Desquamative Gingivitis - A Clinicopathological Review.

This article aims to review the etiology, clinical features and diagnosis of desquamative gingivitis in order to outline all the aspects necessary to increase the efficiency of patient management. Because of the polymorphic etiology, dental practitioners may elude the correct diagnose. Consequently, we find it important to underline all the clinical features that desquamative gingivitis may have as well as the associated oral lesions. Also we shortly review the systemic disorders that frequently associate desquamative gingivitis. It is important to know that the muco-cutaneous disorders frequently involved can have an abrupt onset with lesions sometimes confined to the gingiva. In evolution these diseases can be life threatening and a quick treatment can assure not only a more favorable evolution but also a better life quality. Laboratory analyses are mandatory in order to correctly diagnose the main systemic disorder. Histology and direct immunofluorescence investigations are the most accurate. Remission of the underlining disease brings improvement or even resolution of the oral lesions.

Possible salivary and serum biomarkers for oral lichen planus.

There are few reports concerning the potential for clinical application of oxidative stress (OS) and collagen degradation markers in oral lichen planus (OLP) patients. We investigated the possibility of using some disease-related biomarkers in saliva and serum of OLP patients. Our study included 30 patients with OLP and 30 controls. We evaluated serum and salivary OS biomarkers including 8-OHdG, MDA, uric acid, TAC and GPx. We also investigated collagen degradation markers such as CTX I and MMP-8. We found significantly increased salivary levels of MMP-8 and CTX I in the OLP group compared to controls and significant differences between the OLP and control groups in serum and saliva for 8-OHdG, MDA (significantly increased), uric acid, TAC and GPx (significantly reduced). Currently there are no criteria for evaluating which OLP patients have a greater risk of malignant transformation. In addition to clinical surveillance, the serum and salivary biomarkers that we evaluated may be useful biomarkers for monitoring OLP patients in the future.

Oxidative stress markers in oral lichen planus.

Oral lichen planus (OLP) is a relatively common disorder whose cause is still unknown. Oral cancer is preceded in most cases by pre malignant lesions-leukoplasia, submucous fibrosis and lichen planus. Free radicals and reactive oxygen species play important roles in both pathogenesis of lichen planus and carcinogenesis. Thus monitoring systemic and saliva compounds important for the antioxidant defence (oxidative balance) could be important for the clinician's treatment strategy. Thorough medical management and early active treatment are necessary to improve symptoms and might also be a relevant prevention strategy from squamous cell carcinoma risk, although data to fully support this statement still need investigation. The principal aim of this study was to determine the systemic uric acid, GGT, and albumin levels as well as the levels of uric acid and albumin in 20 patients diagnosed with lichen planus and 20 controls. Extensive medline search failed to reveal any study of this type. Our results showed a significant decrease of saliva (p < 0.005) uric acid and an increase in serum gamma glutamyl transpherase (GGT) (p < 0.01) as well as in the total antioxidant capacity of saliva in patient group with respect to the control one. The preliminary conclusion of our study is that uric acid, the most important salivary antioxidant and GGT could be considered in the future as useful markers of oxidative stress for elaboration of treatment strategy and monitoring.