Efficacy of Laser Therapy in Trigeminal Neuralgia: a Systematic Review.

Statement of the Problem: Trigeminal neuralgia is the most common and disabling type of neuralgia in craniofacial region. Because of adverse effects of first and second lines of treatment, new modalities including laser therapy have been investigated for treatment of trigeminal neuralgia. Purpose: The aim of this study was to review the effect of laser in trigeminal neuralgia. PubMed, Scopus, Web of Science, Science Direct, and Embase databases from December 1983 to August 2020 were searched using keywords "trigeminal neuralgia" and "laser". Our inclusion criteria were interventional studies with a randomized clinical trial design, which used laser for treatment of trigeminal neuralgia. Materials and Method: In this systematic review, a total of 269 records were identified through systematically searching aforementioned databases among which, 30 were from PubMed and 44 were from Web of Science. A total of 111 records were duplicated and were therefore removed. Results: Only 17 records were considered relevant after reading title and abstracts. After reading full texts of the articles, 13 met the eligibility criteria and were included in our review. Conclusion: This review revealed that low-level laser therapy reduces pain in trigeminal neuralgia specially diode lasers, although there are no standardized protocols for laser procedures.

Evaluation of the salivary level of glutathione reductase, catalase and free thiol in patients with oral lichen planus.

OBJECTIVE: Oral lichen planus (OLP) is a usual chronic inflammatory disease of the oral mucosa with malignant capacity, whose pathogenesis is not yet well known. Free radicals and reactive oxygen species may have a vital role in the pathogenesis of oral lichen planus. This study aimed to assess Glutathione reductase, catalase, and free thiol levels in the saliva of OLP patients and compare it with healthy people. METHODS: In this cross-sectional study, 35 patients with OLP and 20 healthy people were involved. Five mL of whole, unstimulated saliva samples were collected in the morning, and the salivary levels of antioxidants were measured by ELISA technique. In this experiment, sex, age and OLP types were also evaluated. RESULTS: There was a significant decrease in the patients' salivary level of Glutathione reductase (0.2043 mU/ml in patients and 0.3901 mU/ml in the control group) and catalase (0.1525 mU/ml in patients and 0.2700 mU/ml in the control group) (p = 0.001). But there were no differences between the two groups regarding free-thiol levels (0.0586 mU/ml in patients and 0.0569 mU/ml in the control group) (p = 0.7). However, there was no correlation between age and gender with the antioxidants' contents. There was a significant decrease in glutathione reductase and catalase in the erosive type than in the non-erosive type. CONCLUSIONS: In this study, we found that the salivary levels of Glutathione reductase and Catalase were lower in OLP patients than in the healthy group, which means these antioxidants were affected by OLP and also associated with the type of it. So salivary Glutathione reductase and Catalase levels may be used as biomarkers for OLP monitoring and treatment.

Effect of Non-Ablative Non-Thermal CO2 Laser on Drug-Resistant Trigeminal Neuralgia: A Pilot Study.

Background: Trigeminal neuralgia is one of the most severe pain conditions that humans experience. Drug resistance is a challenging event during treatment that results in using higher doses of drugs or referring for neurosurgical treatment. Laser therapy is also an effective method for pain control. Objective: The aim of this study was to evaluate the effect of non-ablative non-thermal CO2 laser (NANTCL) on reducing pain in patients with drug-resistant trigeminal neuralgia (DRTN) for the very first time. Materials and methods: Twenty-four patients with DRTN were randomly divided into laser and placebo groups. Patients in the laser group received NANTCL (10,600 nm, 1.1 W, 100 HZ, 20 sec) on trigger points that were covered with lubricant gel 3 days in a week for 2 weeks. The placebo group received sham laser. The patients were requested to grade their pain on a visual analog scale (VAS) immediately, 1 week, 1 month, and 3 months after treatment. Results: In the laser group, the results revealed a significant decrease between the initial pain and the pain in all follow-up sessions. Only in three patients, 3 months after completion of laser therapy, pain returned to the initial level. In the control group, a significant difference was seen only between the pain of baseline and final session of laser irradiation. In laser group, the mean of pain (VAS) was lower than the placebo group in all follow-up sessions; however, it was only significant for 1 week after laser therapy. Conclusions: This study revealed that short-period application of NANTCL is effective for pain relief in patients with DRTN, especially those with extraoral trigger points. Clinical trial registration number: IRCT2013052113406N1.

Effect of periodontal surgery on the salivary Herpes simplex virus-1 levels-a pilot study.

Background and aim: Herpes simplex viruses (HSV) are one of the most important groups of human pathogenic viruses. The prominent characteristic of this virus is latency and the ability to reactivate. One of the possible factors for reactivation of this virus is dental procedures. The aim of this study was to evaluate the salivary level of Herpes simplex viruses, before and after periodontal (crown lengthening) surgery and its relation with age and sex. Materials and methods: 30 HSV seropositive patients, who needed the crown lengthening surgery and accepted to cooperate in this research, were included as experimental group of this study. Unstimulated Saliva samples of the patients were collected in 1.5 ml micro-tubes, before and 24 h after the surgery, and were analyzed by Premix EX taq probe qpcr, using PCR real-time method. Results: No significant statistical differences were observed in the salivary level of HSV before and after crown lengthening procedure (p = 0.18). However, the level of HSV in saliva after surgery was significantly higher than its level before surgery in women as compared to men (p = 0.003). The differences in virus level did not have any significant relationship with patients' age (p = 0.9). Conclusion: It seems that periodontal (crown lengthening) surgery does not affect the level of HSV in saliva yet, but it could be one of the stimulators of increased HSV level after surgery in women as compared to men; but age does not play an important role in changes of level of virus before and after the surgery.

Evaluation of recurrence, mortality and treatment complications of oral squamous cell carcinoma in public health centers in Shiraz during 2010 to 2020.

INTRODUCTION: Oral Squamous cell Carcinoma (OSCC) is the most common oral cancer and is treated with surgery, radiotherapy and chemotherapy. Various complications of treatment include xerostomia, mucositis, and trismus, which affect patients' quality of life. The aim of this study is to evaluate the mortality, recurrence rate and prevalence of oral complications in treated patients. METHOD AND MATERIALS: This cross-sectional study reviewed 326 cases of patients with OSCC who were referred to public health centers in Shiraz (Khalili Hospital and Dental School) from 2010 to 2020. All patients were contacted, and the survivors were called and examined by an oral physician. A medical record was created for them, including demographic information, location of the lesion, type of treatment, history of recurrence, metastasis and oral complications. RESULTS: 53.5% of patients were male and 46.5% were female. The mean age of patients was 58.68 years. Mortality and recurrence rate was respectively 49.8% and 17.8%. The most common location of the lesion was tongue (64%). Surgery was done for all patients. 97.4% of patients complained of xerostomia, 46.2% of mucositis and 44.3% of trismus. CONCLUSION: The most common complications of treatment are xerostomia, mucositis, and trismus, respectively. Frequent and regular follow-ups and supportive therapies reduce these complications and improve patients' quality of life.