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Oral mucous membrane pemphigoid in a group of Thai patients–A 15–year retrospective study. J Dent Sci 2021; 17:1009-1017. [PMID: 35756789 PMCID: PMC9201646 DOI: 10.1016/j.jds.2021.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/22/2022] Open
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Schmidt E, Rashid H, Marzano A, Lamberts A, Di Zenzo G, Diercks G, Alberti‐Violetti S, Barry R, Borradori L, Caproni M, Carey B, Carrozzo M, Cianchini G, Corrà A, Dikkers F, Feliciani C, Geerling G, Genovese G, Hertl M, Joly P, Meijer J, Mercadante V, Murrell D, Ormond M, Pas H, Patsatsi A, Rauz S, van Rhijn B, Roth M, Setterfield J, Zillikens D, C.Prost, Zambruno G, Horváth B, Caux F. European Guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology - Part II. J Eur Acad Dermatol Venereol 2021; 35:1926-1948. [PMID: 34309078 PMCID: PMC8518905 DOI: 10.1111/jdv.17395] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/24/2021] [Indexed: 01/21/2023]
Abstract
This guideline has been initiated by the task force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology, including physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline that systematically reviewed the literature on mucous membrane pemphigoid (MMP) in the MEDLINE and EMBASE databases until June 2019, with no limitations on language. While the first part of this guideline addressed methodology, as well as epidemiology, terminology, aetiology, clinical presentation and outcome measures in MMP, the second part presents the diagnostics and management of MMP. MMP should be suspected in cases with predominant mucosal lesions. Direct immunofluorescence microscopy to detect tissue-bound IgG, IgA and/or complement C3, combined with serological testing for circulating autoantibodies are recommended. In most patients, serum autoantibodies are present only in low levels and in variable proportions, depending on the clinical sites involved. Circulating autoantibodies are determined by indirect IF assays using tissue substrates, or ELISA using different recombinant forms of the target antigens or immunoblotting using different substrates. The major target antigen in MMP is type XVII collagen (BP180), although in 10-25% of patients laminin 332 is recognized. In 25-30% of MMP patients with anti-laminin 332 reactivity, malignancies have been associated. As first-line treatment of mild/moderate MMP, dapsone, methotrexate or tetracyclines and/or topical corticosteroids are recommended. For severe MMP, dapsone and oral or intravenous cyclophosphamide and/or oral corticosteroids are recommended as first-line regimens. Additional recommendations are given, tailored to treatment of single-site MMP such as oral, ocular, laryngeal, oesophageal and genital MMP, as well as the diagnosis of ocular MMP. Treatment recommendations are limited by the complete lack of high-quality randomized controlled trials.
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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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Xiong X, Xu T, Wang X, Qin W, Yu T, Luo G. Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis. BMC Oral Health 2020; 20:150. [PMID: 32434508 PMCID: PMC7240920 DOI: 10.1186/s12903-020-01134-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022] Open
Abstract
Background To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from 1 month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I2 test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77–2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53–1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75–1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70–1.15, P = 0.40) between OLP and non-OLP groups. Conclusions Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.
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Affiliation(s)
- Xiaoqin Xiong
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Tiantian Xu
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Xinhong Wang
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Wenguang Qin
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Ting Yu
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China.
| | - Gang Luo
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China.
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Garcia-Pola MJ, Rodriguez-López S, Fernánz-Vigil A, Bagán L, Garcia-Martín JM. Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e136-e144. [PMID: 30818305 PMCID: PMC6441599 DOI: 10.4317/medoral.22782] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/22/2018] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. Material and Methods The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. Results After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. Conclusions In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis. Key words:Desquamative gingivitis, oral hygiene, oral lichen planus, mucous membrane pemphigoid; pemphigus, plasma cell gingivitis.
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Affiliation(s)
- M-J Garcia-Pola
- Department of Oral Medicine, Faculty of Medicine and Sciences of the Health, Julian Clavería, 33006 Oviedo, Spain,
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Bombeccari GP, Giannì AB, Spadari F. Dental Implants and Oral Lichen Planus. J Prosthodont 2019; 28:e736-e738. [DOI: 10.1111/jopr.12913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 03/08/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Gian Paolo Bombeccari
- Maxillo-Facial and Dental Unit (Head Prof. AB Gianni); Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Italy
| | - Aldo Bruno Giannì
- Maxillo-Facial and Dental Unit (Head Prof. AB Gianni); Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Italy
| | - Francesco Spadari
- Maxillo-Facial and Dental Unit (Head Prof. AB Gianni); Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico; Milan Italy
- Department of Biomedical, Surgical and Dental Sciences; University of Milan; Italy
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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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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: 3] [Impact Index Per Article: 0.5] [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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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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Maderal AD, Lee Salisbury P, Jorizzo JL. Desquamative gingivitis. J Am Acad Dermatol 2018; 78:839-848. [DOI: 10.1016/j.jaad.2017.05.056] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 05/30/2017] [Accepted: 05/31/2017] [Indexed: 12/13/2022]
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Bagan J, Jiménez Y, Murillo J, Bagan L. Oral mucous membrane pemphigoid: A clinical study of 100 low-risk cases. Oral Dis 2018; 24:132-134. [DOI: 10.1111/odi.12744] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 08/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- J Bagan
- Head Service of Stomatology and Maxillofacial Surgery; University General Hospital; Fundación Hospital General Universitario; Valencia University; Valencia Spain
| | | | - J Murillo
- Head Section of Stomatology and Maxillofacial Surgery; University General Hospital; Valencia Spain
| | - L Bagan
- Universidad Europea de Valencia; Valencia Spain
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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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Jascholt I, Lai O, Zillikens D, Kasperkiewicz M. Periodontitis in oral pemphigus and pemphigoid: A systematic review of published studies. J Am Acad Dermatol 2017; 76:975-978.e3. [DOI: 10.1016/j.jaad.2016.10.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/11/2016] [Accepted: 10/17/2016] [Indexed: 10/20/2022]
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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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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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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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Leite FRM, Nascimento GG, Demarco FF, Waechter J, Etges A. Use of Fusidic Acid for Desquamative Gingivitis Treatment: 1-Year Follow-Up. Braz Dent J 2015; 26:422-7. [DOI: 10.1590/0103-64402013x0117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 05/22/2015] [Indexed: 11/22/2022] Open
Abstract
<p>This study evaluated retrospectively the effect of fusidic acid on the management of desquamative gingivitis (DG). The study population consisted of 15 patients with DG. Patients were requested to make topical application of 2% fusidic acid ointment 4 times a day for 6 weeks. Clinical assessments were recorded at baseline, at 6 weeks and 12 months after beginning the therapy. Patients' examination involved lesion size area, pain score and impact on daily activities. All patients presented lesions in maxilla; in 9 patients (60.0%) lesions were predominately at the anterior region and 6 (40.0%) at the posterior region of maxilla. Treatment significantly (p<0.05) reduced the pain intensity (from 5.4±1.12 to 1.16±0.97) and its periodicity (from 53.33% with pain>3 x/week to 13.33%), and the lesion size in 72.47% (±4.12) immediately after 6 weeks of treatment. Improvements were sustained for 12 months compared to baseline (p<0.001). It also reduced the impact of disease in daily activities (eating and oral hygiene performance), and improved the emotional condition of patients, who reported better social relationships and habits. Topical application of fusidic acid may be a possible alternative local palliative therapy for desquamative gingivitis treatment.</p>
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Conservative approach in patients with pemphigus gingival vulgaris: a pilot study of five cases. Int J Dent 2014; 2014:747506. [PMID: 25505912 PMCID: PMC4258340 DOI: 10.1155/2014/747506] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 10/10/2014] [Accepted: 11/05/2014] [Indexed: 11/17/2022] Open
Abstract
Objectives. The aim of this pilot study was to describe the clinical efficacy of a conservative oral hygiene protocol in patients affected by gingival pemphigus vulgaris (PV) applied in a case series. Methods. Subjects suffering from PV with gingival localisation and slightly responsive to conventional treatment with systemic corticosteroids and immunosuppressive drugs were selected among individuals treated in the Unit of Oral Medicine Section of the University of Turin. Five subjects received nonsurgical periodontal therapy, over a 7-day period, including oral hygiene instructions; patients were instructed about domiciliary oral hygiene maintenance and instructions were reinforced at each visit and personalised if necessary. Clinical outcome variables were recorded at baseline (before starting) and 16 weeks after intervention, including full mouth plaque score (FMPS), bleeding scores (FMBS), probing pocket depth (PPD), oral pemphigus clinical score (OPCS), and patient related outcomes (visual analogue score of pain). Results. Five patients were treated and, after finishing the proposed therapy protocol, a statistical significant reduction was observed for FMBS (P = 0.043) and OPCS (P = 0.038). Conclusions. Professional oral hygiene procedures with nonsurgical therapy are related to an improvement of gingival status and a decrease of gingival bleeding in patients affected by PV with specific gingival localization.
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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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Salgado DS, Jeremias F, Capela MV, Onofre MA, Massucato EMS, Orrico SRP. Plaque control improves the painful symptoms of oral lichen planus gingival lesions. A short-term study. J Oral Pathol Med 2013; 42:728-32. [PMID: 23721580 DOI: 10.1111/jop.12093] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Lichen planus is a mucocutaneous disease with manifestation in the oral mucosa, the gingiva being one of the most affected regions. In some cases, the lesion may be painful and lead to fragility of the tissues, so that precise diagnosis and adequate treatment are indispensible factors for improving the clinical condition. The aim of this study was to evaluate the effectiveness of plaque control in the improvement of clinical features and painful symptoms of oral lichen planus with gingival involvement. METHODS Twenty patients diagnosed with gingival lichen planus confirmed by histopathological examination were selected. The patients were evaluated by a trained examiner, with regard to the clinical features of the lesions [Index of Escudier et al. (Br J Dermatol, 157, 2007, 765)]; painful symptoms (Visual Analog Scale); and periodontally, as regards the visible plaque and gingival bleeding indices. Periodontal treatment consisted of supragingival scaling and oral hygiene instruction, with professional plaque removal afterward for a period of 4 weeks. The entire sample was evaluated at the baseline and at the conclusion of treatment, and the results were analyzed by the Wilcoxon nonparametric test. RESULTS The data demonstrated that the majority of patients were women (90%), with a mean age of 55.9 years. Periodontal treatment resulted in statistically significant reduction (P < 0.05) in the periodontal indices, with consequent improvement in the clinical features and painful symptoms of the lesions. CONCLUSIONS It was demonstrated that plaque control was effective in improving the clinical features and painful symptoms of oral lichen planus with gingival involvement.
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Affiliation(s)
- Daniela S Salgado
- Diagnostic and Surgery Department, Araraquara School of Dentistry, Univ. Estadual Paulista (UNESP), Araraquara, Brazil
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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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Arduino PG, Lopetuso E, Carcieri P, Giacometti S, Carbone M, Tanteri C, Broccoletti R. Professional oral hygiene treatment and detailed oral hygiene instructions in patients affected by mucous membrane pemphigoid with specific gingival localization: a pilot study in 12 patients. Int J Dent Hyg 2011; 10:138-41. [DOI: 10.1111/j.1601-5037.2011.00527.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hernández G, Lopez-Pintor RM, Arriba L, Torres J, de Vicente JC. Implant treatment in patients with oral lichen planus: a prospective-controlled study. Clin Oral Implants Res 2011; 23:726-732. [DOI: 10.1111/j.1600-0501.2011.02192.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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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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Hodgson TA, Chaudhry SI. PLENARY ABSTRACT: The management of oral lichen planus: symptom control at what risk? Oral Dis 2010. [DOI: 10.1111/j.1601-0825.2010.01752.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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