Doxycycline: An option in the treatment of ulcerated oral lesions?

WHAT IS KNOWN AND OBJECTIVES: In addition to its antimicrobial effect, doxycycline has potent anti-inflammatory activity. In view of these pharmacological characteristics, its use in the management of inflammatory, autoimmune and granulomatous diseases has been proposed. The objective of this study was to investigate, through a systematic literature review, the effect of doxycycline on pain and healing of ulcerated lesions of the mouth. METHODS: An electronic search was performed in accordance with PRISMA guidelines in PubMed, Cochrane Central Register, Web of Science, Bireme/LILACS and Scopus databases. Controlled, randomized clinical trials were selected. The concentration of doxycycline, frequency of application, pain relief and clinical remission of the lesions were analysed. RESULTS AND DISCUSSION: According to the inclusion criteria, five articles were selected. In four of these studies, doxycycline was used in the treatment of aphthous stomatitis, and in one study, it was used in the treatment of herpes labialis. In all studies, the drug was used topically, both as a hydrogel and as a crushed tablet (along with a prosthetic adhesive). The groups treated with doxycycline showed faster healing of lesions and lower pain scores compared to placebo. WHAT IS NEW AND CONCLUSION: The present study suggests that topical doxycycline has a positive effect on the treatment of recurrent aphthous ulceration and herpes labialis. Experimental animal studies and double-blind randomized clinical trials should be performed on other oral lesions, such as traumatic ulcers and mucositis.

Exodontias múltiplas em paciente radioterápico: indicações, risco de osteorradionecrose e possível reabilitação oral: relato de caso / Multiple tooth extractions in radiotherapy patients: indications, osteoradionecrosis risk and possible oral rehabilitation: case report

A osteorradionecrose (ORN) é uma das complicações bucais mais graves pós-tratamento de câncer de cabeça e pescoço, sendo a extração dentária, por meio de sua estimulação traumática, apontada como um importante fator predisponente. As indicações e métodos preventivos para a realização destes procedimentos em pacientes irradiados são questionados, se tornando fundamental o conhecimento de protocolos adequados. O presente artigo relata um caso de exodontias múltiplas em um paciente oncológico em fase terminal, cujas medidas preventivas foram realizadas, não ocorrendo desenvolvimento de complicações. Por meio de revisão de literatura, explana as possíveis indicações deste procedimento, o risco de desenvolvimento de osteorradionecrose e as possibilidades de prevenção para esta sequela. Além disso, aborda uma alternativa de reabilitação oral viável após este tipo de cirurgia, por meio de overdenture sobre dentes em mandíbula. (AU)

Osteoradionecrosis (ORN) is one of the most severe oral complications after the head and neck cancer treatment. Tooth extraction, through its traumatic stimulation, is identified as an important predisposing factor. Indications and preventive methods for carrying out these procedures in irradiated patients are questioned, thus, knowledge of appropriate protocols is essential. This article reports a case of multiple tooth extractions in a cancer patient in terminal stage whose preventive measures were taken without the occurrence of complications. Based on a literature review, this paper accounts the possible indications of this procedure, the risk of developing osteoradionecrosis, and the prevention possibilities for this sequela. In addition, this report addresses a viable oral rehabilitation alternative after this kind of surgery by using overdenture on the lower jaw teeth. (AU)