PRELIMINARY ANALYSES FROM A HOSPITAL BASED STUDY ON 3154 WESTERN SICILIAN PATIENTS WITH ORAL MUCOSAL LESIONS

Objectives: Diagnosis of the wide variety of lesions that occur in the oral cavity is an essential part of dental practice. The objective of this study was to explore the demographic and behavioural profiles of patients affected by oral cavity diseases on a wide spectrum. Methods: Demographic and behavioural data of 3154 patients with at least one oral cavity disease among those consecutively visited between 2004 and 2009 at the Unit of Oral Medicine, were recorded: gender, age, smoking status, alcohol consumption, drugs use. Analysis was restricted to the eleven more frequent oral cavity diseases. Firstly, Multiple Correspondence Analysis (MCA) was applied as a descriptive tool to geometrically characterize which diseases are more or less similar in terms of their demographical and behavioural profiles in a sub-space of low-dimensionality (Benzecri, 1992; Greenacre, 1993); Secondly, the simultaneous marginal homogeneity hypothesis (SMH) for the multivariate distributions associated to the detected profiles was tested (Agresti and Klingenberg, 2005; Lang, 2004). Results: On the first principal MCA axis, similar profiles were found for the couples Carcinoma-Leucoplachia, Alitosi-SAR and for the couple BMS-ONM. The score-type test of SMH and the goodness-of-fit tests of SMH models confirmed that profiles of some oral cavity disorders could not be considered significantly different at a significance level of 5%. Conclusion: Simultaneously modelling joint and marginal distributions of multivariate binary response contributed a very important issue to preventive oral medicine, in other words some oral mucosal lesions can be considered similar in terms of demographical and behavioural profiles

Association of oral lichen planus with thyroid disease in a Finnish population: A retrospective case-control study: "A different finding from a Mediterranean area".

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Mucoadhesive polymers for oral transmucosal drug delivery: a review

he oral mucosa offers an interesting site for the application of dosage forms that release drugs within/throughout the oral mucosa, by assuring a high drug bioavailability for topic and systemic effects. However, the relative permeability of the oral mucosa and the washing effect related to the oral fluids and mechanical stresses must be considered in the formulation of oral dosage forms. Since a sustained drug release can be guaranteed only if dosage forms remain in contact with the oral site of absorption/application for a prolonged time, the development of mucoadhesive dosage forms is mandatory. The mucoadhesion is a complex phenomenon and the mucoadhesive bond consists of two different parts, the mucoadhesive polymers and the mucous substrate. In addition to factors related to the oral mucosa and oral environment features, the physical-chemical characteristics of mucoadhesive polymers must be also considered as factors influencing the mucoadhesive bonds. While it is not possible to modify the mucosal features or it is possible to modify or inhibit only in part certain mucosal processes, the knowledge of polymer properties influencing mucoadhesive bonds allows to modify or to control these properties in developing increasingly effective mucoadhesive systems. The aims of this review are to discuss the several mechanisms and factors behind the phenomenon of mucoadhesion with particular reference to the features of the oral environment, oral mucosa, and polymeric compounds influencing mucoadhesion process. Finally, a brief mention to the main mucoadhesive dosage forms designed for oral transmucosal drug delivery is made

Carbamazepine transbuccal delivery: the histo-morphological features of reconstituted human oral epithelium and buccal porcine mucosae in the transmucosal permeation

Transbuccal drug delivery is an attractive way of administration since several well-known advantages are provided, especially with respect to peroral management. Carbamazepine (CBZ) is an anticonvulsant which is useful in controlling neuropathic pain, and it is currently administered by peroral route, although its absorption and bioavailability is limited due to various factors. The oral cavity could be an interesting site for transbuccal CBZ delivery due to two properties: slow administration of constant low drug doses and less dose-related side effects. However, in transbuccal absorption a major limitation could be the low permeability of the mucosa which results in low drug bioavailability; thus the aptitude of the drug to penetrate the buccal mucosa has to be assessed by using tissue models resembling human normal mucosa. In our experience, CBZ well permeates mucosal membranes. In order to assess the efficacy of CBZ transbuccal delivery and to verify the reliability of these tissues in permeability testing before and after the passage of CBZ, the histo-morphological features of reconstituted human oral (RHO) epithelium (E) and buccal porcine mucosae were investigated. Significant histological changes due to CBZ passage were observed both in RHO-E and porcine mucosa. The main findings detected in RHO samples were cellular swellings with a signet ring-like appearance, nuclear swelling, prominent nucleoli lined against the nuclear membrane and the presence of keratohyalin granules. The most striking finding regarding porcine buccal mucosa was a cytoplasmic vacuolization, mainly involving the basal layer

Medium-Term Culture of Primary Oral Squamous Cell Carcinoma in a Three-Dimensional Model: Effects on Cell Survival Following Topical 5-Fluororacile Delivery by Drug-Loaded Matrix Tablets

Since the activity of several conventional anticancer drugs is restricted by resistance mechanisms and dose-limiting side-effects, the design of formulations for local application on malignant lesions seems to be an efficient and promising drug delivery approach. In this study, the effect of locally applied 5-FU on cell death was evaluated both in a SCC4/HEK001 model and in a newly proposed 3D outgrowth model of oral squamous cell carcinoma (OSCC). Initially, the optimal drug dose was established by delivery of solutions containing different amounts of 5-FU. The solution containing 1% (w/v) of 5-FU resulted effective in inducing cell death with complete eradication of cell colonies. Buccal tablets were designed to deliver 5-FU locoregionally to the cancer lesions of the oral cavity. Tablets were prepared using a drug loaded matrix of acrylic/methacrylic acid copolymer containing 1% (w/w) of 5-FU and applied on 3D outgrowths. The drug release from tablets appeared to be sufficient to induce cell death as confirmed by transmission electron microscopy and enzymatic assay (TUNEL). After 120 h of treatment, when about 90% of the drug had been discharged from the tablets into the culture environment, 5-FU caused loss of cell-cell communications and apoptotic cell death. After 192 h, a complete disaggregation of the 3D oral outgrowths and the death of all the cells was observed. Buccal matrix tablets could be considered a promising new approach to the locoregional treatment of OSCC. Risks of systemic toxicity are avoided since very low drug doses are delivered

Recent Advances in Drug Delivery from the Oral Cavity. Focus on innovative buccal drug delivery devices

In this report, the drug administration via the oral cavity is discussed. Regional variations in oral mucosae, drug delivery via the keratinised mucosae for local treatment, and drug delivery via the not keratinised mucosae for local and systemic treatments are analyzed, focusing on Buccal drug delivery devices. Finally the IntelliDrug Device is presented as a revolutionary delivery system