The efficacy of fluoxetine in BMS-A cross-over study.

BACKGROUND: Burning mouth syndrome (BMS) is an intraoral burning or dysaesthetic sensation, recurring daily for more than two hours during the period longer than 3 months. The objective was to evaluate and analyse the efficacy of serotonin reuptake inhibitor fluoxetine on psychological factors, as well as on pain in participants with BMS. METHODS: In a 6-month study, 100 participants with primary and secondary BMS were divided into two groups-fluoxetine and control (placebo) and examined by the dentist and the neurologist. Depression and anxiety were estimated by Hamilton Scale for Depression (HAM-D) and Anxiety (HAM-A) and Beck Depression Inventory (BDI) and the pain intensity by visual analogue scale (VAS). RESULTS: Mean age of the participants was 60.33 in fluoxetine group and 67.4 in control group. Most of the participants were female-74% in the fluoxetine and 78% in the control group. Statistical difference between the fluoxetine and the control group was found in HAM-D results (P < .05). Values of other scales and VAS decreased significantly after the therapy in both groups (P < .05). CONCLUSIONS: Our trial results indicate that fluoxetine therapy not only improves the psychological status of participants with BMS but also fluoxetine decreases the intensity of pain in these patients.

Expression and role of p53 in oral lichen planus patients.

PURPOSE: Oral lichen planus (OLP) is an autoimmune skin and mucosal disorder. The range of malignant transformation in OLP varies between 0.1-3%. p53 is a tumor suppressor protein. Defective p53 could allow abnormal cells to proliferate, resulting in cancer. p53 plays an important role in cell cycle control and apoptosis and loss of p53 function has been demonstrated in about half of all human cancers. The purpose of the study was to investigate the malignant potential of OLP on the basis of p53 expression and to correlate p53 expression with clinical and histopathological features of OLP. METHODS: 40 patients with OLP underwent biopsy. All tissue samples were treated immunohistochemicaly using avidin-biotin peroxidase complex method. RESULTS: In 80% of OLP specimens the nuclei of basal and parabasal keratinocytes were p53-positive, but in low numbers. Low percentage of p53-positive cells in older and medium percentage of p53-positive cells in younger group of OLP patients were noted. Higher intensity of p53 stained keratinocytes, no matter their low number, could represent mutant and more stable form of p53 protein, and at the same time signal for monitoring of disease due to potential malignant transformation. Low percentage and weak intensity of p53-positive cells was detected mostly in OLP specimens with highly expressed civatte bodies (CB). Upregulation of apoptosis didn't correspond with the expression of CB. CONCLUSION: We believe that low percentage of p53-positive and well-marked keratinocytes in OLP represent the influence of mutant p53 protein, and that increasing expression of this protein could serve as a valuable diagnostic sign of early carcinogenesis. According to our results intensity of p53 coloration of keratinocytes could help assessing the malignant potential of OLP.

Association of vdr, cyp27b1, cyp24a1 and mthfr gene polymorphisms with oral lichen planus risk.

OBJECTIVES: The current study investigated the association between VDR EcoRV (rs4516035), FokI (rs2228570), ApaI (rs7975232) and TaqI (rs731236), CYP27B1 (rs4646536), CYP24A1 (rs2296241), and MTHFR (rs1801133) gene polymorphisms and risk of oral lichen planus (OLP) occurrence. MATERIALS AND METHODS: The study group consisted of 65 oral lichen planus patients and 100 healthy blood donors in the control group. Single nucleotide polymorphisms were genotyped by real time PCR or PCR-restriction fragment length polymorphism (RFLP) method. RESULTS: Heterozygous as well as mutated genotype of vitamin D receptor (VDR) FokI (rs2228570) polymorphism was associated with increased oral lichen planus risk in comparison with wild type genotype (odds ratio (OR) = 3.877, p = 0.017, OR = 38.153, p = 0.001, respectively). A significantly decreased OLP risk was observed for heterozygous genotype of rs2296241 polymorphism in CYP24A1 gene compared with the wild type form (OR = 0.314, p = 0.012). VDR gene polymorphisms ApaI and TaqI were in linkage disequilibrium (D' = 0.71, r(2) = 0.22). Identified haplotype AT was associated with decreased OLP risk (OR = 0.592, p = 0.047). CONCLUSION: Our results highlight the possible important role of VDR FokI (rs2228570) and CYP24A1 rs2296241 gene polymorphisms for oral lichen planus susceptibility. CLINICAL RELEVANCE: Identification of new molecular biomarkers could potentially contribute to determination of individuals with OLP predisposition.

TLR2, TLR3, TLR4 and CD14 gene polymorphisms associated with oral lichen planus risk.

The aim of this study was to assess whether polymorphisms in toll-like receptor (TLR) and cluster of differentiation 14 (CD14) genes are associated with oral lichen planus (OLP) risk and clinical course of the disease. The study group consisted of 101 patients with confirmed OLP and 104 healthy blood donors without systemic or oral mucosal diseases. Single nucleotide polymorphisms of TLR2 (rs3804099), TLR3 (rs3775291 and rs5743312), TLR4 (rs4986790 and rs4986791), and CD14 (rs2569190) genes were genotyped using real-time PCR or PCR-restriction fragment length polymorphism (PCR-RFLP). The rs5743312 TLR3 gene polymorphism was associated with increased OLP risk in comparison with the wild type genotype (OR = 15.984, P = 0.011). No association with OLP risk was observed for the polymorphisms studied in TLR2, TLR4 and CD14 genes or for the rs3775291 polymorphism of the TLR3 gene. The polymorphisms of the TLR3 gene were in linkage disequilibrium (D' = 1, r(2) = 0.1). Identified haplotypes were not associated with the risk of OLP. The findings of the current study suggest that the TT genotype of the rs5743312 TLR3 gene polymorphism may play a significant role in the aetiology of OLP.

Effect of Low-level Light Therapy on Post-operative Healing of Secondary Chronic Osteomyelitis of the Jaws - A Prospective Study.

Introduction: Osteomyelitis of the jaws is a common disease of the maxillofacial region. The goal of treatment is to alleviate pain, reduce infection, inhibit the progression of the disease and induce bone and mucosal healing. In addition to surgical management and antibiotic and oxygen hyperbaric therapy, new therapeutic strategies for the treatment of osteomyelitis are developed. One of the novel approaches is photobiomodulation therapy or low-level light therapy (LLLT). Materials and Methods: After surgical treatment, experimental group patients (n = 4) were treated with LLLT for five sessions with an extraoral pulsed 635-nm LED lamp (Repuls7, Repuls Lichtmedizintechnik GmbH, Austria), maximum output power: 140 mW/cm2, frequency: 2.5 Hz, duty cycle: 50%. Clinical achievement and patient pain perception (through Visual Analogue Scale score) were evaluated at 1-, 3- and 6-month follow-up appointments and compared with control group (n = 4) patients, treated with standard therapy. Results: At three and six months, clinical achievement was better in patients treated with LLLT. Pain and discomfort resolution was significantly greater in the experimental group. Discussion: Taking into consideration the results of this study, it can be concluded that LLLT shows potential for improving clinical outcome of surgical and medical treatment of secondary chronic osteomyelitis of the jaws. Furthermore, pain and discomfort were significantly reduced in patients treated with LLLT. Further research with a larger sample size is needed to obtain a more accurate insight into this promising field.

Role of tumor suppressor protein p16 in patients with oral lichen planus.

PURPOSE: Oral lichen planus (OLP), is considered premalignant condition. This study tried to investigate the possibility of malignant transformation in OLP patients, by measuring the level of tumor suppressor protein p16INK4A, which is a product of the cyclin-dependent kinase inhibitor 2 (CDK2). CDK inhibitors may be responsible for maintenance of cell cycle. An imbalance in the cell cycle regulatory pathway involving p16/pRb may lead to unrestricted proliferation and tumorigenesis. METHODS: 40 patients with OLP underwent biopsy. Two control groups were included in this research, 13 healthy persons and 12 patients with oral squamous cell carcinoma (OSCC). All tissue samples were treated immunohistochemically using avidin-biotin peroxidase complex method. RESULTS: The number of patients with p16 positive cells was significantly higher in OLP (72.5%) in comparison to OSCC (33.33%). Although the prevalence of patients with p16 positive cells in OSCC was low, they expressed the highest percentage of p16 positive keratinocytes. Staining intensity of cytoplasm was also higher in p16 positive keratinocytes of OSCC in comparison to OLP. CONCLUSIONS: These results suggest that inactivation of p16 is an early detectable event in oral tumorigenesis. P16 expression could also be connected with tumor grading and may be useful marker in oral tumor progression.

Calcitonin gene-related peptide levels in saliva of patients with burning mouth syndrome.

Burning mouth syndrome (BMS) is an intraoral burning sensation for which no medical or dental cause can be found. Recent studies suggest that primary neuropathic dysfunction might be involved in the pathogenesis of BMS. Calcitonin gene-related peptide (CGRP) plays an important role in the development of pain and serves as a biological marker of trigeminovascular activation. The aim of this study was to determine the levels of CGRP in the saliva of BMS patients and estimate the trigeminovascular activation in BMS. CGRP levels were measured, by RIA method in 78 BMS patients and 16 healthy subjects. The levels of CGRP were non-significantly decreased in BMS patients in comparison to healthy subjects. These results suggest that trigeminal nerve degeneration may be the underlying cause of BMS.