Abstract
Few studies have already been performed to assess oral bacteria during steroid therapy for oral lichen planus (OLP). Thus, the aim of our study was to analyze the effect of dexamethasone mouthrinse treatment on the oral bacteria of OLP patients. This prospective study was conducted on patients who were diagnosed with OLP and treated with 0.05% dexamethasone mouthrinse twice per day for 4 weeks. Using unstimulated saliva of the patients before and after treatment, the qualitative and quantitative changes in oral bacteria were analyzed using quantitative real-time polymerase chain reaction (qPCR). The qPCR results were analyzed using Wilcoxon signed-rank test to the quantitative changes with dexamethasone mouthrinse. The statistical significance was considered at a level of 0.05. In total, 20 patients were enrolled in this study, wherein all were noted to show improved symptoms of OLP. Fifteen patients (75%) had a qualitative change in the oral microbial species and an improved relative periodontitis risk score (from 26.1 ± 10.7 to 20.9 ± 9.2; p = 0.008). However, quantitative changes in all species were determined to be not statistically different before and after the treatment. Most OLP patients had a changed microbial community composition after 0.05% dexamethasone mouthrinse for 4 weeks. In particular, the composition of the periodontopathic bacteria was improved after the treatment.
Highlights
Oral lichen planus (OLP) has been identified as a relatively common chronic mucosal disease that occurs in 0.1–4% of the total population [1]
The detection frequency was decreased for four microbial species: Tannerella forsythia (Tf) (65% to 50%), Treponema denticola (Td) (15% to 10%), Prevotella intermedia (Pi)
Fusobacterium nucleatum (Fn) and Streptococcus mitis (Sm) were detected in all OLP patients, and the other species were observed in the following order: Prevotella nigrescens (Pn) (75%), Tf (65%), Porphyromonas gingivalis (Pg) (55%), Streptococcus mutans (Smu)
Summary
Oral lichen planus (OLP) has been identified as a relatively common chronic mucosal disease that occurs in 0.1–4% of the total population [1]. Histological features of OLP include hyperkeratosis, destruction of basal cells and the basement membrane, T-lymphocyte infiltration in adjacent connective tissue, and the appearance of Civatte bodies [2]. In terms of these characteristics, the origin and development process of OLP has not yet been clearly elucidated. It has been revealed that OLP is an autoimmune disease in which an immunologically mediated attack by T-lymphocytes destroys keratinocytes [3]. Treatment of OLP cannot be focused on a specific target; it is limited to symptomatic treatment using immunomodulatory therapy. Steroid therapy has been most commonly used in symptomatic management, which includes topical application and
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