Treatment of recurrent aphthous stomatitis (RAS; aphthae; canker sores) with a barrier forming mouth rinse or topical gel formulation containing hyaluronic acid: a retrospective clinical study.

BACKGROUND: Use of hyaluronic acid-based products has become a valuable alternative to drug-based approaches in the treatment of recurrent aphthous stomatitis (RAS). The presented study aimed to investigate the effect of a barrier forming hyaluronic acid containing mouth wash or a topical gel formulation on the healing of RAS and patient's quality of life. METHODS: For this single-center retrospective study, medical records of the Dental School of the University of Brescia were screened for adult and systemically health patients suffering from minor recurrent aphthous stomatitis (RAS) and treated with either a barrier forming, hyaluronic acid containing mouth wash (GUM® AftaClear® rinse) or a topical gel (GUM® AftaClear® gel) in 2015. All patients fulfilling the in-/exclusion criteria and presenting full data sets on lesion diameter, lesion color, as well as pain perception for baseline (day 0) and 4 and 7 days after treatment were enrolled into the presented study. RESULTS: Out of 60 screened patients, a total of 20 patients treated with the Rinse formulation and 25 treated with the Gel formulation were eligible for the enrollment into this study. Both groups showed equal distribution in patient's age, sex and presented a similar mean lesion size (3.0 ± 1.0 mm), lesion color distribution as well as pain perception at baseline. All patients showed significant normalization of lesion color, reduction of pain, and lesion dimension within the course of their treatment. After 7 days, the mean percentage of lesion reduction was highly significant for both groups attaining 77.4 ± 30.1% in the Rinse group and 81.2 ± 23.1% in the Gel group with a complete lesion closure obtained in 60 and 56% of the cases, respectively. However, a significant (p < 0.05) higher percentage of lesions in the Gel group (72%) compared to the Rinse group (40%) showed an improvement in lesion size already after 3 days. CONCLUSIONS: Within the limitation of retrospective design, it can be concluded that both the barrier forming hyaluronic acid containing mouth rinse as well as the topical gel formulation are effective in the treatment of minor recurrent aphthous stomatitis (RAS), with a trend for an earlier healing onset for the topical Gel formulation.

In vitro evaluation of the effects of a fluoride-releasing composite on enamel demineralization around brackets.

OBJECTIVES: The aim of this in vitro study was to evaluate the effectiveness of a fluoride-releasing bonding agent in inhibiting enamel demineralization around orthodontic brackets after the exposure to a demineralizing solution. MATERIALS AND METHODS: Twenty-six extracted upper molars were bonded with two different composites: Transbond XT (TXT) and Transbond Plus (TPlus), fluoride-releasing (both 3M Unitek, Monrovia, CA, USA). The samples were exposed to an acid lactic solution for three days and then subjected to Metallographic Optical Microscope (MOM) and Scanning Electron Microscope/Energy Dispersive X-Ray (SEM/EDX) analyses. Enamel surface was examined in different areas: un-treated, etched and primer-painted, un-treated area with no acid exposure, central area with bracket bonded. The maximum demineralization depths and the fluoride content at 100, 200 and 300 µm depth were evaluated. RESULTS: MOM analysis showed statistically significant (p<0.001) differences in demineralization depth for TPlus group compared to TXT group with lower values for the first one. EDX analysis confirmed the presence of fluoride in TPlus group. CONCLUSIONS: The fluoride content of TPlus appeared able to weakly reduce the enamel demineralization.