Effectiveness of Pentoxifylline Therapy for Management of Oral Submucous Fibrosis

Introduction: Oral submucous fibrosis is a chronic oral disease characterized by progressive buildup of constricting collagen bands in the cheeks and adjacent structures of the mouth due to chewing of areca nut. This can severely restrict mouth opening and tongue movement causing pain and burning sensation in the mouth. Aims: This study evaluates the efficacy of pentoxifylline in the management of oral submucous fibrosis. Methods: A hospital-based study, conducted in the dental outpatient department of Nepalgunj Medical College from October 2019 to September 2020. Forty-nine patients who were diagnosed histopathologically with oral submucous fibrosis were included. The patients were divided into two groups. In group A, patients were given, 200 mg thrice daily for first 30 days, then dose hiked to 400 mg thrice daily for two more months. Group B patients received treatment with multi-vitamin capsules (B-complex one capsule before sleep daily) for three months. All patients were followed up for six months and were assessed for maximum inter-incisor opening, pain on opening of mouth and burning sensation. Results: There was no statistical difference in mouth opening at baseline and first follow up. The mouth opening was significantly more in group A compared to group B from second follow up which persisted till third follow up (p <0.05). Pain and burning sensation significantly reduced in group A compared to group B from 2nd follow up which persisted till 3rd follow up (p <0.05). Few patients had nausea, dyspepsia and vomiting during treatment in group A which resolved within a few days without the need for cessation of the drug. Conclusion: Pentoxifylline can bring about significant clinical improvements in the symptoms of oral submucous fibrosis like mouth opening, pain and burning sensation, thereby improving the quality of life of the affected individuals.

Nrf2 in the Field of Dentistry with Special Attention to NLRP3

The aim of this review article was to summarize the functional implications of the nuclear factor E2-related factor or nuclear factor (erythroid-derived 2)-like 2 (Nrf2), with special attention to the NACHT (nucleotide-binding oligomerization), LRR (leucine-rich repeat), and PYD (pyrin domain) domains-containing protein 3 (NLRP3) inflammasome in the field of dentistry. NLRP3 plays a crucial role in the progression of inflammatory and adaptive immune responses throughout the body. It is already known that this inflammasome is a key regulator of several systemic diseases. The initiation and activation of NLRP3 starts with the oral microbiome and its association with the pathogenesis and progression of several oral diseases, including periodontitis, periapical periodontitis, and oral squamous cell carcinoma (OSCC). The possible role of the inflammasome in oral disease conditions may involve the aberrant regulation of various response mechanisms, not only in the mouth but in the whole body. Understanding the cellular and molecular biology of the NLRP3 inflammasome and its relationship to Nrf2 is necessary for the rationale when suggesting it as a potential therapeutic target for treatment and prevention of oral inflammatory and immunological disorders. In this review, we highlighted the current knowledge about NLRP3, its likely role in the pathogenesis of various inflammatory oral processes, and its crosstalk with Nrf2, which might offer future possibilities for disease prevention and targeted therapy in the field of dentistry and oral health.

The Influence of Hyaluronic Acid Adjunctive Therapy of Periodontitis on Salivary Markers of Oxidative Stress: Randomized, Controlled Clinical Trial

Periodontitis is a common oral disease affecting the tooth-supporting tissues. Bacteria have been long viewed as the main causative factor in its development; however, many investigations have proved that aberrant immune and inflammatory response and the resulting misbalance between the damage caused by reactive oxygen species and the antioxidant capacity of tissues may be an underlying factor in disease progression that reduces healing potential. The objective of the current trial is to assess the outcomes of the addition of hyaluronic acid (HA) to standard non-surgical periodontal therapy (NST) on some major oxidative stress markers in saliva. HA-based gel designed for dental application was used and the measurements were taken after 3 months. HA adjunctive therapy had a significantly greater increase in markers with antioxidant properties as well as total antioxidant capacity compared to standard NST alone. Furthermore, clinically measured levels of gingival inflammation (bleeding on probing-BOP) and periodontal destruction (clinical attachment loss-CAL) were significantly correlated with these markers, and the correlation was negative. This investigation demonstrates that HA may indeed express antioxidant properties and improve the antioxidant capacity of periodontal tissues, thus improving the prognosis for the teeth and the results of periodontal therapy. Further investigations will be necessary to determine the duration of these effects over time.

Diagnosis and detection of VicK gene in Streptococcus mutans isolated from the saliva of patients with diabetic type 2 with tooth decay in the Iraqi population

Type 2 diabetes mellitus (T2DM) is gradually becoming more common in Iraq. Salivary changes and proliferation of specific bacterial communities cause oral disease that can adversely affect systemic conditions such as diabetes. Fifty saliva samples were collected from people with T2DM suffering from tooth decay and twenty-five people without T2DM suffering from tooth decay. The periodontal status, the extent of the root surface, and coronal caries were evaluated. Saliva was cultured for investigating Streptococcus mutans. The results showed that patients with type 2 diabetes had significantly more severe Periodontitis and a higher prevalence and magnitude of bacterial caries. Diabetic subjects had higher levels of Hemoglobin A1c (HbA1c) and Random Blood Sugar (R.B.S.). The S. mutans diagnosis by PCR for Sanger Sequencing technique by using VicK gene sequences (1300bp). The PCR products of the isolate were submitted to Macrogen Company for sequencing. Selected seven isolates as new isolates registered in global gene bank as locally S. Mutans isolates in Bagdad city/Iraq and their accepted accession numbers include LOCUS MT603520, MT603521, MT603522, MT603523, MT603524, MT603525,and MT603526 of nucleotide sequence. The VicK genes isolates' phylogenetic trees revealed a genotype that was closely connected to other isolates in GenBank. Furthermore, gene sequencing demonstrated a success rate of 99 percent. resemblance to other isolates in the GenBank database The likelihood of a link between S. Mutans and dental carries was determined by these findings.

Antimicrobial activity of essential oils against Pasteurella spp. isolated from the oral cavity of domestic cats

ABSTRACT: Pasteurella spp. have been identified predominantly in the oral microbiota of domestic cats. However, Pasteurella spp. was significantly more prevalent in cats with inflammatory oral disease; and consequently, it was considered as part of the etiology in this disease. In addition, in animals, Pasteurella spp. have become increasingly resistant to a large number of antimicrobials. Natural products, especially essential oils, could contribute to minimizing this issue. This study determined the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of six essential oils against Pasteurella spp. isolates from the oral cavity of domestic cats. Our results showed that essential oils with better antimicrobial effectiveness against most of the Pasteurella isolates were lemongrass, tea tree and clove, with inhibition values between 50 to 800 µg mL-1. All essential oils showed bacteriostatic activity against the species of Pasteurella isolated from the domestic cats. These results suggested that lemongrass, tea tree and clove oils have potential to be used in products for oral hygiene and treatment of oral infections in domestic cats.