Decreased recurrence of symptoms in oral lichen planus with intralesional injection of hyaluronic acid and triamcinolone.

Oral lichen planus (OLP) is a chronic non-infectious, inflammatory, immunological disease. In contrast to skin lesions, which are often self-limiting, oral lesions rarely heal on their own and can be resistant to local and systemic treatments. In this clinical trial, hyaluronic acid (HA) was mixed with triamcinolone for intralesional injection to reduce side effects in the treatment of OLP. This randomized clinical trial with a split-mouth design was performed on 28 patients with OLP. The mouth was divided randomly into two sides: a test side, which received HA combined with triamcinolone, and a control side, which received triamcinolone alone. The rate of symptom recurrence was 74.1% on the control side and 11.1% on the test side (significant difference, P<0.01). Pain scores did not differ between the two groups when assessed after 2 weeks. The group treated with a combination of HA and triamcinolone experienced a significantly better resolution of lesions and symptoms. Considering the role of HA in tissue healing and in regulating inflammatory responses, as well as its antioxidant and hydration properties, it appears that HA could be effective in improving of OLP and decreasing the rate of symptom recurrence.

Comparative evaluation of low-level laser and CO2 laser in treatment of patients with oral lichen planus.

A comparative evaluation of low-level laser and CO(2) laser therapies was performed, for the treatment of oral lichen planus (OLP). In a randomized open clinical trial, 28 patients with 57 lesions were randomly assigned to two groups. One group received CO(2) laser therapy, the other received low-level laser therapy (LLLT) for 5 sessions every other day. Participants were examined before the treatment, after 2 weeks, and at 1, 2 and 3 months, to assess the changes in sign and symptom scores. Improvements in size of lesions, in pain and clinical response scores were achieved in both groups. After 3 months, clinical response showed 100% and 85% partial to complete improvement in LLLT and CO(2) laser surgery, respectively. This demonstrates a quick and pronounced beneficial effect in controlling symptoms related to OLP. Both methods may be effective in the treatment of OLP, and can be used as alternative therapy alongside standard treatment modalities. The present study showed that LLLT displayed better results than CO(2) laser therapy as alternative or additional therapy, but further investigations in comparison with standard treatment modalities with a prolonged follow-up period will be necessary to confirm the efficacy of laser therapy in the treatment of OLP.

Serum and saliva magnesium in postmenopausal women with xerostomia.

OBJECTIVES: The aim of this study was to investigate serum, stimulated and unstimulated salivary magnesium in postmenopausal women with xerostomia. MATERIALS: A case-control study was carried out on 60 selected postmenopausal women aged 41-77 years with or without xerostomia (30 as cases with xerostomia and 30 as controls without xerostomia), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Unstimulated and paraffin-stimulated saliva samples were obtained by expectoration. Magnesium concentration was determined by the spectrophotometer method. Statistical analysis was carried out using Student's t-test. RESULTS: The mean serum concentration, but not stimulated and unstimulated whole saliva magnesium concentrations, was significantly higher in the cases than in the controls. CONCLUSION: Serum magnesium level appears to be associated with xerostomia in menopause.

Relationship of unstimulated saliva cortisol level with severity of oral dryness feeling in menopausal women.

BACKGROUND: Menopause may be associated with some adverse changes, such as oral dryness (OD) feeling. The exact mechanisms that mediate sensation of OD in menopausal women have not been firmly established. The purpose of this study was to assess the relationship of unstimulated whole saliva cortisol level with severity of OD feeling in menopausal women. METHODS: A case control study was carried out on 70 selected menopausal women with/without OD feeling, conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences, Iran. The xerostomia inventory (XI) score was used as an index of OD feeling severity. Unstimulated whole saliva cortisol concentration was measured by ELISA. Statistical analysis of student's t-test and Spearman correlation was used. RESULTS: The mean cortisol concentration of saliva was significantly higher in women with OD feeling than the control. There was significant positive correlation between the XI score and the concentration of unstimulated whole saliva cortisol (r = 0.559, p = 0.025). CONCLUSIONS: Unstimulated whole saliva cortisol is higher in menopausal women with OD feeling than in controls and this correlates with the severity of OD.

Hepatitis B virus infection in dentistry: a forgotten topic.

More than two billion people have been infected with hepatitis B virus (HBV). Globally, 350-400 million suffer from chronic HBV infection. It is postulated that dentists and dental staff are infected and transmit the virus to their patients more than any other occupation. The aim of this article is to review the HBV incidence in dental society, the points of view of dentists and their patients regarding transmission of the virus during dental procedures, the occurrence of HBV outbreaks in dental clinics and the importance of methods of preventing HBV infection in dentistry.

Increased salivary lipid peroxidation in human subjects with oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory mucosal disease of unknown aetiology. Recently, increased oxidative stress has been implicated in the pathogenesis of various diseases. The aim of this study was to evaluate the total antioxidant capacity (TAC) and lipid peroxidation level, in the saliva of patients with OLP. METHOD: Thirty patients with OLP (15 men, 15 women; mean age 44.0, SD +/- 11.4 years) and 30 control subjects (16 men, 14 women; aged 23-67 years), matched for age and gender, were enrolled in this case and control study. This study was conducted at the Clinic of Oral Medicine of Tehran University of Medical Sciences in 2007. The unstimulated whole saliva malondialdehyde (MDA), as an indicator of lipid peroxidation and TAC levels were assayed by thiobarbituric acid and ferric reducing antioxidant potential (FRAP), respectively, in both groups. RESULTS: Mean levels of saliva MDA, but not TAC, in patients with OLP was significantly higher than those of the control group. CONCLUSION: We conclude that OLP patients have more cellular lipid peroxidation than healthy subjects.

Stimulated whole salivary flow rate and composition in menopausal women with oral dryness feeling.

The aim of this study was to compare stimulated whole saliva flow rate and composition of menopausal women with/without oral dryness (OD) feeling. A case-control study was carried out in 42 selected menopausal women aged 52-73 years with or without OD feeling (21 as case and 21 as control) conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Paraffin-stimulated saliva samples were obtained by expectoration. The stimulated whole saliva composition was measured by a spectrophotometer [magnesium (Mg(+2)), calcium (Ca(+2)), chloride (Cl(-)), inorganic phosphate (Pi) and total protein], flame-photometry [sodium (Na(+))] and ion selective electrode (ISE) [potassium (K(+))] methods. No significant differences were found in stimulated whole saliva flow rate, Mg(+2), Cl(-), Pi, Na(+), K(+) and total protein concentrations between the two groups, but the mean calcium concentration was significantly higher in cases than in controls (P = 0.003). It seems that the level of salivary calcium concentration may be higher in menopausal women with OD feeling than in the control group.

Effect of pilocarpine hydrochloride on unstimulated whole saliva flow rate and composition in patients with chronic graft-versus-host disease (cGVHD).

A double-blind, placebo-controlled study was conducted to evaluate the effect of orally administered pilocarpine on unstimulated whole-saliva flow and composition in 28 patients with chronic graft-versus-host disease (cGVHD). Thirteen patients were treated with pilocarpine of 20 mg/day orally for 7 days, and 15 patients with placebo. Unstimulated whole saliva was collected in the morning on four occasions (30 min before pilocarpine or placebo intake, and 1 h, 1 day and 7 days after the first intake). Significantly, higher salivary flow rates, and sodium and total protein outputs were observed in the second samples of pilocarpine-treated patients compared with controls, whereas calcium and IgA outputs were not altered. Changes in these parameters were not significant in the third and fourth samples, although they were higher in the pilocarpine group. Patients who had received pilocarpine expressed satisfaction with their treatment. These data suggest that pilocarpine may improve salivary flow rate and the feeling of xerostomia in patients with cGVHD.