Journal of Dental Research, Dental Clinics, Dental Prospects
Volume:4 Issue: 1, Winter 2010

Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many un-established etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

Background and aims. Lichen planus is a relatively common chronic mucocutaneaous disease with an unknown cause, and is considered a manifestation of cell-mediated immune response. Hepatitis C virus (HCV) and its subgroups have been associated with lichen planus in different geographic locations. The present study was undertaken to evaluate the prevalence of HCV antibody in patients with lichen planus in northwest Iran. Materials and methods. This descriptive analytical study included 30 patients with cutaneous lichen planus, 30 pa-tients with oral lichen planus, and 30 healthy individuals as controls. Anti-HCV test was run for all the subjects. Descriptive statistics as well as chi-square test, to compare means in the three study groups, were applied to the data using SPSS 14.0 computer software.Results. Age and sex differences between the groups were not significant. No statistically significant differences were observed in anti-HCV test results between the groups (P = 0.50). Conclusion. No statistically significant relationships were observed between lichen planus and HCV antibody in the studied samples

Background and aims. The clinical management of oral lichen planus poses considerable difficulties to the clinician. In recent years, researchers have focused on the presence of pathogenic microorganisms such as Candida albicans in the patients with refractory lichen planus. The aim of the present study was to investigate the prevalence of candida species in the erosive oral lichen planus lesions.Materials and methods. Twenty-one patients with erosive oral lichen planus and twenty-one healthy individuals aged 18-60 were randomly selected; samples were taken from the tongue, saliva and buccal mucosa with swab friction. Theses samples were sent to the laboratory for determining the presence of candida species in cultures and direct examination method. Results. No significant difference was found between healthy individuals and patients with erosive lichen planus regarding presence of candida species. The type of candida in the evaluated samples was Candida albicans in both healthy and patient groups.Conclusion. According to the results, candida was not confirmed as an etiologic factor for erosive lichen planus lesions

Background and aims. Lichen planus (LP) is a relatively common, chronic dermato-mucosal disease that often affects the oral mucosa. Among bacterial infections affecting LP, Helicobacter pylori has recently been proposed as an important etiologic factor. The present study was designed to evaluate the association of LP and H. pylori infection.Materials and methods. This study included 30 patients with skin LP, 30 patients with oral LP and 30 healthy individuals without LP as control group. Patients and control group were selected from those referred to a dental and a dermatology clinic. Urea breathing test (UBT) was performed for all subjects. Descriptive statistic (frequency and percentage) were applied and chi-square test was employed to compare mean differences, using SPSS 13.0 computer software. Results. UBT test were positive in 24 patients (80%) in oral LP group, 22 patients (73.3%) in skin LP group, and 20 individuals (66.7%) in the control group. No significant differences were found in the positive test results between the three groups (P = 0.50).Conclusion. In this study, no significant association was found between LP and H. Pylori infection

Background and aims. Lichen planus is a relatively common mucocutaneous disease, with an unknown etiology. There is no complete cure for oral lichen planus (OLP), but some drugs, including corticosteroids, retinoids, cyclosporine and antibiotics are commonly used for treatment of OLP. The aim of the present study was to compare the effect of combination of triamcinolone and vitamin A mouthwash with triamcinolone mouthwash alone on OLP.Materials and methods. Twenty OLP patients were randomly divided into two groups of 10. The experimental group was treated with combination of triamcinolone and vitamin A mouthwash and the control group was treated with triamcinolone-containing mouthwash alone. The patients were examined once every two weeks and the lesion size, pain and burning sensation were recorded based on visual analogue scale during a two-month period. Data were analyzed by Mann-Whitney U test using SPSS software. Results. The use of combination of triamcinolone-vitamin A mouthwash was effective in decreasing the pain and burning sensation of OLP (P = 0.012). Decrease in pain and burning sensation were similar in both groups (P = 0.73). The use of combination of triamcinolone-vitamin A mouthwash led to a decrease in the size of keratotic, atrophic and erosive OLP lesions (P = 0). Decrease in the size of the lesions was significantly greater in the study group compared to the control group (P = 0.029).Conclusion. The use of combination of triamcinolone-vitamin A mouthwash is effective in decreasing the size of keratotic, atrophic or erosive lesions.

Background and aims. Lichen planus is a relatively common mucocutaneous disease, with an unknown etiology. There is no complete cure for oral lichen planus (OLP), but some drugs, including corticosteroids, retinoids, cyclosporine and antibiotics are commonly used for treatment of OLP. The aim of the present study was to compare the effect of combination of triamcinolone and vitamin A mouthwash with triamcinolone mouthwash alone on OLP.Materials and methods. Twenty OLP patients were randomly divided into two groups of 10. The experimental group was treated with combination of triamcinolone and vitamin A mouthwash and the control group was treated with triamcinolone-containing mouthwash alone. The patients were examined once every two weeks and the lesion size, pain and burning sensation were recorded based on visual analogue scale during a two-month period. Data were analyzed by Mann-Whitney U test using SPSS software. Results. The use of combination of triamcinolone-vitamin A mouthwash was effective in decreasing the pain and burning sensation of OLP (P = 0.012). Decrease in pain and burning sensation were similar in both groups (P = 0.73). The use of combination of triamcinolone-vitamin A mouthwash led to a decrease in the size of keratotic, atrophic and erosive OLP lesions (P = 0). Decrease in the size of the lesions was significantly greater in the study group compared to the control group (P = 0.029).Conclusion. The use of combination of triamcinolone-vitamin A mouthwash is effective in decreasing the size of keratotic, atrophic or erosive lesions.

Background and aims. The purpose of this study was to determine efficacy of 19% Elaeagnus angustifolia (EA) topical gel in the treatment of symptomatic oral lichen planus.Materials and methods. Patients with symptomatic oral lichen planus referring to the Department of Oral Medicine, Faculty of Dentistry at Shahid Beheshti University of Medical Sciences were asked to participate in the study. Twenty-eight patients who were histopathologically diagnosed with lichen planus were divided into two groups (15 in the case and 13 in the control groups). The subjects were randomly assigned to either topical gel of EA or placebo in a double-blind manner. They were then instructed to apply the medication on dried lesions three times daily. Pain and size of the lesions were evaluated after 2 weeks. Data were analyzed by SPSS 12.0 software, using t-test, paired t-test, Fisher’s exact test and chi-square test.Results. Twenty-eight patients (m/f: 7/21) with symptomatic oral lichen planus participated in the study. Fifteen patients (m/f: 4/11) received E A gel and 13 patients (m/f: 3/10) received placebo. There was a 75% decrease in pain (33.3% in the case and 7.7% in the control groups), and a decrease of 50% in size (33.3% in the case group) and 75% only in 7.6% of the case group.Conclusion. The results suggest that 19% EA gel is efficient in the treatment of symptomatic oral lichen planus, with anti-inflammatory and analgesic effects, as well.

Recalcitrant gingival erythematous lichen planus lesions comprise a considerable therapeutic problem. This case of chronic desquamative gingivitis in a 25-year-old woman with erosive oral lichen planus was treated with topical and systemic corticosteroid administration, followed by placement of a free gingival graft on right upper quadrant. Although recurrence of the lesions was observed following both treatment modalities, free gingival graft despite being an aggressive therapy, proved more effective and with fewer side effects compared with topical or systemic steroid therapy, and seems to be a promising treatment modality with the benefit of more stable results, among others.