• Journal of Oral Medicine and Pain
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• 제24권2호
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• pp.145-161
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• 1999

The proto-oncogene bcl-2 confers a survival advantage to cells by blocking programmed cell death (apoptosis). Overexpression of bcl-2 probably plays a role in tumorigenesis, and the expression of the bcl-2 protein has been investigated in many kinds of tumors. An increased expression of nitric oxide synthetase(NOS) has been observed in human colon cancer cell lines as well as in human gynecological, breast, and CNS tumors. However there have been only a few reports on the expression of bcl-2 and $NOS_2$ in oral white lesions and cancer. The aim of this study was to investigate the relationship between the expression of Bcl-2 and $NOS_2$ and several pathological parameters such as histological types and layers. We reported desregulation of bcl-2 and $NOS_2$ expression during progression from oral white lesion, lichen planus and leukoplakia to squamous cell carcinoma. The obtained results were as follows: 1. Immunohistochemical analysis with monoclonal antibodies to bcl-2 oncoprotein and $NOS_2$ in formalin-fixed paraffin-embedded tissue sections revealed that bcl-2 expression is restricted to the basal cell layer and $NOS_2$ was mild expressed only in subepithelial inflammatory cells in normal human mucosa. There wasn't specific finding of those in lichen planus and leukoplakia. 2. Bcl-2 immunoreactivity in severe epithelial dysplasia or CIS occurs throughout the epithelium, $NOS_2$ reactivity in most superficial layer were noted. 3. In well-differentiated squamous cell carcinomas, mostly bcl-2 was overexpressed. In moderated and poor squamous cell carcinomas, the expression of $NOS_2$ was increased and that of bcl-2 was decreased. 4. The immunoreactivity of bcl-2 was 12.5% of normal mucosa, 30% of leukoplakia, 44% of lichen planus and 67% of carcinoma in situ. In carcinoma, those were 43%, 50% and 67% according to differentiation, respectively. 5. The immunoreactivity of $NOS_2$ was 25% of normal mucosa, 70% of leukoplakia, 78% of lichen planus and 100% of carcinoma in situ and epithelial dysplasia. In carcinoma, those were higher in moderated(100%) and poor(83%) squamous cell carcinomas than in well differentiated type(71%). 6. The expression of bcl-2 and $NOS_2$ by Western blot was increased highly in lichen planus and leukoplakia. Therefore, the expression of bcl-2 was increased in the white and precancerous lesions and that was decreased by differentiation of carcinoma. However, $NOS_2$ immunoreactivity in carcinoma in situ was lower than those in moderated and poor squamous cell. These findings suggest that the interaction of bcl-2 and $NOS_2$ may be roled importantly in growth and development of carcinoma.

• Journal of Oral Medicine and Pain
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• 제40권4호
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• pp.135-139
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• 2015

Desquamative gingivitis (DG) is a gingival manifestation of systemic mucocutaneous disorders such as mucous membrane pemphigoid, oral lichen planus, and pemphigus vulgaris. The lesion is very painful, so affects the patient's ability to do proper oral hygiene practices. This may be a potential risk factor for long-term periodontal health. However, there is some controversy about the relationship between the existence of DG and periodontal status. Although the correlation between DG-associated diseases and periodontal status is not to be certain, early diagnosis and appropriate treatment including adequate plaque control and removal of local factors is very important for preventing the progression of diseases and destruction of periodontal tissues.

• 대한치과의사협회지
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• 제38권11호통권378호
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• pp.1075-1081
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• 2000

• Journal of Oral Medicine and Pain
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• 제44권1호
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• pp.1-10
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• 2019

Purpose: The aim of this study was to evaluate the optimal doses of intralesional triamcinolone acetonide (TA) in the treatment of oral lichen planus (OLP). Methods: A randomized clinical trial was performed. Sixty-two lesions of OLP were received 12 mg (group A) or 20 mg (group B) of TA intralesionally weekly for 2 weeks. Subjective symptoms, lesion size, favorable conversion of clinical subtypes, and clinical response were evaluated at weeks 0, 1, 2, and 4. Results: After two consecutive injections of TA, group B showed significant reduction in burning sensation and reticular area (p<0.01). Favorable conversion and complete response were greater in group B. Mild oral candidiasis was developed in group B (10.7%). Conclusions: A 20-mg injection of TA was much more effective compared with 12-mg injection of TA in the treatment of OLP.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제33권4호
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• pp.281-287
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• 2007

Purpose: This study was conducted in order to evaluate how chemiluminescent lighting($ViziLite^{(R)}$) could increase the sharpness of margin and contrast to normal mucosa in the diagnosis of oral lichen planus(OLP), the most frequent oral premalignant lesion, compared with direct visual inspection under incandescent light. Methods: 41 consecutive patients, diagnosed to have OLP with visual inspection under incandescent light, were further examined with chemiluminescent light. The degrees of margin sharpness and lesion contrast were ranked on a scale from 1 to 3 for all patients under visual inspection and chemiluminescent light. The presence of additional lesion only detected by chemiluminescent light, complication, and discomfort were checked for each patient. After both screening tests, biopsy specimens were harvested from all patients with scalpels and histopathologic assessments were done. Results: All 41 patients were diagnosed to have OLP by both visual inspection and chemiluminescent light examination. This result was definitively diagnosed by histopathology. Degrees of margin sharpness and lesion contrast were increased by chemiluminescent light compared with visual inspection, but only the difference of lesion contrast was statistically significant. In 22.0% of patients, additional lesions were detected and 88.9% of them were diagnosed to have OLP histopathologically. 17.1% of patients noted discomfort and 9.8% of patients showed complications after chemiluminescent test. Conclusion: Chemiluminescent light may not be proper for the screen test of oral cancer or premalignant lesion but showed some possibility for additional diagnostic tool for definitively diagnosed patients in determination of lesion margin and scope.

• Journal of Oral Medicine and Pain
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• 제46권2호
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• pp.41-48
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• 2021

Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권3호
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• pp.203-210
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• 2004

The purpose of this study was comparing the effectiveness in the topical applications of cyclosporine with that of steroid, the conventional and standard drug in the treatment of oral lichen planus. 21 patients with oral lichen planus were treated with cyclosporine (n=11) or steroid (n=10) by random allocations. They were recalled 2 weeks, 4 weeks, and 8 weeks after initial treatments. In each recall, the lesion size, clinical symptoms like pain or burning sensation, and side effects were evaluated. The differences of these measurements were compared and the effects of each drug were checked. In reticulation types, steroid showed higher effectivity than cyclosporine and this difference was significant statistically. But in erythema type lesions, either drug showed no significant recovery, statistically. However, the effect of cyclosporine was thought to be more effective. The pain of the lesions was significantly decreased by cyclosporine but not by steroid. The decrease of burning sensation was more dependant upon steroid than cyclosporine, but no statistical relationship could be found. There were no clinical side effects. There was limitation to draw in conclusion due to small pool of this study group. But with the results, this suggestion could be proposed that either drug might be superior to another in effectivity in a specific lesion type or patient symptom, so selection and usage of one drug in a specific case could be better than universal application of one drug in all cases.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6979-6983
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• 2013

Background: Oral lichen planus (OLP) is categorized as premalignant lesion although its malignant potential is a matter of controversy. The objective of this study was to investigate Ki67 expression in OLP, oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). Materials and Methods: Expression of Ki67 was evaluated through immunohistochemistry (IHC) in groups of A (17 cases of epithelial hyperplasia), B (16 cases of OLP), C1 (10 cases of mild epithelial dysplasia), C2 (10 cases of severe epithelial dysplasia), D1 (10 cases of well-differentiated OSCC), and D2 (10 cases of poorly-differentiated OSCC). Results: There was a significant difference in Ki67 expression based on quantitative analysis among the six studied groups as well as group B compared bilaterally with groups C2, D1 and D2 (p< 0.0001). However, there was no significant difference between groups B and C1 or between groups D1 and D2 (p> 0.05). Conclusions: Based on the results of the present study it may not be possible to definitely consider malignant transformation potential for OLP. However, expression of Ki67 was significantly higher in OLP than that of epithelial hyperplasia with no significant difference from that of mild epithelial dysplasia. This should be considered by clinicians to carefully and regularly follow up OLP lesions to detect potential subtle changes at an early stage.

• International Journal of Oral Biology
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• 제45권1호
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• pp.1-7
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• 2020

Oral lichen planus (OLP) is a chronic inflammatory disease observed in approximately 0.5-2.2% of the population, and it is recognized as a premalignant lesion that can progress into oral squamous cell carcinoma (OSCC). The rate of malignant transformation is approximately 1.09-2.3%, and the risk factors for malignant transformation are age, female, erosive type, and tongue site location. Malignant transformation of OLP is likely related to the low frequency of apoptotic phenomena. Therefore, apoptosis-related genetic factors, like p53, BCL-2, and BAX are reviewed. Increased p53 expression and altered expression of BCL-2 and BAX were observed in OLP patients, and the malignant transformation rate in these patients was relatively higher. The involvement of microRNA (miRNA) in the malignant transformation of OLP is also reviewed. Because autophagy is involved in cell survival and death through the regulation of various cellular processes, autophagy-related genetic factors may function as factors for malignant transformation. In OLP, decreased levels of ATG9B mRNA and a higher expression of IGF1 were observed, suggesting a reduction in cell death and autophagic response. Activated IGF1-PI3K/AKT/mTor cascade may play an important role in a signaling pathway related to the malignant transformation of OLP to OSCC. Recent research has shown that miRNAs, such as miR-199 and miR-122, activate the cascade, increasing the prosurvival and proproliferative signals.

• Journal of Oral Medicine and Pain
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• 제37권1호
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• pp.19-25
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• 2012

2010년부터 2011년까지 양산부산대학교 치과병원 구강내과에 초진 내원한 외래환자 중 재발성 아프타성 구내궤양(RAU)으로 임상 진단된 환자 20명과 구강편평태선으로 임상진단 된 환자 33명, 부산대학교 치의학전문대학원생 59명을 대조군으로 정하고 간이정신진단검사를 시행하여 다음과 같은 결론을 얻었다. 1. RAU 환자군과 편평태선 환자군, 대조군은 9개 증상차원 기본척도의 T 점수 평균값은 모두 65 이하로 정상범위 내에 있었다. 2. RAU 환자군은 정상 대조군에 비하여 SOM 지수가 유의하게 높았으며 (P<0.05), DEP 지수에서 높은 경향을 보였다. 3. RAU의 여성 환자군은 여성 대조군에 비하여 SOM, DEP, HOS 지수가 유의하게 높았고 (P<0.05), ANX 지수에서 높은 경향을 보였다. 4. RAU 환자군은 편평태선 환자군에 비하여 HOS 지수가 유의하게 높았으며 (P<0.05), O-C, I-S, DEP 지수에서 높은 경향을 보였다.