Mignogna Michele D, Lo Russo Lucio, Fedele Stefano
Department of Odontostomatological and Maxillofacial Sciences, Section of Oral Medicine, University of Naples Federico II, Faculty of Medicine, School of Dentistry, Naples, Italy.
J Clin Periodontol. 2005 Oct;32(10):1029-33. doi: 10.1111/j.1600-051X.2004.00761.x.
Oral lichen planus (OLP) is one of the most common oral mucosa disorders. OLP gingival involvement is very frequently observed, and it is characterized by wide variations in clinical appearance and symptoms, leading, in many cases, to misdiagnosis or undiagnosis. This can be potentially harmful since OLP patients require appropriate management in oral and periodontal care, together with an adequate systemic evaluation.
In this paper, we have analysed the prevalence and clinical aspects of gingival lesions in our series of 700 patients affected by OLP. Furthermore, we have discussed the possible periodontal implications on the basis of the available literature.
Data from 700 patients affected by OLP, clinically and histologically assessed, have been studied; the location and morphology of lesions, the symptoms and the progression of the disease have been considered, with particular attention given to gingival involvement.
Gingival lesions have been diagnosed in 48% of cases, usually associated with diffuse oral involvement. Only 7.4% of patients had OLP lesions confined to the gingiva. The morphology of lesions included all the forms originally described for OLP (reticular, papular, plaque, atrophic, erosive and bullous). The symptoms, if present, varied from mild discomfort to severe oral pain, with the general trend increasing from the keratotic to the erosive forms. The gingiva was involved in four out of 21 of our oral cancer cases, which developed from pre-existing OLP lesions.
OLP is a very proteiform disorder; considering the high frequency of gingival involvement and its influence on oral health, it is our opinion that periodontologists should be involved in OLP management and should become familiar with its clinical aspects and related themes.
口腔扁平苔藓（OLP）是最常见的口腔黏膜疾病之一。OLP累及牙龈非常常见，其临床表现和症状差异很大，在许多情况下会导致误诊或漏诊。这可能具有潜在危害，因为OLP患者在口腔和牙周护理方面需要适当的管理，同时还需要进行充分的全身评估。
本文分析了我们系列中700例OLP患者牙龈病变的患病率和临床特征。此外，我们根据现有文献讨论了可能的牙周影响。
研究了700例经临床和组织学评估的OLP患者的数据；考虑了病变的位置和形态、症状以及疾病的进展，特别关注牙龈受累情况。
48%的病例诊断出牙龈病变，通常与口腔弥漫性受累有关。仅7.4%的患者OLP病变局限于牙龈。病变形态包括最初描述的OLP的所有形式（网状、丘疹状、斑块状、萎缩性、糜烂性和大疱性）。如果有症状，症状从轻度不适到严重口腔疼痛不等，一般趋势是从角化型到糜烂型逐渐加重。在我们的21例口腔癌病例中，有4例起源于先前存在的OLP病变，牙龈受累。
OLP是一种非常多样的疾病；考虑到牙龈受累的高频率及其对口腔健康的影响，我们认为牙周病医生应参与OLP的管理，并应熟悉其临床特征和相关主题。
