Combined treatment of dexamethasone mouthwash and low-level laser therapy in the management of aphthous-like ulcers caused by nonsteroidal anti-inflammatory drugs: A case report.

A case of major aphthous-like ulcer was described in a 50-year-old patient. The patient showed the main signs of aphthous stomatitis painful ulcer, 1-2 cm in diameter, located on the ventral of the tongue, buccal mucosa, and the palate. These ulcers persisted for more than 3 weeks. The patient's self-administration of a nonsteroidal anti-inflammatory drug (NSAID) was suggested as the leading cause of aphthous-like ulcers in this case. ulcers were treated with dexamethasone mouthwash and low-level laser therapy (LLLT).

Exploring How People Interact With Dental Misinformation on Social Media: A Cross-Sectional Study.

BACKGROUND: Social media has been widely utilized to spread health-related information, which has led to the possibility of spreading medical misinformation. The extent of the issue is unknown, even though policymakers, researchers, and medical professionals agree that health misinformation must be controlled and combated. OBJECTIVE: A cross-sectional study was conducted by the faculty of dentistry at Damascus University. METHODS: This quantitative cross-sectional study used a voluntary questionnaire distributed online in social media groups. Participants were of different ages, genders, and educational levels. RESULTS: Of the 301 questionnaires collected, 291 were analyzed. The study sample comprised secondary education certificates, university students, and postgraduate students. 96.6% of the study sample used two or more SM applications. 71.5% of the study sample uses Facebook more than other applications for dental information research, followed by Instagram (14.8%), Telegram (8.2%), and finally WhatsApp (5.5%). There was a significant difference between the age of the respondents and the SM application they used most (p = 0.027). 46.4% of the study sample were neutral in their answer about what they believed in the trust of information on SM sites, followed by 42.3% who did not agree with the trust of information on SM sites and 11.3 who agreed. 89.7% of the study sample visit the dentist when facing a medical problem, while 10.3% follow advice on SM sites. There was a significant difference between the age of respondents and the source they relied on when facing a medical problem (p = 0.019). 50.2% of the study sample sometimes feels that the advice on SM sites is marketing for a company or product or advertising for doctors and not others. CONCLUSION: In particular, understanding the methods and prevalence of health misinformation, as well as the current gaps in knowledge in this area, will help us to guide future research and, more specifically, to develop evidence-based digital policy action plans targeted at addressing this public health issue through various social media platforms.

Efficacy of Hyaluronic Acid in Relieving Post-implantation Pain: A Split-Mouth Randomized Controlled Trial.

Background Many patients suffer from some degree of pain following the surgical procedures of dental implantation. The fear of pain may be one reason for postponing such prosthodontic treatments. Many procedures have been suggested to control post-implantation pain. This trial evaluated the effectiveness of using hyaluronic acid (HA) during dental implantation on patients' perceived pain during the postsurgical soft-tissue healing period. Methodology A split-mouth randomized controlled trial (RCT) was conducted. The trial sample consisted of 22 dental implants in 11 patients (five males and six females). Patients were selected from those attending the Department of Oral Medicine at the Faculty of Dentistry, University of Damascus between February 2021 and May 2022. The implants were performed in similar bone quality and density for each patient as the implants were inserted in the same jaw on both sides to ensure the same physiological conditions. The study sample was divided into two groups. The first group (the experimental group) consisted of 11 implants in which the implant site was drilled, following which HA was placed inside the implant site and on the surrounding bone before the flap was returned and sutured. The second group (the control group) comprised 11 implants following the conventional procedure without applying any material to the implant socket. The main outcome measure was pain perception which was assessed using the visual analog scale (VAS). Patients were asked to record their perceived pain on the first, third, and tenth days. Two-sample t-tests were used to detect significant differences. Results There were statistically significant differences in the mean pain intensity between the experimental and control groups on the first, third, and tenth days (p < 0.05). The mean values of perceived pain in the control group were 5.68, 1.72, and 0.56 on the first, third, and tenth days, respectively. In comparison, the mean values of perceived pain in the experimental group were 4.52, 1.14, and 0.18 on the first, third, and tenth days, respectively. The maximum perceived pain in the control group was 7.5 on the first day following implantation, whereas the maximum value recorded in the experimental group was 6.5. At the third assessment time (i.e., 10 days following the surgical intervention), the mean values were in the very mild category of pain intensity. Conclusions This study showed that applying HA in the implant cavity and on the surrounding bone effectively reduced pain after dental implant surgery in comparison with the control group. Patients had lower mean pain scores at one, three, and ten days following surgery compared to the conventional method. HA is suggested to be an adjunctive method to control postsurgical pain after dental implantation.

Assessment of the Possible Correlation between the Presence of Helicobacter Pylori Infection and Hairy Tongue Lesion in a Group of Patients in Syria: A Cross-Sectional and Pilot Study.

BACKGROUND: This study aimed to evaluate the correlation between the presence of hairy tongue and H. pylori infection in patients referring to their blood test based on the serum levels of anti-H pylori IgG antibodies. METHODS: This cross-sectional study was conducted in the Department of Oral Medicine, University of Damascus Dental School, between February 2021 and January 2022. The sample size of 40 patients (23 males, 17 females), whose ages ranged from 20-79 years with a mean age of 41.5 ± 12 years, was calculated using the G*power 3.1.3, with a statistical power of 80% and a significance level of 0.05. The hairy tongue index was assessed by a visual method based on observing the dorsum tongue appearance. Then, a blood test was performed to detect the presence of H. pylori by Immulite 2000 XPi. Statistical analysis was performed using SPSS software 22.0, Chi-square. RESULTS: The prevalence of hairy tongue was higher among males (75%) as compared to females (25%) and was found to be statistically significant (p = 0.026). The hairy tongue lesions were found to be least in the 20-39 age group and most prevalent in the 40-59 age group, without statistically significant correlation. H. pylori infection was detected positive in 70% and negative in 30% of hairy tongue patients, compared to the control group, where the rates were 15% and 85%, respectively, with a statistically significant correlation between infection with H. pylori and hairy tongue (p = 0.001). CONCLUSION: Our results strongly suggest that the hairy tongue might be considered an indicator of H. pylori infection.

Assessment of the Effectiveness of Aloe vera Versus Amlexanox in the Treatment of Recurrent Aphthous Ulcers: A Three-Arm Placebo-Controlled Randomized Clinical Trial.

Background Recurrent aphthous ulcers are one of the most common lesions of the oral mucosa. Most currently available treatment methods aim to relieve symptoms, speed up healing and prevent ulcer recurrence. The current study aimed to compare the effectiveness of Aloe vera gel with that of amlexanox 5% oral paste in the treatment of recurrent small-type aphthous ulcers. Materials and Methods The study was conducted on 60 patients (27 males and 33 females) attending the Department of Oral Medicine at the Faculty of Dentistry at Damascus University. The sample age ranged between 15 to 25 years, with an average age of 20.3 ± 2.4 years. Patients were diagnosed with recurrent aphthous ulcers of the small type. The sample was divided into three groups with equal numbers of patients (n=20 for each group) according to the provided drug: Aloe vera, amlexanox, and the placebo groups. Patients' ulcer size was measured on day 0 of treatment, and the ulcer size reduction was assessed on day 3 and day 5. The pain was also recorded at the first visit, and then pain reduction was assessed during follow-up visits. Results The mean ulcer size on the fifth day of treatment was 1.85 mm2, 4.05 mm2, and 6.20 mm2 in the Aloe vera, the amlexanox, and the placebo groups, respectively. The differences between groups were significant (p=0.003). The mean pain on the fifth day was 0.80 cm, 1.60 cm, and 3.20 cm in the Aloe vera, the amlexanox, and the placebo groups, respectively. The differences between groups were significant (p=0.026). Conclusions Within the limits of the current trial, both treatment groups proved effective in accelerating ulcer healing with the superiority of Aloe vera compared to amlexanox, as it achieved a greater reduction in ulcer size and pain when assessed on the fifth day of treatment.

Assessment of jawbone trabecular bone structure amongst osteoporotic women by cone-beam computed tomography: the OSTEOSYR project.

OBJECTIVE: To assess the trabecular bone structure of jawbones and the dens (the odontoid process of the second cervical vertebra) amongst osteoporotic and nonosteoporotic women using cone-beam computed tomography (CBCT). Analysis of the dens trabecular bone structure aimed to test the validity of CBCT in such analysis. METHODS: Thirty-eight women who went under dual-energy X-ray absorptiometry (DXA) examination were scanned by CBCT. Cuboids from different areas of jawbones and the dens were extracted from each scan. Trabecular thickness (Tb.Th), trabecular separation (Tb.S), bone volume fraction (BV/TV), specific bone surface (BS/TV) and connectivity density were calculated. Student's t-test, Pearson correlation, and logistic regression analysis were used to explore differences in these measures between groups. RESULTS: Jawbone-derived measures showed insignificant differences (P > 0.05) between osteoporotic and non-osteoporotic groups, and weak correlations with femoral neck and lumbar vertebrae T-scores (r ≤ 0.4). Dens-derived measures, however, resulted in the opposite (r = 0.34-0.38 [P value = 0.02-0.036] and r = 0.48-0.61 [P value ≤ 0.003]) and the highest accuracy of osteoporosis prediction: 84.2% and 78.9% respectively. CONCLUSION: Trabecular bone structure of the mandible and maxilla is not affected in osteoporosis as assessed by CBCT. Dens trabecular bone analysis revealed the opposite, so some trabecular bone measures may be assessed by CBCT, which may aid in predicting osteoporosis.

Evaluation of premalignant and malignant lesions by fluorescent light (VELscope).

AIM: The purpose of this study was the early detection of premalignant and malignant oral soft lesions by fluorescent light (VELscope). MATERIALS AND METHODS: A total of 748 patients were evaluated through clinical and fluorescent light analysis of the entire oral cavity. Any lesion that was detected underwent a surgical excision biopsy as the golden standard for the detection of the lesion's histology; then a comparison was made between the results to assure the efficacy of the fluorescent light analysis outcome. RESULTS: About 9.4% of the lesions detected were abnormal lesions and 83.09% had loss of fluorescent light effect. Based on the use of surgical biopsy, the machine had a sensitivity of 74.1% and a specificity of 96.3%. According to the statistical analysis, the P value was much lower than 0.05, so we can conclude that at 95% confidence level, there was significant agreement between VELscope results and biopsy results. Kappa coefficient value was approximately 0.5, which means that the strength of the agreement was medium. CONCLUSION: VELscope can be used as a clinical diagnostic aid in the detection of premalignant and malignant lesions of the oral cavity. In addition, it helps in the detection of the borders in both surgical biopsy and surgical excision.

Levels of salivary IgA in patients with minor recurrent aphthous stomatitis: a matched case-control study.

OBJECTIVES: Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease. Despite plenty of studies on aetiopathogenesis of RAS, a definite cause is not clear. The objective of this study was to determine the potential changes of salivary IgA and salivary flow rate in patients affected with minor form of RAS. MATERIALS AND METHODS: Levels of salivary IgA in 33 patients with acute RAS (minor form) and 33 matched healthy controls were determined using enzyme-linked immunosorbent assay. Resting salivary flow rates were determined too. Both measurements, levels of salivary IgA and resting salivary flow rate, were performed again for each RAS patient in remission phase. RESULTS: Levels of salivary IgA were significantly increased in acute phase of RAS [median (interquartile range)-124.94 µg/mL (106.22-136.31)] in comparison with the levels in healthy controls [88.92 µg/mL (76.85-93.91; P < 0.001)] and with the levels in remission phase [102.4 µg/mL (84.6-120.16; P = 0.01)]. Even in the disease-free period (remission phase), levels of salivary IgA remained significantly higher in comparison with the levels in healthy controls (P = 0.01). Salivary flow rates, on the other side, were not influenced by the disease state (RAS vs. healthy), phase (acute vs. remission) or even gender (males vs. females). CONCLUSION: Marked increase of salivary IgA in acute and remission phases of the minor RAS may suggest a potential role for this immunoglobulin in pathogenesis of the disease. CLINICAL RELEVANCE: Salivary IgA may be an important aetiological agent in the pathogenesis of RAS, and hence, its immunomodulation may help prevent the disease.

Study of some salivary changes in cutaneous psoriatic patients.

OBJECTIVE: To assess any alteration in the levels of some salivary components, and to correlate the same with the severity of the disease. METHODS: Unstimulated whole saliva samples were collected and analyzed in 20 randomly selected Syrian uncomplicated psoriatic patients presenting to the Dermatological Diseases Hospital, Damascus University, Syria between February and June 2010, and in 20 healthy matched controls. Sodium (Na+), potassium (K+), chloride (Cl-), and alpha amylase (sAA) was analyzed. The salivary flow rates (SFR) and pH was also studied. The Psoriasis Area and Severity Index was used to assess the severity of the disease. Student t-test and correlation coefficients (r) were used to compare differences between groups. RESULTS: The SFR and pH were normal in both groups. Psoriatics had significantly higher K+ and sAA concentrations (K+ mean = 21.38 mmol/L, sAA mean = 64.26 IU/ml) than the controls (K+ mean = 17.69 mmol/L, sAA mean = 43.14 IU/ml), whereas there was no significant rise in the other salivary ions studied. Neither the severity nor the duration of the disease showed correlation to the according variables. No differences were observed between the age and the gender for each of the studied variables. CONCLUSION: Psoriasis patients have higher concentration rates of salivary potassium ions and sAA compared with the controls. However, these salivary changes are not related to the severity or the duration of this dermatological disease. Further studies are required to support these results.