Oral lichen planus is associated with temporomandibular malfunction

Objective: to investigate whether there is a very close association between isolated oral lichen planus and parafunctions of the masticatory organ. The exact pathogenesis of OLP is still unknown. Mechanical irritation of the mucosa has been supposed as a co-factor in small observation groups. Based on our own clinical experience, we hypothesized that temporomandibular disorders (TMD) may be highly associated with OLP. Methods: In this prospective, case-controlled study 54 (gender: 30m, 24f, 58±13 yrs.) consecutive patients with clinical and histopathological secured isolated oral lichen planus were enrolled. The control group consisted of 51 subjects (gender: 31m, 20f, 50±13 yrs.) matched by age, gender and social economic status. OLP was secured by photodocumented clinical as well as histological means. Exclusion criteria for an enrollment in the study were pretreatment of the OLP, hepatitis C infection, medication with drugs discussed in the pathogenesis of OLP as well as nicotine and alcohole abuse. Informed written consent was obtained by each subject participating in both groups. A complete clinical function analysis of the mastigatory organ was performed. Additionally, symptoms for parafunctions were recorded. Detailed patients history regarding parafunctions, complete dental status and stability of occlusion were recorded. Exact localizations of affected surfaces within the mucosa as well as the extent of the lesions were obtained. For data analysis k-s test, t-test and chi-square test were used. Results: Comparing the two groups a significantly higher count of TMD parafunction signs were assigned in the patients group (p<0.001). Evaluation of parafunctional, muscle palpation and isometric findings showed significant differences comparing the two groups. All findings related to parafunctional activities showed higher scores in the patients group (p<0.001). Conclusions: The results determined a strong association between mucosal lesions and parafunctional findings in OLP-affected patients.