DOI QR코드

DOI QR Code

Effect of supportive periodontal treatment in the oral lichen planus patients

구강편평태선 환자에서 보조적 치주치료의 효과

  • Kwon, Eun-Young (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Choi, Jeomil (Department of Periodontology, School of Dentistry, Pusan National University) ;
  • Lee, Ju-Youn (Department of Periodontology, School of Dentistry, Pusan National University)
  • 권은영 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 최점일 (부산대학교 치의학전문대학원 치주과학교실) ;
  • 이주연 (부산대학교 치의학전문대학원 치주과학교실)
  • Received : 2015.04.02
  • Accepted : 2015.05.31
  • Published : 2015.06.30

Abstract

Lichen planus is an immune-mediated mucocutaneous disease, affects more frequently middle-aged Caucasian women and makes signs and symptoms in the oral mucosa. Cutaneous lichen planus lesions cause itching but they are self-limiting, oral lichen planus lesions are usually chronic, recalcitrant to treatment and potentially premalignant in some cases. Although, oral lichen planus is non-plaque related disease, they possess particular problems because plaque control is complicated by pain and bleeding and might cause plaque-related disease. The resulting condition comprises accumulations of plaque, which again can influence the progress of oral lichen planus with burning sensation, spontaneous gingival bleeding. Thus, it should be noted that both medication and supportive periodontal treatment are essential for the remission of the lesions. This case report introduces topical corticosteroid therapy and supportive periodontal treatment including intensive oral hygiene procedures to obtain an improvement of subjective symptoms and objective changes and to prevent relapse the lesions.

편평태선은 면역 매개 점막피부 질환으로 병인은 여전히 알려져 있지 않고, 중년의 백인 여성에서 흔히 발생하고 구강점막에서 증상이나 징후가 생기기도 한다. 편평태선의 피부 병소는 가려움을 유발하나 자기 제한적이고, 구강편평태선의 구강 병소는 만성적이고 좀처럼 스스로 치유되지 못하고, 드물긴 하나 잠재적으로 전암 병소로 발전할 수 있다. 구강편평태선은 비록 비치태 연관 질환이나 통증, 출혈로 인해 적절한 치태 조절이 어렵게 되어 치태 연관 질환을 야기할 수 있고, 작열감, 자발적인 출혈 등 구강편평태선과 관련된 점막 증상이 축적된 치태에 의해 더욱 악화될 수 있다. 따라서 구강편평태선 환자에서 구강편평태선 자체의 약물적 치료뿐만 아니라 적절한 구강 위생 관리, 치석 제거 등의 치주 치료가 동반되어야 한다. 본 증례에서는 구강편평태선 환자에서 국소적인 코르티코스테로이드 치료뿐만 아니라 구강 위생 교육을 포함한 치주 치료를 통해 증상 및 징후를 개선시키고 재발 방지를 도울 수 있었다.

Keywords

References

  1. Guiglia R, Di Liberto C, Pizzo G, Picone L, Lo Muzio L, Gallo PD, Campisi G, D'Angelo M. A combined treatment regimen for desquamative gingivitis in patients with oral lichen planus. J Oral Pathol Med 2007;36:110-6. https://doi.org/10.1111/j.1600-0714.2007.00478.x
  2. Salgado DS, Jeremias F, Capela MV, Onofre MA, Massucato EM, Orrico SR. Plaque control improves the painful symptoms of oral lichen planus gingival lesions. A short-term study. J Oral Pathol Med 2013;42:728-32. https://doi.org/10.1111/jop.12093
  3. Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V oral lichen planus: clinical features and management. Oral Dis 2005;11:338-49. https://doi.org/10.1111/j.1601-0825.2005.01142.x
  4. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol 2008;158:573-7.
  5. Lodi G, Carrozzo M, Furness S, Thongprasom K. Interventions for treating oral lichen planus: a systematic review. Br J Dermatol 2012;166:938-47. https://doi.org/10.1111/j.1365-2133.2012.10821.x
  6. Scully C, el-Kom M. Lichen planus: review and update on pathogenesis. J Oral Pathol 1985;14:431-58. https://doi.org/10.1111/j.1600-0714.1985.tb00516.x
  7. Eisen D. The clinical features, malignant potential, and systemic associations of oral lichen planus: a study of 723 patients. J Am Acad Dermatol 2002;46:207-14. https://doi.org/10.1067/mjd.2002.120452
  8. Gorsky M, Raviv M. Efficacy of etretinate (tigason) in symptomatic oral lichen planus. Oral Surg Oral Med Oral Pathol 1992;73:52-5. https://doi.org/10.1016/0030-4220(92)90153-H
  9. Ertugrul AS, Arslan U, Dursun R, Hakki SS. Periodontopathogen profile of healthy and oral lichen planus patients with gingivitis or periodontitis. Int J Oral Sci 2013;5:92-7. https://doi.org/10.1038/ijos.2013.30
  10. Lopez-Jornet P, Camacho-Alonso F. Application of a motivation-behavioral skills protocol in gingival lichen planus: a short-term study. J Periodontol 2010;81:1449-54. https://doi.org/10.1902/jop.2010.100245
  11. Thorn JJ, Holmstrup P, Rindum J, Pindborg JJ. Course of various clinical forms of oral lichen planus. A prospective follow-up study of 611 patients. J Oral Pathol 1988;17:213-8. https://doi.org/10.1111/j.1600-0714.1988.tb01527.x
  12. Holmstrup P, Schiøtz AW, Westergaard J. Effect of dental plaque control on gingival lichen planus. Oral Surg Oral Med Oral Pathol 1990;69:585-90. https://doi.org/10.1016/0030-4220(90)90241-J
  13. Ramon-Fluixa C, Bagan-Sebastian J, Milian-Masanet M, Scully C. Periodontal status in patients with oral lichen planus: a study of 90 cases. Oral Dis 1999;5:303-6.
  14. Lo Russo L, Fedele S, Guiglia R, Ciavarella D, Lo Muzio L, Gallo P, Di Liberto C, Campisi G. Diagnostic pathways and clinical significance of desquamative gingivitis. J Periodontol 2008;79:4-24. https://doi.org/10.1902/jop.2008.070231
  15. Vincent SD, Fotos PG, Baker KA, Williams TP. Oral lichen planus: the clinical, historical, and therapeutic features of 100 cases. Oral Surg Oral Med Oral Pathol 1990;70:165-71. https://doi.org/10.1016/0030-4220(90)90112-6