Evaluation of the clinical effectiveness of diagnosis and monitoring of inflammatory and destructive diseases of the oral mucosa from the standpoint of a patient-guided approach

At present, a significant increase in inflammatory-destructive pathologies of the oral mucosa has been revealed. However, despite the high prevalence and the trend towards a constant increase in the number of diseases, there is no single diagnostic algorithm for examining and managing these patients in dental practice. To solve the above problems, a complex system of a patient-oriented approach to the diagnosis and monitoring of the inflammatory-destructive process in diseases of the oral mucosa was developed.

Aim. To evaluate the effectiveness of the developed complex system of a patient-oriented approach to the diagnosis and monitoring of inflammatory-destructive diseases of the oral mucosa.

Materials and methods. A survey of 60 patients with inflammatory-destructive diseases of the oral mucosa was carried out, which were divided into 2 groups. In the main group, diagnostics and monitoring were carried out using the developed system, in the control group – according to the generally accepted scheme.

Results. Taking into account the data of the study, we can confidently speak about the clinical effectiveness of the developed complex system of a patient-oriented approach to the diagnosis and monitoring of the inflammatory-destructive process in diseases of the oral mucosa. When managing patients using the proposed system, a personalized approach is provided, the dynamics of the course of the pathological process is objectively and accurately assessed, certain periods of clinical observation are offered in order to correct the prescribed therapy regimen.

Conclusions. The use of a patient-oriented approach in the diagnosis and monitoring of the system helps to reduce the time of regeneration of inflammatory-destructive diseases of the oral mucosa, improves the effectiveness of the treatment of this pathology, and also improves the patient's quality of life.

1. Alrashdan MS, Cirillo N, Mccullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016; 308(8): 539-551. DOI: 10.1007/s00403-016-1667-2.

2. Uspenskaya O. A., Tiunova N. V., Timoshenko A. D. et al. Experience in the use of collagen-based drugs in the complex treatment of chronic recurrent aphthous stomatitis. Medical alphabet. 2019; 2(11): 43-45. (In Russ.). DOI 10.33667/2078-5631-2019-2-11(386)-43-45.

3. Iordanishvili A. K. Comparative clinical evaluation of the effectiveness of the treatment of traumatic lesions of the oral mucosa. Periodontology. 2019; 24(90): 67-72. (In Russ.). DOI 10.25636/PMP.1.2019.1.12.

4. Chikunov S.O., Dzalaeva F.K., Utyuzh A.S., Dzhagaeva Z.K. Yumashev A.V. The quality of life of patients with signs of pathology of the temporomandibular joint during complex dental orthopedic rehabilitation. Problems of dentistry. 2020; 16(2): 144-150 (In Russ.). DOI: 10.18481/2077-7566-20-16-2-144-150.

5. Latysheva S.V., Budevskaya T.V. Analysis of the identified lesions of the oral mucosa during the initial admission of patients. Modern dentistry. 2017; 1:34-37. (In Russ.).

6. Makedonova Yu.A., Poroisky S.V., Gavrikova L.M., Afanas'eva O.Yu., Dyachenko S.V., Alexandrina E.S. Comparative analysis of the effectiveness of treatment of traumatic lesions of the oral mucosa in patients with concomitant pathology. Periodontology. 2021; 26(3):229-233. (In Russ.). DOI: 10.33925/1683-3759-2021-26-3-229-233.

7. Radwan-Oczko M, Bandosz K, Rojek Z, Owczarek-Drabińska JE. Clinical Study of Oral Mucosal Lesions in the Elderly-Prevalence and Distribution. Int J Environ Res Public Health. 2022; 19(5): 2853. DOI: 10.3390/ijerph19052853. PMID: 35270543.

8. Yu. A. Makedonova, S. V. Poroisky, L. M. Gavrikova, and O. Yu. The manifestation of diseases of the oral mucosa in patients who have undergone COVID-19. Bulletin of the Volgograd State Medical University. 2021; 1(77): 110-115. (In Russ.). DOI: 10.19163/1994-9480-2021-1(77)-110-115.

9. Titarenko M. A., Stolyarova V. A., Sysolyatin P. G., Baydik O. D. Features of the clinical course of lichen planus of the oral mucosa in patients with impaired carbohydrate metabolism. Clinical dermatology and venereology. 2018; 17(4): 58-64. (In Russ.). DOI 10.17116/klinderma20181704158.

10. Chiang CP, Yu-Fong Chang J, Wang YP, Wu YH, Lu SY, Sun A. Oral lichen planus – Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formos Med Assoc. 2018; 117(9): 756-765. DOI: 10.1016/j.jfma.2018.01.021. Epub 2018 Feb 19. PMID: 29472048.

11. Romano A, et al. Analysis of oral mucosa erosive-ulcerative lesions by reflectance confocal microscopy. J Biol Regul Homeost Agents. 2019. PMID: 31538445.

12. Abaeva O.P., Romanov S.V., Ryabova E.N. Quality of life in patients undergoing kidney and liver transplantation. Preventive medicine. 2020; 23(1): 121-126. (In Russ.)]. DOI: 10.17116/profmed202023011121.

13. Samedov F.V., Kondratieva T.A., Domenyuk D.A. Dynamics of changes in integral indicators of the quality of life and dental status of children with chronic somatic pathology at the stages of complex treatment. Medical alphabet. 2020; 23:34-40. (In Russ.).

14. Verbovoi A.F., Sharonova L.A., Burakshaev S.A., Kotelnikova E.V. Changes in the skin and oral mucosa in diabetes mellitus and their prevention. Medical advice. 2017; 3. (In Russ.)]. DOI: 10.21518/2079-701X-2017-3-54-57.

15. Samulak-Zielińska R, Dembowska E, Lizakowski P. Dental treatment of post-myocardial infarction patients: A review of the literature. Dent Med Probl. 2019; 56(3): 291-298. DOI: 10.17219/dmp/109232.

16. Alimova D. M., Bakhramova F. N., Abdullaeva M. R. Analysis of the microflora of the oral cavity in the clinical course of chronic recurrent aphthous stomatitis. Dentistry. 2020; 1:22-25. (In Russ.). DOI 10.34920/2091-5845-2020-06.

17. Arutyunov S.D., Pertsov S.S., Muslov S.A., Shanidze Z.L. Studies of thresholds of pain sensitivity of the oral mucosa to mechanical stimuli. Russian Dental Journal. 2018; 1:11–17. (In Russ.).

18. Joel B Epstein, Dana C Villines, Shenda Baker Efficacy of a glycopolymer-based oral rinse upon pain associated with ulcerative and erosive lesions of the oral mucosa: A within-subject pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126(3): 240-245. DOI: 10.1016/j.0000.2018.05.009.

19. Ibragimova M. Kh., Ubaidullaeva N. I. Features of the clinical manifestation of chronic recurrent aphthous stomatitis in the oropharyngeal region in patients with chronic cholecystitis. Dentistry. 2020; 4:11-13. (In Russ.). DOI 10.34920/2091-5845-2020-83.

20. Villanueva-Sánchez FG, Escalante-Macías LH, Zambrano-Galván G, Cuevas-González JC, Maya-García IA. Oral lichen planus. Case report and literature review. Rev Alerg Mex. 2018; 65(4): 424-430. DOI: 10.29262/ram.v65i4.342. PMID: 30602213.

21. Spanemberg JC, Cardoso JA, Slob EMGB, López-López J. Quality of life related to oral health and its impact in adults. J Stomatol Oral Maxillofac Surg. 2019; 120(3): 234-239. DOI: 10.1016/j.jormas.2019.02.004.

22. Nejabi MB, Noor NAS, Raufi N, Essar MY, Ehsan E, Shah J, Shah A, Nemat A. Tongue ulcer in a patient with COVID-19: a case presentation. BMC Oral Health. 2021; 21(1): 273. DOI: 10.1186/s12903-021-01635-8. PMID: 34016110.

23. Jana A, Thomas J, Ghosh P. Erosive oral lichen planus inflicts higher cellular stress than reticular type. J Oral Maxillofac Pathol. 2021; 25(2): 279-285. DOI: 10.4103/0973-029X.325127. Epub 2021 Aug 31. PMID: 34703122.

24. Benli M, Batool F, Stutz C, Petit C, Jung S, Huck O. Orofacial manifestations and dental management of systemic lupus erythematosus: A review. Oral Dis. 2021; 27(2): 151-167. DOI: 10.1111/odi.13271.

25. Makedonova Yu. A., Gavrikova L. M., Dyachenko S. V., Dyachenko D. Yu. The effectiveness of telemedicine technologies in the treatment of patients with diseases of the oral mucosa. Bulletin of the Volgograd State Medical University. – 2021; 4(80): 76-81. (In Russ.). DOI 10.19163/1994-9480-2021-4(80)-76-81.

26. Dyachenko D.Yu., Dyachenko S.V. Application of the finite element method in computer simulation to improve the quality of patient care in dentistry: a systematic review. Kuban Scientific Medical Bulletin. 2021; 28(5): 98-116. (In Russ.). DOI: 10.25207/1608-6228-2021-28-5-98-116.

27. Gavrikova L.M., Makedonova Yu.A., Dyachenko S.V. The effectiveness of complex relief of pain in the treatment of patients withdiseases of the oral mucosa. Russian journal of pain. 2020; 18:18-19. (In Russ.).

28. Rashid H, Lamberts A, Diercks GFH, Pas HH, Meijer JM, Bolling MC, Horváth B. Oral Lesions in Autoimmune Bullous Diseases: An Overview of Clinical Characteristics and Diagnostic Algorithm. Am J Clin Dermatol. 2019; 20(6): 847-861. DOI: 10.1007/s40257-019-00461-7. PMID: 31313078.

29. Reren E.V., Toma E.I., Sharifov A.A., Kabanov V.Yu., Malyi A.Yu. Quality of life of a dental patient after orthopedic treatment. Russian dentistry. 2017; 10(2): 62-65. (In Russ.)]. DOI: 10.17116/rosstomat201710262-65.

30. Sekulic S, John MT, Häggman-Henrikson B, Theis-Mahon N. Dental patients' functional, pain-related, aesthetic, and psychosocial impact of oral conditions on quality of life-Project overview, data collection, quality assessment, and publication bias. J Oral Rehabil. 2021; 48(3): 246-255. DOI: 10.1111/joor.13045.

31. Graziani F, Tsakos G. Patient-based outcomes and quality of life. Periodontol 2000. 2020; 83(1): 277-294. DOI: 10.1111/prd.12305.