J Periodontal Implant Sci.  2018 Aug;48(4):213-223. 10.5051/jpis.2018.48.4.213.

Factors affecting treatment outcomes in patients with oral lichen planus lesions: a retrospective study of 113 cases

• Park SY
• Lee HJ
• Kim SH
• Kim SB
• Choi YH
• Kim YK
• Yun PY

• KMID: 2465387
• DOI: http://doi.org/10.5051/jpis.2018.48.4.213

Abstract

PURPOSE
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.

Keyword

Corticosteroid methanetriol mixture; Logistic models; Oral lichen planus; Retrospective studies; Survival analysis

MeSH Terms

Dental Records
Dentistry
Dexamethasone
Female
Follow-Up Studies
Humans
Lichen Planus, Oral*
Logistic Models
Male
Retrospective Studies*
Seoul
Survival Analysis
Dexamethasone

Figure

• 

  Figure 1 Distribution of OLP lesions in this study. (A) Distribution of OLP lesions according to site (number of patients, percentile to total), (B) distribution of OLP lesions according to patients' age (number of patients) and rate of new lesion formation in gingival and mucosal lesions (percentile), (C) histogram of clinical outcomes according to follow-up duration (days). OLP: oral lichen planus.

• 

  Figure 2 Kaplan-Meier survival curves showing failure estimates. The time to new lesion formation or expansion of OLP was calculated from the index date to the date when a new lesion was observed. The pattern of dexamethasone use and mode of dexamethasone treatment did not significantly influence the time to failure (P=0.234 and P=0.789, respectively). However, a history of malignancy significantly affected the time to failure (P=0.008). Menopause showed a near-significant relationship (P=0.039). Younger patients had a higher failure rate than elderly patients (P=0.013). The location of the OLP lesion was a significant factor affecting new lesion formation or lesion expansion (P=0.049). OLP: oral lichen planus.

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