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Science Forum Index » Medicine - Dentistry Forum » lichen planus
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| John & Ninetta |
 Posted: Tue May 22, 2007 7:46 pm |
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just wondering from the dentists on this group......
What proportion of your patients that present with the reticular pattern of
lichen planus on the attached gingiva acutally have symptoms of "tooth
sensitivity" in the affected area.
John |
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| Amatus Cremona |
| Posted: Wed May 23, 2007 6:27 am |
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I cannot ever remember seeing those two associated with each other. Maybe
just my 53 year old memory.
--
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Amatus
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"John & Ninetta" <jsuljak@sentex.net> wrote in message
news:C6udnW-UH69RE87bnZ2dnUVZ_jKdnZ2d@sentex.net...
Quote: just wondering from the dentists on this group......
What proportion of your patients that present with the reticular pattern
of lichen planus on the attached gingiva acutally have symptoms of "tooth
sensitivity" in the affected area.
John
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| Dartos |
| Posted: Wed May 23, 2007 7:31 am |
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Can't say it doesn't happen, but the soft tissue problems
seem to overshadow looking for other symptoms.
I don't see LP very often so I am no expert (and I hit the
double nickel in Dec., so I may be slower than AC <G>).
D
Amatus Cremona wrote:
Quote: I cannot ever remember seeing those two associated with each other. Maybe
just my 53 year old memory.
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| Mark & Steven Bornfeld |
| Posted: Wed May 23, 2007 10:37 am |
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John & Ninetta wrote:
Quote: just wondering from the dentists on this group......
What proportion of your patients that present with the reticular pattern of
lichen planus on the attached gingiva acutally have symptoms of "tooth
sensitivity" in the affected area.
John
I have had an unusual (for me) number of patients with LP this past
year. I don't remember (but I'm another double-nickel guy) any
reticular variant that was symptomatic for either soft tissue or teeth.
However, I've had 4 or 5 that had qualities of erosive LP, and at least
one had significant soft tissue symptoms. All got referred to an oral
path I work with.
Steve
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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001 |
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| jay |
| Posted: Wed May 23, 2007 12:41 pm |
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Oral lichenoid lesions related to dental restorative materials.Issa Y,
Duxbury AJ, Macfarlane TV, Brunton PA.
Turner School of Dentistry, University of Manchester, UK.
OBJECTIVES: To determine the effectiveness of replacing restorations
considered to be the cause of an oral lichenoid lesion (oral lichenoid
reaction)(OLL). DESIGN: Clinical intervention and nine-month follow
up. SETTING: The study was carried out in the University Dental
Hospital of Manchester, 1998-2002. SUBJECTS AND METHODS: A total of 51
patients, mean age 53 (SD 13) years, who had oral lesions or symptoms
suspected to be related to their dental restorations were
investigated. Baseline patch tests for a series of dental materials,
biopsies and photographs were undertaken. Thirty-nine out of 51 (76%)
of patients had their restorations replaced. RESULTS: The clinical
manifestations of OLL were variable; the majority of OLL were found to
be in the molar and retro molar area of the buccal mucosa and the
tongue. Twenty-seven (53%) patients had positive patch test reactions
to at least one material, 24 of them for one or more mercury compound.
After a mean follow up period of nine months, lesions adjacent to
replaced restorations completely healed in 16 (42%) patients (10
positive and 6 negative patch tests). Improvement in signs and
symptoms were found in 18 (47%) patients (11 positive and 7 negative
patch tests). CONCLUSION: OLLs may be elicited by some dental
restorations. Replacing restorations adjacent to these lesions is
associated with healing in the majority of cases particularly when
lesions are in close contact with restorations. A patch test seems to
be of limited benefit as a predictor of such reactions.
PMID: 15789104 [PubMed - indexed for MEDLINE] |
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| jay |
| Posted: Wed May 23, 2007 12:42 pm |
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Oral lichen planus and allergy to dental amalgam
restorations.Laeijendecker R, Dekker SK, Burger PM, Mulder PG, Van
Joost T, Neumann MH.
Department of Dermatology, Albert Schweitzer Hospital, Dordrecht, The
Netherlands. R.Laeijendecker@asz.nl
OBJECTIVES: To determine contact allergies in patients with oral
lichen planus and to monitor the effect of partial or complete
replacement of amalgam fillings following a positive patch test
reaction to ammoniated mercury, metallic mercury, or amalgam. DESIGN:
In group A (20 patients), the oral lesions were confined to areas in
close contact with amalgam fillings. In group B (20 patients), the
lesions extended 1 cm beyond the area of contact with amalgam
fillings. In group C (20 patients), the oral lesions had no
topographic relationship with amalgam fillings. Partial or complete
replacement of amalgam fillings was recommended if there was a
positive patch test reaction to ammoniated mercury, metallic mercury,
or amalgam. Control group D (20 patients) had signs of allergic
contact dermatitis. RESULTS: Amalgam fillings were replaced in 13
patients of group A, with significant improvement. Dental amalgam was
replaced in 8 patients of group B, with significant improvement. In
group C, amalgam replacement in 2 patients resulted in improvement in
1 patient. These results were evaluated after 3 months. No positive
patch test reactions to mercury compounds were found in patients with
concomitant cutaneous lichen planus and in group D. CONCLUSIONS:
Contact allergy to mercury compounds is important in the pathogenesis
of oral lichen planus, especially if there is close contact with
amalgam fillings and if no concomitant cutaneous lichen planus is
present. In cases of positive patch test reactions to mercury
compounds, partial or complete replacement of amalgam fillings will
lead to a significant improvement in nearly all patients.
PMID: 15611418 [PubMed - indexed for MEDLINE] |
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| jay |
| Posted: Wed May 23, 2007 12:44 pm |
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Lichenoid reaction associated to amalgam restoration.[Article in
English, Spanish]
Segura-Egea JJ, Bullón-Fernández P.
Dpto. de Estomatología, Facultad de Odontología, Universidad de
Sevilla. segurajj@wanadoo.es
Hypersensitivity to mercury associated with amalgam restorations may
occur and present in one of two different ways. Most commonly it
presents as an oral lichenoid reaction affecting oral mucosa in direct
contact with an amalgam restoration and represents a delayed, type IV,
cell mediated immune response to mercury or one of the other
constituents of the dental amalgam. We report a case of oral lichenoid
reaction associated to amalgam restoration. A 38 year-old woman
presented a caries lesion of tooth #37. A Blacks class I preparation
was performed and filled with amalgam. After 19 months, intra-oral
examination revealed atrophic lesion, lightly erythematous, affecting
the left buccal mucous. The lesion contacted directly with the amalgam
restoration in the lower first molar. The right buccal mucosa was
normal. His medical history was unremarkable, he was taking no
medication and had no known allergies. However, the patient had felt
certain rare sensation in that zone when eating sharp meals. Biopsy
showed histological changes compatible with oral lichen planus. The
patient decided not to change again the restoration, because she did
not have important annoyances and she did not wish to be treated
again. Other restorations were performed with composite resins, and no
reaction was evidenced in the mucosa.
PMID: 15580119 [PubMed - indexed for MEDLINE] |
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| jay |
| Posted: Wed May 23, 2007 12:46 pm |
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Healing of oral lichenoid lesions after replacing amalgam
restorations: a systematic review.Issa Y, Brunton PA, Glenny AM,
Duxbury AJ.
University Dental Hospital of Manchester, England, UK.
OBJECTIVE: We sought to systematically review the literature related
to oral lichenoid lesions (OLLs) and amalgam restorations. STUDY
DESIGN: Cohort and case-controlled studies (no randomized controlled
trials or controlled clinical trials available) were reviewed with
respect to inclusion criteria and data on patients with OLLs,
treatment interventions, and the measurement of outcomes. RESULTS:
Fourteen cohort and 5 case-controlled trials met the criteria. The
study population consisted of 1158 patients (27% male and 73% female;
age range, 23-79 years). From 16% to 91% of patients had positive
patch test results for at least 1 mercury compound. Of 1158 patients,
636 had to have their restorations replaced. The follow-up period
ranged from 2 months to 9 1/2 years. Complete healing ranged from
37.5% to 100%. The greatest improvements were seen in lesions in close
contact with amalgam. CONCLUSIONS: Protocols must be standardized to
obtain valid results. The replacement of amalgam restorations can
result in the resolution or improvement of OLLs. Patch testing seems
to be of limited value. The topographic relationship between an OLL
and an amalgam restoration is a useful--but not conclusive--marker.
PMID: 15529127 [PubMed - indexed for MEDLINE] |
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| Newbie |
| Posted: Wed May 23, 2007 1:30 pm |
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On Tue, 22 May 2007 20:46:24 -0400, "John & Ninetta" <jsuljak@sentex.net> wrote:
Quote: just wondering from the dentists on this group......
What proportion of your patients that present with the reticular pattern of
lichen planus on the attached gingiva acutally have symptoms of "tooth
sensitivity" in the affected area.
John
The incidence of lichen planus being rare, have one patient
who has significant pain associated with flare ups.
Pt. is a nurse and has learned to adapt and avoid things
that trigger flare ups. |
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| Newbie |
| Posted: Wed May 23, 2007 2:06 pm |
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On Wed, 23 May 2007 18:30:32 GMT, Newbie <nox@bix.nex> wrote:
Quote: On Tue, 22 May 2007 20:46:24 -0400, "John & Ninetta" <jsuljak@sentex.net> wrote:
just wondering from the dentists on this group......
What proportion of your patients that present with the reticular pattern of
lichen planus on the attached gingiva acutally have symptoms of "tooth
sensitivity" in the affected area.
John
The incidence of lichen planus being rare, have one patient
who has significant pain associated with flare ups.
Pt. is a nurse and has learned to adapt and avoid things
that trigger flare ups.
Completely skipped the answer ! whoops !
Symptoms are largely a burning sensation in the soft tissue.
Sometimes she has tooth pain but pt is able to differentiate. |
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