Comparing the effects of cryotherapy with nitrous oxide gas versus topical corticosteroids in the treatment of oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa with treatment challenges for clinicians. AIMS: The objective of this study is to compare the effects of cryotherapy as a new modality with topical corticosteroids as a conventional therapy in the treatment of OLP. MATERIALS AND METHODS: Thirty patients with bilateral OLP lesions were selected. From each patient a lesion on one side was chosen randomly for a single session of cryotherapy with nitrous oxide gas and the lesion on the other side received triamcinolone acetonide 0.1% ointment in orabase. Treatment outcome was measured by means of an appearance score, pain score (visual analogue scale), and severity of lesions before treatment and after 2, 4 and 6 weeks of treatment. STATISTICAL ANALYSIS USED: Paired samples t-test and Wilcoxon test. RESULTS: In both methods of treatment sign score, pain score and severity of lesions was significantly reduced in all follow-up sessions (P<0.05). But the treatment outcome and relapse was not significantly different between the two treatment methods (P>0.05). CONCLUSION: Cryotherapy with nitrous oxide gas is as effective as topical triamcinolone acetonide in the treatment of OLP with no systemic side effects and needs less patient compliance. It can be considered as an alternative or adjuvant therapy in OLP patients to reduce the use of treatments with adverse effects.

The adjunct therapeutic effect of lasers with medication in the management of orofacial pain: double blind randomized controlled trial.

OBJECTIVE: This study aimed to evaluate the efficacy of laser therapy in conjunction with a pharmaceutical approach to alleviate myofascial pain dysfunction syndrome. BACKGROUND DATA: A few clinical studies have evaluated the analgesic effect of laser therapy on orofacial pain, most of which reported controversial results. Myofascial pain dysfunction syndrome (MPDS), trigeminal neuralgia, and atypical facial pain are the most common facial pain. METHODS: A double-blind randomized controlled trial was designed to evaluate the therapeutic effect of GaAs laser (peak power 10 W; pulse frequency 3000 Hz; average power 0.012 W; wavelength 980 nm; irradiation duration 300 sec; and dose 12.73 J/cm(2)) on the management of common orofacial pain. The laser group (n=30) received 10 sessions of treatment with GaAs laser. The control group (n=30) was treated identically with sham laser. All patients received the appropriate pharmaceutical treatment as well. Visual analog scale (VAS) was recorded for all patients at baseline, and immediately, 2, and 4 months after the final treatment session. The qualitative variables among the groups were compared using the χ(2) test. RESULTS: Both groups demonstrated a significant reduction in pain with the progression of time (p<0.05). The difference between the two groups was not significant (p>0.05). Whereas laser therapy in the present study failed to show any significance over the control group, the role of covariates such as radiation parameters (wave length, dose) should not be overlooked. CONCLUSIONS: We found no significant level of efficacy for the GaAs laser in the management of common orofacial pain. Further studies are suggested to evaluate the efficacy of other types of lasers with different parameters in the management of orofacial pains.

Subcutaneous connective tissue reactions to various endodontic biomaterials: an animal study.

BACKGROUND AND AIMS: Biocompatibility of root-end filling materials is a matter of debate. The aim of this study was to compare the biocompatibility of a variety of commercial ProRoot WMTA cements and a resin-based cement (Geristore®) with different pH values of setting reaction and different aluminum contents, implanted into the subcutaneous connective tissue of rats at various time intervals. MATERIALS AND METHODS: Fifty Sprague-Dawley rats were used in this study. Polyethylene tubes were filled with Angelus WMTA, ProRoot WMTA, Bioaggregate, and Geristore. Empty control tubes were implanted into subcutaneous tissues and harvested at 7-, 14-, 28- and 60-day intervals. Tissue sections of 5 µm were stained with hematoxylin and eosin and observed under a light microscope. Inflammatory reactions were categorized as 0, none (without inflammatory cells); 1, mild (inflammatory cells ≤25); 2, moderate (25-125 inflammatory cells); and 3, severe (>125 inflammatory cells). Statistical analysis was performed with Kruskal-Wallis and Mann Whitney U tests. RESULTS: ProRoot WMTA and Angelus elicited significantly less inflammation than other materials (P<0.05). After 7 days, however, all the materials induced significantly more inflammation than the controls (P<0.05). Angelus-MTA group exhi-bited no significant differences from the Bioaggregate group (P=0.15); however, ProRoot WMTA elicited significantly less inflammation than Bioaggregate (P=0.02). Geristore induced significantly more inflammation than other groups (P<0.05). CONCLUSION: Geristore induced an inflammatory response higher than ProRoot WMTA; therefore, it is not recommended for clinical use.

Healing acceleration in hamsters of oral mucositis induced by 5-fluorouracil with topical Calendula officinalis.

OBJECTIVE: This study assessed the potential of topical Calendula officinalis extract on the healing of oral mucositis induced by 5-fluorouracil (5-FU) in hamsters. STUDY DESIGN: Oral mucositis was induced in 60 male hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on days 1 and 2. On days 12-17, 5% and 10% C. officinalis gel and gel base groups were treated and then compared with a control group. Macroscopic and microscopic scores and weights were evaluated. RESULTS: Microscopic and macroscopic scores of mucositis were lower in the 5% and 10% C. officinalis gel groups than in the gel base and control groups (P < .05). Weight gain was noted in the treatment groups compared with the gel base and control groups (P < .05). CONCLUSIONS: Calendula officinalis extract accelerated the healing of oral mucositis in hamsters.