Determination of Effectiveness of Photobiomodulation in the Treatment of Oral Submucous Fibrosis.

Context: Oral submucous fibrosis (OSMF) is chronic, scarring disease of the oral cavity. Cytokines and growth factors produced by inflammatory cells play a major role in its pathogenesis. Low-level laser therapy (LLLT) application, which has an anti-inflammatory, was used to determine the improvement in mouth opening. Aims: The aim of the study is to evaluate the effectiveness of laser photobiomodulation (PBM) in OSMF treatment. Materials and Methods: Thirty patients who were diagnosed with OSMF after obtaining consent form and ethical clearance were included. LLLT was applied for 4 cycles for 15 s each in the left and right buccal mucosa. Therapy was done on day 0, 3, 7, and 15 and measurements were done immediately after each LLLT application. Patients were recalled after 1, 3, and 6 months from the commencement of the therapy for follow-up measurements. Results: The mean increase in mouth opening following application of LLLT from day 0 to day 15 was 9.91 ± 3.34, and day 1-6 months was 14.29 ± 6.82, which was statistically significant. Conclusions: The study shows significant improvements in the mouth opening of the OSMF patient during treatment and postoperatively. Thus, our study confirms LLLT can be used as one of the modality in OSMF management.

Comparative evaluation of fluconazole and clotrimazole in treatment of oral candidiasis.

Context: Oral candidiasis is the most common opportunistic infection affecting the oral mucosa. Most commonly, the lesions are caused by Candida albicans and other organisms isolated are Candida glabrata, Candida krusei, Candida parapsilosis and Candida dubliniensis. As an opportunistic infection, it is seen affecting the young, old and debilitating people. This infection is seen to be enervative, exhausting and crippling; a few routinely employed antifungal agents are used in our study. Aims: We aimed to compare the clinical and mycological effectiveness of topical fluconazole and clotrimazole in the treatment of oral candidiasis. Settings and Design: A total of 40 subjects were taken and randomly divided into two groups of 20 each. Group 1 included patients treated with topical clotrimazole and Group 2 included patients treated with topical fluconazole. Subjects and Methods: Patients were graded according to severity, and swab was taken for species identification and colony count. Patients were treated with clotrimazole and fluconazole according to their group they were also assessed post treatment for clinical signs and colony count changes. Statistical Analysis Used: Data were analyzed using the statistical package SPSS 22.0 (SPSS Inc., Chicago, IL, USA), and the level of significance was set at P < 0.05. Descriptive statistics was performed to assess the mean and standard deviation of the respective groups. Results: The clinical resolution rate of 80% and 100% was noted in the clotrimazole and fluconazole groups, respectively. The mycological cure rate of 82.52% and 86.38% was noted in the clotrimazole and fluconazole groups, respectively. Statistically significant results were obtained in clinical resolution rates and no significant results were obtained when mycological cure rates were compared. Conclusions: We conclude that the clinical cure rate of fluconazole is slightly better than clotrimazole while mycological cure rate was approximately similar.

Von recklinghausens disease: a series of four cases with variable expression.

Though neurofibromatosis type I (NFI) is a fairly common condition, it has a variable expressivity and penetrance. Here we present a series of cases with striking differences in the presentation especially in the oral cavity. NFI, also known as von Recklinghausen's neurofibromatosis, is an autosomal dominantly inherited neurogenetic disorder affecting 1:3000 newborn (Bongiorno et al., Oral Dis 12:125-129, 2006). About 50 % of NFI patients have no family history of the disease. There is no prevalence for gender or race in NFI. Expressivity in NFI is tremendously variable, but subtle phenotypic patterns may exist within subgroups of affected patients. Furthermore, 50 % of cases are sporadic and arise from germ cell mutation (Bongiorno et al., Oral Dis 12:125-129, 2006). The precise constellation of findings in any one individual is extremely variable, both within a family and between different families (Batsakis, Tumors of the head and neck: clinical and pathological considerations, 2nd edn. Williams and Wilkins, Baltimore, pp 313-333, 1979). Only 4-7 % of patients affected by neurofibromatosis exhibit oral manifestations (Güneri et al., Turk J Pediatr 48(2):155-158, 2006).