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Panta P, Reddy P, Misra SR, Segonds-Pichon A, Patil S. Impact of COVID-19 Lockdown on Oral Oncology-related Outpatient Volume at Indian Dental Institutions. J Contemp Dent Pract 2021; 22:501-505. [PMID: 34318767 DOI: 10.5005/jp-journals-10024-3036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
AIM AND OBJECTIVE This study aimed to evaluate the impact of the lockdown on oral oncology-related out-patient volume at Indian dental institutions. MATERIALS AND METHODS The total number of newly diagnosed cases of oral submucous fibrosis, oral leukoplakia, oral lichen planus, and oral cancers, recorded at two dental institutional settings before lockdown (January-March 2020) and after lockdown (June-August 2020), were included retrospectively and compared. RESULTS The study included a total of 797 cases at both institutions. At Institution-I, a total of 312 cases were recorded before the lockdown, and 63 cases were recorded after the lockdown. At Institution-II, a total of 311 cases were reported before lockdown, and 111 cases were recorded after lockdown. Comparisons between the pre-lockdown and post-lockdown data yielded a significant change in the proportions of oral sub-mucous fibrosis, oral leukoplakia, oral lichen planus, and oral cancers at both institutions (Chi-square test; p < 0.001). Following the lockdown, a substantial reduction was observed in the proportion of oral submucous fibrosis (OSMF) cases at both institutions, and the proportion of oral cancers increased at both institutions. There was a significant difference between the proportions of cases reported before lockdown at both institutions (p < 0.001). However, after-lockdown, no such differences were noted (p = 0.69); the absence of significance could most likely be due to the low sample size or low-power during the post-lockdown period. CONCLUSION The oral potentially malignant disorders (OPMD) and oral cancer (OC) patient volumes reduced substantially following lockdown. During the post-lockdown period, the proportion of oral cancers increased, whereas the proportion of OSMF cases decreased. Results indicate that OPMD and oral cancer patients were impacted differently by the lockdown. CLINICAL SIGNIFICANCE This study provides insight into the impact of lockdown and highlights the importance of reestablishing oral oncology-related patient care. A vital discussion is also provided on useful compensatory strategies that may reduce delays during the ongoing crisis. How to cite this article: Panta P, Reddy P, Misra SR, et al. Impact of COVID-19 Lockdown on Oral Oncology-related Outpatient Volume at Indian Dental Institutions. J Contemp Dent Pract 2021;22(5):501-505.
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Affiliation(s)
- Prashanth Panta
- Department of Oral Medicine and Radiology, MNR Dental College and Hospital, Sangareddy, Telangana, India, Phone: +91 9701806830, e-mail:
| | - Prashanthi Reddy
- Department of Oral Medicine and Radiology, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Satya Ranjan Misra
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Bhubaneswar, Odisha, India
| | - Anne Segonds-Pichon
- Department of Bioinformatics, The Babraham Institute, Cambridge, United Kingdom
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Yang XY, Li XZ, Zhang SN. Urinary metabolomic signatures in reticular oral lichen planus. Heliyon 2020; 6:e04041. [PMID: 32490246 PMCID: PMC7256305 DOI: 10.1016/j.heliyon.2020.e04041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/22/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease. Among all the clinical forms in OLP, reticular type has the highest incidence rate. Previous studies have applied metabolomics to investigate the metabolic changes of oral mucosa and blood samples from reticular OLP patients. Urinary metabolomic signatures is also useful in analyzing the pathological changes of the patients, which was a complement to the previous studies. Through these researches, we may have a more comprehensive understanding of the disease. Metabolic profiles of urinary samples from OLP patients and control subjects were analyzed by liquid chromatography (LC)-mass spectrometry (MS) system. Differentially expressed metabolites were identified via OSI/SMMS software for the pathology analysis. Totally, 30 differentially expressed metabolites were identified. Pathological network showed that these metabolites participated in 8 pathological processes, that is, DNA damage and repair disorder, apoptosis process, inflammatory lesion, oxidative stress injury, carbohydrate metabolism disorder, mood dysfunction, abnormal energy expenditure, and other pathological process. These findings demonstrated that the analysis of human urine metabolome might be conducive to the achievement of the objectives of this study.
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Affiliation(s)
- Xu-yan Yang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, PR China
| | - Xu-zhao Li
- College of Pharmacy, Guizhou University of Traditional Chinese Medicine, Guian new area 550025, PR China
| | - Shuai-nan Zhang
- College of Pharmacy, Guizhou University of Traditional Chinese Medicine, Guian new area 550025, PR China
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Cassol-Spanemberg J, Rodríguez-de Rivera-Campillo ME, Otero-Rey EM, Estrugo-Devesa A, Jané-Salas E, López-López J. Oral lichen planus and its relationship with systemic diseases. A review of evidence. J Clin Exp Dent 2018; 10:e938-e944. [PMID: 30386529 PMCID: PMC6203921 DOI: 10.4317/jced.55145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. OBJECTIVE Review the relevant information to OLP and its relationship with systemic diseases. MATERIAL AND METHODS Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation. RESULTS Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients. CONCLUSIONS Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended. Key words:Oral lichen planus, etiopathogenesis, systemic diseases.
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Affiliation(s)
- Juliana Cassol-Spanemberg
- PhD. Postdoctoral Research Fellow. Specialist in Stomatology and Public Health. Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, Spain
| | - María-Eugenia Rodríguez-de Rivera-Campillo
- MD, DDS, PhD, Dermatologist and Dentist. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Eva-María Otero-Rey
- DDS, PhD, Odontology. Professor of Master of Daily Practice Dentistry. Department of Stomatology. School of Dentistry. University of Santiago de Compostela, Spain
| | - Albert Estrugo-Devesa
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Enric Jané-Salas
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - José López-López
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona - Head of the Medical Surgical Area and Medical Director of Dentistry Hospital Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
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A study of depression and quality of life in patients of lichen planus. ScientificWorldJournal 2015; 2015:817481. [PMID: 25802892 PMCID: PMC4353444 DOI: 10.1155/2015/817481] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 02/09/2015] [Indexed: 11/17/2022] Open
Abstract
The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck's depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life.
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Pramod R, Pandit S, Desai D, Suresh K, Ingaleshwar P, Shetty S, Ahamad S. Immunohistochemical assessment of proliferating cell nuclear antigen protein expression in plaque, reticular and erosive types of oral lichen planus. Ann Med Health Sci Res 2014; 4:598-602. [PMID: 25221712 PMCID: PMC4160688 DOI: 10.4103/2141-9248.139337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Proliferating cell nuclear antigen (PCNA) is a nuclear protein synthesized in the late G1 and S-phase of the cell cycle. Immunodetection of this protein represents a useful marker of the proliferation status of lesions. AIMS The aim of this study is to evaluate the immunohistochemical expression of PCNA in oral lichen planus (OLP) and to assess the PCNA expression in a different layer of epithelium in different types of OLP. SUBJECTS AND METHODS A total of 96 cases of histologically proven OLP, 32 cases each of erosive, reticular and plaque type were selected. Two sections were taken from each one for H and E. Other sections were stained according to super sensitive polymer horseradish peroxidase method for identifying PCNA expression. RESULTS Of the three types of OLP, erosive type showed higher expression of PCNA (average 66.8%, minimum of 55% and maximum of 80.3%) followed by reticular (average 37.7%, minimum of 26% and maximum of 47%) and plaque type (average 17%, minimum of 5% and maximum of 25%) indicating increased proliferative activity. The erosive type also showed higher expression of PCNA in all the layers of epithelium followed by reticular and plaque type. CONCLUSION PCNA is a good marker to indicate proliferation status of disease. Out of three types, erosive type possess more proliferative ratio, chances of malignant changes is more in this type.
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Affiliation(s)
- Rc Pramod
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - S Pandit
- Department of Oral Pathology and Microbiology, A J Institute of Dental Sciences, Mangalore, Karnataka, India
| | - D Desai
- Department of Oral Pathology and Microbiology, A J Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Kv Suresh
- Department of Oral Medicine and Radiology, School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed University, Karad, Satara, Maharashtra, India
| | - Ps Ingaleshwar
- Department of Oral Pathology and Microbiology, A J Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Sj Shetty
- Department of Oral Pathology and Microbiology, A J Institute of Dental Sciences, Mangalore, Karnataka, India
| | - S Ahamad
- Department of Oral Pathology and Microbiology, KMCT Dental College, Calicut, Kerala, India
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Vineetha R, Pai KM, Vengal M, Gopalakrishna K, Narayanakurup D. Usefulness of salivary alpha amylase as a biomarker of chronic stress and stress related oral mucosal changes - a pilot study. J Clin Exp Dent 2014; 6:e132-7. [PMID: 24790712 PMCID: PMC4002342 DOI: 10.4317/jced.51355] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 12/14/2013] [Indexed: 12/03/2022] Open
Abstract
Introduction: Salivary biomarkers are suggested to provide a reliable, noninvasive and objective measurement of chronic psychosocial stress and helps in assessment of pivotal role of stress in causation or precipitation of multitude of health problems.
Objectives: To evaluate the usefulness of salivary alpha amylase activity as an objective indicator of chronic stress and to find out any correlation between stress- related mucosal complaints and its levels.
Study Design: Study was conducted among 50 subjects suffering from chronic stress related problems and 50 non-stressed individuals who were screened with a psychometric questionnaire. Brief case history and oral examination was carried out and about one ml of unstimulated saliva was collected. Salivary alpha amylase levels estimated were compared between study and control group and between subjects with and without oral mucosal changes using non parametric Mann Whitney U test.
Results: There was statistically significant higher salivary alpha amylase levels in study group (p =.002) and salivary alpha amylase between the oral mucosal complaints group and without oral mucosal complaints group within the total study population were found to be statistically significant (p=0.045).
Conclusions: Salivary amylase activity increases in patients with chronic psychosocial stress and may be used as a biomarker of chronic stress, but it may not be an indicator to suggest the development of stress related oral mucosal changes.
Key words:Salivary biomarker, salivary alpha amylase, psychosocial stress, sympathetic nervous system, oral mucosal changes.
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Affiliation(s)
- Ravindranath Vineetha
- MDS, Associate Professor. Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University. Karnataka State, India
| | - Keerthilatha-M Pai
- MDS, Professor and Head. Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University. Karnataka State, India
| | - Manoj Vengal
- MDS, Professor and Head. Department of Oral Medicine and Radiology, Vyas Dental College, Jodhpur, Rajasthan, India
| | - Kodyalamoole Gopalakrishna
- M.Sc, PhD. Associate professor. Department of Biochemistry, Kasturba Medical College, Manipal University, Karnataka, India
| | - Dinesh Narayanakurup
- MPhil, PhD, Associate Professor and Head. Department of Clinical Psychology, Kasturba Medical College, Manipal University, Karnataka, India
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Abstract
Dermatological conditions are intimately related to stress. There was a great interest in this field in the last years. Stress could be involved as a trigger factor for a lot of cutaneous diseases: alopecia areata, psoriasis, vitiligo, lichen planus, acne, atopic dermatitis, urticaria. For other conditions: seborrheic dermatitis, hyperhydrosis, herpes, pemphigus, a.s.o, there are anecdotal notices. On the other hand, the skin disease itself could induce a secondary stress for the patient, influencing his quality of life. The stress per se is less important than the “perceived stress”, the patient’s perception of the stressful situation. This perception could be influenced by the psychological state of the patient. Anxiety, depression could change the perception of the event. It is important to take care of these aspects during the consultation. A good cooperation with psychiatrist or/and psychologist could improve the results, besides the specific therapy.
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Kapoor C, Wadhwan V, Vaidya S, Malik S. Triology of nitric oxide, mast cell and stress in pathogenesis of oral lichen planus. J Oral Maxillofac Pathol 2013; 17:156-62. [PMID: 24250071 PMCID: PMC3830219 DOI: 10.4103/0973-029x.119741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Oral Lichen planus (OLP) is chronic, autoimmune, mucocutaneous disease. Numerous etiological factors have been proposed, but an authoritative and exact source of the disease has not been brought forward. Reactive nitrogen species (RNS), mast cell (MC) and stress are considered to play a key role in inflammation-mediated carcinogenesis generating nitric oxide (NO). AIM To evaluate the salivary NO levels, mast cells and stress levels and to correlate them in pathogenesis of OLP. MATERIALS AND METHODS The study was conducted using saliva samples of patients. The study consisted of two groups: Group-I constituted the subjects with OLP group (n=25) and group II comprised the control group (n=25). The saliva of the patients was evaluated using Griess Reagent and Spectrophotometer, MC count done by using special stains, and stress levels measured using DASS Scale. RESULTS The difference between the means was found to be highly significant (P < 0.05). The intergroup comparison of optical density (OD) values, a mast cell count and stress level was found to be highly significant. CONCLUSION Salivary NO, increase in mast cell count and stress has a definitive role in OLP pathogenesis.
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Affiliation(s)
- Charu Kapoor
- Department of Oral Pathology and Microbiology, Bhojia Dental College, Budh, Baddi, Solan, Himachal Pradesh, India
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Krasowska D, Pietrzak A, Surdacka A, Tuszyńska-Bogucka V, Janowski K, Roliński J. Psychological stress, endocrine and immune response in patients with lichen planus. Int J Dermatol 2008; 47:1126-34. [DOI: 10.1111/j.1365-4632.2008.03858.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Manolache L, Seceleanu-Petrescu D, Benea V. Lichen planus patients and stressful events. J Eur Acad Dermatol Venereol 2008; 22:437-41. [PMID: 18363912 DOI: 10.1111/j.1468-3083.2007.02458.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE To evaluate the possible role of stress before the onset/extension of lichen planus. PATIENTS AND METHOD Forty-six outpatients with lichen planus were enrolled. The design was a case-control study (controls had skin diseases with low psychosomatic component). Stressful situations were evaluated using Holmes and Rahe's social readjustment rating scale. RESULTS Lichen planus had an incidence of 0.36% among dermatological conditions. In the lichen planus group, there was a female predominance (76%) and a median age around 50 years. More than 67% of cases experienced at least one stressful event, compared with 21% of controls (chi(2) = 17.58, P < 0.001). The odds ratio was 7.44. There was a borderline significant difference in the mean number of stressful events between lichen planus patients and controls (P = 0.06). We divided the situations described by Holmes and Rahe into three categories: family, personal, and job or financial problems. The presence of major life events was significant different in patients and controls (P = 0.005). Family matters were described by 43.6% of lichen planus patients, statistically significant compared with controls (P = 0.002). In almost 25% of cases of lichen planus, 'the stressful event' was represented by the illness or death of someone dear. 'Personal problems' seemed to be important compared with controls (P = 0.04), exams representing 25% of these matters. There was no difference between the patients and controls regarding the importance of job or financial changes. CONCLUSION Stressful situations, especially related to family, may have a role in the onset and extension of lichen planus lesions.
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Affiliation(s)
- L Manolache
- Cetatea Histria Polyclinic, Bucharest, Romania.
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Colquhoun AN, Ferguson MM. An association between oral lichen planus and a persistently dry mouth. ACTA ACUST UNITED AC 2004; 98:60-8. [PMID: 15243472 DOI: 10.1016/j.tripleo.2003.11.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between oral lichen planus and dry mouth by comparing xerostomia scores of individuals with oral lichen planus to those of healthy matched controls. STUDY DESIGN Patients who had attended 1 of 2 centers for the management of oral lichen planus (n=116), along with age- and sex-matched control subjects (n=348), were sent a questionnaire. Nonresponders were invited to complete the questionnaire by telephone in lieu of mailing a reply. A standardized medical history was obtained for all subjects. RESULTS The difference between patients with oral lichen planus and control subjects for all xerostomia questions was statistically significant. In the lichen planus group, the mean xerostomia score was 20.4, whereas for control patients, the mean score was 14.7 (P <.001). Stepwise conditional logistic regression analysis for the matched case-control groups was performed. CONCLUSION The results demonstrate an association between oral lichen planus and xerostomia in some individuals.
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Affiliation(s)
- Angus N Colquhoun
- Department of Stomatology, University of Otago, PO Box 647, Dunedin, New Zealand.
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Durán Bouza M, Simón MA, Seoane JM. An Evaluation of Pharmacological Treatment Combined with Stress Inoculation Training in the Management of oral Lichen Planus. Psychol Health 2002. [DOI: 10.1080/0887044021000054791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ramón-Fluixá C, Bagán-Sebastián J, Milián-Masanet M, Scully C. Periodontal status in patients with oral lichen planus: a study of 90 cases. Oral Dis 1999; 5:303-6. [PMID: 10561718 DOI: 10.1111/j.1601-0825.1999.tb00094.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study was carried out to relate periodontal status to the oral lesions in patients with oral lichen planus (OLP). MATERIALS AND METHODS Periodontal status was evaluated in 90 patients with OLP and in 52 controls, in terms of the plaque index (PII), simplified calculus index (CIS) and periodontal disease index (PDI). RESULTS No significant differences were observed between the two groups as regards the different periodontal indices. The plaque and calculus indices were higher in the more extensive forms of OLP (P = 0.02 and P = 0.012, respectively), and in the presence of gingival involvement (P = 0.004 and P = 0.04). A significant association was also observed between the presence of atrophic-erosive lesions and increased periodontal deterioration (P = 0.037). CONCLUSIONS Increased plaque and calculus deposits are associated to a significantly higher incidence of atrophic-erosive gingival lesions in patients with OLP.
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