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Background:
Oral lichen planus and mouth dryness are common pathoses, yet not entirely understood. These two conditions may be associated, with a few studies investigating the relationship between mouth dryness and oral lichen planus providing conflicting results. None of the studies have explored the specific impact of disease treatment on mouth...
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Treating oral lichen planus (OLP) is a big challenge for clinicians. Despite numerous existing remedies, to date, no effective cure has been found, which is mainly attributed to the lack of understanding of the pathogenesis of the disease. Our aim was to compare the effectiveness of topical steroids and diode laser in treating OLP patients. Twenty-...
Citations
... However, patients with OLP often complain of oral dryness [37]. In line with previous studies, the present study revealed a higher prevalence of subjective dry mouth (80%) in patients with OLP compared to age-and gender-matched controls (48%) [23,[37][38][39]. The low salivary flow rate among OLP patients has previously been linked to a decrease in the expression of muscarinic receptors in the salivary glands [19], or the side effects of medications [23]. ...
Objectives
Salivary proteins, acidic glycoproteins, and free calcium might take part in oral mucosal defence against inflammation in oral lichen planus (OLP). The study aimed to investigate whether the levels of sulfated and sialylated glycoproteins, total protein, and free calcium in saliva from patients with OLP differ from those of individuals without oral mucosal diseases.
Material and Methods
Patients diagnosed with OLP (n = 25) and two control groups without any oral mucosal disease; age- and gender-matched controls (n = 25, 65.6 ± 2.9 years), and younger controls (n = 25, 41.8 ± 2.5 years) were included. Subjective dry mouth (xerostomia) was assessed by asking a single-item question. Chew-stimulated whole saliva was collected to measure sulfated and sialylated glycoproteins by the Alcian Blue method. The total protein was determined spectrophotometrically, and the free calcium measured using an electrode.
Results
The output of salivary sulfated and sialylated glycoproteins in the OLP group (21.8 ± 2.4 µg/min) was lower than in the age- and gender-matched controls (43.0 ± 2.9 µg/min, p = 0.0002), whereas the total protein and calcium output did not differ between the three groups (p > 0.05). The prevalence of xerostomia was significantly higher in the OLP group compared to both control groups (p = 0.038).
Conclusions
Patients with OLP showed a high prevalence of xerostomia and lower levels of salivary acidic type glycoproteins compared to the individuals without oral mucosa disease.
Clinical relevance
It is relevant to investigate the role of acidic glycoproteins in the pathogenesis of OLP.
... Al-Janaby et al. 2017 [19] Case group included 19 people with OLP and xerostomia before treatment with topical corticosteroids; Control group included 19 people with OLP and xerostomia after treatment with topical corticosteroids ...
Background and Objectives Oral lichen planus (OLP) is an chronic inflammatory mucocutaneous disease, which mostly affect the oral mucosa. This study aims to review the studies related to the presence of xerostomia (dry mouth) in patients with OLP and its possible mechanisms. Subjects and Methods In this review study, a search was conducted in Medline, Scopus, Embase and Web of Science databases on related studies published from 1965 to 2021 using the keywords oral lichen planus, xerostomia, hyposalivation, salivary gland hypofunction, and oral dryness. Clinical studies on the association between OLP and xerostomia, and those with well-defined design and methodology were included in the review. Results About 8 articles were finally selected based on the entry criteria. These articles were about the histopathological examination of salivary glands, evaluation of salivary compositions, saliva flow rate assessment, and feeling of dry mouth using a questionnaire. Conclusion The relationship between OLP and xerostomia has been shown in many studies. Various mechanisms have been proposed in this regard. The mentioned mechanisms are the inflammatory and autoimmune disorders of the sensory nervous system, changes in saliva composition, and changes in the saliva flow rate.
... Clinical signs of xerostomia were identified: stick test (dental mirror sticks to the buccal mucosa and offers resistance while withdrawing) [Makeeva I et al., 2013;Al-Janaby H et al., 2017], dryness and discomfort throughout the day, the need for drinking water with food, rough mucosa. The rate of mixed unstimulated salivation in ml/min was determined by spitting method [Makeeva I et al., 2013;Arakelian M et al. 2016]. ...
Lichen planus is one of the most common chronic relapsing diseases of skin and oral mucosa. Stress is considered to be an important factor for oral lichen planus development and flare-up. An association of oral lichen planus with hepatitis has also been shown. A 59-year-old male patient hospitalized in the hepatology department was referred to a dentist with the complaints of oral mucosa pain, burning sensation and dry mouth. The hyperemia of buccal and lingual mu-cosa, multiple whitish popules merging into reticular pattern and painful erosions were determined. The dental diagnosis was oral lichen planus, combination of papular, reticular and ero-sive forms (flare-up). Associated conditions were hepatic cirrhosis of viral etiology, multinodular euthyroid goiter and stress. Systemic therapy included: pancreatic enzymes, antidepressant, hepatoprotective, bactericidal, antibacterial broad spectrum and other drugs. The topical therapy included: Bluem oral rinse, vitamin A, kenalog orabase, solcoseryl dental adhesive paste. After 21 days oral mucosa was of pale pink color. Whitish papules, regionally merging into a characteristic pattern were identified on the buccal mucosa, on the tongue dorsum several pap-ules were defined. The 6-months follow-up demonstrated no worsening. This case report demonstrates the possibility of achieving of significant improvement with prolonged remission period of oral lichen planus in patient with hepatitis C with the use of topical corticosteroids and epi-thelial agents in conjunction with the treatment provided by hepatologist and psychotherapist. KeywordS: lichen planus, oral mucosa pain, burning sensation and dry mouth, Bluem oral rinse, cortico-steroids and epithelial agents.
... In addition to its common symptoms like pain and irritation, OLP is associated with a number of other symptoms including xerostomia [3]. Various studies have documented the association of lichen planus with hyposalivation and xerostomia [4][5][6][7]. The prevalence of xerostomia in OLP patients is higher than that of healthy people. ...
Objectives: Oral lichen planus (OLP) is one of the common chronic, autoimmune disorders in oral cavity. Regarding the role of adrenergic receptors in mediating stress and that’s effect on salivary composition, the purpose of this study was to investigate salivary levels of α1- and β1-adrenergic receptors in OLP patients to response to this research question: Do agonist or antagonist of adrenergic receptors affect hyposalivation of OLP patients? Method: In this case-control study, stimulated and unstimulated saliva samples were collected from 33 patients and 33 healthy individuals. The salivary flow rate and levels of α1- and β1-adrenergic receptors were measured by ELISA assay. Data were analyzed using SPSS 25 and T-test. Results: The stimulated and unstimulated salivary flow rate was significantly lower in OLP patients than healthy subjects. The α1-adrenergic receptors in the unstimulated saliva of patients was significantly higher than in the healthy subjects (p
... We thank the letter's author for the interest in our study [1]. In response to the points raised: ...
... The recently published research article "Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids" by Hala Al-Janaby, et al. [1] was studied with great interest. The article concluded that treatment with topical corticosteroids in patients with oral lichen planus could result in improving the symptoms of xerostomia. ...
... Salivary gland dysfunction: objective evidence of alterations (qualitative and/or quantitative) in saliva output. Dysfunction may include a decrease (hypofunction) or an increase (hyperfunction) of the saliva output (Mahvash Navazesh 2017) are commonly observed in patients with oral lichen planus [1], the results of the above study could significantly impact the management and treatment of those patients.With respect to the results presented in the article, the followings are of concern: ...
... This approach has not been adopted for most of the participants in the study. It should also be mentioned that some patients could develop symptoms of lichenoid reactions (LR) instead, and therefore, the results of the study could not be applicable to OLP, especially when considering the completely different etiopathogenesis of lichenoid reactions [1]. Out of 19 participants in this study who had OLP, 12 participants were taking medications that influence the 2. ...
Objective:
The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth.
Study design:
A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized.
Results:
From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains.
Conclusion:
There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
Objective:
To identify all outcome measures used to assess salivary gland hypofunction (i.e., objective measures used to determine actual changes in saliva quantity or to assess response to treatment of salivary gland hypofunction) and to group these into domains.
Study design:
A systematic review including clinical trials and prospective or retrospective observational studies involving human participants with dry mouth, with any type of intervention where the objective assessment of salivary gland hypofunction was described.
Results:
Five hundred fifty-three studies involving 31,507 participants were identified. Most assessed salivary gland hypofunction and xerostomia (68.7%), whereas 31.3% assessed salivary gland hypofunction alone. Most studies investigated the "amount of saliva," and the highest number of outcome measures were within the domain of "clinical/objective signs of salivary gland hypofunction."
Conclusions:
Seven domains encompassing 30 outcome measures were identified, confirming the diversity in outcomes and outcome measures used in research regarding salivary gland hypofunction. Identified items will be used in conjunction with those identified regarding xerostomia to create a core outcome set for dry mouth quantification for use in future clinical trials, with the overall goal of improving the standardization of reporting, leading to the establishment of more robust evidence for the management of dry mouth and improving patient care.
Background and Objectives
Oral lichen planus (OLP) is a common T-cell-mediated inflammatory oral mucosal disease. One of the complaints among OLP patients is xerostomia. However, the relationship between oral dryness and a decreased salivary-flow rate in these patients is not yet conclusive. So, we investigated oral dryness and the salivary-flow rate in OLP patients using various measurements.
Material and Methods
Thirty OLP patients and 30 controls were included. The oral-dryness symptoms were collected using the Xerostomia Inventory (XI) and Bother Index (BI). The salivary-flow rate was measured using a Modified Schirmer Test (MST) and the spitting method. The clinical signs of dry mouth were determined by the clinical oral-dryness score (CODS). The Thongprasom score was used to evaluate the severity of OLP. The data were analyzed using the Mann-Whitney U test and Spearman’s rank correlation coefficient.
Results
The XI score and BI score in the OLP group were significantly higher than in the control group. However, CODS, MST, the unstimulated salivary-flow rate, and the stimulated salivary-flow rate were not significantly different between the two groups. There was no correlation between oral dryness and the salivary-flow rate in OLP patients. The severity of OLP was also not correlated to oral dryness and the salivary-flow rate.
Conclusion
OLP patients had more complaints about mouth dryness than the controls. However, the salivary-flow rates between the two groups were not different. Additionally, the severity of OLP was not related to dry mouth or the salivary-flow rate. The possible reasons for oral dryness among people with OLP require further investigation.
Background
Oral lichen planus (OLP) is a common, chronic immunological and inflammatory condition. Many of the OLP patients complain of xerostomia. The M3 muscarinic cholinergic receptors (MR3) are the main receptors in the salivary glands responsible for water secretion into the saliva. This study aimed to assess the level of M3 muscarinic cholinergic receptors in minor salivary glands of OLP patients.
Methods
This case‐control cross‐sectional study evaluated 40 OLP patients and 22 controls. All participants completed two questionnaires (xerostomia and xerostomia inventory). Stimulated and unstimulated saliva samples were collected. The saliva flow rate was calculated by dividing the saliva volume (in milliliters) by time (in minutes). Six minor salivary glands were also surgically removed from the lower lip of patients and controls, and weighed using a digital scale with 10‐4 g accuracy. They were then frozen at ‐80°C, and the level of M3 receptors of the glands was determined using the ELISA kit.
Results
The unstimulated and stimulated saliva flow rate was significantly lower in OLP patients. The xerostomia inventory score was significantly higher in the OLP group. The level of M3 muscarinic receptors in minor salivary glands of OLP patients was significantly higher than that in controls.
Conclusions
It may be concluded that the reduction in saliva flow significantly increases the number of M3 receptors in an attempt to compensate for this shortage and prevent xerostomia (compensatory upregulation).
