Oral events related to low-dose methotrexate in rheumatoid arthritis patients

Low-dose methotrexate (MTX) is frequently used for patients with rheumatoid arthritis (RA). High doses of MTX frequently produce side effects. The aim of this study was to explore oral complications of low-dose MTX therapy in a population of RA patients. This is a cross-sectional study in which oral examination was performed on a population of RA patients. Patients undergoing MTX therapy (5-20 mg weekly) for at least six months were included in the study group, and RA patients being treated under another regimen were used as controls. The frequency of oral lesions was compared between groups. The chi-square test was used to compare frequencies. Relative risk (RR) and its confidence interval (CI) were established. Significance level was set at 0.05. Twenty-eight RA patients on a low-dose MTX regimen and 21 controls were enrolled in the study. Oral lesions were found in 22 patients (78.6%) undergoing MTX therapy, and in 5 patients (23.8%) undergoing other therapies (p < 0.001). There were no significant differences regarding age, gender or dosage. The most common oral events observed in patients in the MTX group were ulcerative/erosive lesions (60.7%) and candidiasis (10.7%). Patients in the control group presented lower prevalence of the same lesions (p < 0.001). The RR for developing oral lesions was 11.73 (CI 2.57 - 58.98), with low-dose MTX therapy. In conclusion, the prevalence of oral mucosa lesions in RA patients receiving low doses of MTX therapy is higher than in RA patients not receiving the drug.     

Diclofenac in hyaluronic acid gel: an alternative treatment for actinic cheilitis

Objective

Actinic cheilitis (AC) is a precancerous lesion of the lip vermillion caused by prolonged exposure to ultraviolet light. The aim of this study was to evaluate the effect of 3% diclofenac in 2.5% hyaluronic acid gel in the treatment of AC.

Methods

Thirty-four patients with chronic AC were treated twice a day with topical diclofenac during a period of 30 to 180 days. The individuals were followed up every 15 days by means of clinical examination and digital photographic documentation.

Results

Of the 27 patients that completed the study, 12 (44%) showed complete remission of the whitish plaques and exfoliative areas, and 15 (56%) had partial remission of the clinical picture of cheilitis. The latter group was submitted to excision of the leukoplakic areas which diagnosis varied from mild to moderate epithelial dysplasia.

Conclusion

The results suggest a promising role for diclofenac in hyaluronic acid gel in the treatment of AC. This treatment has the advantages of not being invasive and showing few side effects.     

Synthesis and biocompatibility of an experimental glass ionomer cement prepared by a non-hydrolytic sol-gel method

The aims of this study were to demonstrate the synthesis of an experimental glass ionomer cement (GIC) by the non-hydrolytic sol-gel method and to evaluate its biocompatibility in comparison to a conventional glass ionomer cement (Vidrion R). Four polyethylene tubes containing the tested cements were implanted in the dorsal region of 15 rats, as follows: GI - experimental GIC and GII - conventional GIC. The external tube walls was considered the control group (CG). The rats were sacrificed 7, 21 and 42 days after implant placement for histopathological analysis. A four-point (I-IV) scoring system was used to graduate the inflammatory reaction. Regarding the experimental GIC sintherization, thermogravimetric and x-ray diffraction analysis demonstrated vitreous material formation at 110oC by the sol-gel method. For biocompatibility test, results showed a moderate chronic inflammatory reaction for GI (III), severe for GII (IV) and mild for CG (II) at 7 days. After 21 days, GI presented a mild reaction (II); GII, moderate (III) and CG, mild (II). At 42 days, GI showed a mild/absent inflammatory reaction (II to I), similar to GII (II to I). CG presented absence of chronic inflammatory reaction (I). It was concluded that the experimental GIC presented mild/absent tissue reaction after 42 days, being biocompatible when tested in the connective tissue of rats.     

Preventive effect of an iron varnish on bovine enamel erosion in vitro

Objective

The aim of this study was to evaluate, in vitro, the effect of an experimental varnish containing iron on the dissolution of bovine enamel by carbonated beverage.

Methods

Eighty specimens were randomly allocated to four groups (n = 20 per group), according to the following treatments: Fe varnish (FeV, 10 mmol/L Fe), F varnish (FV, 2.71% F), placebo varnish (PV) and control (not treated, NT). The varnishes were applied in a thin layer and removed after 6 h. Then, the samples were submitted to six cycles, alternating re- and demineralisation (only 1 day). Demineralisation was performed with the beverage Coca-Cola^® (10 min, 30 mL/block) and remineralisation with artificial saliva for 1 h. In order to determine the amount of enamel dissolved, the wear was analysed by profilometry. Data were analysed by ANOVA and Tukey's test (p < 0.05).

Results

The mean wear (±S.E.) was significantly lesser for the FeV (0.451 ± 0.018 μm) when compared to the other treatments. The FV caused significantly less wear (0.554 ± 0.022 μm) when compared to PV (0.991 ± 0.039 μm) and NT (1.014 ± 0.033), which did not significantly differ from each other.

Conclusions

The results suggest that the iron varnish can interfere with the dissolution of dental enamel in the presence of acidic beverages.     

Proliferative activity in oral salivary gland tumors: the role of PCNA and AgNOR assessed by a double staining technique

The aim of this study was to evaluate the role of PCNA and AgNOR in the assessment of salivary gland tumor proliferation using a double staining technique. Ten cases of pleomorphic adenoma (PA) and seventeen cases of adenoid cystic carcinoma (ACC) were examined. Numeric and morphometric parameters of AgNOR were evaluated and compared in PCNA-positive and PCNA-negative nuclei. There were statistically significant differences in AgNOR numbers, perimeters and contour indices between PCNA-positive and -negative nuclei in the PA samples. The ACC samples demonstrated significant differences only in the AgNOR areas. Our results show that in salivary gland tumors there is not always a relationship between proliferative activity evaluated by AgNOR numeric and morphometric parameters and PCNA immunostaining.     

Delayed formation of a lower second premolar

Delayed odontogenesis of a lower second premolar is presented in a case treated without extraction and focuses on the 7-year follow-up of the delayed tooth bud. The follow-up was initiated when the crown formation was diagnosed and was finished when the tooth erupted completely into the orthodontically provided space, which enabled the orthodontic leveling and alignment of the delayed premolar. The long follow-up indicates that delayed tooth buds may develop completely and normally.     

Evaluation of oral and nasal odor in patients with and without cleft lip and palate: preliminary report.

OBJECTIVE: To evaluate oral and nasal halitosis parameters in patients with and without clefts. DESIGN: Randomized and prospective study. Patients with and without clefts were evaluated as to oral and nasal halitosis. SETTING: University of S?o Paulo, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, Bauru, Brazil. PATIENTS: Twelve patients with clefts and 12 without clefts were evaluated, and no exclusion criteria were followed. INTERVENTIONS: Nasal and oral halitosis were measured with the use of a portable sulfide monitor during a single visit. RESULTS: One hundred percent of the patients with clefts had altered values for volatile sulfur compounds. Only 33.3% of the patients without clefts had at least one strong value for nasal halimeter measurements, and 58.3% of these patients showed alteration in the nasal values. Statistical evaluation, made using the Mann-Whitney U test, classifying the nasal halimeter values as normal, weak, and strong, showing a statistical significant group difference (p = .003). There was no significant difference in the oral halimeter values between the two groups. CONCLUSIONS: Patients with cleft lip and palate had a tendency to present higher values for the nasal halimeter measurements, when compared with patients without clefts.     

Bifid mandibular condyle: case report and etiological considerations

Bifid mandibular condyle, usually diagnosed on routine radiographic examination, is described in the literature as a rare entity. Its cause is controversial, and it has no predilection by sex or ethnic background. Dental professionals should have some knowledge of this anatomic abnormality, as well as its implications for function and appropriate treatment modalities, so that they can be alert to this potential diagnosis. This paper reports an unusual case of bifid mandibular condyle with possible traumatic cause, with emphasis on the radiographic and tomographic findings.