PREPARATION OF PATIENTS WITH ORAL LICHEN PLANUS FOR PROSTHODONTIC TREATMENT

Oral lichen planus (OLP) accounts for an average of 11% of all diseases of the oral mucosa. The management of OLP, particularly of its erosive-ulcerative form, remains one of the important and not yet fully resolved problems in clinical dentistry. Since the disease typically affects patients over 40 years of age, predominantly women, it is often accompanied by partial or complete tooth loss. Achieving stable remission through comprehensive therapy is the essential prerequisite for prosthetic rehabilitation of patients with OLP presenting with defects of the hard dental tissues and dentition. During remission, the prosthodontist’s task is to provide rational prosthetic treatment using inert, biocompatible restorative materials. Aim. To identify a clinically effective comprehensive method of preparing patients with OLP for prosthodontic treatment, particularly those with the erosive-ulcerative form and partial or complete tooth loss. Material and methods. Dental examination, OLP treatment, and complete oral cavity sanation were performed in 56 patients aged 26 to 88 years with OLP and partial or complete tooth loss, referred to the Ural State Medical University for assessment of the feasibility of rational prosthetic treatment. Women accounted for 78.6% (n = 44) and men for 21.4% (n = 12). Two comprehensive OLP treatment regimens were compared during preprosthetic preparation: conventional comprehensive therapy including oral glucocortic oids, and a modified regimen including hydroxychloroquine, levocetirizine, and topical mometasone furoate lotion (Elocom). Conclusion. The results of clinical and laboratory investigations, together with the assessment of quality of life using the OHIP-14 questionnaire at different stages of followup, allow us to recommend modifying the conventional treatment of OLP by adding hydroxychloroquine, levocetirizine, and topical mometasone furoate lotion. This should be followed by rational prosthetic treatment during remission using metal-free and monomerfree restorative materials.