RESUMO
OBJECTIVE: To assess the need for prosthodontic treatment and to substantiate the features and perspectives for optimizing prosthodontic treatment in patients with mucoperiodontal manifestations of lichen planus (LP). MATERIAL AND METHODS: For assessment of the need and identification of problematic aspects of prosthetic treatment 74 patients (48.3% of the primary sample of all patients with oral LP) with oral LP-associated mucoperiodontal lesions (MPL) participated in a multicenter open cohort prospective controlled clinical trial with elements of retrospective analysis. The prospective part of the study summarizes the results of prosthodontic treatment of 41 patients (8 men and 33 women aged 45-70 years) carried out using improved therapeutic and diagnostic algorithms applied to the specifics of the MPL forms and stages. RESULTS: The use of standard protocols of prosthodontic treatment without taking into account the status of oral mucosa in patients with oral LP was associated with the development of nonspecific (prosthetic stomatitis - 25.8%; contact-allergic stomatitis - 22.6%; focal hyperplasia - 16.1%; decubital ulcers - 12.9%, etc.) and oral LP-associated specific reactions (Kebner's symptom - 35.5%; transformation of the typical form into complicated ones - 22.6%; desquamative gingivitis and gingival lichenization - 19.4% each; gum recession - 16.5%) with the involvement of skin and mucous membranes of other localizations (6.5%) and the appearance of symptoms of carcinophobia/dentophobia (25.8%). Prosthetic treatment according to improved protocols for the management of patients with oral LP indicated a decrease in the frequency of nonspecific oral mucosal reactions (by 70.7%, p<0.001), single (4.8%) specific reactions, improvement of masticatory efficiency by 32.8-55.3% (p<0.01), harmonization of speech function, maintenance of a high level of hygiene of prostheses, a significant reduction in the time of adaptation to removable dentures and increased satisfaction with the results of treatment on the GRS scale (1.06±0.3 points after treatment; 3.8±0.5 points before treatment; p<0.001). CONCLUSION: The best dynamics of clinical and sociological indicators was noted in persons with prosthetic replacement structures based on implants.
