Abstract
The aim of this study was to evaluate the efficacy of a 0.05% clobetasol propionate ointment administered in trays to 22 patients with desquamative gingivitis in a double-blind, crossover, placebo-controlled trial. Patients received container number 1 and were instructed to apply the ointment 3 times a day for 2 weeks, and to reduce the application to once a day in the third week. Next, the patients were then instructed to discontinue the treatment for 2 weeks, and were then given container 2, used in the same way and for the same length of time as container 1. Regarding signs, 17 patients presented some improvement, while 5 experienced worsening with clobetasol propionate. With the placebo, 14 patients presented some improvement, and 8 patients presented worsening. For symptoms, there was complete improvement in 2 patients, partial improvement in 12, no response in 7, and worsening in 1 with clobetasol propionate. With the placebo, there was partial improvement in 8 patients, no response in 12 and worsening in 2. No statistically significant difference was found between clobetasol and placebo (p>0.05). Within the period designed to treat the gingival lesions of the patients, clobetasol propionate did not significantly outperform the placebo.
Highlights
Management of the gingival manifestations, clinically known as desquamative gingivitis, of autoimmune and inflammatory mucocutaneous diseases represents a great challenge to oral medicine clinicians, since most of these diseases are of a chronic nature [1,2,3]
While systemic therapy may be required for the underlying disease, especially in cases associated with pemphigus vulgaris (PV), topical corticosteroids are often the mainstay for the treatment of localized gingival lesions [4,5,6,7,8]
Complete improvement was observed in 2 patients (9.1%), partial improvement in 12 (54.5%), no response in 7 (31.8%) and worsening in 1 during the clobetasol phase
Summary
Management of the gingival manifestations, clinically known as desquamative gingivitis, of autoimmune and inflammatory mucocutaneous diseases represents a great challenge to oral medicine clinicians, since most of these diseases are of a chronic nature [1,2,3]. While systemic therapy may be required for the underlying disease, especially in cases associated with pemphigus vulgaris (PV), topical corticosteroids are often the mainstay for the treatment of localized gingival lesions [4,5,6,7,8]. Clobetasol propionate has yielded good results with minimal side effects when properly used [5,9,10,11]. Some studies have reported good outcomes for patients with oral lesions treated with clobetasol propionate in a mouthwash [3], and in an ointment with or without an adherent vehicle [7,8,9,10,11,12]. It has been reported that the grainy texture of the paste with adherent vehicle is generally disliked, often affecting patient compliance. Physiological mouth movements can displace the corticosteroid from its initial location, precluding good control of the contact
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