Prevalence of Oral Lichen Planus in Diabetes Mellitus: a Meta-Analysis Study

Thyroid Dysfunction and Oral Lichen Planus: Evidence From Two-Sample Mendelian Randomization Analysis

INTRODUCTION AND AIMS

Epidemiological studies have shown that the association between thyroid dysfunction (TD) and oral lichen planus (OLP) is controversial, and the causal relationship remains ill-defined. This study aims to investigate their probable mutual causality using bidirectional Mendelian randomization (MR) analyses.

METHODS

We extracted genetic instruments for OLP and 10 phenotypes of TD from the genome-wide association studies database. The inverse variance weighted method was primarily used to evaluate the bidirectional causal relationship between TD and OLP. The results' robustness was verified by sensitivity analysis (Cochran's Q test, MR-Egger intercept, and leave-one-out test). Bonferroni correction threshold (0.05/10) was applied to determine significant differences.

RESULTS

Forward MR analysis indicated that Hashimoto's thyroiditis (HT) was suggestively linked to a higher likelihood of developing OLP (P = .0077), while hypothyroidism significantly increased the risk of OLP occurrence (P = .0002). The reverse MR study found that OLP was suggestively related to the occurrence of hyperthyroidism (P = .0126) and thyroid cancer (P = .0244). Furthermore, OLP was found to significantly increase the risk of HT (P = 3.47 × 10-⁸), Graves' disease (P = 1.03 × 10-⁵), hypothyroidism (P = 1.08 × 10-⁸), and elevated thyroid-stimulating hormone levels (P = 1.99 × 10-⁶). No major pleiotropy or heterogeneity was detected (P > .05).

CONCLUSION

These findings suggest that hypothyroidism significantly increases the risk of OLP, while OLP may contribute to the development of autoimmune thyroid disorders, particularly HT, Graves' disease, hypothyroidism, and thyroid-stimulating hormone. These findings highlight the complex interaction between endocrine and immune systems, emphasizing the need for further research into shared molecular pathways and potential clinical implications.

CLINICAL RELEVANCE

This study provides a genetic foundation for understanding the relationship between TD and OLP, which aids early screening and diagnosis and informs therapy development.

Impact of diabetes mellitus on patients affected by oral lichen planus: a retrospective study

Introduction

The association between diabetes mellitus (DM) and oral lichen planus (OLP) has been widely reported. However, most of the studies focused on epidemiological aspects and shared inflammatory pathways, with few exploring the consequences of this association on the clinical course of OLP. The study aims to retrospectively observe the impact of DM on the clinical presentation and management strategy of OLP.

Methods

A total of 97 OLP patients were retrieved from the Department database. The patients were distributed into two groups: OLP patients with DM "test group" (n = 47) and OLP patients without DM "control group" (n = 50). The descriptive and statistical analyses were performed on the variables related to the clinical presentation of OLP, the management of OLP, and the general and demographic information.

Results

Regarding primary outcomes related to the clinical presentation variables, DM patients were symptomatic and more susceptible to present atrophic lesions at the first visit, compared to those without DM with a statistical significance (p = 0.0017 and p = 0.0016 respectively). Buccal mucosa was generally the most affected site in both groups and was notably higher in patients with DM (p = 0.0286). Regarding the management variables, DM patients were subjected to a higher number of follow-ups per year (p = 0.0420), a higher number of prescribed general treatments per year (p = 0.0006), and a higher number of prescribed non-cortisone-based treatments per year (p = 0.0001). In regard to the secondary outcomes related to the general and demographic variables, a statistically significant difference was observed with concomitant diseases, where patients with DM were more susceptible to concomitant diseases (p = 0.0321), particularly cardiopathy (p = 0.0422), arterial hypertension (p = 0.0418), dyslipidemia (p = 0.0411), and coagulopathy (p = 0.0411).

Discussion

DM patients were highly presented with symptomatic OLP and showed a difference in the management strategy where more follow-ups and treatment prescriptions were needed. It seems that the clinician should consider DM as an essential co-factor that may influence the management procedures of OLP. Considering interdisciplinary management and involving endocrinologists may add significant value to the OLP management process.

Oral Lichen Planus: An Updated Review of Etiopathogenesis, Clinical Presentation, and Management

Lichen planus (LP) is a chronic idiopathic immune-mediated inflammatory condition. LP is a heterogeneous disease with varied clinical presentations having different natural history, prognosis, sequelae, and outcomes. It can affect skin, hair, nails, and mucosae. Mucosal LP (including oral LP) tends to be persistent and resistant to treatment, compared to cutaneous LP. Oral LP (OLP) is broadly divided into two main categories: hyperkeratotic (usually asymptomatic) and erosive (commonly symptomatic). It can present with symptoms including odynophagia, dysphagia, dysgeusia, and sensitivity to hot spicy foods. Apart from the superficial epidermal changes, which vary with the type of clinical presentation, histopathologically oral LP shows a unifying similar and consistent feature of a lichenoid interface dermatitis. Recently, researchers have highlighted the critical role played by IL-17 in the pathogenesis of OLP. World Health Organization has categorized oral LP as one of the oral potentially malignant disorders (OPMD), albeit with a low risk of malignant transformation. Also, in the last couple of years there have been various reports on the usage of newer drugs like anti-IL17, anti-IL12/23, anti-IL 23, PDE4 inhibitors, and JAK inhibitors in the management of refractory OLP. The principal aim of treatment still remains to resolve the symptoms, prolong the symptoms free period, and reduce the risk of potential malignant transformation. We have described many new revelations made in recent times regarding the etiopathogenesis, associated conditions as well as management of OLP. Thus, the objective of this review is to present a comprehensive up-to-date knowledge including the recent advances made regarding OLP.

CD8 + T-cell marker genes reveal different immune subtypes of oral lichen planus by integrating single-cell RNA-seq and bulk RNA-sequencing

BACKGROUND

Oral lichen planus (OLP) is a local autoimmune disease induced by T-cell dysfunction that frequently affects middle-aged or elderly people, with a higher prevalence in women. CD8 + T cells, also known as killer T cells, play an important role in the progression and persistence of OLP. In order to identify different OLP subtypes associated with CD8 + T cell pathogenesis, consensus clustering was used.

METHODS

In this study, we preprocessed and downscaled the OLP single-cell dataset GSE211630 cohort downloaded from Gene Expression Omnibus (GEO) to finally obtain the marker genes of CD8 + T cells. Based on the expression of marker genes, we classified OLP patients into CMGs subtypes using unsupervised clustering analysis. The gene expression profiles were analyzed by WGCNA using the "WGCNA" R package based on the clinical disease traits and typing results, and 108 CD8 + T-cell related OLP pathogenicity-related genes were obtained from the intersection. Patients were once again classified into gene subtypes based on intersection gene expression using unsupervised clustering analysis.

RESULTS

After obtaining the intersecting genes of CD8 + T cells related to pathogenesis, OLP patients can be precisely classified into two different subtypes based on unsupervised clustering analysis, and subtype B has better immune infiltration results, providing clinicians with a reference for personalized treatment.

CONCLUSIONS

Classification of OLP into different subtypes improve our current understanding of the underlying pathogenesis of OLP and provides new insights for future studies.

Association between oral lichen planus and systemic conditions and medications: Case-control study

OBJECTIVE

The aim of this study is to investigate the association between oral lichen planus (OLP) and a variety of systemic conditions, medication, and supplement usage.

MATERIALS AND METHOD

A total of 156 patients diagnosed with OLP and 156 controls at Columbia University Irving Medical Center from 2000 to 2013 were selected as part of the matched (1:1) case-control study. Demographics, systemic conditions, prescription medications and supplements were extracted from the patients' medical records. A univariable conditional logistic regression (CLR) analysis was performed to calculate unadjusted odds ratio, to identify significant variables associated with OLP (p < .10). Significant variables were further tested using multivariable CLR analysis with both forward and backward selection to calculate adjusted odds ratio (aOR) and further distinguish variables associated with OLP (p < .05).

RESULTS

This analysis identified six significant variables: thyroid disorder (aOR:5.1,95%CI:2.3-11.2), any form of cancer (aOR:3.4,95%CI:1.4-8.4), type 2 diabetes (aOR:2.8,95%CI:1.2-6.3), hyperlipidemia (aOR:2.3,95%CI:1.3-4.1), oral sedative usage (aOR:6.3,95%CI:1.8-22.5), and vitamin D supplementation (aOR:2.7,95%Cl:1.3-6.0).

CONCLUSION

Thyroid disorders, cancer, type 2 diabetes, hyperlipidemia, sedatives, and vitamin D supplementation were found to be associated with OLP. Additional investigation is required to explore these associations, which could shed light on the potential mechanism of OLP and reinforce the idea that oral lesions could be predicative of previously undetected systemic conditions.

Oral Health Messiers: Diabetes Mellitus Relevance

This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for "diabetes mellitus and oral complications" was done. The search was also carried out for "diabetes mellitus" and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45-88% in patients with type 2 diabetes compared to 38.3-45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.

Oral lichen planus and associated comorbidities: An approach to holistic health

Lichen planus (LP) is a chronic inflammatory disorder with involvement of skin, oral and genital mucosa, scalp, and nail appendages. Oral lichen planus (OLP) lesions demonstrate a number of morphologic presentations, persist for a long time with rare self-resolution, and undergo malignant changes. OLP has been associated with numerous systemic connotations such as metabolic syndrome, diabetes mellitus, hypertension, thyroid diseases, psychosomatic ailments, chronic liver disease, gastrointestinal diseases, and genetic susceptibility to cancer. The oral health physician should be aware of these systemic associations and should work in close connect with the primary healthcare physicians to rule out the predisposing factors for the associated comorbidities. This article aims to highlight the various systemic associations of OLP and warrants the screening of these ailments in OLP for prevention and effective management.

Clinical profile of 102 patients with oral lichen planus in Thailand

Background

Oral lichen planus (OLP) is a chronic inflammatory disease of the skin and mucous membrane presented with various clinical appearances. The aim of the present study was to elucidate the clinical profile of patients with OLP.

Material and Methods

The dental records of 102 patients who visited Oral Medicine Clinic, Dental Hospital, Naresuan University during 2002-2018 were retrospectively reviewed.

Results

There were 75 (73.5%) women and 27 (26.5%) men, giving a female to male ratio of 2.8:1. The age of OLP patients ranged 20-81 years old with the mean age of 56.4 ± 13.2 years old. Seventy-eight patients (76.5%) had the history of systemic diseases and hypertension was the predominantly one. Most patients were non-smokers (98%), non-drinkers (86.3%) and non-betel nut chewers (98%). The atrophic form (93.1%) was the most common OLP. The lesions were mainly symptomatic (92.2%) and involved multiple locations (67.6%) where the buccal mucosa (79.4%) primarily affected. Only 2% were extraoral lesions detected on the skin. Patients had no family history of OLP or malignant transformation. Ninety-one patients (89.2%) were treated with topical steroid and only 4 patients were prescribed a combination of tropical and systemic steroid.

Conclusions

The results of the study indicated that most of characteristics are in accordance with previous studies. Since, OLP is a chronic inflammatory oral mucosal disease with high recurrence rate, early detection, accurately diagnosis, and long-term follow-up are necessary to evaluate the exacerbation and malignant transformation.

Key words:Clinical profile, demographic, oral lichen planus, retrospective study.

Knowledgeability, attitude, and practice behaviors of primary care providers toward managing patients' oral health care in medical practice: Wisconsin statewide survey

BACKGROUND

In this study, the authors sought to explore the receptivity, preparedness, and rates of adoption of integrated medical-dental models of care (MOCs) in the practice setting among primary care providers (PCPs) treating patients with diabetes mellitus (DM).

METHODS

The authors conducted an anonymous statewide survey targeting PCPs across a range of Wisconsin-based practice settings to evaluate knowledgeability, attitude, practice behaviors, and perceived barriers to oral health screening in a medical setting. Qualitative analytical approaches included thematic analyses applied to evaluate the status of and barriers to integrated medical-dental MOC adoption.

RESULTS

The integrated medical-dental MOC adoption rate was 34%. Top perceived barriers to integrated medical-dental MOC adoption included insurance coverage (71%) and care access (70%). A total of 39% indicated competency for educating patients about the association between DM and periodontitis. Although 72% of PCPs indicated optimal periodicity for oral health assessment as frequent, 39% reported frequently conducting such assessments.

CONCLUSIONS

Although PCPs indicate receptivity to integrated medical-dental MOCs, PCPs identify suboptimal education, lack of adequate training in oral-systemic disease assessment, and barriers to oral health care access as barriers to integrated medical-dental MOC adoption.

PRACTICAL IMPLICATIONS

Integrated medical-dental MOC adoption in care delivery to patients with DM remains below average. Interdisciplinary efforts and education are needed to address identified barriers to care integration.

Evaluation of the Salivary Level of Cortisol in Patients with Oral Lichen Planus: A Meta-Analysis

Background and objective: Cortisol, as the main human glucocorticoid, is considered to be a biological marker of stress and anxiety. Since it is known that oral lichen planus (OLP) can appear and worsen during stressful events, cortisol levels have been previously studied in OLP patients. The present meta-analysis aims to assess the salivary concentration of cortisol in OLP patients compared to healthy controls. Materials and methods: Web of Science, PubMed, Cochrane Library, and Scopus databases were searched up to October 2018. The RevMan 5.3 software was used with the mean difference (MD) and 95% confidence intervals (CIs). The CMA 2.0 Software was used to evaluate the publication bias, sensitivity analysis, and meta-regression as possible sources of heterogeneity. Results: 10 studies were analyzed and a total of 269 OLP patients and 268 controls were included. The pooled MD of the salivary levels of cortisol in OLP patients compared with controls was 4.27 ng/mL (95% CI: 2.33, 6.21; P < 0.0001), thus, the salivary level of cortisol in OLP patients was significantly higher than in controls. In Indian-based population studies, a significant difference in the salivary cortisol levels in OLP patients compared with controls was detected (MD = 5.62 ng/mL; 95% CI: 2.67, 8.56; P = 0.0002). In addition, a significant difference in the salivary cortisol levels in the OLP patients compared with the controls was obtained in studies performed with enzyme-linked immunosorbent assay (ELISA) method (MD = 5.33 ng/mL; 95% CI: 2.72, 7.93; P < 0.0001). Conclusion: We suggest that supportive psychological treatment together with the conventional therapy could increase patients' capability to prevent stress, anxiety, and depression.

Mannose-Binding Lectin 2 (MBL2) combined genotypes deficiency is associated with susceptibility for Oral Lichen Planus

Oral Lichen Planus (OLP) is an oral inflammatory condition, mediated by host immune system reaction, presenting basal membrane damages with inflammatory lesions in the mouth and/or skin. In this study, the role of functional polymorphisms in the MBL2 gene, encoding for Mannose-Binding Protein C (MBP-C), a member of the innate immune response and an acute-phase protein able to activate the complement cascade, was investigated to assess a possible association with OLP susceptibility in Italian patients. Two variations at the promoter region (called H/L and X/Y) and three at the first exon (at codon 52, 54, and 57) of the MBL2 gene were analyzed in 69 OLP patients and 244 healthy controls from northeastern Italy. Considering the polymorphisms singularly, the MBL2 X allele and C/T genotype of the D allele (correlated with low MBP-C expression) were associated with susceptibility to develop OLP. Moreover, when taking into account MBL2 combined genotypes, more OLP patients were deficient MBP-C producers than not deficient, who were more represented among healthy controls. MBL2 combined genotypes, responsible for deficient MBP-C production, are associated with an increased risk of developing OLP.

Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “mouth disease”, “oral keratosis”, “oral leukokeratosis”, and “oral leukoplakia”. Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Applying the Taguchi Method to the Optimization of Anticancer Activity of Bacterial Alginate-CuO Bionanocomposite

AIM:

In recent decades, despite various types of cancer inflicting many people worldwide, the existing therapies are not satisfactory and have many side effects. The present study was conducted to optimise the synthesis of novel alginate-CuO nanocomposite with utmost anticancer activity.

METHODS:

In this study, 9 nanocomposites were designed using Taguchi method and three factors including copper oxide nanoparticles, alginate biopolymer and stirring times were assessed at three different levels. The anticancer activity of the synthesised nanocomposites was evaluated on the MCF-7 cell line using the MTT method. Using the Qulitek-4 software, we determined the optimum conditions for the synthesis of alginate-CuO nanocomposite with the highest anticancer activity.

RESULTS:

The results indicated that all three factors (copper oxide, alginate and stirring time) were effective on the anticancer activity of the alginate-CuO nanocomposite. Also, the nanocomposite produced under the conditions of experiment 9 (8 mg/ml of copper oxide, 2 mg/ml of alginate and 60 min of stirring time) provided the highest growth inhibition rate as 75.63% against cancer cells.

CONCLUSION:

The synthesised alginate-copper oxide nanocomposites in this study showed a significant anticancer effect. Therefore, the synthesised nanocomposite under optimal conditions can be used in the design of new anticancer drugs.

Serum and Salivary IgA, IgG, and IgM Levels in Oral Lichen Planus: A Systematic Review and Meta-Analysis of Case-Control Studies

Immunoglobulins (IgA, IgG, and IgM) are significant anti-inflammatory factors. The meta-analysis aimed to assess the serum and salivary levels of Igs as more important immunoglobulins in patients affected by oral lichen planus (OLP) compared to the healthy controls. Four databases, including PubMed/Medline, Scopus, Web of Science, and Cochrane Library as well as Iranian databases were checked up to January 2018 without language restriction. The quality of each involved study was done using the Newcastle⁻Ottawa Quality Assessment Scale (NOS) questionnaire. A random-effects model analysis was done by RevMan 5.3 software applying the mean difference (MD) plus 95% confidence intervals (CIs). The CMA 2.0 software was applied to calculate the publication bias among the studies. Out of 70 studies found in the databases, 8 studies were involved and analyzed in the meta-analysis. The meta-analysis included 282 OLP patients and 221 healthy controls. The pooled MDs of serum levels of IgA, IgG, and IgM were -0.13 g/L [95% CI: -0.24, -0.02; P = 0.02], 1.01 g/L [95% CI: -0.91, 2.93; P = 0.30], and -0.06 g/L [95% CI: -0.25, 0.14; P = 0.56], respectively; whereas, the salivary IgA and IgG levels were 71.54 mg/L [95% CI: 12.01, 131.07; P = 0.02] and 0.59 mg/L [95% CI: -0.20, 1.38; P = 0.14], respectively. Considering the few studies performed on saliva, the results suggested that the salivary levels, especially IgA level had higher values than the serum levels. Therefore, the salivary immunoglobulins can play a significant function in the OLP pathogenesis.

A systematic review and meta-analysis study of salivary and serum interleukin-8 levels in oral lichen planus

Introduction

Interleukin-8 (IL-8) is an important mediator of the host response to injury and inflammation that the clinical severity of oral lichen planus (OLP) is associated with elevated serum IL-8 levels.

Aim

To evaluate serum and salivary IL-8 levels of the OLP patients compared with the healthy controls and measurement of IL-8 level in which sample is more valuable.

Material and methods

Five databases including PubMed/Medline, Web of Science, Science Direct, Cochrane Library and Scopus were searched for the evaluation of serum and salivary IL-8 levels of the OLP patients compared with the healthy controls in the English abstract. The Newcastle-Ottawa Quality Assessment Scale (NOS) was used for checking the quality of the studies. A random-effect model was used for calculating the mean difference (MD) and 95% confidence intervals (CIs).

Results

Nine studies were included in the meta-analysis. The pooled estimate showed a significant difference between two groups that the salivary IL-8 level in the OLP patients was higher than the healthy controls (MD = 766.32 pg/ml, 95% CI: 394.90-1137.75; p < 0.0001) and also the serum IL-8 level in the OLP patients was higher than the healthy controls (MD = 8.38 pg/ml, 95% CI: 3.32-13.44; p = 0.001).

Conclusions

The higher levels of IL-8 in saliva compared with serum suggest that measurement of this marker in saliva may be more useful than serum measurements for determining therapeutic and diagnostic aims.

Effect of diabetes mellitus type 2 on salivary glucose, immunoglobulin A, total protein, and amylase levels in adults: A systematic review and meta-analysis of case-control studies

Background:

Saliva is a fluid with the complex compound which can be used as diagnostic markers for type 2 diabetes (T2D). This meta-analysis evaluated salivary glucose, immunoglobulin A (IgA), total protein, and amylase levels in adult T2D compared with the controls as well as the correlation of salivary glucose levels with serum glucose and hemoglobin A1C (HbA1c) levels in both groups.

Materials and Methods:

Web of Science, Scopus, PubMed, and Cochrane Library databases were searched up to July 2017. A random-effects analysis was performed using the mean difference (MD) and 95% confidence intervals. The search terms were “T2D, IgA, amylase, total protein, or glucose” combination with “saliva.” The studied variables were the sample size, the percentage of male, the mean age, the condition of saliva sampling, and the salivary levels of mentioned factors.

Results:

A total of 25 studies were included in this meta-analysis with 1432 and 900 diabetic patients and healthy controls, respectively. MD of salivary glucose level in patients with T2D, compared with the healthy controls, in fasting and nonfasting conditions were 6.23 mg/dL (P = 0.0002) and 6.70 mg/dL (P < 0.00001), respectively. Furthermore, the fasting salivary total protein in the patients was significantly higher than the controls (MD = 167.96 mg/dL; P = 0.03). Non-fasting salivary amylase and secretory IgA levels were significantly lower in the patients (MD = −48.61 IU/mL; P < 0.00001) than in the controls (MD = −9.42 IU/mL; P = 0.0006), respectively. The pooled estimate showed a significant correlation between salivary and serum glucose in the patients (r = 0.765; P < 0.001) and the controls (r = 0.646; P < 0.001) and between salivary glucose and serum glycated hemoglobin in the patients (r = 0.721; P < 0.001).

Conclusion:

Measurement of these salivary factors can be helpful for diagnostic and monitoring purposes of T2D. In addition, salivary glucose as a diagnostic tool can evaluate serum glucose and HbA1c levels in the diabetic patients.

Lichen planus and diabetes mellitus: Systematic review and meta-analysis

OBJECTIVE

The aim of this study was to perform a systematic review and meta-analysis answering the following questions: (a) "What is the prevalence and risk of oral lichen planus among patients with diabetes mellitus?" and (b) "What is the prevalence and risk of diabetes mellitus among patients with oral lichen planus?".

MATERIAL AND METHODS

A bibliographic search was conducted in PubMed/Medline and Scopus database from 1966 to March 2018, using the following terms: "Lichen planus" AND "Diabetes mellitus" AND "Prevalence" AND "Oral mucosal lesions".

RESULTS

Twenty-two studies were included in this review. Twelve studies assessed the prevalence of diabetes mellitus among patients with lichen planus. The prevalence reported ranges from 1.6% to 37.7% with a relative risk of 2.432. Ten studies assessed the prevalence of lichen planus among patients with diabetes mellitus which showed a prevalence of lichen planus ranging from 0.5% to 6.1% with a relative risk of 1.4.

CONCLUSIONS

Contradictory results were found when analyzing the relationship between lichen planus and diabetes mellitus. Diverse factors should be considered when studying this association for a correct interpretation of results. Diabetes mellitus has high prevalence and morbidity, which is why new case-control studies are needed to further investigate this association.

The burden of Diabetes, Its Oral Complications and Their Prevention and Management

BACKGROUND

Diabetes mellitus (DM), chronic disease, is a public health problem that affects 8.5% adult population worldwide. The number of adults with DM has risen sharply from 108 million in 1980 to 422 million in 2014. In 2012, 1.5 million individuals died because of DM and an additional 2.2 million deaths occurred because of high blood glucose level resulting in cardiovascular and other systemic diseases. DM brings huge economic loss to patients, their families, and healthcare systems. Globally, the cost of DM was US$1•31 trillion in 2015.

AIM

This review article utilised the prevalence data of diabetes mellitus from the World Health Organization and International Diabetes Federation to provide a comprehensive picture of the disease in different parts of the world.

METHODS

Electronic databases such as Google Scholar, Medline via PubMed, Scopus, and Web of Science were used to search the literature. The library resources of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia were used to retrieve studies on the topics of the present review.

RESULTS

Systemic complications of DM include heart attack, kidney disease, limb loss, blindness, and peripheral nerve damage. More than 90% of diabetic patients were found to have oral manifestations. It is known that DM severely damages oral tissues causing periodontal disease, tooth loss, xerostomia, caries, burning mouth disorder, taste and salivary gland dysfunction, delayed wound healing, lichen planus, geographic tongue, and candidiasis. The evidence is mounting about a strong bidirectional relationship between DM and periodontal disease. Unfortunately, many diabetic patients are unaware of the association between DM and oral health, and only a small percentage of them visit the dentist for routine dental check-ups. Changes in lifestyles (control of blood glucose levels and self-care practices), regular dental check-ups with emphasis on periodontal assessment, and reinforcement of oral health instructions can effectively prevent oral complications of DM. Scaling and root planning are effective in improving glycemic control among diabetic patients.

CONCLUSION

Dental professionals should be part of the multidisciplinary team that helps individuals with diabetes.

Correlation Between Oral Lichen Planus and Thyroid Disease in China: A Case-Control Study

BACKGROUND

A possible relationship between oral lichen planus (OLP) and thyroid disease has received attention in recent years.

OBJECTIVE

This study aimed to evaluate the correlation between OLP and thyroid diseases in Chinese ethnic patients.

METHODS

192 OLP patients, 123 patients with oral lichenoid lesions (OLLs), and 162 controls were recruited in this case-control study. All participants received screening for thyroid function and underwent ultrasound. Sex and age of the patients in the three groups were matched. The prevalence of thyroid diseases in the subjects was analyzed. Using logistic regression, the odds ratio (OR) with 95% confidence intervals was appraised for associations between OLP, OLL, and different types of thyroid diseases [Hashimoto's thyroiditis (HT), hypothyroidism, and thyroid nodule].

RESULTS

The prevalence of thyroid diseases in the OLP group (72.4%) and OLL group (68.3%) was higher than the control group (49.4%) with statistical significance. The OR of HT was 3.16 (1.87-5.33) for OLP, 2.09 (1.18-3.70) for OLL, while the OR of thyroid nodule was 2.31 (1.30-4.09) for OLP.

CONCLUSION

Our study suggested a close relationship between OLP/OLL and HT and thyroid nodule in a Chinese population. The possible mechanism behind this association warrants further investigation.

Salivary and serum levels of tumor necrosis factor-alpha in oral lichen planus: a systematic review and meta-analysis study

OBJECTIVE

Tumor necrosis factor-α (TNF-α) has a role in the progression of the oral lichen planus (OLP). The aim of this meta-analysis study was to evaluate the salivary and serum TNF-α levels in patients with OLP.

STUDY DESIGN

We searched in the databases of PubMed/Medline, Science direct, Scopus, Web of Science, and Cochrane Library for studies reported from 1983 to 2016. All studies were checked for evaluation of salivary and serum levels of TNF-α in patients with OLP compared with healthy controls.

RESULTS

Twelve studies were included in the meta-analysis. The mean difference of 7 studies reporting salivary TNF-α levels in patients with OLP versus healthy controls was 25.90 pg/mL (95% confidence interval [CI] 15.31-36.49; P < .00001) and 7 studies reporting serum TNF-α levels was 1.65 pg/mL (95% CI -0.82 to 4.11; P = .19).

CONCLUSIONS

In patients with OLP, the higher levels of TNF-α in saliva compared with serum suggest that measurement of this marker in saliva may be more useful than in serum for determining diagnostic and therapeutic aims.