucosa jugal o sítio anatômico mais acometido (46,8%). CONCLUSÃO: A ocorrência de doenças dermatológicas imunologicamente mediadas que apresentam manifestação oral ainda é um fato incomum, semelhante ao observado na maioria das regiões mundiais. No entanto, a busca pelo diagnóstico precoce é um requisito essencial para a condução do tratamento dessas doenças, tendo em vista o possível comprometimento sistêmico do organismo nos pacientes.
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Affiliation(s)
- Chris R Irwin
- Consultant/Reader in Restorative Dentistry, Department of Restorative Dentistry, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast
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López-Jornet P, Camacho-Alonso F. Application of a motivation-behavioral skills protocol in gingival lichen planus: a short-term study. J Periodontol 2011; 81:1449-54. [PMID: 20572768 DOI: 10.1902/jop.2010.100245] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The main objective of the present study was to assess the efficacy of a motivation–behavioral skills protocol for plaque control in patients with gingival lichen planus. METHODS A pre- and post-test descriptive clinical study was made of 40 consecutive white patients with gingival lichen planus: five males (12.5%) and 35 females (87.5%); mean age: 57 years. A motivation–behavioral skills protocol for oral hygiene was applied, with the determination of gingival scores (gingival index, plaque extension, and Community Periodontal Index of Treatment Needs [CPITN]) and patient evaluation after 4 and 8 weeks. RESULTS The clinical parameters in relation to the different forms of gingival lichen planus showed statistically significant improvements for gingival index, plaque extension, and CPITN (P <0.001) as determined 4 and 8 weeks after starting the program. CONCLUSIONS The application of an active prevention program in patients with gingival lichen planus is important because it offers benefits for periodontal health. However, more long-term studies are needed to confirm the results obtained.
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Affiliation(s)
- Pia López-Jornet
- Department of Oral Medicine, Murcia University Dental School, Murcia, Spain.
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Arduino PG, Farci V, D’Aiuto F, Carcieri P, Carbone M, Tanteri C, Gardino N, Gandolfo S, Carrozzo M, Broccoletti R. Periodontal status in oral mucous membrane pemphigoid: initial results of a case-control study. Oral Dis 2010; 17:90-4. [DOI: 10.1111/j.1601-0825.2010.01709.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gagari E, Damoulis PD. Desquamative gingivitis as a manifestation of chronic mucocutaneous disease. J Dtsch Dermatol Ges 2010; 9:184-8. [PMID: 21050381 DOI: 10.1111/j.1610-0387.2010.07543.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Desquamative gingivitis (DG) is a clinical descriptive term indicating "peeling gums". DG is usually the result of a disease process that causes separation of the epithelium from the underlying connective tissue in the oral masticatory mucosa. DG may be a manifestation of several mucocutaneous diseases, most commonly cicatricial pemphigoid, pemphigus vulgaris and lichen planus. Correct diagnosis of the underlying disease in DG patients requires careful clinical observation, detailed examination of medical history, biopsy and histopathological examination of the lesions as well as more specialized tests such as direct and indirect immunofluorescence. Treatment of DG consists of treating the underlying disease and often requires the use of immunosuppressive agents, such as corticosteroids. Elimination of local gingival irritants, such as dental plaque and calculus, can significantly improve the treatment outcome.
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Affiliation(s)
- Eleni Gagari
- Department of Dermatology, National and Kapodistrian University, Athens, Greece.
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Lo Russo L, Guiglia R, Pizzo G, Fierro G, Ciavarella D, Lo Muzio L, Campisi G. Effect of desquamative gingivitis on periodontal status: a pilot study. Oral Dis 2010; 16:102-107. [PMID: 19735453 DOI: 10.1111/j.1601-0825.2009.01617.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
OBJECTIVE Desquamative gingivitis (DG) represents the gingival manifestation associated with several mucocutaneous disorders and systemic conditions. Little is known of whether or not DG could influence the onset or progression of plaque-related periodontitis. In this study, the potential impact of DG on plaque-related attachment loss and pocket formation has been evaluated. METHODS A cross-sectional evaluation of 12 patients with DG [eight oral lichen planus (OLP), four mucous membrane pemphigoid (MMP)], never treated for DG lesions or plaque-related periodontitis, was carried out. Probing depth (PD), clinical attachment loss (CAL), full-mouth plaque (FMPS), and bleeding (FMBS) scores were evaluated at six sites per tooth. Clinical parameters of sites with DG lesions were compared with that of DG unaffected sites. RESULTS Median PD and CAL, as well as FMPS and FMBS, were not significantly different (P > 0.05 Mann-Whitney test) for both OLP and MMP patients. However, a negative association between DG lesions and PD < 4 mm (OLP: OR = 0.26; MMP: OR = 0.47), and a positive association with PD 4-6 mm (OLP: OR = 3.76; MMP: OR = 2.68) and with PD > 6 mm (only for OLP: OR = 3.83) were found to be significant. CONCLUSIONS The potential interference between DG lesions and periodontitis needs further prospective investigation; nonetheless, a higher level of attention might be prudent.
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Affiliation(s)
- L Lo Russo
- Department of Surgical Sciences, Faculty of Medicine, School of Dentistry, University of Foggia, Foggia, Italy.
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Schellinck AE, Rees TD, Plemons JM, Kessler HP, Rivera-Hidalgo F, Solomon ES. A Comparison of the Periodontal Status in Patients With Mucous Membrane Pemphigoid: A 5-Year Follow-Up. J Periodontol 2009; 80:1765-73. [DOI: 10.1902/jop.2009.090244] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lo Russo L, Fierro G, Guiglia R, Compilato D, Testa NF, Lo Muzio L, Campisi G. Epidemiology of desquamative gingivitis: evaluation of 125 patients and review of the literature. Int J Dermatol 2009; 48:1049-52. [PMID: 19775398 DOI: 10.1111/j.1365-4632.2009.04142.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Torchia D, Caproni M, Fabbri P. Linear IgA disease and desquamative gingivitis: time for inclusion in mucous membrane pemphigoid. Oral Dis 2008; 14:768-9 author reply 770. [DOI: 10.1111/j.1601-0825.2008.01485.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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