Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector32140210.17816/pmj40141-52Research ArticleComplicated clinical variants of mucoperiodontal lesions: desquamative gingivitisGilevaO. S.<p>MD, PhD, Professor, Head of the Department of Therapeutic Dentistry and Propedeutics of Dental Diseases</p>o.s.gileva@yandex.ruLibikT. V.<p>Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Therapeutic Dentistry and Propedeutics of Dental Diseases</p>o.s.gileva@yandex.ruE.A. Vagner Perm State Medical University1603202340141521603202316032023Copyright © 2023, Eco-Vector2023<p><strong>Objective.</strong> To study the frequency, clinical and topographic features, risk factors for development, quality of primary diagnosis and treatment of desquamative gingivitis in patients with chronic pathology of the oral mucosa.</p>
<p><strong>Materials and methods. </strong>A cohort cross-sectional clinical study with elements of sociological analysis of patients (<em>n</em> = 314; 99 males and 215 females aged 18 to 62 years), who visited the medical advisory center for oral mucosal diseases (OMD) was conducted. According to the results of clinical and laboratory studies, the diagnosis of the main oral mucosal disease was formulated, and patients with desquamative gingivitis were isolated into a separate group. Hygienic (OHI-S) and periodontal (PMA, BoP, PBI, CPITN) indices were evaluated, and impact of oral pathology on the patients quality of life using OHIP-49-RU index was assessed for objectification of periodontal status.</p>
<p><strong>Results.</strong> High (17.8 %) incidence of desquamative gingivitis was found in patients with chronic oral mucosal diseases of predominantly autoimmune origin (lichen planus, pemphigus vulgaris, erythema multiforme, psoriasis). Desquamative gingivitis develops significantly more often (60.7 %) in women and affects the vestibular surfaces of the anterior-upper dentogingival segment, manifests clinically apparent edema, pain, hemorrhagic and sensory-paresthetic symptoms, which limit the functionality of the patient (chewing, speech, oral hygiene, social communication and professional realization), that significantly reduces the key parameters of patients quality of life.</p>
<p><strong>Conclusions.</strong> The main reasons for chronization of desquamative gingivitis and low effectiveness of its treatment are the following: low level of polyclinic diagnostics, problems of differential diagnosis, the predominant use of irrational, pathogenetically unjustified means and methods of treatment, as well as the lack of interdisciplinary approaches to the planning of complex therapy.</p>Mucoperiodontal lesionsoral mucosal diseasesdesquamative gingivitisperiodontal diseasesМукопародонтальные поражениязаболевания слизистой оболочки ртадесквамативный гингивитзаболеваний пародонта[Shaqman M., Hamdan A., Karadsheh O., Sawair F., Hassona Y. Desquamative gingivitis: a challenging diagnosis for clinicians. Br. Dent. J. 2020; 229 (1): 26–30. DOI: 10.1038/s41415-020-1848-4][Gileva O.S., Koshkin S.V., Libik T.V., Gorodilova E.A., Khalyavina I.N. Periodontal aspects of oral mucosal diseases: lichen planus. Periodontology 2017; 22 (3 (84)): 9–14 (in Russian).][Vaillant L., Chauchaix-Barthès S., Hüttenberger B., Arbielle B., Machet M., Jan V., Goga D., Lorette G. Le syndrome "gingivite érosive chronique": étude rétrospective de 33 cas [Chronic desquamative gingivitis syndrome: retrospective analysis of 33 cases]. Ann Dermatol Venereol. 2000; 127 (4): 381–387.][Libik T.V., Gileva O.S., Kuklina E.A., Kuklin N.S., Rogozhnikov A.G. Mucoperiodontal lesions: improvement of prosthodontic treatment considering the initial indicators of patients’ oral health. Dentistry 2021; 100 (6–2): 22–28. DOI: 10.17116/stomat 202110006222 (in Russian).][Holmstrup P., Plemons J., Meyle J. Non-plaque-induced gingival diseases. J. Clin. Periodontol. 2018; 45 (20): S28–S43. DOI: 10.1111/jcpe.12938][Maderal A.D., Lee Salisbury P. 3rd, Jorizzo J.L. Desquamative gingivitis: Diagnosis and treatment. J. Am. Acad. Dermatol. 2018; 78 (5): 851–861. DOI: 10.1016/j.jaad.2017.04.1140. PMID: 29678379][Cabras M., Gambino A., Broccoletti R., Arduino P.G. Desquamative gingivitis: a systematic review of possible treatments. J. Biol. Regul. Homeost. Agents. 2019; 33 (2): 637–642.][Gileva O.S., Libik T.V., Gibudallina N.V., Sivak E.Yu., Gavrilenko M.S., Beleva N.S., Zadorina I.I. Key dental problems of COVID-19 pandemic period: monitoring of oral health in patients with chronic oral mucosal diseases. Dentistry. 2021; 100 (6–2): 8–15. DOI: 10.17116/stomat20211000628 (in Russian).][Karagoz G., Bektas-Kayhan K., Unur M. Desquamative gingivitis: A review. J. Istanb. Univ. Fac. Dent. 2016; 50 (2): 54–60. DOI: 10.17096/jiufd.57228][Mathew M., Nayak V.S., Ramaiah S.K., Sethuraman S. Desquamative gingivitis: a definite indicator for mucocutaneous disorders. BMJ Case Rep. 2022; 15 (1): e247857. DOI: 10.1136/bcr-2021-247857][Kramer I.R., Pinborg J.J., Bezroukov V., Infirri J.S. Guide to epidemiology and diagnosis of oral mucosal diseases and conditions, World Health Organization. Community Dent. Oral Epidemiol. 1980; 8 (1): 1–26.][Glickman I., Smulow J.B. Histopathology and histochemistry of chronic desquamative gingivitis. Oral Surg. Oral Med. Oral Pathol. 1966; 21 (3): 325–332.][Guiglia R., Di Liberto C., Pizzo G., Picone L., Lo Muzio L., Gallo P.D., Campisi G., D'Angelo M. A combined treatment regimen for desquamative gingivitis in patients with oral lichen planus. J. Oral Pathol. Med. 2007; 36 (2): 110–6. DOI: 10.1111/j.1600-0714.2007.00478.x. PMID: 17238974.][Nazukin E.D., Yakov A.Yu., Gorodilova E.A., Gileva O.S., Libik T.V. Comparative evaluation of various treatment methods efficacy in patients with partial and complete defects of dentition according to oral indicators of quality of life (“Oral Health Impact Profile”, OHIP-49-RU). Dentistry for everyone 2015; 2: 14–18 (in Russian).]