Comparison of the effects of transcutaneous electrical nerve stimulation and low-level laser therapy on drug-resistant temporomandibular disorders

Statement of the Problem: Temporomandibular disorder [TMD] is a clinical term used for clinical signs and symptoms that affect the temporomandibular joints, masticatory muscles, and associated structures. Surgical and non-surgical treatments can be used for management of TMD. Non-surgical route is the main part of the treatment, since clinicians prefer non-aggressive treatment for TMD such as pharmacological and physical therapy. Low-level laser therapy [LLLT] and transcutaneous electrical nerve stimulation [TENS] are the main procedures in physical therapy

Purpose: The aim of this study was to evaluate the effectiveness of TENS and LLLT in treatment of TMD patients who did not respond to pharmacological therapy

Materials and Method: This clinical trial was performed on 45 patients who randomly received either TENS or LLLT for 8 sessions. LLLT was applied with diode laser [Ga-Al-As, 980nm, dose 5micro/cm[2]] and TENS by using two carbon electrodes with 75 Hz frequency [0.75 msec pulse width]

Helkimo index and visual analogue scale [VAS] were measured during the treatment period and throughout the follow-up sessions

Results: Significant reduction in the VAS and Helkimo index was observed in both TENS and LLLT group. There was no significant difference between the two methods during the treatment; however, TENS was more effective in pain reduction in follow-ups

Conclusion: This study justified the use of TENS therapy as well as LLLT in drug-resistant TMD. Both were useful in relieving the pain and muscles tenderness, although, TENS was more effective than LLLT

Evaluation of the Ki-67 and MCM3 expression in cytologic smear of oral squamous cell carcinoma

Statement of the Problem: Squamous cell carcinoma [SCC] is the most frequent oral cancer whose 5-year survival rate is 80% for early-detected lesions and nearly 30-50% for advanced lesions. Early detection of oral cancers and precancerous lesions can improve the patient's survival and decrease the morbidity

Purpose: This study aimed to evaluate and compare the Ki-67 and MCM3 expression in cytologic smear of oral SCC [OSCC]

Materials and Method: We examined 48 oral brush biopsies including 28 OSCC and 20 healthy non-smoking samples. Immunocytochemistry staining was performed for Ki-67 and MCM3 by using an EnVision-labeled peroxidase system, and labeling index [LI] was calculated

Results: Out of 28 OSCC cases, 27[96.4%] cases contained MCM3 positive cells and 22[78%] cases contained Ki-67 positive cells. All normal mucosa were Ki-67 and MCM3 negative. MCM3 and Ki-67 LI were significantly higher in OSCC than normal mucosa [p< 0.001]. MCM3 LI was significantly higher than Ki-67 LI in OSCC group [p< 0.001]

Conclusion: Immunocytologic evaluation of Ki-67 and MCM3 can be used for early detection of OSCC. Furthermore, MCM3 may be a more sensitive cytologic bi-omarker than Ki-67 in SCC patients

Susceptibility of candida albicans and candida dubliniensis to photodynamic therapy using four dyes as the photosensitizer

Statement of the Problem: Oral candidiasis is the most common opportunistic infection affecting the human oral cavity. Photodynamic therapy, as one of its proposed treatment modalities, needs a distinct dye for achieving the best effect

Purpose: The purpose of this study was to evaluate photosensitization effects of four distinct dyes on standard suspension of Candida albicans [C. albicans] and Candida dubliniensis [C. dubliniensis] and biofilm of C. albicans considering the obtained optimum dye concentration and duration of laser irradiation

Materials and Method: In this in vitro study, colony forming units [CFU] of two sets of four groups of Laser plus Dye [L+D+], Dye [L-D+], Laser [L+D-] and No Laser, No Dye [L-D-] were assessed individually with different methylene blue concentrations and laser irradiation period. The photodynamic therapy effect on standard suspension of Candida species [using methylene blue, aniline blue, malachite green and crystal violet] were studied based on the obtained results. Similar investigation was performed on biofilm of C. albicans using the spectral absorbance. Data were imported to SPSS and assessed by statistical tests of analysis of variance [ANOVA] and Tukey test [alpha= 0.05]

Results: CFU among the different dye concentration and irradiation time decrease in dose- and time-dependent manner [p> 0.05], all of which were significantly lower than the control groups [p< 0.05]. Among the examined photosensitizers, there was no statistically significant difference, [p> 0.05] though all of them were significantly decrease CFU compared with the control groups [p<0.05]. In L+D- and L+D+ groups, biofilm was significantly destroyed more than that of L-D- [p< 0.05]

Conclusion: Photodynamic therapy might be used as an effective procedure to treat Candida associated mucocutaneous diseases and killing biofilm in the infected surfaces such as dentures

In vitro inhibitory effects of chlorhexidine and Persica mouthwashes on HSV-1 compared with acyclovir

Recurrent intraoral herpes is a common oral disease that causes painful ulcers and viral shedding, resulting in various complications for patients. The antiviral efficacy of oral mouthwashes has not been adequately studied, although they are a readily available and rapid treatment modality for oral ulcers. In this experimental study, viricidal effects of chlorhexidine and Persica mouthwashes on Vero cell lines were examined, before and after HSV-1 infection of the cells, in the presence of various concentrations of mouthwashes at different time intervals by using quantal assays. Then the results were compared with those of acyclovir. The 50% cytotoxic concentrations [CC[50] of the two mouthwashes were determined. Data was analyzed by one-way and two-way ANOVA [alpha = 0.05]. CC[50] of Persica at 5- and 30-minute intervals were 0.2% and 0.14%, respectively. Chlorhexidine was toxic at durations more that 5 minutes. Before inoculation, both mouthwashes showed viricidal effects and Persica showed more viricidal effect than chlorhexidine and acyclovir [p values of 0.0001 and 0.04, respectively]. After virus inoculation antiviral effects of these mouthwashes were only limited to concentrations above 1/4. Acyclovir demonstrated the highest antiviral effect [p value = 0.0001]. Considering the better direct anti-HSV effect of the herbal mouthwash, Persica, and its less side effects compared to chlorhexidine, it can be used to reduce oral fluid contamination caused by viral shedding and reduce infectivity ofintra-oral ulcers