Retrospective Study of Oral Lichen Planus and Oral Lichenoid Lesions: Clinical Profile and Malignant Transformation

Statement of the Problem: Oral lichen planus (OLP) and other oral lichenoid lesions (OLL) are reported to have the potential of malignant transformation and dysplastic changes, turning into oral squamous cell carcinoma (SCC). While the world health organization (WHO) has classified OLP as a precancerous lesion of the oral cavity, there is still much debate among researchers about its risks and malignancy potential.  Purpose: The present study aimed to determine malignant transformation in OLP and OLL and understand related risk factors. Materials and Method: This retrospective study was performed on 356 patients of the Oral Medicine Department of Dental School of Kerman Medical University from 1998 to 2020. All patients’ records were gathered. In addition, patients were followed up routinely. Second biopsy was taken as needed. The samples, previously taken from the patients, were re-evaluated according to WHO histopathologic criteria for diagnosing OLP, OLL, dysplasia, and SCC by an experienced pathologist and compared with first reports. Results: Dysplastic changes were observed in 6.2% of the patients. In more than half of the patients, dysplastic changes were present right from the start and 2.20% of the patients had experienced dysplastic changes averagely within 2.05 years of the onset of lesions. Multiple logistic regression showed that the risk of dysplasia increases with aging (p= 0.013), smoking (p= 0.0001), and thyroid disorders (p= 0.008). Conclusion: Given the rather high prevalence of oral lichen planus and lichenoid lesions, further research appears to be needed to determine the etiology of these lesions, malignant transformations, and the factors affecting this probability. Considering the findings, it is imperative to meticulously record the information of all patients with oral lichen planus and lichenoid lesions in the initial examinations as well as close follow-ups and employ diagnostic tools such as toluidine blue staining or even repeat biopsy when necessary

Dental Faculty Experiences of Drug Prescription Patterns: A Qualitative Study

Background: Dental prescribing is considered a basis for short-term treatment of clinical problems. Therefore, dentists should be familiar with the patterns of rational drug prescription. Neglecting this important issue can lead to misprescription and side effects. Accordingly, the present study aimed to investigate the experiences of a group of dental specialists about prescribing drugs.Methods: This qualitative study was conducted using a conventional content analysis approach. A total of 19 specialists from 5 different fields (oral diseases, pediatric dentistry, oral and maxillofacial surgery, endodontics, and periodontics) participated in this study. Purposive and theoretical sampling was used to collect data and semi-structured in-depth interviews were conducted in the form of focus group discussions from each department at Kerman dental school. Data collection and content analysis were performed simultaneously. Results: The analysis of the data revealed five categories including more frequently prescribed drugs, common concerns about prescribing drugs, recommendations for reducing potential side effects, experience of clinical pharmacology training, and criteria for prescribing new drugs.Conclusion: Since the knowledge of dental students affects the quality and effectiveness of treatment and patient safety, this study emphasized the need to improve clinical pharmacology training provided to dentistry students, residents, and dentists