TOPICAL NON-AROMATIC VERY RICH IN STERANES (NAVS) NAPHTHALAN FOR THE TREATMENT OF ORAL LICHEN PLANUS AND RECURRENT APHTHOUS STOMATITIS

Uvod: NAVS Nearomatski visokosteranski naftalan prirodno je mineralno ulje dobiveno složenim nizom postupaka separacije i rafinacije čime je očuvana steranska struktura NAVS-a kojoj se pripisuju ljekovita svojstva. Svrha istraživanja bila je ispitati učinkovitost NAVS-a u liječenju oralnog lihena planusa (OLP) i rekurentnih aftoznih ulceracija (RAU) te potvrditi sigurnost njegove primjene. Materijali i metode: Istraživanje je provedeno kao randomizirana dvostruko-slijepa studija na pedeset i sedam ispitanika (30 OLP, 27 RAU). Primjena NAVS-a 3x dnevno tijekom 28 dana provedena je u ispitnoj skupini, a 0,05% betametazon dipropionata u kontrolnoj skupini. Klinički intenzitet bolesti (REU) bilježen je u ispitanika s OLP-om. Broj i promjer lezija u bolesnika s RAU bilježen je na 0., 3. i 5. dan. Intenzitet boli i nelagode procjenjivan je korištenjem vizualne analogne skale (VAS) i upitnikom OHIP-14, prije i nakon liječenja. Rezultati: Veće smanjenje REU zabilježeno je u NAVS skupini (NAVS 67,21%, betametazon 66,30%), iako ne statistički značajno (p=0,4421). Nije bilo statistički značajne razlike u smanjenju OHIP-14 između NAVS (74,38%) i betametazon skupine (67,55%) (p=0,8191). Smanjenje VAS-a za NAVS iznosilo je 96,29%, a za betametazon 93,66% (p=0,3722). Nije bilo statistički značajne razlike između skupina u smanjenju broja (3. dan p=0,48; 5. dan p=0,75) i veličine lezija (3. dan p=0,40; 5. dan p=0,83) u ispitanika s RAU. Zabilježeno je smanjenje VAS-a i OHIP-14 u obje skupine ispitanika 8. dana po završenoj terapiji, međutim razlika nije bila statistički značajna (VAS p=0,59; OHIP-14 p=0,69). Zaključak: NAVS je uspješno smanjio kliničke znakove i simptome OLP-a, te broj, veličinu lezija i simptome u bolesnika s RAU.Introduction: "Non-aromatic Very rich in Steranes" (NAVS) naphtalan is a natural mineral oil, produced by various methods of separation, with a preserved sterane structure which has healing properties. The purpose of this study was to evaluate the effectiveness of NAVS in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). Material and Methods: A randomized, double-blind trial was designed. Fifty seven patients (30 OLP, 27 RAS) were randomized into two groups to receive NAVS or 0,05%-betamethasone dipropionate in adhesive paste 3x daily for 28 days. The severity of the OLP lesions (REU) was objectively scored. The number and the diameter of RAS lesions were assessed on days 0, 3 and 5. The intensity of the pain/discomfort was determined using a visual analogue scale (VAS) and OHIP-14-questionnaire before and after the therapy. Results: Greater REU reduction was observed in NAVS group (NAVS 67,21%, betamethasone 66,30%), although it was not statistically significant (p=0,4421). No statistically significant differences in the reduction of the OHIP-14 between NAVS (74,38%) and betamethasone group (67,55%) were observed (p=0,8191). VAS reduction for NAVS was 96,29% and for betamethasone 93,66% (p=0,3722). There were no statistically significant differences between the two groups in reduction of number (day 3. p=0,48; day 5. p=0,75) and lesion diameter (day 3. p=0,40; day 5. p=0,83) in RAS patients. VAS and OHIP-14 reduction was observed in both groups 8 days after the completion of therapy, but the difference was not statistically significant (RAS p=00,59; OHIP-14 p=0,69). Conclusion: NAVS has successfully reduced the clinical signs and symptoms of OLP. It has reduced the number, diameter and symptoms in patients with RAS

TOPICAL NON-AROMATIC VERY RICH IN STERANES (NAVS) NAPHTHALAN FOR THE TREATMENT OF ORAL LICHEN PLANUS AND RECURRENT APHTHOUS STOMATITIS

Uvod: NAVS Nearomatski visokosteranski naftalan prirodno je mineralno ulje dobiveno složenim nizom postupaka separacije i rafinacije čime je očuvana steranska struktura NAVS-a kojoj se pripisuju ljekovita svojstva. Svrha istraživanja bila je ispitati učinkovitost NAVS-a u liječenju oralnog lihena planusa (OLP) i rekurentnih aftoznih ulceracija (RAU) te potvrditi sigurnost njegove primjene. Materijali i metode: Istraživanje je provedeno kao randomizirana dvostruko-slijepa studija na pedeset i sedam ispitanika (30 OLP, 27 RAU). Primjena NAVS-a 3x dnevno tijekom 28 dana provedena je u ispitnoj skupini, a 0,05% betametazon dipropionata u kontrolnoj skupini. Klinički intenzitet bolesti (REU) bilježen je u ispitanika s OLP-om. Broj i promjer lezija u bolesnika s RAU bilježen je na 0., 3. i 5. dan. Intenzitet boli i nelagode procjenjivan je korištenjem vizualne analogne skale (VAS) i upitnikom OHIP-14, prije i nakon liječenja. Rezultati: Veće smanjenje REU zabilježeno je u NAVS skupini (NAVS 67,21%, betametazon 66,30%), iako ne statistički značajno (p=0,4421). Nije bilo statistički značajne razlike u smanjenju OHIP-14 između NAVS (74,38%) i betametazon skupine (67,55%) (p=0,8191). Smanjenje VAS-a za NAVS iznosilo je 96,29%, a za betametazon 93,66% (p=0,3722). Nije bilo statistički značajne razlike između skupina u smanjenju broja (3. dan p=0,48; 5. dan p=0,75) i veličine lezija (3. dan p=0,40; 5. dan p=0,83) u ispitanika s RAU. Zabilježeno je smanjenje VAS-a i OHIP-14 u obje skupine ispitanika 8. dana po završenoj terapiji, međutim razlika nije bila statistički značajna (VAS p=0,59; OHIP-14 p=0,69). Zaključak: NAVS je uspješno smanjio kliničke znakove i simptome OLP-a, te broj, veličinu lezija i simptome u bolesnika s RAU.Introduction: "Non-aromatic Very rich in Steranes" (NAVS) naphtalan is a natural mineral oil, produced by various methods of separation, with a preserved sterane structure which has healing properties. The purpose of this study was to evaluate the effectiveness of NAVS in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). Material and Methods: A randomized, double-blind trial was designed. Fifty seven patients (30 OLP, 27 RAS) were randomized into two groups to receive NAVS or 0,05%-betamethasone dipropionate in adhesive paste 3x daily for 28 days. The severity of the OLP lesions (REU) was objectively scored. The number and the diameter of RAS lesions were assessed on days 0, 3 and 5. The intensity of the pain/discomfort was determined using a visual analogue scale (VAS) and OHIP-14-questionnaire before and after the therapy. Results: Greater REU reduction was observed in NAVS group (NAVS 67,21%, betamethasone 66,30%), although it was not statistically significant (p=0,4421). No statistically significant differences in the reduction of the OHIP-14 between NAVS (74,38%) and betamethasone group (67,55%) were observed (p=0,8191). VAS reduction for NAVS was 96,29% and for betamethasone 93,66% (p=0,3722). There were no statistically significant differences between the two groups in reduction of number (day 3. p=0,48; day 5. p=0,75) and lesion diameter (day 3. p=0,40; day 5. p=0,83) in RAS patients. VAS and OHIP-14 reduction was observed in both groups 8 days after the completion of therapy, but the difference was not statistically significant (RAS p=00,59; OHIP-14 p=0,69). Conclusion: NAVS has successfully reduced the clinical signs and symptoms of OLP. It has reduced the number, diameter and symptoms in patients with RAS

Oralni lihen panus i oralna lihenoidna reakcija - novosti

Oral lichen planus (OLP) and oral lichenoid reaction (OLR) are clinically and histopathologically similar diseases. Whereas OLP is a consequence of T cell mediated autoinflammatory process to a still unknown antigen, OLR might be caused by drugs, dental restorative materials and dental plaque. Pubmed was searched and 24 publications published over the last three years regarding etiology, diagnosis and malignant alteration were included in this study. Patients with OLR who have amalgam fillings near lesions should have them replaced, i.e. when possible they should be referred to patch test, as well as when drug-induced OLR are suspected. OLR lesions induced by drugs should disappear when the offending drug has been discontinued. Histology finding in OLR consists of more eosinophils, plasma cells and granulocytes in comparison to OLP lesions. Furthermore, OLP lesions showed more p53, bcl-2 and COX-2 positivity when compared to OLR. OLP is characterized by infiltration, atrophic epithelium, rete pegs and Max Joseph spaces, while deep infiltration into connective tissue and hyperkeratosis were the criteria for making the diagnosis of OLR. The number of degranulated mastocytes in the reticular layer, as well as the number of capillaries was higher in OLR in comparison to OLP. It seems that OLR are more prone to malignant alteration in comparison to OLP.Oralni lihen planus (OLP) i oralna lihenoidna reakcija (OLR) su dvije klinički i patohistološki slične bolesti. OLP je posljedica autoimunog procesa koji je posredovan T limfocitima na još uvijek nepoznati antigen, a OLR može biti uzrokovana lijekovima, dentalnim materijalima i dentalnim plakom. Cilj je ovoga preglednog rada bio istražiti Pubmed te su uključena 24 rada koja su publicirana u posljednje tri godine, a s obzirom na etiologiju, dijagnostiku i malignu alteraciju ovih bolesti. Oboljeli od OLR koji u blizini lezija imaju amalgame trebaju ih zamijeniti kompozitnim ispunima, odnosno kad je moguće treba ih uputiti na patch test, kao i onda kada se sumnja da je OLR uzrokovana lijekovima. OLR uzrokovane lijekovima trebale bi se povući kada osoba prestane uzimati suspektni lijek. Patohistološki nalaz u OLR se sastoji od više eozinofila, plazma stanica i granulocita u usporedbi s lezijama kod OLP. Nadalje, lezije OLP imaju više pozitivnih nalaza p53, bcl-2 i COX-2 u usporedbi s lezijama OLR. OLP obilježava infiltracija, atrofični epitel, zupci pile i Max Josephovi prostori, dok OLR karakterizira dublja infiltracija u vezivno tkivo i hiperkeratoza. Broj degranuliranih mastocita u retikularnom sloju, kao i broj kapilara je veći u OLR u usporedbi s OLP. Čini se kako su OLR sklonije malignoj alteraciji u odnosu na OLP

Gingival Necrosis Caused by an Ill-Fitting Denture

U ovom prikazu opisali smo slučaj 80-godišnjeg pacijenta koji je bio upućen u Zavod za oralnu medicinu Stomatološkog fakulteta u Zagrebu zbog gingivalnog ulkusa prisutnog osam dana. Na kliničkom pregledu uočena je eksponirana kost na bezubom alveolarnom grebenu u području molara s desne strane mandibule veličine 0,8 cm u promjeru. Inače, pacijent je svakodnevno uzimao doksazosin jer je imao teškoća s urinarnim traktom te ipatropij-bromid zbog respiratornih tegoba. Donju djelomičnu protezu nije promijenio već šest godina. Na početku je, točnije prva tri dana, bio liječen parodontnim zavojem (Resopack, HagenWerken, Njemačka) uz preporuku da ne nosi protezu, no nakon tri dana klinički pregled nije pokazao poboljšanje stanja. Zato smo se odlučili na liječenje topikalnim kortikosteroidom (betametazon) i oralnim antiseptikom (klorheksidin-diglukonat) tri puta na dan. Nakon tri tjedna lezija je zacijelila. Naveden je popis mogućih čimbenika koji mogu rezultirati nastankom ulkusa gingive.We present a case of an 80-year-old male who was referred to the Department of Oral Medicine, School of Dental Medicine University of Zagreb, Croatia due to gingival ulcer which was present for eight days. Clinical examination has revealed exposed bone on the toothless alveolar ridge in the lower molar region on the right side of 0.8 cm in diameter. Otherwise, the patient was taking doxazosin due to urinary problems and ipatropium bromide due to respiratory problems. The patient wore a 6-year-old partial lower denture. He was initially treated with periodontal bandage (Resopack, HagenWerken, Germany) for the first three days and was instructed not to wear the denture; however, no benefit could be seen. Therefore, we added a local corticosteroid (betamethasone) and an oral antiseptic (chlorhexidine digluconate) applied three times a day. After 3 weeks the lesion healed. A list of possible causative factors regarding gingival ulcers is included

Sindrom pekućih usta – goruća enigma

Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by an intraoral burning sensation and an absence of oral mucosal lesions and disturbances in laboratory findings. Burning symptoms usually affect the anterior two-thirds of the tongue, its lateral borders, hard palate and labial mucosa, but other oral cavity sites may also be affected. Taste alterations and a decrease in the salivary flow rate frequently accompany the burning symptoms. This condition mostly affects peri- and postmenopausal women. To date, the etiology of BMS remains unclear. This unknown etiology means that no appropriate treatment is currently available. A large number of the treatments and medications have been tried for BMS, but treatment management remains unsatisfactory in some patients. The purpose of this article is to present current knowledge on the treatment of BMS.Sindrom pekućih usta (SPU) kronično je bolno stanje koje je karakterizirano osjećajem žarenja u usnoj šupljini bez vidljivih promjena na sluznici i poremećaja u laboratorijskim nalazima. Simptomi žarenja obično zahvaćaju prednje 2/3 trećine i lateralne površine jezika, tvrdo nepce, labijalnu sluznicu, ali može biti zahvaćena bilo koja regija u usnoj šupljini. Simptomi žarenja obično su praćeni promjenom osjeta okusa te smanjenim lučenjem sline. Ovo stanje najviše pogađa žene u peri- i postmenopauzi. S obzirom na to da je etiologija SPU-a nepoznata, ne postoji niti odgovarajuće liječenje. Dostupno je više različitih terapija i lijekova za SPU, međutim, liječenje kod pojedinih pacijenata i dalje je bezuspješno. Svrha ovog rada je prikazati trenutno znanje o liječenju SPU-a

Oral lichen planus - retrospective study of 563 Croatian patients

Objectives: To investigate the epidemiological and clinical characteristics of oral lichen planus (OLP) in a group of Croatian patients seen between 2006 and 2012. Study D esign: A group of 563 patients with a diagnosis of OLP was retrospectively reviewed in our clinic. Data regarding age, gender, medical history, drugs, smoking, alcohol, chief complaint, clinical type, localization, his - tology, treatment and malignant transformation were registered. Results: Of the 563 patients, 414 were females and 149 were males. The average age at the diagnosis was 58 (range 11-94). The most common site was buccal mucosa (82.4%). Most of our patients did not smoke (72.5%) or consume alcohol (69.6%). Patients reported oral soreness (43.3%), mucosal roughness (7%), xerostomia (3%), gingival bleeding (2%) and altered taste (0.5%) as the chief complaint, while almost half of them were asympto - matic (44.2%). The most common types of OLP were reticular (64.8%) and erosive (22.9%). Plaque-like (5.7%) atrophic/erythemtous (4.3%) and bullous (2.3%) type were also observed. Malignant transformation rate of 0.7% was recorded. Conclusions: OLP mostly affects non-smoking middle-aged women. Buccal mucosa is the most commonly af - fected site. In almost half of the cases patients are asymptomatic. In spite of the small risk for malignant transfor - mation all patients should be regularly monitored

Psychological status and recurrent aphthous ulceration [Psihološki status i rekurentne aftozne ulceracije]

Recurrent aphthous ulceration (RAU) are a disease of an unknown etiology and mediated through T-cell lymphocytes. Evidence suggests that RAU is connected with chronic bowel disease, haematinic deficiencies, AIDS, food hypersensitivity and severe stress. The aim of this study was to determine whether differences in anxiety and depression could be seen in patients with RAU during acute phase and remision period and in comparison to the healthy controls. There were 30 patients with RAU (age range 36.27 +/- 15.308) and 30 controls aged 29.83 +/- 9.082. Every participant with RAU fullfilled STAI and Beck Depression Inventory II test during acute phase and during remission period as well as controls. Statistical analysis was performed by use of descriptive statistics and t-test. There are no differences in the level of depression and stress between the two phases of the RAU (acute versus remission period) as well as in comparison to the controls. Patients with acute RAU are more anxious than patients with RAU during remission period. We might conclude that psychological disturbances do not preceed the development of RAU and that the patients with acute RAU are more anxious when compared to the condition when they do not have RAU due to the discomfort they experience