Periodontitis Clinical Trial
Official title:
Assessment of Periodontal Status in Patients With Oral Lichen Planus
The aim is to investigate the influence of oral lichen planus on periodontal status of systemically healthy individuals.
Lichen planus, a chronic immune-mediated inflammatory disease affects the skin and mucous
membranes. Oral lichen planus is the mucosal counterpart of cutaneous lichen planus. It was
reported first described in 1866 as white papular eruptions in the oral cavity. The
prevalence of OLP varies from 0.1% to 4%. OLP mostly occurs in middle aged and elderly
patients, with female to male ratio of 3:2. OLP is characterized by lesions consisting of
radiating white, grey, velvety, thread-like papules in a linear, annular and retiform
arrangement forming typical lacy, reticular patches, rings and streaks. The lesions are most
common on buccal mucosa, tongue, lips, gingiva, floor of mouth, palate. Clinically OLP has
six clinical presentations namely reticular, erosive, atrophic, plaque-like, papular,
bullous.
Reticular form, the most common clinical form presents as fine, asymptomatic intertwined
lace-like pattern called "Wickham striae" in a bilateral symmetrical form. It mainly involves
the posterior mucosa of the cheek. Erosive OLP represents symptomatic lesions. Atrophic
lesions may resemble the combination of two clinical forms, such as the presence of white
striae characteristic of the reticular type surrounded by an erythematous area. Plaque-like
form mainly found on dorsum of the tongue and the mucosa of the cheek reveals whitish
homogeneous irregularities similar to leukoplakia. Papular form presents with small white
papules with fine striae in its periphery. Bullous form is the most unusual clinical form,
exhibiting blisters that increase in size and tend to rupture, leaving the surface ulcerated
and painful.
The pathogenesis of the disease is characterized by cytotoxic CD8+ T lymphocytes migration to
the epithelium inducing apoptosis of basal keratinocytes. A number of etiological factors in
OLP have been proposed such as local and systemic inducers of cell-mediated hypersensitivity,
drugs, dental materials, infectious agents, and stress. The existence of a local
cell-mediated immune disorder has been postulated as a factor underlying development of the
lesions specifically, a delayed cellular hypersensitivity response probably triggered by some
exogenous agent. Periodontal diseases are the most prevalent oral microbial infections that
lead to chronic inflammation of the supporting tissues of teeth. Periodontal disease has a
complex pathogenesis involving host microbiome interactions. It has an impact on both local
and systemic health. The pathogenesis of periodontal disease involves a local inflammatory
reaction and the activation. Thus, it is possible to speculate that some interference could
exist and that the potential effect arising from these shared mechanismsā mediators could be
localized to sites where OLP lesions are present and alteration of host immune response in
OLP may have an impact on periodontal health. With this consideration, the present study is
aimed to assess periodontal status in systemically healthy individuals with and without oral
lichen planus.
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