Sobocinski V, Dridi S-M, Bisson C, Jeanne S, Gaultier F, Prost-Squarcioni C, Bernard P, Pascal F, Lefevre B, Weber P, Abasq C, Agbo-Godeau S, Joly P, Ingen-Housz-Oro S, Duvert-Lehembre S
Clinique dermatologique, hôpital Charles-Nicolle, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.
Service d'odontologie, hôpital Henri-Mondor, 51, avenue du maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
Ann Dermatol Venereol. 2017 Mar;144(3):182-190. doi: 10.1016/j.annder.2016.09.680. Epub 2016 Dec 20.
Autoimmune bullous diseases (AIBD) may cause chronic oral lesions that progress insidiously.
To provide recommendations for optimal oral-dental management of patients presenting AIBD with oral involvement.
In the absence of scientific studies with high levels of proof, these recommendations have been drawn up at two meetings by a committee of experts on AIBD comprising 7 dermatologists, 1 stomatologist, 1 maxillofacial surgeon, 2 odontologists and 4 parodontologists.
The oral lesions associated with AIBD may be classified into three grades of severity: severe (generalised erosive gingivitis affecting at least 30% of dental sites), moderate (localised erosive gingivitis affecting less than 30% of dental sites) and controlled (no erosive oral lesions). Good oral-dental hygiene suited to the severity of the oral lesions, must be practised continually by these patients so as to avoid the formation of dental plaque, which aggravates symptoms. Dental and parodontal care must be considered in accordance with the severity grade of the oral lesions: in severe cases, the dental plaque must be eliminated manually with a curette, but several types of care (descaling, treatment for tooth decay, non-urgent extractions, etc.) must be suspended until the grade of severity is moderate or until the disease is stabilised.
自身免疫性大疱性疾病（AIBD）可能导致慢性口腔病变，且病变进展隐匿。
为患有口腔受累的AIBD患者提供最佳口腔牙科管理建议。
由于缺乏高水平证据的科学研究，这些建议由一个AIBD专家委员会在两次会议上制定，该委员会由7名皮肤科医生、1名口腔外科医生、1名颌面外科医生、2名牙科学专家和4名牙周病学专家组成。
与AIBD相关的口腔病变可分为三个严重程度等级：重度（广泛性糜烂性牙龈炎，累及至少30%的牙位）、中度（局限性糜烂性牙龈炎，累及少于30%的牙位）和可控（无糜烂性口腔病变）。这些患者必须持续保持适合口腔病变严重程度良好的口腔卫生，以避免牙菌斑形成，因为牙菌斑会加重症状。必须根据口腔病变的严重程度等级来考虑牙齿和牙周护理：在重度病例中，必须用刮匙手动清除牙菌斑，但在病情严重程度降至中度或疾病稳定之前，必须暂停几种护理措施（洗牙、龋齿治疗、非紧急拔牙等）。
