Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus. Part II 4-Year Follow-Up

Abstract

Purpose: To evaluate marginal bone loss (MBL) of dental implants inserted in active lichen planus patients.

Materials and methods: The study included 59 subjects divided into 3 groups depending on their lichen planus diagnosis and administration of a low dose of corticosteroids: 17 healthy individuals, 20 controlled lichen planus patients controlled using low doses of systemic corticosteroids, and 22 noncontrolled lichen planus patients. During 4-year follow-up sessions MBL was evaluated, and biopsies were collected from lichen planus patients and examined. Two-way ANOVA was used to analyze the data (α = 0.05).

Results: There was no statistically significant difference in MBL between healthy and controlled patients; however, noncontrolled patients exhibited increased MBL (F = 1309, p < 0.001) which reached 2.53 mm after 4 years. There were significant interactions between state of the disease (F = 1309, p < 0.001), evaluation time (F = 317, p < 0.001), and interaction between state of the disease and observation time (F = 159, p < 0.001). Histopathologic examination of collected biopsies revealed healthy tissue architecture of the controlled patients, while inflammatory cellular infiltration and signs of classical destructive tissue were observed for noncontrolled patients.

Conclusions: Lichen planus patients receiving dental implants should be controlled on a low-dose of corticosteroids to prevent accelerated MBL and to reduce remission of clinical manifestations.

Keywords: Corticosteroids; fixed implant-supported prosthesis; implant; inflammatory infiltrate; lichen planus; long-term survival; marginal bone loss; osseointegration.