ABSTRACT
Statement of the Problem: A significant proportion of patients undergoing chemotherapy or radiotherapy suffer from mucositis. The first symptom of oral mucositis is pain. Severe pain, burning sensation, and discomfort in the oral cavity make it difficult to continue treatment and even continue living in these patients
Purpose: The aim of this study was to evaluate and compare the effect of amitriptyline mouthwash [in two forms of simple and niosomal] as a local anesthetic agent with benzydamine HCl mouthwash in oral mucositis after radiotherapy or chemotherapy
Materials and Method: This double-blind study was performed on 60 patients with oral mucositis caused by radiotherapy and chemotherapy. The severity of mucositis was determined based on patient judgment; then dental examination was performed and recorded in a checklist. Three groups were assigned based on using either benzydamine HCL, amitriptyline, or niosomal form of amitriptyline. Pain and burning sensation were evaluated with VAS at different time intervals: before use and one, five, ten, and thirty minutes and one hour after using mouthwash. T-test was used to compare the intensity of pain between the two groups. ANOVA and Tukey test were used to compare the intensity of pain between groups
Results: Statistical analyses showed the maximum reduction in pain intensity at two different time intervals [p= 0.04]. Ten minutes after the use of niosomal form of amitriptyline, a 95% decrease in pain was observed. A 99% reduction in pain occurred after the use of simple form of amitriptyline [p= 0.04]
Conclusion: Use of amitriptyline mouthwash had local anesthetic effects in oral mucositis without systemic side effects. Decrease in the severity of pain with the use of amitriptyline mouthwash was more than that of benzydamine HCL mouthwash
ABSTRACT
This cross-sectional survey determined the dental prevalence of apical periodontitis [AP] in selected Iranian population, and evaluated the influence of the quality of root canal treatment [RCT] and their coronal restorations [CR] on the periapical status. A total of 1064 panoramic radiographies were evaluated by two observers during 2009. The quality of RCT i.e. length/density of root fillings and CR in addition to periapical status of endodontically treated teeth were recorded. Their interrelationship was analyzed by Chi-squared, logistic regression and Spearman's rho statistics. Hosmer and Lemeshow tests were used for assessing fitness of logistic regression model and one sample k-s test was used for evaluating of normality of the data. Our results showed that 527 teeth [52%] of the endodontically treated teeth presented with AP radiographically. The percentages of teeth which fulfilled the criteria of an acceptable RCT or CR radiographically were 42.3 and 62.5 respectively. Incidence of AP among teeth with acceptable RCT [29.1%] was significantly lower than those suffering from unacceptable RCT [68.8%] [P<0.001]. Moreover, adequate CR demonstrated a significantly better periapical status [58.6%] compared to teeth with inadequate CR [30.3%] [P<0.001]. The incidence of AP ranged from 25.6% [good qualities] to 79.5% [bad qualities] [P<0.001]. Cases with both unacceptable RCT/CR were 11 times more likely to have AP than cases with acceptable RCT/CR. The quality of RCT and CR were found to impact the periapical health of endodontically treated teeth. There are a significant high number of technically unacceptable endodontic and restorative treatments in Iran; therefore considerable efforts are needed to improve the standards of endodontic and restorative treatments