Park Shin-Young, Lee Hyo-Jung, Kim So-Hyun, Kim Sung-Beom, Choi Yong-Hoon, Kim Young-Kyun, Yun Pil-Young
Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.
Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.
J Periodontal Implant Sci. 2018 Aug 29;48(4):213-223. doi: 10.5051/jpis.2018.48.4.213. eCollection 2018 Aug.
Oral lichen planus (OLP) is a chronic oral mucosal disease that has been recognized as an immune condition. The purpose of this study was to evaluate factors affecting the clinical outcomes of topical corticosteroid application on OLP lesions using dexamethasone gargle and ointment.
The charts of patients who were clinically diagnosed with OLP and treated with dexamethasone from July 2003 to August 2017 at the Section of Dentistry of Seoul National University Bundang Hospital were thoroughly evaluated to identify subjects who were suitable for this retrospective study. For each patient, age at the index date, gender, medical history, and dental records related to OLP lesions and dexamethasone treatment were reviewed.
In total, 113 of the 225 patients were included in the present study. Among them, 79 patients were female (69.9%) and 34 were male (30.1%), with a mean age of 57.6 years. The average duration of dexamethasone treatment was 4.7 months and the mean follow-up period was 2.24 years. Improvements were observed within 1 year after dexamethasone treatment in most cases, and 17.7% of patients had a new OLP lesion after treatment. New OLP lesions were more frequently gingival than mucosal, although mucosal OLP lesions were more common than gingival OLP lesions in all age groups. In age- and gender-adjusted multivariate logistic regression, a history of malignant disease was found to be a significant factor affecting the formation of new lesions. Gingival OLP lesions and intermittent use of dexamethasone showed near-significant associations. In Kaplan-Meier failure analysis, history of malignancy, menopausal status, age, and the site of the OLP lesion were significant factors affecting clinical outcomes.
The treatment outcomes of OLP were significantly influenced by age, history of malignancy, menopausal status, and the site of the OLP lesion, but not by factors related to dexamethasone treatment.
口腔扁平苔藓（OLP）是一种慢性口腔黏膜疾病，已被确认为一种免疫性疾病。本研究的目的是评估使用地塞米松含漱液和软膏局部应用皮质类固醇治疗OLP病变的临床效果的影响因素。
对2003年7月至2017年8月在首尔国立大学盆唐医院牙科临床诊断为OLP并用地塞米松治疗的患者病历进行全面评估，以确定适合这项回顾性研究的受试者。对每位患者的索引日期年龄、性别、病史以及与OLP病变和地塞米松治疗相关的牙科记录进行了审查。
本研究共纳入225例患者中的113例。其中，女性79例（69.9%），男性34例（30.1%），平均年龄57.6岁。地塞米松治疗的平均持续时间为4.7个月，平均随访期为2.24年。大多数病例在地塞米松治疗后1年内观察到病情改善，17.7%的患者治疗后出现新的OLP病变。尽管在所有年龄组中黏膜OLP病变比牙龈OLP病变更常见，但新的OLP病变牙龈部位比黏膜部位更频繁。在年龄和性别调整的多因素逻辑回归分析中，恶性疾病史被发现是影响新病变形成的一个重要因素。牙龈OLP病变和地塞米松的间歇使用显示出接近显著的关联。在Kaplan-Meier失败分析中，恶性疾病史、绝经状态、年龄和OLP病变部位是影响临床结果的重要因素。
OLP的治疗结果受年龄、恶性疾病史、绝经状态和OLP病变部位的显著影响，而不受地塞米松治疗相关因素的影响。
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