Clinical evaluation of high and low-level laser treatment [CO[2]vs InGaAlP diode laser] for recurrent aphthous stomatitis

Statement of the Problem: Recurrent aphthous stomatitis [RAS] is one of the most common lesions in the oral cavity. Due to its multifactorial nature, there is no definitive treatment for RAS. Laser therapy is one of the suggested treatments to reduce patient's discomfort

Purpose: The purpose of the present clinical trial is to assess the effect of low and high level laser therapy on pain control and wound healing of RAS

Materials and Method: Thirty six patients with minor RAS were divided into three groups. Group 1 [n=14] received CO[2] laser, group 2 [n=12] were treated with In-GaAlP Diode laser and group 3 [n=10] received sham laser as placebo. All patients were evaluated daily up to 15 days after receiving one session of laser therapy. Pain severity before and after treatment, wound healing, patient's satisfaction, and functional disturbance before and after treatment were recorded for each patient

Results: According to statistical analysis, pain reduction after treatment in group 1 was 7.00+/-2.41, in group 2 was 2.08+/-2.31, and in group 3 was 1.40+/-1.77. In addition, a significant difference was observed in the reduction of functional complications in CO[2] laser treated patients compared to the other two groups

Conclusion: High-level laser treatment showed analgesic effects on RAS, but no healing was observed. Low-level laser therapy demonstrated no positive effect on recurrent aphthous ulcers

[A] comparative in vitro study of the effects of irsha and chlorhexidine mouthwashes and acyclovir on HSV-1

Objective: Being able to cause disease in human, herpes simplex viruses [HSVs] clinically demonstrate themselves as intra-oral, extra-oral or recurrent lesions. The existing acyclovir has the selective anti-herpetic drug to control HSV infections. Due to emerged resistance to this drug and limitations of using it in especial situations, there is a need for alternative treatments such as available mouthwashes. This study aimed to compare two mouthwashes [Irsha and Chlorhexidine] with Acyclovir on HSV-1 in vitro

Methods: In this experimental research, we used MTT [Thiazolyl Blue Tetrazolium Bromide] colorimetric test to determine the cytotoxicity level of three solutions consecutively, antiseptic and nonalcoholic Irsha mouth wash [blue-colored], chlorhexidine 0.2% mouthwash, and acyclovir and absorbed wavelengths were recorded by Eliza Reader. After infecting the cells with different dilutions of HSV-1 in different concentrations of Irsha and chlorhexidine mouthwashes, we analyzed their antiherpetic effects on Vero cells. By using suitable statistical tests in version 15 of SPSS the results were then analyzed

Results: The results showed that in the concentrations of 0.38% for Irsha and 0.003% for chlorhexidine these mouthwashes kill 50% of Vero cells [CC[50]]. After determining CC[50], we detected the antiviral effects of Irsha and chlorhexidine mouthwashes and acyclovir solutions. We observed a significant difference between 0.5% concentration of Irsha mouthwash and other concentrations of it. The least logarithm of virus titration was observed in 0.002% concentration of chlorhexidine mouthwash. Both tested acyclovir concentrations [1250 [micro/ Mililiter and 2500 micro g/mL[micro/ Mililiter] had a similar effect on decreasing virus titre

Conclusion: According to our results, anti-herpetic effect of Irsha is less than chlorhexidine and anti-herpetic effect of Acyclovir and Chlorhexidine is stronger than Irsha

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

Serum level of galectin-3 in patients with oral squamous cell carcinoma

Galectin-3, a member of the family of beta-galactoside-binding animal lectins, has been implicated in tumor invasion and metastasis. Using an ELISA kit, we assessed the circulating levels of galectin-3 in sera from 40 oral squamous cell carcinoma [OSCC] patients and from 43 healthy controls. Serum galectin-3 levels in OSCC patients were significantly higher [5.1 +/- 2.5 ng/ml] when compared with healthy controls [2.6 +/- 3.07 ng/ml, P<0.0005]. There was no apparent correlation between serum galectin-3 concentration and clinico-pathological features such as stage, tumor size, nodal status, distant metastasis and histological grade. This result suggests that, in addition to other tests, measurement of serum galectin-3 concentrations can be utilized as an adjuvant test for establishing a diagnosis of OSCC

incidence of intravascular needle entrance during inferior alveolar nerve block injection

Dentists administer thousands of local anesthetic injections every day. Injection to a highly vascular area such as pterygomandibular space during an inferior alveolar nerve block has a high risk of intravascular needle entrance. Accidental intravascular injection of local anesthetic agent with vasoconstrictor may result in cardiovascular and central nervous system toxicity, as well as tachycardia and hypertension. There are reports that indicate aspiration is not performed in every injection. The aim of the present study was to assess the incidence of intravascular needle entrance in inferior alveolar nerve block injections. Three experienced oral and maxillofacial surgeons performed 359 inferior alveolar nerve block injections using direct or indirect techniques, and reported the results of aspiration. Aspirable syringes and 27 gauge long needles were used, and the method of aspiration was similar in all cases. Data were analyzed using t-test. 15.3% of inferior alveolar nerve block injections were aspiration positive. Intravascular needle entrance was seen in 14.2% of cases using direct and 23.3% of cases using indirect block injection techniques. Of all injections, 15.8% were intravascular on the right side and 14.8% were intravascular on the left. There were no statistically significant differences between direct or indirect block injection techniques [P = 0.127] and between right and left injection sites [P = 0.778]. According to our findings, the incidence of intravascular needle entrance during inferior alveolar nerve block injection was relatively high. It seems that technique and maneuver of injection have no considerable effect in incidence of intravascular needle entrance