口腔扁平苔藓的临床特征及其与牙科修复材料和口腔健康相关生活质量的因果关系。
Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life.
作者信息
Daume Linda, Kreis Constance, Bohner Lauren, Jung Susanne, Kleinheinz Johannes
机构信息
Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.
出版信息
BMC Oral Health. 2021 May 15;21(1):262. doi: 10.1186/s12903-021-01622-z.
BACKGROUND
The aim of this study was to investigate the influence of clinical characteristics and dental restorative materials on oral health-related quality of life in patients with oral lichen planus. In particular, the influences of amalgam and metals were investigated.
METHODS
A total of 112 patients with clinical and histological features of oral lichen planus from the Department of Cranio-Maxillofacial Surgery at the University Hospital of Münster participated in this prospective study. Clinical parameters of oral lichen planus and the dental restorative materials used were evaluated. Oral health-related quality of life was investigated by using the short form of the German version of the Oral Health Impact Profile (OHIP-14). In addition, physical pain was rated on a visual analogue scale.
RESULTS
The average OHIP-14 score was 13.54. A high correlation was seen between OHIP and pain. Likewise, higher OHIP-values were seen for male patients, and such as for those patients with non-reticular forms of oral lichen planus (OLP). A local form of OLP is more often seen on female patients, such as with the presence of reticular lichen. In regard to the restorations, the presence of composite restorations is correlated with a local lichen, whereas the presence of gold restorations is often seen with a generalized lichen. Furthermore, the grading of strength of association between mucosal lesion and amalgam/metal was tested. No significant differences revealed the analysis of the relationship between gender, clinical form of OLP, age, and presentation form between the 4 gradings of Thornhill.
CONCLUSIONS
The oral health-related quality of life is significantly limited in patients with oral lichen planus. But these OHIP scores are not influenced by the restorative materials. Here, pain severity is the most important aspect. We found no statistical differences in the clinical parameters between patients with amalgam or metal restoration and patients without these restorations. It is not necessary to replace amalgam fillings that are not in direct contact with mucosal surfaces.
背景
本研究旨在调查临床特征和牙科修复材料对口腔扁平苔藓患者口腔健康相关生活质量的影响。特别研究了汞合金和金属的影响。
方法
明斯特大学医院颅颌面外科的112例具有口腔扁平苔藓临床和组织学特征的患者参与了这项前瞻性研究。评估了口腔扁平苔藓的临床参数和使用的牙科修复材料。通过使用德文版口腔健康影响量表简表（OHIP-14）调查口腔健康相关生活质量。此外，用视觉模拟量表对身体疼痛进行评分。
结果
OHIP-14平均得分为13.54。OHIP与疼痛之间存在高度相关性。同样，男性患者以及非网状形式口腔扁平苔藓（OLP）患者的OHIP值较高。OLP的局部形式在女性患者中更常见，例如网状苔藓的存在。关于修复体，复合树脂修复体的存在与局部苔藓相关，而金修复体的存在常与泛发性苔藓相关。此外，测试了黏膜病变与汞合金/金属之间关联强度的分级。Thornhill的4个分级在性别、OLP临床形式、年龄和表现形式之间的关系分析中未显示出显著差异。
结论
口腔扁平苔藓患者的口腔健康相关生活质量受到显著限制。但这些OHIP评分不受修复材料的影响。在此，疼痛严重程度是最重要的方面。我们发现有汞合金或金属修复的患者与没有这些修复的患者在临床参数上没有统计学差异。对于不与黏膜表面直接接触的汞合金填充物，没有必要进行更换。
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