Oral lichen planus (OLP) is a chronic and inflammatory oral mucosal disease that commonly affects middle-aged females. Most OLP cases might exhibit such symptom as pain, roughness and other discomfort, and more severe forms may show a high risk of developing oral cancer. Active preventive measure, precise diagnosis and standard therapeutic approach play a vital role in the management and prevention of OLP. This guideline is a revision on the base of trial in 2012, which mainly covers the following 8 aspects: etiology and medical records, clinical manifestations, pathological manifestations, diagnosis, differential diagnosis, laboratory examination, disease treatment and prevention, aiming at providing scientific evidence and guidance for the dental clinicians in diagnose and treatment of OLP.
Diagnosis, Differential ; Female ; Humans ; Lichen Planus, Oral/therapy* ; Middle Aged ; Mouth Neoplasms

OBJECTIVE: To observe the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) for the treatment of erosive oral lichen planus (EOLP). METHODS: Sixty patients with clinically and pathologically diagnosed EOLP were randomly divided into the experimental group and control group according to the random number. Patients in the experimental group were treated with lyophilized powder containing Nr-CWS combined with normal saline. Patients in the control group received topical placebo without Nr-CWS combined with normal saline. Changes in the EOLP lesion area and the patient's pain level were recorded at the timepoints of weeks 1, 2, and 4 after the two different treatments, respectively. The changes of the patient's REU scoring system (reticulation, erythema, ulceration), the visual analogue scale and the oral health impact score (OHIP-14) were compared between the experimental group and control group after treatment, and the safety indicators of the two groups at the initial diagnosis and after 4 weeks' treatment were also observed, respectively. RESULTS: Totally, 62 patients with clinically and pathologically diagnosed EOLP were enrolled, 2 of whom were lost to the follow-up, with 31 in the experimental group, and 29 in the control group. The mean age of the experimental group and control group were (52.9±12.4) years and (54.07±12.40) years, respectively. There was no significant difference in the oral periodontal index between the experimental group and control group. In the experimental group, the erosive area of oral lichen planus was significantly reduced 1, 2, and 4 weeks after the Nr-CWS's treatment (P < 0.05), the reduction rate was 81.75%, the patient's pain index was also decreased (P < 0.05), and in addition, the OHIP-14 was reduced (P < 0.05). The changes of the REU scoring system, the visual analogue scale and the OHIP-14 were significantly different between the experimental group and control group after treatment. There was no significant difference in the safety index between the two groups. CONCLUSION The priliminary data show that the Nr-CWS is effective and safe to treat EOLP.
Adult ; Aged ; Cell Wall Skeleton ; Humans ; Lichen Planus, Oral/drug therapy* ; Middle Aged ; Pain Measurement ; Rhodococcus

To analyze the incidence and distribution of oral mucosal diseases in Hunan Province and provide reference for prevention and treatment.
 Methods: The clinical data for all patients, who were treated in Xiangya Hospital of Central South University from April 2013 to March 2017, were collected. After screening, weighing and classifying, sex and age distribution for the disease was analyzed.
 Results: The female with the age between 40 to 49 were in the majority among 21 972 patients. The ratio between men to women was 1:1.05. According to the classification of diseases, the most common diseases were as follows: recurrent aphthous ulcer (27.17%), burning mouth syndrome (15.72%), oral submucous fibrosis (14.75%), oral lichen planus (10.38%), oral leukoplakia (4.21%), traumatic ulceration (4.14%), chronic cheilitis (3.47%), oral fungal infection (3.26%), and atrophic glossitis (2.74%). Recurrent oral ulcer (28.65%), burning mouth syndrome (23.70%) and oral lichen planus (13.31%) were the most common 3 kinds of oral mucosal diseases during females in Hunan. Oral submucous fibrosis was the most common oral mucosal disease among males in Hunan (28.56%).
 Conclusion: Recurrent oral ulcer, burning mouth syndrome and oral lichen planus are very popular in women in Hunan Province, and oral submucous fibrosis is the most common disease in male in this region. It shows a high trend of incidence in the surrounding provinces.
Adult ; Age Distribution ; Burning Mouth Syndrome ; epidemiology ; China ; epidemiology ; Female ; Fibrosis ; Humans ; Incidence ; Leukoplakia, Oral ; epidemiology ; Lichen Planus, Oral ; epidemiology ; Male ; Middle Aged ; Mouth Diseases ; epidemiology ; therapy ; Mouth Mucosa ; pathology ; Oral Submucous Fibrosis ; Oral Ulcer ; epidemiology ; Sex Distribution ; Stomatitis, Aphthous ; epidemiology

BACKGROUND: The treatment options for oral lichen planus (OLP) are numerous and include topical and systemic agents. Intralesional and systemic corticosteroids are used; however, the therapeutic results are often disappointing. OBJECTIVE: To compare the influence of ozone, laser, and topical corticosteroid therapies in the treatment of OLP. METHODS: One hundred twenty adult patients with < or =3 cm atrophic-erosive biopsy-proven OLPs in the tongue or buccal mucosa were recruited into the study. They were randomly assigned, by preoperative envelope drawing, to be treated with low-level laser therapy (LLLT group), ozone therapy (ozonated group), and topical corticosteroid therapy (positive control group). A placebo treatment containing base ointment without the active corticosteroid component was administered to patients in the negative control group. Response rate scores were determined on the basis of changes in the appearance score and pain score of the lesions between baseline and after each treatment. RESULTS: The study subjects consisted of 56 male and 64 female OLP patients with a combined mean age of 42.6+/-8.3 years (range, 28~55 years). No statistically significant difference was detected in clinical severity among the groups. The sign scores decreased in almost all scoring groups; however, statistically significant improvement was found in the ozonated and corticosteroid-treated groups. Symptom improvement was achieved after treatment with LLLT, ozone, and corticosteroid (p<0.05). The efficacy indices were significantly higher in the ozonated and corticosteroid-treated groups. CONCLUSION: Ozone and corticosteroid therapies were more effective than 808-nm LLLT in the treatment of OLP.
Adrenal Cortex Hormones ; Adult ; Dentistry ; Female ; Humans ; Low-Level Light Therapy* ; Lichen Planus ; Lichen Planus, Oral* ; Male ; Mouth Mucosa ; Ozone* ; Tongue

OBJECTIVETo assess the efficacy and safety of topical tacrolimus for erosive oral lichen planus (EOLP).

METHODSLiteratures published up to December 2013 were searched from PubMed, Embase, CENTRAL, Chinese BioMedical Literature Database (CBM), and System for Information on Grey Literature in Europe (SIGLE). All randomized controlled trials (RCTs) of topical tacrolimus for EOLP which compared with other interventions or a placebo were considered in this Meta-analysis. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane Handbook and the materials were analyzed with the software Revman 5.2.5. The primary outcome measures were the symptoms (e.g. pain, discomfort) complained by patients. The secondary outcome measures included the improvement rate of clinical signs assessed by the investigators and the incidence of adverse effects (e.g. clinical candidiasis).

RESULTSA total of 9 RCTs involving 476 patients were finally included. The pooled odds ratio (OR) of clinical improvement for topical tacrolimus vs. topical corticosteroids was 1.19 [95% confidence interval (CI): 0.64-2.22, I2: 44%]. Regarding to 0.1% tacrolimus and 0.03% tacrolimus, the pooled OR were 1.87 (95% CI: 0.60-5.82) and 1.47 (95% CI: 0.14-16.04) respectively in subgroup analysis. No serious adverse events were reported in topical tacrolimus group.

CONCLUSIONSThere was no evidence to support that topical tacrolimus for EOLP was more effective and safer than topical corticosteroids in this Meta-analysis. Clinical assessment criteria should be established and accepted by clinicians and researchers before further RCTs are undertaken.

Administration, Topical ; Humans ; Immunosuppressive Agents ; administration & dosage ; Lichen Planus, Oral ; drug therapy ; Randomized Controlled Trials as Topic ; Tacrolimus ; administration & dosage ; adverse effects

Biopsy ; Cell Transformation, Neoplastic ; Diagnosis, Differential ; Glucocorticoids ; therapeutic use ; Humans ; Lichen Planus, Oral ; diagnosis ; pathology ; therapy ; Mouth Mucosa ; pathology ; Practice Guidelines as Topic

Antibodies, Monoclonal ; therapeutic use ; Cell Transformation, Neoplastic ; Dexamethasone ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Glucocorticoids ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Lichen Planus, Oral ; diagnosis ; pathology ; therapy ; Phototherapy ; Prednisone ; therapeutic use ; Recombinant Fusion Proteins ; therapeutic use

Combined Modality Therapy ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Integrative Medicine ; Lichen Planus, Oral ; classification ; diagnosis ; therapy ; Medicine, Chinese Traditional ; Phototherapy ; Phytotherapy

Administration, Topical ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Lichen Planus, Oral ; complications ; drug therapy ; pathology ; Oral Ulcer ; drug therapy ; etiology ; Tacrolimus ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome

Humans ; Immunotherapy ; methods ; Integrative Medicine ; Lichen Planus, Oral ; immunology ; pathology ; therapy