Relevant contact sensitivities in patients with the diagnosis of oral lichen planus☆, ☆☆

Yiannias, James A.; el‐Azhary, Rokea A.; Hand, Jennifer H.; Pakzad, Soheil Y.; Rogers, Roy S.

doi:10.1016/s0190-9622(00)90123-3

Cited by 110 publications

(98 citation statements)

References 8 publications

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“…Their etiopathogenesis is not quite clear, however, they are most commonly considered an immunopathological reaction to various etiological factors such as pharmaceuticals, graft vs host disease reaction and contact reaction to dental materials 10,17,18 . A number of studies have confi rmed the frequent association between lichenoid reaction and contact hypersensitivity to dental metals.…”

Section: Discussionmentioning

confidence: 99%

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Oral Lichenoid Lesions and Allergy to Dental Materials

Ditrichová¹,

Kaprálová²,

Tichý³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background: Dental materials, oral hygiene products and food additives may cause contact allergic reactions in the mouth with varied clinical presentation. Oral lichenoid lesions (lichen planus-like lesions) can be induced by hypersensitivity to dental restorative metals, acrylates, fl avorings and other substances.Aim: The aim of this study was to demonstrate contact allergy to dental materials in patients with oral lichenoid lesions using patch tests.Patients and methods: Routine patch tests with two sets of allergens -"European Standard" and "Dental Screening" (Chemotechnique Diagnostics, Sweden) supplemented with pulverized amalgam, iridium, indium, menthol, sorbic acid and platinum were done on a set of 25 patients with lichenoid lesions located on the buccal mucosa, tongue and lips. Application and interpretation of the tests were conducted according to ICDRG (International Contact Dermatitis Research Group).Results: 15 (60 %) patients showed sensitization to 1 or more allergens, with a total of 31 positive reactions. The greatest frequency of positive reactions was to dental metals, with a total of 27 positive reactions. The order of tested metals according to frequency of positive reactions was mercury (6/25/24 %), amalgam (6/25/24 %), nickel (4/25/16 %), palladium (4/25/16 %), cobalt (3/25/12 %), gold (2/25/8 %), chrome (1/25/4 %), indium (1/25/4 %). The clinical relevance of the results with regard to the material's presence in the mouth was demonstrated in 11 (44 %) patients. In 9 patients, replacement of the positively tested materials led to healing or to signifi cant regression of mucosal changes. Conclusions:The results of the patch tests showed the possible contribution of contact sensitization in the pathogenesis of lichenoid manifestations in the oral cavity. Due to the premalignant character of these lesions, replacement of positively tested materials and follow up of these patients is advised.

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Section: Discussionmentioning

confidence: 99%

“…There is currently little information on the relationship between lichenoid reactions and synthetic resins 18,26 . These modern so-called esthetic materials have only lately come to the forefront; although in some countries they have almost completely replaced amalgam and are currently the primary dental restoration material 27,28 .…”

mentioning

confidence: 99%

Oral Lichenoid Lesions and Allergy to Dental Materials

Ditrichová¹,

Kaprálová²,

Tichý³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…These lichenoid contact sensitivity reactions are usually in contact with (or close to) an amalgam or composite resin dental restoration or a denture component (Lind, 1988;Bolewska et al, 1990). Flavorings, especially cinnamates in toothpaste, may also trigger lichenoid contact sensitivity reactions, although there is little published evidence in support of this observation (Miller et al, 1992;Yiannias et al, 2000). Circumstantial evidence implicates various bacteria and viruses in the etiology of OLP, although any causal role remains speculative (Scully et al, 1998).…”

Section: Clinical Features Of Olpmentioning

confidence: 99%

The Pathogenesis of Oral Lichen Planus

Sugerman

Savage²,

Walsh³

et al. 2002

Critical Reviews in Oral Biology & Medicine

643

584

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Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8 + cytotoxic T-cells. Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase (MMP) activation in OLP lesions. These mechanisms may combine to cause T-cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T-cell migration, and keratinocyte apoptosis in OLP. OLP chronicity may be due, in part, to deficient antigen-specific TGF-␤1-mediated immunosuppression. The normal oral mucosa may be an immune privileged site (similar to the eye, testis, and placenta), and breakdown of immune privilege could result in OLP and possibly other autoimmune oral mucosal diseases. Recent findings in mucocutaneous graft-versus-host disease, a clinical and histological correlate of lichen planus, suggest the involvement of TNF-␣, CD40, Fas, MMPs, and mast cell degranulation in disease pathogenesis. Potential roles for oral Langerhans cells and the regional lymphatics in OLP lesion formation and chronicity are discussed. Carcinogenesis in OLP may be regulated by the integrated signal from various tumor inhibitors (TGF-␤1, TNF-␣, IFN-␥, IL-12) and promoters (MIF,. We present our recent data implicating antigen-specific and non-specific mechanisms in the pathogenesis of OLP and propose a unifying hypothesis suggesting that both may be involved in lesion development. The initial event in OLP lesion formation and the factors that determine OLP susceptibility are unknown.

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“…Currently, the diagnosis of an OLL related to dental materials, according to Al-Hashimi et al According to the different publications, it is much more infrequent to find OLL in an oral cavity with amalgam fillings without direct contact, and which may be explained by excessive levels of total mercury in saliva. Even less common are distant or extraoral lesions, whose manifestations may occur in any area of the skin (being especially frequent in face and limbs) and especially in mucosa (16). Oral mucosa OLLs related to amalgam may have variable manifestations such as stretch marks and plaques, or as erythematous, erosive, atrophic or ulcerative lesions.…”

Section: Oral Lichenoid Lesions Related To Contact With Dental Materialsmentioning

confidence: 99%

Oral lichenoid lesions related to contact with dental materials: A literature review

Mj¹,

Martínez-Sahuquillo-Márquez²,

Gallardo³

et al. 2009

Med Oral

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Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and are clinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions related to contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remains difficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planus and other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated review of the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we made searches in the Pubmed® and Cochrane® databases. Among the literature we found several published papers, from which we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study. After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial. However, there are different aspects in the clinical presentation, pathological study and results obtained when replacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis of OLLC.

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Relevant contact sensitivities in patients with the diagnosis of oral lichen planus☆, ☆☆

Cited by 110 publications

References 8 publications

Oral Lichenoid Lesions and Allergy to Dental Materials

Oral Lichenoid Lesions and Allergy to Dental Materials

The Pathogenesis of Oral Lichen Planus

Oral lichenoid lesions related to contact with dental materials: A literature review

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