Evaluation of the Effects of Photodynamic Therapy With Methylene Blue on Different Candida Species In Vitro.

Introduction: Oral candidiasis is the most prevalent opportunistic infection of the oral cavity. The most common cause of this infection is Candida albicans. Considering the side effects of conventional antifungal therapies, this study aimed to evaluate the efficacy of photodynamic therapy with new methylene blue (a photosensitizer) in inhibiting the growth of C. albicans, C. tropicalis, C. glabrata, and C. krusei in vitro. Methods: In this experimental study, 200 samples of standard suspension (0.5 McFarland) were prepared from C. albicans, C. tropicalis, C. glabrata, and C. krusei (50 samples from each species). The samples of each species were divided into five groups (n=10), including photodynamic therapy with a photosensitizer, with or without laser irradiation, nystatin treatment, laser therapy, and control. Next, cultivation of samples was performed on Sabouraud dextrose agar, and the colony-forming units were determined after 24 hours of incubation at 37 °C. Data were analyzed in SPSS version 22 by means of the Kruskal-Wallis test (P<0.05). Results: The most sensitive and resistant species to nystatin therapy were C. glabrata and C. krusei, respectively. On the other hand, C. krusei was the most sensitive species to photodynamic therapy, and C. glabrata was the most resistant type to this treatment. The highest therapeutic effectiveness was attributed to nystatin therapy, although photodynamic therapy was also effective. Laser therapy was recognized as the least effective method. Conclusion: Photodynamic therapy with new methylene blue, as a suitable adjunct therapy, can be effective in the management of candidiasis. It may also be a potential novel treatment for immunocompromised patients with oral candidiasis.

Sensitivity of Four Various Candida Species to Photodynamic Therapy Mediated by Indocyanine Green, an in vitro Study.

STATEMENT OF THE PROBLEM: Various species of candida contribute to oral candidiasis. It is the time to shift from conventional rigid antimicrobial therapies to more patient specific and safer ones. PURPOSE: The present study aimed to investigate antifungal effects of photodynamic therapy (PDT) using Indocyanine green as photosensitizer and low-power laser irradiation on the viability of candida albicans, candida tropicalis, candida glabrata and candida krusei, and to compare it with Nystatin as the conventional treatment. MATERIALS AND METHOD: In this in vitro study, 0.5 McFarland suspensions of candida's species were prepared (n=50, each). Each strain was then divided into five groups of 10 samples each, according to the following experimental interventions: (1) Nystatin, (2) photodynamic therapy: laser irradiation (wavelength= 808 nm, power= 100 mW, energy density= 10 J/cm2, exposure duration= 100 s) in the presence of the photosensitizer, (3) laser irradiation alone, (4) treatment with the PS alone and (5-control: no exposure to laser light or photosensitizer. Next, serial dilutions were prepared and seeded onto Sabouraud dextrose agar. The colonies were counted, and the values of log (CFU/ml) were analyzed by variance and the Tamhan test (p< 0.05). RESULTS: Photodynamic therapy mediated indocyanine green is significantly effective in reducing the number of CFU/ml of all species of candida tested, compared to control group (p< .001). Nystatin, laser irradiation and photodynamic therapy, with respectively decreasing potency, have considerably reduced the number of candida's colonies in all four bacterial strains (p<. 05). Photosensitizer alone, showed impressive antimicrobial potency against all species of candida except candida albicans, in comparison to control group. CONCLUSION: It seems that laser therapy alone is more powerful than photodynamic therapy mediated indocyanine green; however, conventional treatment has still the top antimicrobial efficacy towards all candida species.

Comparative Study of Punica granatum Gel and Triadent Oral Paste Effect on Recurrent Aphthous Stomatitis, a Double Blind Clinical Trial.

STATEMENT OF THE PROBLEM: Recurrent aphthous stomatitis is a common oral lesion, and the use of herbal remedies containing tannin and flavonoid has been reported to be effective in treating aphthous stomatitis. PURPOSE: This study was aimed to evaluate the effect of Punica granatum muco-adhesive gel on controlling the oral recurrent aphthous stomatitis and its comparison with Triadent oral paste. MATERIALS AND METHOD: In this double-blind clinical trial, 60 patients with minor aphthous stomatitis were enrolled. These patients had no systemic diseases and were not on any medications. The patients were randomly treated with Punica granatum formulated gel, Triadent oral paste and placebo. The time of pain elimination and the time of complete healing were recorded and the pain degree was assessed and recorded by each patient. The data were analyzed using survival analysis and ANOVA test. RESULTS: The Kaplan-Meier survival analysis demonstrated that pain relief time in Punica granatum group was lower than placebo group (p= 0.002), even so, it caused no significant difference with the Triadent group in comparison with the placebo group (p= 0.08). The survival analysis also indicated that the wound healing time in Punica granatum group was significantly lower than the other two groups (p< 0.05). CONCLUSION: Punica granatum gel has a successful effect in controlling and treating recurrent aphthous stomatitis. It can be considered as an affordable and inexpensive treatment.

Association of A-197G polymorphism in interleukin-17 gene with chronic periodontitis: Evidence from six case-control studies with a computational biology approach.

AIM: The aim of the present study was to evaluate the association of interleukin-17 (IL-17) A-197G gene polymorphism with chronic periodontitis (CP) in a case-control study, a meta-analysis, and an in silico approach. METHODS: In the case-control study, 122 cases with CP and 126 healthy controls were recruited; IL-17 A-197G genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism. In the meta-analysis, comprehensive literature retrieval was performed on valid databases to identify relevant studies. Bioinformatics tools were employed to investigate the effects of A-197G transition on the promoter region of IL-17. RESULTS: Our case-control study revealed a significant association between IL-17 A-197G transition and CP. The overall meta-analysis revealed significant associations between the IL-17 A-197G polymorphism and CP risk in homozygote co-dominant and recessive models. The stratified analysis also showed a statistically significant association between the mentioned transition and CP risk in the Caucasian population. The in silico analysis revealed that the A-197G polymorphism could make changes in protein-binding sites of the IL-17 promoter region. CONCLUSIONS: Our study supports that IL-17 A-197G transition could be a genetic risk factor for CP. However, further studies with a larger sample size among different ethnicities are required to obtain a more accurate conclusion.

Effect of Herbal Echinacea on Recurrent Minor Oral Aphthous Ulcer.

BACKGROUND: The oral aphthous is a common oral ulcer with intense pain and there is no treatment for it, yet. Echinacea is an herbal medicine that moderated the immune system. OBJECTIVE: The aim of this study was to investigate the effects of Echinacea on the treatment of aphthous ulcer. METHODS: 50 patients with minor aphthous participated in our study. 25 patients take 3 tablets in a day for five weeks (case group) and 25 patients didn't take any tablets (control group). The patients were monitored for one month before taking the tablets for six months. During this period, the number of lesions, complete improvement of ulcers, recurrence rate and intensity of pain were considered in each month. Finally, the Friedman and ANOVA tests used to analyze the obtained data. RESULT: Our study showed a significant difference between a number of lesions during six-month in case and control groups (p>0.001). In this way, we observed that the number of lesions was decreased significantly after six months in the case group. Hence, ANOVA analysis showed a significant decrease between each month for the intensity of pain (p=0.025), complete improvement (p<0.001) and recurrence rate (p=0.026). CONCLUSION: In conclusion, we showed that Echinacea tablets as an herbal medicine have positive effects on a number of lesions, intensity of pain, complete improvement and recurrence rate in patients with recurrent minor aphthous ulcers.

Salivary levels of interleukin-8 in oral lichen planus and diabetic patients: A biochemical study.

BACKGROUND: This study aimed to assess the salivary levels of interleukin-8 (IL-8) in oral lichen planus (OLP) and diabetes mellitus (DM) patients, and OLP + DM patients in comparison with healthy individuals. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted on 75 patients (30 with OLP, 5 with both OLP and DM, 20 with DM and 20 healthy controls). The salivary levels of IL-8 and fasting blood sugar and 2-h postprandial blood glucose levels were measured in all the subjects. Data were analyzed with one-way ANOVA and post hoc least significant difference tests. RESULTS: The mean salivary level of IL-8 was the highest in OLP + DM patients, followed by DM, OLP and control groups, respectively. Pair-wise comparisons of the groups revealed significant differences in the salivary levels of IL-8 between OLP and control, DM and control, also OLP + DM patients and control (P < 0.05). CONCLUSION: The increasing salivary level of IL-8 in the control, OLP, DM, OLP + DM groups, respectively, indicates the role of this inflammatory cytokine in the pathogenesis of OLP and diabetes.

Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients.

This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A significant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were significantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21-13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy.

Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients

Abstract This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A significant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were significantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21–13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy.

Serum level of Interleukin-8 in subjects with diabetes, diabetes plus oral lichen planus, and oral lichen planus: A biochemical study.

BACKGROUND: Correlation between diabetes mellitus (DM) and oral lichen planus (OLP) seems probable. Since Interleukin-8 (IL-8) is an important inflammatory mediator involved in both conditions, this study aimed to measure and compare the serum level of IL-8 in DM, OLP, and DM + OLP patients in comparison with healthy individuals. MATERIALS AND METHODS: This cross sectional study was conducted on 75 patients (30 OLP, 5 OLP and type II DM, 20 type II DM, and 20 healthy controls). Serum levels of IL-8, fasting blood sugar (FBS) and 2-h postprandial blood sugar were measured in the four groups. Data were analyzed using SPSS version 20 by one-way ANOVA and post_hocleast significant difference test. RESULTS: Type II DM patients with OLP had the highest mean serum level of IL-8 followed by OLP, DM and control groups, respectively. Pairwise comparison of groups revealed significant differences in serum IL-8 between the control and OLP and also control and OLP+DM (P < 0.05) groups. No other significant differences were noted. The mean levels of FBS and 2-h postprandial blood sugar were the highest in OLP+DM patients followed by DM, OLP and control groups, respectively. CONCLUSION: The ascending trend of serum level of IL-8 in the control, DM, OLP, and DM+OLP patients may indicate the role of this factor in the pathogenesis of DM and OLP. Moreover, it may play a synergistic role in patients suffering from both conditions.

The Serum and salivary level of malondialdehyde, vitamins A, E, and C in patient with recurrent aphthous stomatitis.

BACKGROUND: Oral recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease affected oral mucosa which has afflicted about 20% of the society. Etiology of this disease is unknown. Three main factors influencing aphthous stomatitis are genetic, hematologic, and immunologic factors. Another proposed factor that may be considered in etiology of aphthous ulcer is oxidant, anti-oxidant imbalance in the body. The purpose of this study was the evaluation of lipid peroxide enzyme as an important oxidant agent and anti-oxidant vitamins in the saliva and serum of the patients suffering from RAS and compare it to healthy people. MATERIALS AND METHODS: In this cross-sectional, descriptive - analytical study, 25 patients suffering from RAS were compared to 24 healthy individuals. Applying enzyme-linked immunosorbent assay method, the amount of malondialdehyde (MDA) as well as Vitamins A, E, and C were measured in the saliva and serum of two groups. The results were analyzed by Statistical Package for the Social Sciences (SPSS) software version (11.5), t-test and χ(2). RESULTS: No significant difference was detected between salivary and serum levels of antioxidant vitamins (A, E, and C) and MDA in both experimental groups (P > 0.05). CONCLUSION: According to the results of this study, RAS is not associated with oxidant-antioxidant imbalance in the body. However, it seems quite necessary to carry out more studies in this area.

Evaluation of the Effectiveness of the Iralvex Gel on the Recurrent Aphthous Stomatitis Management.

Introduction. As there is no definitive treatment for the recurrent aphthous stomatitis (RAS), most of the available therapies aim at decreasing pain and discomfort. The aim of this study was to investigate the effectiveness of the Iralvex gel on the RAS management. Material and Methods. In this double-blind and placebo-controlled clinical trial study, twenty patients were treated with the Iralvex gel and the other twenty patients were treated with placebo. In every participant complete healing of lesions, pain duration, and intensity were evaluated. Data were analyzed by independent t-test and analysis of variance. Results. Pain was relieved after 6.10 ± 0.29 days in the Iralvex group in comparison to 8.00 ± 0.33 days in the placebo group (P value ≤0.001). Complete remission in the Iralvex group was after 6.80 ± 0.27 days and 10.20 ± 0.42 days in the placebo group (P value ≤ 0.001). Furthermore, significant differences in the pain intensity between Iralvex and placebo group measured on days 1, 3, and 5 were obtained (P value ≤ 0.01). Conclusion. The results of this study show that Iralvex gel is effective and cheap remedy for treatment of RAS without side effects. This trial is registered with IRCT201207253251N3.

The comparison of salivary level of estrogen and progesterone in 1(st) , 2(nd) and 3(rd) trimester in pregnant women with and without geographic tongue.

BACKGROUND: Geographic tongue (GT) was first reported as a wandering rash of the tongue in 1831; however, its etiopathogenesis remains unclear. Increased prevalence of GT has been documented in the pregnancy. The aim of this study was to compare the level of salivary estrogen and progesterone in pregnant women with and without GT. MATERIALS AND METHODS: This analytical-descriptive study consisted of 26 pregnant women (13 with GT, 13 without GT) with an age range between 18 years and 45 years. The estrogen and progesterone level was measured during 1(st) , 2(nd) and 3(rd) trimester of pregnancy. Saliva sampling was performed to determine the level of sex hormones. The samples were stored at -80°C and determined by Eliza method. The results were analyzed by t-test and repeated measure ANOVA (α = 0.05). RESULTS: The mean level of estrogen for control and case group was 49.4and 52.33 in the 1(st) , 71.05 and 74.12 in the 2(nd) and 109.1 and 112.16 in the 3(rd) trimester respectively. The mean level of progesterone was 0.72 and 0.72 in the 1(st) , 1.14 and 1.21 in the 2(nd) and 1.3 and 1.28 in the 3(rd) trimester of pregnancy for the control and case groups respectively. Even though, there was no significant difference regarding the level of sex hormones between case and control groups (P < 0.05), but the difference between the level of these hormones during 3 trimesters of pregnancy was significant in each group (P = 0.001). CONCLUSION: The level of sex hormones is not the only etiologic factor of GT in pregnant women, but other factors such as genetic potential, human leukocyte antigen marker and stress may aggravate the incidence of this lesion.

The efficacy of Punica granatum extract in the management of recurrent aphthous stomatitis.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is a common, painful ulcerative disorder of the oral cavity with unknown etiology. No documented cure exists and topical application of medications aims to reduce pain associated with this condition. The aim of this study was to evaluate the efficacy of Punica granatum (PG) extract on the clinical management of RAS. METHODS: A total of 40 patients with RAS participated in this randomized, double-blind, and placebo-controlled study. During three episodes of RAS, the efficacy of topical PG gel (10%) was evaluated. Patients were randomly assigned to use placebo gel or PG gel daily. The time of pain elimination and the time of complete healing were recorded and the pain degree was assessed and recorded by each patients in different time intervals including: Before using the oral gel (day 0), and on days 1, 3, 5, 7 after using the product. Data were analyzed using the repeated measures ANOVA, paired and independent t-test. FINDINGS: Mean time of pain elimination showed a significant difference (P < 0.001) between PG group (3.4 ± 1.09) and placebo group (5.9 ± 0.6). The mean duration of complete healing also showed a significant difference (P < 0.001) between PG group (5.3 ± 0.81) and placebo group (8.6 ± 0.99). The visual analog scale score in PG group was significantly less than the placebo group in all time intervals (day 1 to day 7) (P < 0.001). CONCLUSION: The findings of this study revealed that PG extract in the form of oral gel (10%) may be beneficial in reducing RAS pain and has a positive effect in reducing the overall time period of complete healing. It was concluded that PG is an effective herbal medicine for the management of RAS.