Randomised controlled trial comparing the clinical effectiveness of mouthwashes based on essential oils, chlorhexidine, hydrogen peroxide and prebiotic in gingivitis treatment.

AIM: The present clinical study aimed to investigate the clinical efficacy of 5 types of mouthwash based on different active substances. MATERIALS AND METHODS: The study included 180 patients divided into 6 groups of 30 patients, each group rinsing with one of the following types of mouthwash based on: essential oils, combination of essential oils and 0.12% chlorhexidine, hydrogen peroxide (0.8%), prebiotic, 0.2% chlorhexidine, and placebo. All participants underwent professional mechanical plaque removal after which they were instructed to rinse with 15 ml mouthwash 2 times a day for 21 days. During the study period, patients were monitored at days 0, 14, and 21, examining oral hygiene index, gingival index, bleeding index, and presence of side effects. RESULTS: Gingival index, bleeding index, and oral hygiene index were reduced statistically significantly in all treatment groups. Adjunctive use of mouthwashes demonstrated better clinical effectiveness compared to mechanical plaque control (and placebo mouthwash). The gingival index and the plaque index were reduced most significantly in the group using mouthwash with hydrogen peroxide. The bleeding index decrease was most significant in the group using 0.2% chlorhexidine. CONCLUSIONS: All tested mouthwashes demonstrated significant clinical effectiveness in different degrees in gingivitis treatment. New formulas with prebiotic and combination of essential oils and chlorhexidine indicate promising effectiveness.

Effects of Low Level Laser Therapy on Erosive-atrophic Oral Lichen Planus.

BACKGROUND: The erosive-atrophic form of oral lichen planus (OLP) is associated with severe pain and burning sensation and is often unresponsive to treatment. Topical corticosteroids are considered as a medication of first choice but they can produce adverse effects. Therefore, new therapeutic approaches are required. AIM: The aim of this study was to investigate the effectiveness of biomodulation with diode laser in patients presenting with long-standing erosive-atrophic OLP. MATERIALS AND METHODS: Twelve patients, clinically and histologically diagnosed with OLP, participated in this study. The level of pain and the clinical scores of total 59 lesions were recorded before treatment using visual analog scale and Thongprasom sign scoring system respectively. All patients received low level laser therapy (LLLT) with diode laser (810 nm) with parameters (0.5 W, 30 s, 1.2 J/cm2) three times weekly for a month. The response rate was assessed according to the decrease in pain and sign scores. Treatment efficacy index was calculated. RESULTS: There was a significant reduction in pain after LLLT (p<0.0001). Improvement in clinical signs was achieved in 59.3% of the lesions. At the end of the treatment 5.1% of the lesions exhibited score 5; 6.8% - score 4, 11.9% of the lesions were scored 3 and 8.5% and 30.5% showed score 2 and score 1, respectively. Complete resolution was revealed in 37.3% of the lesions. All patients experienced some degree of improvement. Most of the cases showed moderate recovery. CONCLUSION: The present results indicate that LLLT is an effective and harmless modality for management of erosive-atrophic OLP.

Oral Lichen Planus - Known and Unknown: a Review.

Lichen planus is a chronic mucocutaneous inflammatory disease aff ecting 1-2% of the general population with maximum prevalence of the disease in women above the age of 40. Its aetiology remains unclear and the pathogenesis is still the object of much speculation. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. The present paper presents the most well-known external agents (viruses in particular), internal agents like stress, and the heat shock protein thought to be trigger factors and describes the action of diff erent cells and proteins associated with the development of that disease. Diagnosis is based on clinical and histopathologic evidence; direct and indirect immunofluorescence techniques can also be of use. Despite the wide variety of therapeutic modalities, treatment outcomes are often insufficient. Currently, topical corticosteroids are widely accepted as a standard therapy, but also retinoids, calcineurin inhibitors and other immunosuppressants can be administered. Because of the aspect relevant to these drugs, priority is given to alternative harmless methods such as LLLT and PDLT. There is an ongoing controversy in the literature about the possible premalignant character of oral lichen planus, however, periodic followup is recommended.