Aphthous Research Articles

54647 Efficacy of Colchicine Treatment for Aphthous Ulcers in Pediatric Patients

54647 Efficacy of Colchicine Treatment for Aphthous Ulcers in Pediatric Patients

Comparative Efficacy of Triadent and Ora-Aid Mucoadhesive Patch for Treatment of Minor Aphthous Ulcers: A Clinical Trial

Comparative Efficacy of Triadent and Ora-Aid Mucoadhesive Patch for Treatment of Minor Aphthous Ulcers: A Clinical Trial

The Connection Between Recurrent Aphthous Stomatitis (RAS) and Psychological Stress in Patients at RSGM Nala Husada

Background: The most common oral soft tissue disease at RSGM Nala Husada is recurrent aphthous stomatitis. RAS is a condition marked by inflammation of the orakl mucosa, which manifests as one or more ulcers that recur over time. RAS can be influenced by various predisposing factors, with stress being a common trigger. Stress refers to the body's reaction to challenges or pressures that lead to uncomfortable feelings, which are perceived differently by each person. Objective: To determine the relationship between stress in patients with recurrent aphthous stomatitis at RSGM Nala Husada. Materials and Methods: The population and samples of all RAS patients who visited RSGM Nala Husada were taken by purposive sampling with a total of 100 people. The level of stress experienced by a person measured from the Depresion Anxiety Stress Scale (DASS) questionnaire which consists of 42 questions. Data on RAS were taken from subjective examination and intra-oral examination. Processing of data using correlation test with Spearman test in SPSS program. Results: The results of the Spearman test are a weak correlation, which can be seen from R= 0.115 (Sig = 0.175.> 0.05). A positive R value means that the relationship is in the same direction. Conclusion: In this study there was no significant relationship between psychological stress in RAS patients at RSGM Nala Husada. Therefore, it is necessary to review further the severity, duration and intensity of stress that can trigger the emergence of RAS and reconsider other predisposing factors related to RAS besides stress.

Injuries of the oral mucosa. Clinical cases

Background. Often with some infectious diseases, in addition to the typical manifestations, characteristic inflammatory changes are observed on the mucous membranes, which can imitate the course of other diseases. The purpose was to remind dentists and general practitioners about the importance of differential diagnosis of lesions of the oral mucosa in infectious and non-infectious pathologies on the example of clinical cases. Materials and methods. We conducted an empirical, descriptive study of 3 clinical cases of lesions of the oral mucosa in children who underwent inpatient treatment at the Kyiv City Children’s Clinical Infectious Hospital in 2023–2024. Results. In the first clinical case, the manifestation of type 1 diabetes was described, which was accompanied by oral candidiasis that was previously regarded as a suspicion of measles. The second clinical case demonstrates aphthous ulcers in HIV infection, which was previously mistaken for acute tonsillitis in a child. The third case described enteroviral vesicular stomatitis, which by the nature of the elements resembled chicken pox. Conclusions. Lesions of the oral mucosa can mimic the manifestations of common infectious and non-infectious diseases. Therefore, differential diagnosis of lesions of the oral mucosa is extremely important in various fields of medicine and dentistry.

Mussel-inspired adhesive drug-loaded hydrogels for oral ulcers treatment

Oral aphthous ulcers are common mucosal lesions that cause pain and discomfort. There are diverse biomaterials and drug treatments for oral ulcers used in both research and clinical settings. However, the complex oral environment often results in low adhesion and short drug retention times, which lead to poor drug availability and treatment outcomes. In this study, a mussel-inspired adhesive hydrogel was developed by grafting catechol onto hyaluronic acid (C-HA), and dopamine was added for oxidative pre-polymerization to form modified hyaluronic acid (M-HA), which remarkably increased the adhesion of the hydrogels. Then, M-HA was interpenetrated into the gelatin methacryloyl (GelMA) network. Chlorhexidine gluconate (CHG) was then incorporated into the hydrogel to enhance its availability and therapeutic effect through its sustained-release capability. The GelMA/M-HA hydrogel demonstrated strong adhesion to wet tissues, antibacterial and anti-inflammatory properties, and good biocompatibility. In both rat oral ulcers and infected wounds, the adhesive hydrogel significantly accelerated the healing of the ulcers and infected wounds. These results indicated that this adhesive hydrogel offers a promising new strategy for the treatment of oral ulcers in clinical practice. Statement of significanceOral ulcers are a common and high-incidence mucosal condition that seriously affect people's daily lives, often making it difficult for patients to chew and speak. However, a dynamic oral environment with various types of bacteria influences drug availability and treatment effects in clinical settings. To address this challenge, an adhesive, mussel-inspired, drug-loaded hydrogel was constructed using natural macromolecules (hyaluronic acid and gelatin) with good biocompatibility. Chlorhexidine gluconate (CHG), with its broad-spectrum antibacterial activity, has been incorporated to synergistically promote oral ulcer healing. The splendid adhesion, antibacterial, and therapeutic effects of this hydrogel demonstrated a new strategy for treating oral ulcers.

Comparison of Functional Groups in Green Tea Kombucha (Camellia sinensis) and Chamomile Flower Kombucha (Matricaria chamomilla) Using Fourier Transform Infrared Spectroscopy (FTIR)

Kombucha is a fermented beverage made by SCOBY (Symbiotic Culture of Bacteria and Yeast). Substrates in making kombucha drinks can use ingredients that contain high phenolic compounds, such as green tea and chamomile flowers. Green tea is a type of tea that is not fermented or non-fermented and contains more catechins (one of the flavonoid components) and is beneficial for health. Chamomile flower preparations in the form of tea are believed to reduce pain, because they contain flavonoid compounds that can reduce pain, can cure canker sores, overcome sleep problems, digestion, anxiety. This study aims to determine the functional groups contained in chamomile flower kombucha and green tea. The method used is the analysis of functional groups using Fourier Transform InfraRed, then comparisons are made on the resulting functional groups. The results showed that the functional groups contained in chamomile flower kombucha are C-O ether, C-N amine, C=C alkene, C≡C alkyne, C=O ester, and O-H alcohol. While the functional groups found in green tea are C-N amine, C=C alkene, C≡C alkyne, and O-H alcohol. Thus, chamomile flower kombucha and green tea are known to contain secondary metabolite compounds of flavonoids, phenolics, saponins, and tannins.

Synthesis and biological applications of nanocomposite hydrogels based on the methacrylation of hydroxypropyl methylcellulose and lignin loaded with alpha-pinene

Oral conditions, such as recurrent aphthous stomatitis, are chronic inflammatory disorders that significantly affect the life quality. This study aims to develop a novel buccal mucoadhesive based on methacrylate hydroxypropyl methylcellulose (M-HPMC) and methacrylate lignin (M-SLS) encapsulated with nanostructured lipid carriers (NLCs) for controlled release of alpha-pinene (α-pinene). NLCs with particle sizes of 152 ± 3 nm were prepared by using stearic acid and oleic acid as solid and liquid lipids, respectively. Following the successful synthesis of M-HPMC and M-SLS, various concentrations of α-pinene loaded NLCs (0, 18, 38, and 50 wt%) were encapsulated in M-HPMC/M-SLS hydrogel. It was demonstrated that the physiological and mechanical performances of hydrogels were changed, depending on the NLC content. Remarkably, the incorporation of 18 wt% NLC improved the compressive strength (143 ± 14 kPa) and toughness (17 ± 1 kJ/m3) of M-HPMC/M-SLS hydrogel. This nanocomposite hydrogel considerably decreased dissipated energy from 1.64 kJ/m3 to 0.99 kJ/m3, after a five-cycle compression test. The nanocomposite hydrogel exhibited controlled α-pinene release for up to 96 h which could significantly improve the antioxidant activity of M-HPMC/M-SLS matrix. Moreover, the reinforcing M-HPMC/M-SLS hydrogel with α-pinene-loaded NLCs resulted in increased adhesive strength (113.5 ± 7.5 kPa) to bovine buccal mucosa and cytocompatibility in contact with fibroblasts.

Assessment of Quality of Life in Patients with Chronic Oral Mucosal Diseases Using the Indonesian Version of the Chronic Oral Mucosal Disease Questionnaire-15 (COMDQ-15).

Chronic oral mucosal diseases (COMDs) can significantly impair the quality of life (QoL) of affected individuals. Monitoring the overall disease's impact and the efficacy of treatments requires the use of the Chronic Oral Mucosal Diseases Questionnaire-15 (COMDQ-15) as a standardized instrument for measuring QoL in these patients. This study aimed to assess QoL in patients with COMDs using an Indonesian version of the COMDQ-15. Seventy patients diagnosed with recurrent aphthous stomatitis (RAS), oral lichen planus, autoimmune blistering diseases (ABD), and cheilitis were included. Levels of QoL among different groups of disease were compared. Various potential factors influencing QoL were evaluated. Bivariate analysis was performed to identify factors associated with overall and specific aspects of QoL. The mean total COMDQ-15 score was 20.83 ± 10.07. The highest scores were in the physical discomfort domain (8.76 ± 4.65), while the lowest was in the medication and treatment domain (2.13 ± 1.99). Physical discomfort was significantly associated with gender, major RAS, and cheilitis. Social and emotional aspects were significantly associated with age and ABD, while patient support was linked to employment status, RAS types, and cheilitis. The Indonesian version of the COMDQ-15 is a valid and reliable tool for assessing QoL in patients with COMDs.

Optimization and clinical evaluation of hyaluronic acid proniosome loaded in-situ gel for the management of recurrent aphthous stomatitis

Recurrent aphthous stomatitis (RAS) is a frequent unpleasant oral condition that causes ulcers. Hyaluronic acid (HY) is an inherent polymer owing antioxidant, anti-inflammatory, and anti-bacterial patterns. D-optimal response surface design was used to investigate the impact of surfactant type (Span 80 or Brij®35) and the concentration of HY (0.5 % or 1), on three selected dependent variables: zeta potential (ζ, ZP, R1), particle size (PS, R2), and entrapment efficiency (%EE, R3). The optimized HYPN was then loaded in thermosensitive in-situ gel. The clinical efficacy in patients with RAS was evaluated by measuring the improvement in pain levels (using the Visual Analog Scale), reduction in ulcer size, enhancement in quality of life (measured by OHIP-14 scores), and analysis of pro-inflammatory Tumor Necrosis Factor Alpha (TNF-α) and total antioxidant capacity (TAC) in saliva samples. The optimized formula obtained a mucoadhesive strength of 26 ± 1.76 N/m2. A burst release of 38 ± 1.56 % after 2 h was obtained followed by 80 ± 2.21 % till 24 h, with a transbuccal flux (Jss) 425 ± 7.9 μg/h.cm2. Clinically, a significant difference (P ≤ 0.001) in pain scores, ulcer diameter, OHIP-14 scores, TAC, and TNF-α between the in-situ gel containing HYPN and the placebo gel was found. The mean values for the number of recurrences at 6 months follow-up were 2.55 ± 1.13 and 4.63 ± 1.75, respectively, before and after treatment. The thermosensitive mucoadhesive in-situ gel seems to be a promising therapeutic choice for RAS treatment.

FORMULATION OF PROPOLIS-BASED RECURRENT APHTHOUS STOMATITIS (RAS) PROTECTIVE PATCH WITH COMBINATION OF PVP AND CELLULOSE MATERIALS

Objective: The objective of this study was to obtain a mucoadhesive patch for recurrent aphthous stomatitis (RAS) with propolis, proven propolis’ antibacterial ability against bacteria in the oral cavity, and to obtain the physical characteristics of the produced patch. Methods: The patch was produced using a solvent-casting method. The antibacterial properties were determined by the disc diffusion method against S. mutans, S. oralis, S. sanguinis, and S. gingivalis. The physical characteristics of the patch was determined by examining weight and thickness dimension, swelling, surface pH, and structure observation. Results: The patch was made from 8 formulations with different propolis concentrations, Polyvinylpyrrolidone (PVP), and the use of cellulose materials (Hydroxypropyl methylcellulose and Carboxymethylcellulose). The concentrations of propolis used were 3%, 5%, 7%, and 10%. While the ratio of PVP and cellulose material in the formulation is 2:1. Results showed that propolis had a zone of inhibition greater than 2 mm against S. oralis, S. sanguinis, S. mutans, and P. gingivalis bacteria. Patches produced were clear to brown-colored films with high swelling percentage due to hydrophilic polymers used. The patch thickness that is closest to the requirements of the buccal patch was F8 with 0.36+0.04 mm. The mean values of the patches have matched normal salivary pH of 5.5–7. Physically, PVP/CMC formulations were more sticky, and the PVP/HPMC patches were more solid and stronger. Conclusion: A mucoadhesive patch was obtained with a combination of PVP/CMC and PVP/HPMC, tween 80 as a surfactant, glycerin as a plasticizer, peppermint oil as a flavor enhancer and preservative, with the active ingredient propolis.

The role of the tonsils in the genesis of PFAPA syndrome: a modern view and description of two clinical cases

In ENT clinical practice, there are cases of a disease similar to those ones of chronic adenotonsillitis, but insensitive to the designated conservative therapy. This disease was first described in 1987 and is called PFAPA syndrome. Its symptoms periodicity and its regression when corticosteroids are prescribed were established. Adenotomy/adenotonsillectomy can eliminate the symptoms of the disease or significantly reduce the frequency of relapses. The histological features of the structure of the palatine and pharyngeal tonsils, as well as the characteristics of the PFAPA-syndrome, were revealed. Clinical Case Description: patient K., 3 years old, repeated cases of fever were recorded in the child from the age of 1 year 3 months. They were initially regarded as manifestations of acute respiratory viral infections, complicated by adenoiditis, pharyngitis, aphthous stomatitis and cervical lymphadenitis, with a frequency of 1.5–2 months, 6–7 episodes per year. The antiviral therapy was prescribed without any effect. A prednisolone test (1.5 mg/kg) was positive; it led to a rapid normalization of body temperature and condition improvement. The adenotonsillectomy was done. Surgical intervention and the postoperative period were uneventful. The follow-up period was without any recurrence of the disease for more than 1 year. Patient F., 6 years old, had, the recurrent (each 1.5–2 months), acute respiratory viral infections, adenotonsillitis, accompanied by lymphadenitis and febrile fever. A prednisolone test was positive. The patient was diagnosed with PFAPA syndrome by the age of 6. The adenotonsillectomy was done. No disease relapses were noted in the follow-up.

Comparative analysis of adverse events associated with CDK4/6 inhibitors based on FDA’s adverse event reporting system: a case control pharmacovigilance study

BackgroundCyclin-dependent kinase 4/6 (CDK4/6) inhibitors marked a milestone in the breast cancer treatment. Due to the potential impact of adverse effects on treatment decisions and patient outcomes, careful consideration of the varying toxicities of CDK4/6 inhibitors is crucial, as three inhibitors—palbociclib, abemaciclib, and ribociclib—have been approved with differences in adverse event profiles. However, limitations in clinical trials call for urgent real-world safety studies to evaluate and compare the risk of adverse events (AEs) among these CDK4/6 inhibitors. Therefore, this study aimed to analyze AEs of CDK4/6 inhibitors and provide insights for clinical drug selection, using real world database.MethodsThe AEs of CDK4/6 inhibitors in the FDA Adverse Event Reporting System (2015–2022) were analyzed. Four disproportionality methods were used to detect safety signals: reporting odds ratio (ROR), proportional reporting ratio, Bayesian Confidence Neural Network Propagation, and Multi-Item Gamma Poisson Shrinker. Venn analysis was used to compare and select common and specific AEs.ResultsThis study included 73,042 patients treated with palbociclib, 25,142 with ribociclib, and 7563 with abemaciclib. All three inhibitors had 27 common AEs. Palbociclib exhibited the highest ROR for hematologic toxicities, while ribociclib showed the highest ROR for macrocytosis, nail disorders, and hepatic lesions. Abemaciclib displayed the highest ROR for mucosal toxicity. Common signals for both palbociclib and ribociclib included hematologic toxicities, decreased immune responsiveness, and aphthous ulcers. Myelosuppression, oral pain, and pseudocirrhosis were common signals for palbociclib and abemaciclib. Anemia, hepatotoxicity, and pneumonitis were observed as common signals for ribociclib and abemaciclib. Furthermore, specific AEs associated with palbociclib included fatigue, alopecia, and stomatitis. For ribociclib, specific AEs included electrocardiogram QT prolongation, thrombocytopenia, and decreased hemoglobin. Abemaciclib was specifically linked to diarrhea, vomiting, and interstitial lung disease.ConclusionOur analysis revealed that palbociclib showed a higher risk of hematologic toxicity. Ribociclib showed higher risks of hepatotoxicity, nephrotoxicity, and QT prolongation. Abemaciclib showed higher risks of hepatotoxicity, gastrointestinal effects, interstitial lung disease, and thrombosis. These findings provide valuable insights for CDK4/6 inhibitor selection.

The clinical efficacy of Lou's Wentong method in the treatment of lactational mastitis: A retrospective self-control study with 158 cases

BackgroundAs a common breast disease in lactating women, lactational mastitis is clinically manifested as painful breast lumps and systemic symptoms. To a certain extent, this disease may affect the physical and mental health of lactating women and even the breastfeeding of infants. ObjectiveThis study was conducted to evaluate the clinical efficacy of Lou's Wentong Method in the comprehensive treatment of lactational mastitis and its effects on relevant symptoms. MethodsA total of 158 patients who were diagnosed with lactational mastitis in The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2022 to January 2024 were included in this study to conduct a retrospective analysis. The treatment method comprised oral administration of traditional Chinese medicine prescriptions guided by the concept of “Wentong zhi yong” (warming and dispersing therapy for treating abscesses), puncture and pus extraction for patients with abscess formation, and milk drainage for patients with milk stagnation. The clinical symptoms of these patients were collected according to the seven indexes in Lou's quantitative scorecard for evaluating the condition of canker sores before and after treatment. Additionally, the improvement of each symptom after treatment, the total effective rate of the clinical treatment, and the total symptom evaluation score before and after treatment were also analyzed. ResultsIt was demonstrated that there were significant differences in the overall distribution of different severity symptoms (skin erythema, breast pain, number of lumps, size of lumps, breast abscesses, and body temperature) at three time points (P < 0.01). The evaluation of these symptoms at different time points revealed that all symptoms were effectively mitigated over time. Meanwhile, the efficacy was assessed according to the efficacy index to evaluate the efficacy of Lou's Wentong Method in the comprehensive treatment of lactational mastitis. The results corroborated the pronounced efficacy of Lou's Wentong Method in treating lactational mastitis, exhibiting statistical significance (P < 0.01). ConclusionLou's Wentong Method has significant therapeutic effects in the comprehensive treatment of lactational mastitis. Furthermore, this method is conducive to alleviating the clinical symptoms of these patients as soon as possible and can reduce the pain of patients, thus promoting their recovery.

Risk of immediate postoperative fever in PFAPA patients undergoing tonsillectomy

ObjectivePeriodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children. Tonsillectomy is considered a potential treatment option.A common concept is that patients with PFAPA are more likely to have postoperative fever, which might be hard to distinguish from other etiologies such as malignant hyperthermia or drug adverse effects. For this reason, many institutions require these patients to be cared for at their main center and not at satellite centers.Our objective was to evaluate the rate of immediate postoperative fever in PFAPA patients undergoing tonsillectomy. Material and methodsFollowing IRB approval (STUDY20060029), a retrospective chart review of all PFAPA patients who underwent tonsillectomy at a tertiary children's hospital between January 1st, 2013, and September 30th, 2022.The PHIS database was queried from January 1st, 2013, to June 30th, 2022, for pediatric tonsillectomy and PFAPA. ResultsSixty-one patients underwent tonsillectomy for PFAPA during the study period at our institution. Only one (1.6 %) had immediate postoperative fever. Fever episode resolution was seen in 90.25 % of patients, 41/41 (100 %) of the patients reported fever episodes pre-op, compared with 4/41 (9.75 %) post-op (McNemar's Chi-squared test, Chi2 = 37.0, p < 0.001).481,118 pediatric tonsillectomies were recorded in the PHIS database during this period, 1197 (0.25 %) were also diagnosed with PFAPA. None of the PFAPA patients had an immediate post-operative fever. ConclusionsOur results suggest there is no increased risk of immediate postoperative fever in PFAPA patients undergoing tonsillectomy.

Kaempferia galanga L. alleviates the expression of COX-2 and NF-kappaB-p65 in the oral mucosa ulcer of Wistar rats and exhibits no irritation toward the vascular membrane of chicken eggs and the skin of albino rabbits

The global incidence of recurrent aphthous stomatitis in 2018 reached 5–66 % of the population, while in Indonesia 8 %. Moreover, the prevalence of oral mucosal fibrosis and recurrent aphthous stomatitis among male doctors and nurses in China was 21.24 % and 24.27 %, respectively. Our previous study has shown that the ethanol extract of Kaempferia galanga L. rhizome (EKGR) revealed an accelerated wound-healing effect in the oral mucosa ulcer of Wistar rats. This study aims to explore the effects of EKGR on the expression of NF-kappaB-p65 and COX-2 in the tongue tissue of male Wistar rats by Western blot analysis and immunohistochemistry technique, its safety towards the vascular membrane of the egg chorioallantoic membrane, and its single-dose application on the skin of male rabbits. The rats were randomly assigned into 7 groups: the normal control; the negative control; the positive control (treated with triamcinolone acetonide); and 4 treatment groups of EKGR (0.5 %; 1 %; 2 %; 4 %). Western blot and immunohistochemistry methods were used to measure the expression of NF-kappaB-p65 and COX-2. The hen's egg test-chorioallantoic membrane assay was employed to predict the safety of EKGR towards the vascular membrane. Moreover, the effect of 200 mg/kg BW EKGR application on the dorsal skin of male albino rabbits was also evaluated. EKGR inhibits the expression of NF-kappaB-p65 and COX-2 as proven by WB and IHC results. In the HET-CAM assay, all concentrations of EKGR do not induce irritation responses, which elicits the safety of EKGR. The administration of EKGR causes mild irritation to the dorsal skin of male rabbits but does not induce erythema and edema, no significant changes in BW, no toxic effects on organ macroscopic examination or histopathology, and does not induce abnormalities in the hematological profile of male albino rabbits. EKGR has confirmed its anti-inflammatory activity by suppressing the expression of COX-2 and NF-kappaB-p65 in the oral mucosa ulcer of Wistar rats. EKGR is safe as it does not exhibit irritating potential and harmful effects.

Efficacy of colchicine treatment for aphthous ulcers in pediatric patients: A retrospective review

Efficacy of colchicine treatment for aphthous ulcers in pediatric patients: A retrospective review

Exploring factors for predicting colchicine responsiveness in children with PFAPA

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA) are the most common autoinflammatory syndromes in children. This study aimed to evaluate the clinical and laboratory parameters that may predict colchicine responsiveness.This retrospective, multicenter, cross-sectional study involved nine pediatric rheumatology centers from our country., The patients diagnosed with PFAPA were compared on the basis of their responses to colchicine. In the 806 (42.3% female 57.7% male) patients, the most common clinical findings were fever (100%), exudative tonsillitis (86.5%), pharyngitis (80.9%), and aphthous stomatitis (50.5%). The mean attack frequency was 13.5 ± 6.8 attacks per year lasting for a mean of 3.9 ± 1.1 days. Colchicine treatment was attempted in 519 (64.4%) patients, with 419 (80.7%) showing a favorable response. In patients who underwent MEFV gene analysis (70.8%), the most common variant was M694V heterozygous (16.8%). The presence of pharyngitis (p = 0.03, 95% CI 0.885 to 0.994), the presence of arthralgia (p = 0.04, 95% CI 0.169 to 0.958), and having more frequent attacks (p = 0.001, 95% CI 0.028 to 0.748) were found to be associated with colchicine unresponsiveness, whereas the carriage of the M694V variant (p = 0.001, 95% CI 0.065 to 0.242) was associated with colchicine responsiveness.Conclusion: This study identified the presence of pharyngitis, arthralgia, and increased attack frequency in patients with PFAPA as factors predicting colchicine unresponsiveness, whereas the carriage of the M694V variant emerged as a predictor of colchicine responsiveness. Predicting colchicine response at disease onset may facilitate a more effective management of PFAPA.What is Known:• Colchicine treatment can be used in the prophylaxis of PFAPA disease.• Having the MEFV variant is the most commonly known factor in predicting response to colchicine.What is New:• The presence of pharyngitis or arthralgia, and more frequent attacks in PFAPA disease were found to be independently associated with colchicine unresponsiveness. • Carrying the M694V variant was identified as the sole factor predicting colchicine responsiveness.

Prevalence of stress associated oral mucosal disorders among patients from Southern Rajasthan, India

Data on the prevalence of stress associated oral mucosal lesions/conditions such as Oral lichen planus, Apthous ulcers, Burning mouth syndrome, Headache, Xerostomia, Halitosis, Myofacial pain Dysfunction syndrome amongst population of Southern Rajasthan is of interest to dentists. Cross sectional study had been conducted on 5214 patients from 18-60 years age group who visited the Department of the Oral Medicine and Radiology, Pacific Dental College and Research Centre, Bedla, Udaipur. Findings such as burning of oral mucosa, presence of vesicles and ulcers, striation in oral cavity, limitation of jaw movement, muscular pain were assessed for the establishment of diagnosis. Prevalence of stress associated oral mucosal lesions/conditions like Oral lichen planus, Apthous ulcers, Burning mouth syndrome, Headache, Xerostomia, Halitosis, Myofacial pain Dysfunction syndrome was reported to be 12%, 17%, 3%, 21%, 6 %, 23 and 18% respectively. Besides stress management therapy, Professional consultation along with proper investigation and medicinal treatment is required

Effectiveness of low-level laser therapy in reducing pain score and healing time of recurrent aphthous stomatitis: a systematic review and meta-analysis

BackgroundRecurrent aphthous stomatitis (RAS) is a common chronic inflammatory oral disease that negatively impacts the quality of life. Current therapies aim to reduce pain and healing process yet challenges such as rapid loss due to salivary flushing in topical drugs and adverse effects due to prolonged use of systemic medications require further notice. Low-level laser therapy is reported with immediate pain relief and faster healing thus preserving the potential for optimal treatment modalities. This review critically analyses and summarizes the effectiveness of LLLT in reducing pain scores and healing time of RAS.MethodsA systematic search was conducted in ScienceDirect, PubMed, and Scopus using keywords of low-level laser therapy, photo-biomodulation therapy, and recurrent aphthous stomatitis. RCTs between 1967 to June 2022, presenting characteristics of the laser and reporting pain score and/or healing time of RAS after irradiation were included. Animal studies and recurrent aphthous ulcers with a history of systemic conditions were excluded. Studies were critically appraised using the RoB 2 tool. A meta-analysis was performed using inverse variance random effects.ResultsFourteen trials with a total of 664 patients were included. Reduced pain was reported in 13 studies, while shortened healing time was presented in 4. The pooling of two studies after CO2 irradiation demonstrated faster healing time compared to placebo (MD − 3.72; 95% CI − 4.18, − 3.25).ConclusionPain score and healing time of RAS were reduced after irradiation with LLLT. RoB resulted in “some concerns” urging well-designed RCTs with larger samples to further assess each laser application for comparison.Systematic review registrationPROSPERO CRD42022355737.

Treatment of aphthous ulcers with photodynamic therapy: A randomized controlled clinical study

BackgroundThis study aims to assess whether photodynamic therapy (PDT) offers a clinically effective alternative for treating oral aphthous ulcers, contributing to the ongoing quest for methods to expedite their treatment process amidst the limited understanding of their etiology. Materials and MethodThe study involved thirty volunteers with aphthous ulcers, split equally between a control group and a PDT group. Patients in the PDT group received laser treatment using Indocyanine green upon admission, while the control group received no intervention. Lesion diameter was measured at presentation and on the 3rd, 5th, and 7th days for all patients, with wound healing assessed on the 7th day. Additionally, pain levels were evaluated using the Visual Analog Scale (VAS) preoperatively and on the 1st, 3rd, 5th, and 7th days for the PDT group, and on the corresponding days for the control group. ResultsLesion diameters in the PDT group showed a significant reduction over time (p = 0.001), particularly from preoperative to final measurements. The control group also exhibited a decrease, albeit slower (p = 0.001). The 7th-day healing scores favored the PDT group significantly (p = 0.012). VAS scores in the PDT group decreased significantly over time (p = 0.001), indicating pain reduction. A similar trend was observed in the control group, albeit slower. Between-group differences in healing data and pain data were statistically significant. ConclusionPDT proves effective in reducing aphthous ulcer diameters and pain intensity, facilitating faster healing than the control group. These results advocate for PDT as a viable treatment option for aphthous lesions.