Periodontal Status in Oral Lichen Planus Patients

Assessment of Periodontal Status in Patients With Oral Lichen Planus

The aim is to investigate the influence of oral lichen planus on periodontal status of systemically healthy individuals.

Study Overview

• Status: Unknown
• Conditions: Periodontitis
• Intervention / Treatment: Other: diagnosis of periodontitis in oral lichen planus patients; Other: diagnosis of periodontitis in systemically healthy individuals without oral lichen planus

Detailed Description

Lichen planus, a chronic immune-mediated inflammatory disease affects the skin and mucous membranes. Oral lichen planus is the mucosal counterpart of cutaneous lichen planus. It was reported first described in 1866 as white papular eruptions in the oral cavity. The prevalence of OLP varies from 0.1% to 4%. OLP mostly occurs in middle aged and elderly patients, with female to male ratio of 3:2. OLP is characterized by lesions consisting of radiating white, grey, velvety, thread-like papules in a linear, annular and retiform arrangement forming typical lacy, reticular patches, rings and streaks. The lesions are most common on buccal mucosa, tongue, lips, gingiva, floor of mouth, palate. Clinically OLP has six clinical presentations namely reticular, erosive, atrophic, plaque-like, papular, bullous.

Reticular form, the most common clinical form presents as fine, asymptomatic intertwined lace-like pattern called "Wickham striae" in a bilateral symmetrical form. It mainly involves the posterior mucosa of the cheek. Erosive OLP represents symptomatic lesions. Atrophic lesions may resemble the combination of two clinical forms, such as the presence of white striae characteristic of the reticular type surrounded by an erythematous area. Plaque-like form mainly found on dorsum of the tongue and the mucosa of the cheek reveals whitish homogeneous irregularities similar to leukoplakia. Papular form presents with small white papules with fine striae in its periphery. Bullous form is the most unusual clinical form, exhibiting blisters that increase in size and tend to rupture, leaving the surface ulcerated and painful.

The pathogenesis of the disease is characterized by cytotoxic CD8+ T lymphocytes migration to the epithelium inducing apoptosis of basal keratinocytes. A number of etiological factors in OLP have been proposed such as local and systemic inducers of cell-mediated hypersensitivity, drugs, dental materials, infectious agents, and stress. The existence of a local cell-mediated immune disorder has been postulated as a factor underlying development of the lesions specifically, a delayed cellular hypersensitivity response probably triggered by some exogenous agent. Periodontal diseases are the most prevalent oral microbial infections that lead to chronic inflammation of the supporting tissues of teeth. Periodontal disease has a complex pathogenesis involving host microbiome interactions. It has an impact on both local and systemic health. The pathogenesis of periodontal disease involves a local inflammatory reaction and the activation. Thus, it is possible to speculate that some interference could exist and that the potential effect arising from these shared mechanisms⁄ mediators could be localized to sites where OLP lesions are present and alteration of host immune response in OLP may have an impact on periodontal health. With this consideration, the present study is aimed to assess periodontal status in systemically healthy individuals with and without oral lichen planus.

• Study Type: Observational
• Enrollment (Anticipated): 134

Contacts and Locations

Study Locations

• India
  • Haryana
    • Rohtak, Haryana, India, 124001
      • Recruiting
      • Post Graduate Institute of dental sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 50 years (ADULT)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

systemically healthy individuals with and without oral lichen planus

Description

Inclusion Criteria:

Individuals aged 40-50 yrs. Clinically diagnosed and histo-pathologically confirmed cases of oral Lichen Planus

Exclusion Criteria:

History of periodontal therapy in last one year. Drug-induced lichenoid reaction or any other red or white lesions in the oral cavity.

The presence of any tooth restoration near the lesions. Smokers or patients with history of smoking. systemic diseases or conditions that are reported to be associated with periodontal diseases, including diabetes mellitus, osteoporosis, rheumatoid arthritis Pregnant and lactating women. Patients with history of systemic treatment for oral Lichen Planus Patients with cutaneous lichen planus

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
systemically healthy individuals with oral lichen planus; systemically healthy individuals diagnosed with oral lichen planus on clinical and histopathological basis.	Other: diagnosis of periodontitis in oral lichen planus patients; diagnosis of periodontitis in oral lichen planus patients
systemically healthy individuals without oral lichen planus; systemically healthy individuals without any clinical feature of oral lichen planus.	Other: diagnosis of periodontitis in systemically healthy individuals without oral lichen planus; diagnosis of periodontitis in systemically healthy individuals without oral lichen planus

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical attachment level	CAL will be measured from cementoenamel junction to the base of the pocket using a periodontal probe at 6 sites	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bleeding on probing	BOP will be measured using a periodontal probe at 4 sites	6 months
PLAQUE INDEX	PI will be measured using a periodontal probe at 4 sites	6 months
Gingival index	Gingival index will be measured using a periodontal probe at 4 sites	6 months
Probing pocket depth	Probing pocket depth will be measured from gingival margin to the base of the pocket using a periodontal probe at 6 sites	6 months

Collaborators and Investigators

• Sponsor: Postgraduate Institute of Dental Sciences Rohtak
• Investigators: Principal Investigator: RMA ARYA, Post graduate institute of dental sciences, Rohtak

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2020
• Primary Completion (ANTICIPATED): April 30, 2021
• Study Completion (ANTICIPATED): April 30, 2021

Study Registration Dates

• First Submitted: February 4, 2020
• First Submitted That Met QC Criteria: February 5, 2020
• First Posted (ACTUAL): February 6, 2020

Study Record Updates

• Last Update Posted (ACTUAL): February 11, 2020
• Last Update Submitted That Met QC Criteria: February 8, 2020
• Last Verified: February 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Skin Diseases; Stomatognathic Diseases; Periodontal Diseases; Mouth Diseases; Skin Diseases, Papulosquamous; Lichenoid Eruptions; Periodontitis; Lichen Planus, Oral; Lichen Planus
• Other Study ID Numbers: RMA PGIDS/IEC/2019/32

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: study protocol
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No