An appraisal of highest quality studies reporting malignant transformation of oral lichen planus based on a systematic review

González‐Moles, Miguel Ángel; Ramos‐García, Pablo; Warnakulasuriya, Saman

doi:10.1111/odi.13741

Cited by 69 publications

(49 citation statements)

References 42 publications

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“…The meta-analytical results recently published by our research group are, in this regard, of relevance ( 1 , 4 ). Thus, although non dysplastic OLP may progress to cancer ranging from 0.44-2.28% of the cases ( 1 , 4 , 5 ), our analysis showed significantly higher ratios of malignancy in OLP with dysplasia (6.22%) ( 1 ). We reported that the malignant transformation ratio of OLP has probably been underestimated by the exclusion of cases with dysplasia.…”

Section: Discussionmentioning

confidence: 89%

“…Oral lichen planus (OLP) is currently classified as an oral potentially malignant disorder (OPMD) ( 1 , 2 ) with a global prevalence of around 1% ( 3 ). Several systematic reviews and meta-analyses have estimated the ratios for malignant transformation of OLP ranging from 0.44-2.28% ( 1 , 4 , 5 ). On the aspects related to malignant transformation of OLP, mainly the presence of epithelial dysplasia has generated considerable controversy ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper

González‐Moles¹,

Warnakulasuriya²,

González‐Ruiz³

et al. 2021

Med Oral

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Background Patients with oral lichen planus (OLP) have an increased risk of oral cancer. For this reason, OLP is classified as an oral potentially malignant disorder. However, the precise personal (or individual) risk is unknown. Recent meta-analytical studies have reported that dysplastic OLP may transform to cancer in around 6% of cases, while the rate of transformation is lower (<1.5%) in non-dysplastic cases. The presence of epithelial dysplasia has emerged as the most powerful indicator for assessing cancer risk in oral potentially malignant disorders in routine practice. However, the general acceptance of epithelial dysplasia as an accompanying histologic feature in OLP is subject to great controversy. Many pathologists consider the presence of dysplasia as a criterion to exclude OLP when routinely reporting on this disease. This practice, widespread among oral pathology professionals, has resulted in the underestimation of the potential for malignancy of OLP. Material and Methods A review of the literature was carried out in order to critically analyze the relevance, controversies and challenges encountered across the diagnosis of epithelial dysplasia in OLP. Results 12 studies have been published examining dysplastic changes in OLP, reporting Figures ranging from 0.54% to 25% of cases with dysplasia in the first diagnostic biopsy. The diagnosis of dysplasia in the OLP poses an additional difficulty due to the fact that the affected oral epithelium per se develops changes related to autoimmune aggression. Among the most frequent histological features of OLP that develops dysplasia are basal cell hyperplasia with basaloid appearance, loss of basal cells polarity, cellular and nuclear pleomorphism and irregular stratification. Conclusions Epithelial dysplasia should not be considered an exclusion criterion for OLP; its evaluation requires experienced pathologists in this field. Key words: Oral lichen planus, epithelial dysplasia, oral cancer.

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Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper

González‐Moles¹,

Warnakulasuriya²,

González‐Ruiz³

et al. 2021

Med Oral

View full text Add to dashboard Cite

show abstract

“…Demographically, OLP is more common in women aged more than 40 years. Furthermore, Gonzales-Moles et al [ 1 ] reported a significantly higher prevalence in subjects aged more than 50 years or more than 60 years. Thus, age and sex associated with the malignant transformation risk were suggested to be linked to demographics.…”

Section: Discussionmentioning

confidence: 99%

“…Oral lichen planus (OLP) is a chronic inflammatory oral mucosa disease of unknown etiology that has an estimated global prevalence of 1.01% [ 1 ]. OLP mostly occurs in middle aged persons, with a greater prevalence in females.…”

Section: Introductionmentioning

confidence: 99%

Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients

et al. 2021

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Background Oral lichen planus (OLP) is a chronic inflammatory oral mucosa disease that is recognized as an oral potentially malignant disorder. However, the potentially malignant nature of OLP remains unclear. Methods We designed this study to examine the demographic and clinical characteristics of patients with OLP and evaluate the associated malignant transformation rate. A total of 565 patients with a clinical and histopathological diagnosis of OLP who presented at our department between 2001 and 2017 were retrospectively studied. Patients who had clinical and histopathological features of oral lichenoid lesions (OLLs) classified as oral lichenoid contact lesions, oral lichenoid drug reactions and oral lichenoid lesions of graft-versus-host disease were excluded. Results The study population included 123 men and 442 women aged 21–93 years (mean ± standard deviation, 60.5 ± 11.8). The 565 patients were followed up for a duration of 55.9 ± 45.3 months, during which 4 (0.7%) patients developed squamous cell carcinoma (SCC). In three of these 4 patients who developed SCC, the clinical type of OLP was the red type. Conclusions Our results suggested that OLP was associated with a low risk of malignant transformation. We recommend regular follow-up for OLP patients and clear differentiation of oral epithelial dysplasia and OLLs to enable early detection of malignant transformation. Further investigation of the clinical risk factors associated with malignant transformation is necessary.

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“…OLP is more prevalent in females than in males with a ratio of approximately 2:1, mostly affecting the middle-aged population. Giuliani et al showed on a recently systematic review a worldwide prevalence of 1.01% with being more prevalent in women than in men [ 3 ]. The risk of malignant transformation is 1.2% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

et al. 2021

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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.

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An appraisal of highest quality studies reporting malignant transformation of oral lichen planus based on a systematic review

Cited by 69 publications

References 42 publications

Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper

Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper

Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

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