Natural agents in the management of oral mucositis in cancer patients-systematic review.

INTRODUCTION: Oral mucositis is most severe complication of cancer therapy characterized by ulcerative lesions of oral mucosa causing negative impact on patient's quality of life. Wide variety of therapeutic agents are available to reduce the lesions of mucositis. Currently, natural herbal remedies have become popular in treating this condition due to fewer side effects than synthetic drugs. AIM: The aim of this systematic review is to compile evidence based studies to evaluate the effectiveness of natural agents in the management of oral mucositis induced by chemotherapy or radiotherapy in cancer patients. MATERIALS AND METHOD: Computerized literature searches were performed to identify all published articles in the subject. The following databases were used: PUBMED [MEDLINE], SCOPUS, COCHRANE DATABASE, EMBASE and SCIENCE DIRECT using specific keywords. The search was for limited articles published in English which were read in full by two authors. RESULTS: Twenty six randomized controlled trials satisfied our inclusion criteria. Most studies showed statistically significant result demonstrating the efficacy of natural agents with minimal side effects except manuka honey which was not tolerated by few patients. CONCLUSION: Natural agents proved to be promising in healing cancer induced oral mucositis but future demands further randomized controlled clinical trials on these agents which should also be focused on drug interactions of the natural remedies.

Botulinum toxin in the management of head and neck disorders.

Botulinum toxin is a polypeptide protoxin synthesized by Clostridium botulinum that results in localized reduction of muscle activity by inhibiting acetylcholine release at the neuromuscular junction. In 2004, the US Food and Drug Administration approved its application in the treatment of various medical conditions, such as facial wrinkles, strabismus, cervical dystonia, blepharospasm, and hyperhidrosis. Later, its application extended to improving dental esthetics and gummy smile. It was found to be a safe and effective alternative to medical therapy to treat various head and neck disorders that have a neurologic component. In this review, we will highlight the mechanism of action and therapeutic benefits of botulinum toxin in the management of head and neck disorders.

Molecular and genetic aspects in the etiopathogenesis of ameloblastoma: An update.

Ameloblastoma is the second most common benign epithelial odontogenic tumor and though it is of a benign nature, it is locally invasive, has a high recurrence rate and could potentially become malignant. Many theories have been proposed to explain the pathogenesis of ameloblastoma. Proper understanding of the pathogenic mechanism involved in ameloblastoma and its proliferation aids in constituting proper treatment of choice at an early stage, preventing morbidity associated with extensive therapy. An attempt has been made to discuss the current concepts related to molecular and genetic changes that occur in ameloblastoma as these could affect treatment plan and prognosis.

Efficacy of light based detection systems for early detection of oral cancer and oral potentially malignant disorders: Systematic review

BACKGROUND: Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient survival rates. The aim of this systematic review is to evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of OSCC and OPMD. MATERIAL AND METHODS: The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE] and Science direct. The search was for limited articles published in English or with an English abstract and articles published during the period from January 2005 to April 2014. Clinical trials utilized ViziLite, Microlux TM/DL and Visual Enhanced Light scope (VELscope) for early detection of OPMD and OSCC. RESULTS: Twenty primary studies published satisfied our criteria for selection - 10 utilised chemiluminescence and 10 tissue autofluorescence. Senstivity of Vizilite for detecting OSCC and OPMD ranged from 77.1 % to 100% and specificity was low that ranged from 0% to 27.8%. Most have shown that chemiluminescence increases the brightness and margins of oral mucosal white lesions and thus assist in identification of mucosal lesions not considered under Conventional visual examination. However, it preferentially detects leukoplakia and may fail to spot red patches. Clinical trials demonstrated that sensitivity of VELscope in detecting malignancy and OPMD ranged from 22 % to 100 % and specificity ranged from 16 % to 100%. Most studies concluded that VELscope can help the experienced clinician to find oral precursor malignant lesions. But it could not differentiate between dysplasia and benign inflammatory conditions. CONCLUSIONS: Both devices are simple, non-invasive test of the oral mucosa but are suited for clinicians with sufficient experience and training. More clinical trials in future should be conducted to establish optical imaging as an efficacious adjunct tool in early diagnosis of OSCC and OPMD