Screening for the undiagnosed diabetes at dental chair-side of an Italian university clinic. A pilot prospective study.

AIM: In Italy there is about one undiagnosed case of diabetes for each known case. The dental office might represent an important setting for screening the glycemic status of patients. The aim of the present study was to evaluate the effectiveness of dental chair-side capillary blood sampling for the identification of undiagnosed hyperglycemia in a group of Italian patients. METHODS: Five hundred fifteen patients >45 years old consecutively visiting a public university dental clinic, where admission is regulated by medical or income criteria, were considered for the study. Demographic data, medical history, time of the last caloric intake and waist width were recorded for each participant. All participants underwent an oral examination. Glycemic values were obtained by capillary blood glucose testing. RESULTS: Of the 400 subjects who took part in the study, a low percentage of unaware diabetic individuals (1.7%) was identified. Inclusion criteria restriction to subjects between 50 and 75 years of age and a waist circumference >92 cm would have resulted in a proportion of diabetic patients of 4.3%. CONCLUSION: Dental chair-side in a public university clinic in Italy failed to disclose the expected number of unaware diabetic patients.

An up-to-date view on persistent idiopathic facial pain.

Previously called atypical facial pain, persistent idiopathic facial pain (PIFP) is a common, but poorly defined entity. The cause of PIFP is unknown, but surgery or injury in the distribution of the trigeminal nerve could be reported as early event. Treatment is often unsatisfactory and quality research relating management of this condition is missing. Psychologi-cal distress is frequently observed in patients suffering from persistent idiopathic facial pain. The present review aims at presenting the available knowledge of this elusive orofacial pain condition.

Ability of polyurethane foams to support cell proliferation and the differentiation of MSCs into osteoblasts.

In bone tissue reconstruction, the use of engineered constructs created by mesenchymal stem cells (MSCs) that differentiate and proliferate into three-dimensional porous scaffolds is an appealing alternative to autologous and heterologous bone grafts. Scaffolds considered in this work are represented by polyurethane (PU) foams. Two PU foams (EC-1 and EC-2) were synthesized and characterized for morphology, mechanical properties and in vitro interaction with the osteoblast-like cell line MG63 and MSCs from human bone marrow. EC-1 and EC-2 showed similar densities (0.20 g cm(-3)) with different morphologies: EC-1 showed a more homogeneous pore size (average Phi = 691 microm) and distribution, with a 35% open porosity, whereas EC-2 evidenced a wide range of pore dimension, with an average pore size of 955 microm and a 74% open porosity. The compressive properties of the two foams were similar in the dry condition and both showed a strong decrease in the wet condition. In vitro tests showed good MG63 cell proliferation, as confirmed by the results of the MTT assay and scanning electron microscopy (SEM) observations, with a higher cell viability on EC-2 foam 7 days post-seeding. In the experiments with MSCs, SEM observations showed the presence of an inorganic phase deposition starting day 7 onto EC-1, day 14 onto EC-2. The inorganic particles (CaP) deposition was much more evident onto the pore surface of both foams at day 30, indicating good differentiation of MSCs into osteoblasts. Both PU foams therefore appeared to stimulate cell adhesion and proliferation in vitro, sustaining the MSCs' growth and differentiation into osteoblasts.

Clinical aspect and survival rates in subject with oral cancer: a retrospective cohort study.

AIM: The aim of this study was to describe and evaluate survival in a group of patients with oral malignant neoplasias, observed at the Unit of Oral Pathology and Medicine, University of Milan, between February 1995 and September 2005. METHODS: This retrospective study considered the clinical histories and anamnestic profiles of a group of 108 patients with malignant oral neoplasms. A sample of 72 out of these 108 patients was identified, for whom follow-up data were available for at least 4 months from the date of diagnosis. Survival times for this group were then evaluated. RESULTS: In this group of 108 patients, 103 were affected by squamous cell carcinoma. The ratio of male to female patients was 1.1:1.0 and the average age at the time of diagnosis was 64.9 years. In 44 out of 91 cases, the site affected was the tongue and in 28 out of 45 cases, the lesion was at an early stage (TNM 1 and 2) at the time of diagnosis. Survival in the group of 72 considered was 84% at 2 years from diagnosis and 55% at 5 years. Diagnosis before the age of 65 favoured a positive prognosis (P=0.01), as did lesions diagnosed at TNM 1 stage, though this was not statistically significant (P=0.1). CONCLUSION: The data provided in this retrospective study were consistent with previous reports of survival rates at 5 years from diagnosis and the improved prognosis for patients diagnosed before the age of 65. The only finding that was different from previous studies was the gender distribution, which in this study was almost equal.

Miconazole as adjuvant therapy for oral lichen planus: a double-blind randomized controlled trial.

BACKGROUND: Topical steroids are the first choice for the treatment of oral lichen planus (OLP). Antifungal drugs are often employed together with them, to prevent secondary oral candidosis, although it has been suggested anecdotally that they can also be beneficial for OLP itself. OBJECTIVES: To compare the effect of clobetasol propionate with and without a topical antifungal drug (miconazole) on the symptoms and extension of OLP. METHODS: A randomized, parallel, double-blind trial was conducted at the Unit of Oral Medicine and Pathology of the University of Milan. Thirty-five outpatients with histologically proven OLP were randomly assigned to receive either clobetasol propionate and miconazole, or clobetasol propionate and placebo for 6 weeks. Primary outcomes included symptoms and extension of lesions; adverse effects were also recorded. RESULTS: All the patients who concluded the study (30 of 35) showed clinical and subjective improvement within 3 weeks. The addition of miconazole did not affect in a significant way the signs and symptoms of OLP. No cases of clinical candidosis were seen in the patients taking miconazole, while one-third (five of 15) of the placebo group were affected. CONCLUSIONS: Although effective in preventing iatrogenic candidosis, the addition of miconazole to topical steroid treatment does not improve the efficacy of the therapy.

Oral biopsy. A prospective study on 286 consecutive procedures.

AIM: The aim of the present study was to survey oral biopsy procedures, with particular regard to the incidence of adverse events, patients experience and adequacy of the sample. METHODS: This prospective survey was conducted by collecting detailed information from consecutive patients undergoing oral biopsy; data were obtained on the same day of oral biopsy and after 7 days. RESULTS: Data on 286 procedures were collected. About half of the patients had a relevant medical history and were taking one or more medications. During biopsy, the majority of patients (83%) felt no pain, the others reported mild discomfort. Intraoperative adverse events occurred occasionally (4.5%) and were always easily resolved; 18% patients admitted taking painkillers in the days following surgery. The pathologist was always able to make histological diagnosis, although some samples did not include healthy mucosa (32%) or connective tissue (11%). CONCLUSION: Oral biopsy is a safe and well accepted surgical procedure.

The effect of levosulpiride in burning mouth syndrome.

AIM: This paper evaluated the efficacy of the systemic administration of levosulpiride, an antipsychotic and antidepressant drug, in the management of burning mouth syndrome. METHODS: Forty-four subjects suffering from idiopathic burning mouth syndrome were enrolled in the study. Patients underwent a thorough clinical examination, including salivary flow rate measurements, laboratory tests (complete blood cell counts, blood glucose levels, serum iron and transferrin levels, serum vitamin B(12), and folate levels), patch tests for contact allergy to denture materials, and isolation of Candida species from oral mucosal scrapes. Oral symptoms before and after treatment were assessed using a visual analogue scale. All the patients used systemic levosulpiride (100 mg/daily) for 8 weeks. RESULTS: Of the 39 patients who completed the protocol, none reported complete remission of the oral burning sensation. However, 28 patients reported at least some improvement, and these patients had had oral symptoms for significantly less time than those who reported no improvement. CONCLUSIONS: These preliminary data suggest that levosulpiride is more effective in patients who have recently developed burning/stinging oral sensation.

Clinical and histopathological features of the oral mucosa in allogeneic haematopoietic stem cell transplantation patients.

INTRODUCTION: Chronic graft-versus-host disease (cGVHD) is a common but serious complication of allogeneic haematopoietic stem cell transplantation (HSCT). Oral involvement of cGVHD occurs in 80 to 100% of patients suffering from cGVHD and may be the early manifestation of this complication. AIM: To study whether the histological changes of oral cGVHD are detectable in apparently normal oral mucosa of HSCT patients without clinical manifestations of the disease. PATIENTS AND METHODS: This study enrolled 13 adult patients who underwent allogeneic HSCT for haematological malignancies. The presence of lichenoid, atrophic or erythematous changes of the oral mucosa detected on oral examination approximately 100 days after the HSCT was regarded as positive for cGVHD. An incisional biopsy of the oral mucosa was taken from patients with and without oral cGVHD and the specimens were examined by a pathologist who was unaware of the clinical state of the sampled mucosa. RESULTS: Biopsies were taken from four patients with clinical manifestations of oral cGVHD and from nine patients with apparently normal oral mucosa. Histological cGVHD changes were detected in each of the four patients (100%) with clinical manifestations of oral cGVHD and in six of the nine patients (66.6%) with apparently healthy mucosa. DISCUSSION: Although the histological changes in the oral mucosa without corresponding clinical alterations that were detected in this study are insufficient for a definite diagnosis of oral cGVHD, it appears important to investigate the amount of histological change in predicting clinical onset. A longer follow-up period in patients showing histological changes with no clinical manifestations may elucidate whether these changes are predictive of clinically evident lesions in the mouth or other sites.

Interventions for treating oral leukoplakia.

BACKGROUND: Oral leukoplakia is a relatively common oral lesion that in a small but significant proportion of cases changes into cancer. Since most leukoplakias are asymptomatic, the primary objective of treatment should be to prevent such malignant transformation. OBJECTIVES: To assess effectiveness, safety and acceptability of treatments for leukoplakia. SEARCH STRATEGY: The following databases were searched for relevant trials: Cochrane Oral Health Group's Trials Register (to April 2006), CENTRAL (TheCochrane Library 2006, Issue 1), MEDLINE (from 1966 to December 2005), and EMBASE (from 1980 to December 2005). Handsearching was performed for the main oral medicine journals. References of included studies and reviews were checked. Oral medicine experts were contacted through an European mailing list (EURORALMED). SELECTION CRITERIA: Randomised controlled trials (RCTs), enrolling patients with a diagnosis of oral leukoplakia, were included. Any surgical or medical (topical and systemic) treatment was included. The primary outcome considered was malignant transformation of leukoplakia. Other outcomes considered were clinical resolution, histological modification and frequency of adverse effects. DATA COLLECTION AND ANALYSIS: Data were collected using a specific extraction form. Malignant transformation of leukoplakia, demonstrated by histopathological examination, was the main outcome considered. Secondary outcomes included clinical resolution of the lesion and variation in dysplasia severity. The validity of included studies was assessed by two review authors, on the basis of the method of allocation concealment, blindness of the study and loss of participants. Data were analysed by calculating risk ratio. When valid and relevant data were collected, a meta-analysis of the data was undertaken. MAIN RESULTS: The possible effectiveness of surgical interventions, including laser therapy and cryotherapy, has never been studied by means of a RCT with a no treatment/placebo arm. Twenty-five eligible RCTs of non-surgical interventions were identified: 11 were excluded for different reasons, five were ongoing studies, leaving nine studies to be included in the review (501 patients). Two studies resulted at low risk of bias, six at moderate risk of bias and one at high risk of bias. Vitamin A and retinoids were tested by five RCTs, two studies investigated beta carotene or carotenoids, the other drugs tested were bleomycin (one study), mixed tea (one study) and ketorolac (one study). One study tested two treatments. Malignant transformation was recorded in just two studies: none of the treatments tested showed a benefit when compared with the placebo. Treatment with beta carotene, lycopene and vitamin A or retinoids, was associated with significant rates of clinical resolution, compared with placebo or absence of treatment. Whenever reported, a high rate of relapse was a common finding. Side effects of variable severity were often described; however, interventions were well accepted by patients, since drop-out rates were similar between treatment and control groups. AUTHORS' CONCLUSIONS: To date there is no evidence of effective treatment in preventing malignant transformation of leukoplakia. Treatments may be effective in the resolution of lesion, however relapses and adverse effects are common.

Burning mouth syndrome: a retrospective study investigating spontaneous remission and response to treatments.

OBJECTIVE: The aim of this investigation was to evaluate the spontaneous remission rate of burning mouth syndrome (BMS) in a group of subjects suffering from this syndrome. SUBJECTS AND METHODS: The medical records of BMS patients attending the Unit of Oral Medicine (1995-2002) were reviewed. The patients with a follow-up period of at least 18 months were then contacted over phone and interviewed using a structured ad hoc questionnaire to record their current symptoms and data about their treatment responses to the therapies. RESULTS: Forty-eight women and five men with a mean age of 67.7 years (range 33-82 years) were included in the study (mean duration of BMS 5.5 years, s.d. +/-1.9 years, mean follow-up period of 56 months). As a consequence of different treatments, 26 patients (49.0%) reported no change in oral symptoms, 15 (28.3%) moderate improvement and 10 (18.9%) a worsening of oral complaints. Only two patients (3.7%) reported a complete spontaneous remission of oral symptoms without any treatment. CONCLUSIONS: In this study, a complete spontaneous remission was observed in 3% of the patients within 5 years after the onset of BMS. A moderate improvement was obtained in <30% of the subjects.

Osteonecrosis of the jaws in patients treated with bisphosphonates. Review of the literature and the Milan experience.

AIM: A series of 5 patients with osteonecrosis of the jaws possibly related to the use of bisphosphonates is presented. A brief review of the literature is also proposed. METHODS: A retrospective review of patients who received bisphosphonates and who developed osteonecrosis of the jaws following minor oral surgery was performed. RESULTS: In all 5 patients, a tooth extraction preceded the onset of osteonecrosis of the mandible. Patients were on chronic use of intravenous bisphosphonates. The presenting lesions was a nonhealing extraction socket and an exposed jawbone. Biopsy of the bone lesions showed no evidence of metastatic involvement. Antibiotic therapy, conservative debridement and, in some cases, bone sequestrectomy were performed. CONCLUSIONS: Osteonecrosis of the jaws appears to have a relationship with the use of bisphosphonates. It is important that medical oncologists and dentists become aware of this possible complication in order to perform minor oral surgery prior to starting bisphosphonates treatment.

Lichen planus and hepatitis C virus: a multicentre study of patients with oral lesions and a systematic review.

BACKGROUND: An association between hepatitis C virus (HCV) infection and lichen planus (LP) has been investigated, but results have been inconsistent. OBJECTIVES: To investigate the relationship between LP and HCV seropositivity. Methods In a cross-sectional study we tested the sera of 303 consecutive newly diagnosed patients with histologically proven LP referred to three Italian centres for the presence of anti-HCV IgG. A comparable control group was also tested. Next, in a systematic review, studies were identified by searching different databases in April 2004. Inclusion criteria were: (i) analytical study design; (ii) clinical and histological diagnosis of LP; and (iii) serological test for anti-HCV antibodies as main outcome. The risk of bias was assessed on the basis of characteristics of the study group, appropriateness of the control group and study design. Pooled data were analysed by calculating odds ratios (ORs), using a random effects model. RESULTS: In the cross-sectional study, nearly one in five (19.1%) of the LP group was HCV positive, while a much lower prevalence of infection was found in the control group (3.2%) [OR 7.08; 95% confidence interval (CI) 3.43-14.58]. The systematic review yielded 25 relevant studies, six of which had a low risk of bias. There was a statistically significant difference in the proportion of HCV-seropositive subjects among patients with LP, compared with controls (OR 4.80; 95% CI 3.25-7.09). Following subgroup analyses, the variability of HCV prevalence in patients with LP seemed to depend on geographical area, but not on age. CONCLUSIONS: Anti-HCV circulating antibodies are more common in patients with LP than in controls, although such an association may not be significant in some geographical areas.

Interventions for treating oral leukoplakia.

BACKGROUND: Oral leukoplakia is a relatively common oral lesion that in a small but significant proportion of cases changes into cancer. Since most leukoplakias are asymptomatic, the primary objective of treatment should be to prevent such malignant transformation. OBJECTIVES: To assess effectiveness, safety and acceptability of treatments for leukoplakia. SEARCH STRATEGY: The following databases were searched for relevant trials: Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, EMBASE. Handsearching was performed for the main oral medicine journals. References of included studies and reviews were checked. Oral medicine experts were contacted through an European mailing list (EURORALMED). SELECTION CRITERIA: Randomised controlled trials (RCTs), enrolling patients with a diagnosis of oral leukoplakia, were included. Any surgical or medical (topical and systemic) treatment was included. The primary outcome considered was malignant transformation of leukoplakia. Other outcomes considered were clinical resolution, histological modification and frequency of adverse effects. DATA COLLECTION AND ANALYSIS: Data were collected using a specific extraction form. Malignant transformation of leukoplakia, demonstrated by histopathological examination, was the main outcome considered. Secondary outcomes included clinical resolution of the lesion and variation in dysplasia severity. The validity of included studies was assessed by two reviewers, on the basis of the method of allocation concealment, blindness of the study and loss of participants. Data were analysed by calculating relative risk. When valid and relevant data were collected, a meta-analysis of the data was undertaken. MAIN RESULTS: The possible effectiveness of surgical interventions, including laser therapy and cryotherapy, has never been studied by means of a RCT. Nineteen potentially eligible RCTs of non-surgical interventions were identified: eight were excluded for different reasons, four were ongoing studies, leaving seven studies to be included in the review. Two studies resulted at low risk of bias, four at moderate risk of bias and one at high risk of bias. Vitamin A and retinoids were tested by five RCTs (245 patients), the other drugs tested were bleomycin (one study), mixed tea (one study) and beta carotene (one study). Malignant transformation was recorded in just two studies: none of the treatments tested showed a benefit when compared with the placebo. Treatment with beta carotene and vitamin A or retinoids, was associated with significant rates of clinical resolution, compared with placebo or absence of treatment. Whenever reported, a high rate of relapse was a common finding. Side effects of variable severity were often described; however, interventions were well accepted by patients, since drop-out rates were similar between treatment and control groups. REVIEWERS' CONCLUSIONS: To date there is no evidence of effective treatment in preventing malignant transformation of leukoplakia. Treatments may be effective in the resolution of lesion, however relapses and adverse effects are common.

Transdermal fentanyl in HSCT patients: an open trial using transdermal fentanyl for the treatment of oral mucositis pain.

Fentanyl is a synthetic opioid that can be delivered through a transdermal therapeutic system (TTS). The aim of this study was to assess the efficacy of fentanyl TTS in treating oral mucositis pain in 75 adult hematopoietic stem cell transplant (HSCT) patients. The analysis was based on 62 patients who developed mucositis. Pain control was assessed by the patients using a visual analogue scale (VAS) from day 0 to day +33 after HSCT. Fentanyl TTS was administered at the patient's request. In all, 20 patients did not require fentanyl (group A). The first 22 patients asking for the patch received fentanyl 25 microg/h (group B) and the subsequent 20 patients received 50 microg/h (group C). There were no significant differences in pain relief between groups B and C. The expected effect of a decrease in mean pain score (mean of the VAS scores of all of the patients in the same group each day) following the application of fentanyl TTS was not noted. We can conclude that fentanyl TTS at the doses used in this study may not adequately relieve oral mucositis pain.

Prevention and treatment of chemo- and radiotherapy-induced oral mucositis.

The administration of many chemo-radiotherapy regimens in patients with cancer may be complicated by toxicities that limit the clinicians' abilities to deliver the most effective doses of active agents. Oral mucositis is a major dose-limiting toxic effect and the most important cause of morbidity in patients undergoing chemo-radiotherapy for head and neck cancers, in patients undergoing bone marrow transplantation and those receiving certain chemotherapeutic agents for a variety of human malignancies. The intent of this paper is to review preventive strategies and treatment approaches for patients with established oral mucositis. Many agents of differing mechanisms of action have been used in the prevention and treatment of oral mucositis induced by anticancer therapies. Currently, no intervention is completely successful at preventing or treating oral mucositis. The several solutions, drugs and methods used and studied in the prophylaxis and therapy of chemotherapy or radiotherapy-induced oral mucositis reflects the need of new, more efficient tools in the management of this complication. Current studies and our increasing understanding of the etiology and pathogenesis of oral mucositis will lead to new approaches to the management and improved quality of life for these patients.

Interventions for treating oral leukoplakia.

BACKGROUND: Oral leukoplakia is a relatively common oral lesion that in a varying proportion of cases undergoes malignant transformation. Since most leukoplakias are asymptomatic, the need for treatment is primarily based on the precancerous nature of the lesion. OBJECTIVES: To assess effectiveness, safety and acceptability of treatments for leukoplakia. SEARCH STRATEGY: The following data bases were searched for relevant trials: MEDLINE, EMBASE, CancerLit, Biological Abstracts, Cochrane library. Hand searching was performed for the main oral medicine journals. Oral medicine experts were contacted through an European mailing list (EURORALMED). SELECTION CRITERIA: Randomised controlled trials (RCTs), enrolling patients with a diagnosis of oral leukoplakia, were included. DATA COLLECTION AND ANALYSIS: Data were collected using a specific abstraction form. Malignant transformation of leukoplakia, demonstrated by histopathological examination, was the main outcome considered. Secondary outcomes included clinical resolution of the lesion and variation in dysplasia severity. The validity of included studies was assessed on the basis of the method of allocation concealment, blindness of the study and loss of participants. Data were analysed by calculating relative risk. MAIN RESULTS: The possible effectiveness of surgical interventions, including laser therapy and cryotherapy, has apparently never been studied by means of a RCT. Fourteen potentially eligible RCTs of nonsurgical intervention were identified: five were excluded for different reasons, three were ongoing studies, leaving six studies to be included in the review. Vitamin A and retinoids were tested by four RCTs (224 patients), the other drugs tested were bleomycin (one study), mixed tea (one study) and beta carotene (one study). Malignant transformation was recorded in just two studies: none of the treatments tested showed a benefit when compared with the placebo. Treatment with beta carotene and vitamin A or retinoids, was associated with better rates of clinical remission, compared with placebo or absence of treatment. Whenever reported, a high rate of relapse was a common finding. Side effects of variable severity were often described; however, interventions were well accepted by patients, since drop-out rates were similar between treatment and control groups. REVIEWER'S CONCLUSIONS: To date there is no evidence of effective treatment in preventing malignant transformation of leukoplakia. Treatments may be effective in the resolution of lesion, however relapses and adverse effects are common.

Dental experience and self-perceived dental care needs of patients with angioedema.

The purpose of this study was to investigate the self-perceived dental care needs and dental experiences of patients with angioedema. At the 1998 annual meeting of the Voluntary Association for the Fight, Study and Treatment of Hereditary Angioedema ("Associazione volontaria per la lotta, lo studio e la terapia dell'angioedema ereditario"), a self-administered questionnaire was distributed to participants affected by hereditary or acquired angioedema. Fifty-seven persons completed the questionnaire (37 females, 20 males; mean age, 39 +/- 17 yrs; range, 5-76). The vast majority (91%) had the hereditary form of the disease. One-third of the respondents had some problems in obtaining oral treatment, with one person having been refused care. About half of the group had experienced an acute attack following dental treatment. Preventive measures needed improvement in about two-thirds of respondents. More than half (58%) of the group perceived a need for dental care. We conclude that persons with angioedema may experience difficulty in obtaining dental treatment, a common cause of acute attacks.

GM-CSF mouthrinses in the treatment of severe oral mucositis: a pilot study.

OBJECTIVE: The aim of this open trial was to test the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthrinses as a potential treatment in reducing the duration of severe oral mucositis in patients undergoing bone marrow transplantation for hematologic malignancies. STUDY DESIGN: The study group was composed of 10 consecutive patients suffering from severe oral mucositis during bone marrow transplantation procedures. The control group was similar to the study group in age and gender and comprised 29 historical patients with similar clinical characteristics. Freshly prepared GM-CSF mouthwash (0.5 microg/mL) was administered to the study population for 1 minute 3 times per day after oral hygiene procedures, starting from the first day of mucositis until clinical improvement of oral lesions. The study and control populations were compared with respect to duration of severe oral mucositis (1-9 days, 10-19 days, > or =20 days). RESULTS: There was no statistically (chi2 exact test) significant difference in mean mucositis score between the study group (11.9+/-6.1) and the control group (16.6+/-8.9). However, the duration of severe mucositis appeared to be reduced; 60% of the GM-CSF mouthrinse patients had severe mucositis for less than 9 days, whereas only 28% of the controls had severe mucositis for less than 9 days. In addition, 10% of the GM-CSF mouthrinse patients experienced severe mucositis lasting 20 or more days, whereas 34% of the controls experienced severe mucositis for 20 or more days. CONCLUSIONS: These findings suggest that GM-CSF may reduce the duration of severe mucositis, but controlled, double-blind clinical trials are now required.

Benzydamine hydrochloride oral rinses in management of burning mouth syndrome. A clinical trial.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of the topical use of benzydamine hydrochloride 0.15% oral mouthwashes in the control of burning mouth syndrome symptoms. STUDY DESIGN: In this double-blind, randomized, longitudinal investigation, each of 30 patients with burning mouth syndrome was assigned to one of 3 management modalities. Those in group A received an oral rinse solution of benzydamine hydrochloride 0.15% 3 times a day for 4 weeks, those in group B received a placebo 3 times a day for 4 weeks, and those in group C did not receive any kind of treatment. A visual analog scale was used for evaluation of the symptoms; a Kruskal-Wallis analysis of variance exact test was performed on the resulting data. RESULTS: The findings of this investigation failed to reveal significant differences among the groups. CONCLUSIONS: The clinical application of benzydamine hydrochloride oral rinses in the treatment of patients with burning mouth syndrome did not demonstrate significative efficacy in comparison with use of a placebo solution.