Introduction. In recent years, a special scientific interest has been manifested on the role of the state of oral hygiene in the development of Oral Lichen Planus (OLP). The microbiotope of the oral cavity with an unsatisfactory state of hygiene can be considered as a “perturbing” agent capable of inducing the development of distorted reactions, both specific and nonspecific defense factors, with further occurrence of an autoimmune component in the pathogenesis of OLP. The expressed antigenic load caused by an unsatisfactory oral hygiene probably disrupts the recognition of “one’s own” – “alien”, makes it impossible or difficult to eliminate the antigen + antibody + complement complex, circulating immune complexes (CIC), and thus maintains a steady imbalance. Frequent failures in the treatment of OLP or a short period of remission may be due to a simplified understanding of the role of oral hygiene in the treatment of OLP. The aim of the study was to determine the role of oral hygiene in the pathogenesis of CRPD in individuals with a pattern of genetic determinism to OLP. Materials and methods. The study used clinical and immunological methods of investigation. Under dynamic observation there were 273 patients with OLP, with ages between 21 and 45 years, among them 73 patients with a typical form of CPL and 200 with an erosive form of OLP. All examined patients of the main group belonged to the group risking the development of OLP in their genotype-phenotypic characteristic O (I), P1+, MN, Je(a-b +). To assess the hygienic state of the oral cavity, standard indices – Fedorova- Volodkina and the simplified Green-Vermillion index – were used. For DH determination, inhibition of the migration of leukocytes (RILM) to strepto- and staphylococcus antigens was used. Results and discussion. The study evidenced that a delayed-type hypersensitivity to streptococcus according to RILM was observed in 87.1 ± 3.31% cases, with an erosive form of OLP with red lip rupture, and hygiene Fedorov-Volodkina and Green Vermillion indices of 2.1 ± 0.1 and 1.8 ± 0.2, respectively. In patients with an erosive form of OLP without lesion of the red border, DH to streptococcus occurred in 59.2 ± 5.46% of cases. An unsatisfactory state of oral hygiene was noted in 91.0% of the examined subjects, where the Fedorov-Volodkina and the Green Vermillion indices were of 2.0 ± 0.2 and 1.7 ± 0.1, respectively. A typical form of OLP was associated with DH to streptococcus in 62.0 ± 5.68% of cases. Conclusions. The level of hygiene of the oral cavity is directly correlated with various forms of OLP. The erosive form of OLP, with or without the involvement of the red lip rim in the pathological process, was most often associated with an unsatisfactory state of oral hygiene. A direct correlation was established between the level of CIC and the state of oral hygiene in patients with an erosive form. There is no correlation between the state of oral hygiene and the flat form of OLP and level of CIC.
Keywords:- delayed type hypersensitivity
- indices of hygiene.
- inhibition of leukocyte migration
- oral lichen planus