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Kawamoto A, Sugano N, Sakai M, Ogisawa S, Shiratsuchi H, Seki K, Manaka S, Yoshinuma N, Sato S. Clinical effect of equol supplementation in the treatment of desquamative gingivitis with 1-year follow-up. J Oral Sci 2024; 66:145-150. [PMID: 38749724 DOI: 10.2334/josnusd.24-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
PURPOSE Desquamative gingivitis (DG) is characterized by desquamative erosion, edematous erythema, and vesicle formation on the gingiva. Because of its prevalence in women during the pre- and postmenopausal period, its potential association with female hormones has been suggested. Equol is a soy isoflavone metabolite with a chemical structure similar to estrogen. Scientific evidence suggests that equol helps in alleviating menopausal symptoms. This study evaluated the clinical effect of a 12-month equol supplementation as a substitute for estrogen to alleviate DG symptoms. METHODS The study enrolled 16 women with DG who regularly visited Nihon University School of Dentistry Dental Hospital. Urinary equol levels, periodontal tissue examination, O'Leary's plaque control record, stimulated saliva flow rate, and gingival pain-related questionnaires were evaluated before and after the 12-month daily intake of 10 mg equol supplement. RESULTS Equol supplementation led to a statistically significant improvement in bleeding on probing, visual findings, and reductions in the frequency and severity of gingival pain. CONCLUSION Urinary equol testing and equol supplementation may be novel treatment options for female patients with DG.
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Affiliation(s)
- Aki Kawamoto
- Dental Hygienist Section, Nihon University School of Dentistry Dental Hospital
| | - Naoyuki Sugano
- Department of Periodontology, Nihon University School of Dentistry
- Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Masako Sakai
- Dental Hygienist Section, Nihon University School of Dentistry Dental Hospital
| | - Shouhei Ogisawa
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Hiroshi Shiratsuchi
- Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry
| | - Keisuke Seki
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry
| | - Soichiro Manaka
- Department of Periodontology, Nihon University School of Dentistry
- Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Naoto Yoshinuma
- Department of Periodontology, Nihon University School of Dentistry
- Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
| | - Shuichi Sato
- Department of Periodontology, Nihon University School of Dentistry
- Division of Advanced Dental Treatment, Dental Research Center, Nihon University School of Dentistry
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De D, Hanumanthu V, Jinagal J, Handa S, Mahajan R, Chatterjee D, Kumar V, Saikia B, Nahar Saikia U, Dass Radotra B, Minz RW. Clinical and demographic characteristics of mucous membrane pemphigoid in India: A retrospective analysis. Indian J Dermatol Venereol Leprol 2024; 0:1-6. [PMID: 39152854 DOI: 10.25259/ijdvl_273_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 01/07/2024] [Indexed: 08/19/2024]
Abstract
Background Mucous membrane pemphigoid (MMP) is a rare subepidermal autoimmune blistering disorder. The clinical and demographic parameters of this disease in Indian patients have not yet been elucidated in detail. Objective We aimed to study the clinical and demographic characteristics, disease course, and treatment aspects of MMP patients. Methods The data for this study were obtained by reviewing the case record forms of patients registered in the Autoimmune Bullous Disease (AIBD) Clinic of the Department of Dermatology, Venereology & Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, a tertiary care centre in India. The diagnosis of MMP was established on the basis of clinical and immune-histopathological features which are consistent with standard diagnostic criteria for the disease. Results A total of 52 patients with MMP registered in the AIBD clinic were included. The mean age at disease onset was 50 years and the average age at presentation was 56 years. Females outnumbered males in the study with a ratio of 1.36:1. The oral and ocular mucosae were the most commonly affected sites (82.6% and 63.4% respectively). Visual difficulty was reported by half the patients (26 of 52 patients). IgG, C3, and IgA deposits were detected on direct immunofluorescence (DIF) in 29, 21, and 11 patients, respectively. Serologic analysis was performed in only 7 of the patients and of these, just 1 exhibited a positive result on multivariant ELISA and epidermal pattern of binding on salt split skin indirect immunofluorescence. Most patients were treated with prednisolone (44 of 52). Steroid-sparing adjuvants were used in combination including cyclophosphamide, azathioprine, methotrexate, dapsone, and colchicine. Rituximab was administered in 7 patients with severe or refractory disease. Limitations This is a retrospective analysis of data available from a clinic registry. In patients with negative direct immunofluorescence on biopsy, the diagnosis was based on clinico-pathologic consensus. Conclusion MMP is not as uncommon in India as the paucity of reports suggest. Visual complications are frequent in Indian MMP patients. A high index of suspicion is required for early diagnosis and appropriate treatment to prevent ocular complications.
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Affiliation(s)
- Dipankar De
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Hanumanthu
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jitender Jinagal
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Kumar
- Department of Dermatology, Venereology and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Biman Saikia
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar Saikia
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan Dass Radotra
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ranjana Walker Minz
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Santonocito S, Polizzi A, Matarese M, Caltabiano R, Isola G. Analysis of a Combination Therapy Protocol for the Treatment of Oral Mucous Membrane Pemphigoid: A Retrospective Case Series Study. Int J Dent 2024; 2024:5524514. [PMID: 38362240 PMCID: PMC10869199 DOI: 10.1155/2024/5524514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/05/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024] Open
Abstract
Mucous membrane pemphigoid (MMP) is an autoimmune-based bullous disease affecting the mucous membranes, mainly oral and ocular. One of the most common clinical manifestations is desquamative gingivitis (DG), characterized by intense symptoms and functional limitations. The dentist is among the first specialists to observe DG and, therefore, must be able to diagnose it. In this regard, the purpose of the present study was to evaluate the efficacy and safety of a clinical protocol for the topical management of patients with DG and MMP buccal lesions. Thirteen patients with clinical and histologic diagnoses of MMP-localized DG in the oral cavity were retrospectively enrolled. Each patient received topical treatment with clobetasol propionate oral gel 0.05%; nicotinamide; oral probiotic (contains Bifidobacterium lactis HN019, Kluyveromyces marxianus fragilis B0399, colostrum, and biotin); and doxycycline. Before and after 3 months of therapy, clinic records were collected for each patient. Seven patients (53.8%) had a complete response to treatment; four patients (30.8%) had a partial response to treatment; and, finally, two patients (15.4%) had no benefit from therapy. Dental management of patients presenting solely with oral manifestations of MMP may involve the use of topical corticosteroids, doxycycline, vitamin supplements, and probiotics and associating professional oral hygiene procedures.
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Affiliation(s)
- Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Marco Matarese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Messina 98123, Italy
| | - Rosario Caltabiano
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, Catania 95124, Italy
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Bahramian A, Rahbaran M, Bahramian M, Bohlouli S, Katebi K. Effect of zinc supplementation as an adjuvant to corticosteroid treatment in patients with oral lichen planus: A systematic review. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2023; 15:128-133. [PMID: 38357334 PMCID: PMC10862047 DOI: 10.34172/japid.2023.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/23/2023] [Indexed: 02/16/2024]
Abstract
Background Oral lichen planus (OLP) and one of its main presentations, desquamative gingivitis, are common diseases with no definite treatment. Zinc deficiency has a critical role in the pathogenesis of oral mucosal diseases. The current study systematically reviewed the effect of zinc in addition to topical corticosteroids in the treatment of OLP. Methods English articles in PubMed, Web of Sciences, Embase, and Scopus were searched until August 2022. The differences in symptoms were analyzed, including pain, burning sensation, and lesion sizes in patients with lichen planus receiving zinc supplementation as an adjuvant to corticosteroid treatment. Results A total of 148 articles related to the searched keywords were found. Eventually, two clinical trials were selected. The total population of studied individuals included 60 patients. Due to the high heterogeneity between the studies, meta-analysis was not possible. Administering zinc, in addition to corticosteroids, did not improve the symptoms compared to corticosteroid monotherapy. Conclusion Considering the limited number of studies and lack of sufficient evidence, it is not currently possible to reach a definite conclusion regarding the effects of zinc on OLP.
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Affiliation(s)
- Ayla Bahramian
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mona Rahbaran
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maria Bahramian
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Bohlouli
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Katayoun Katebi
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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González-Serrano J, Serrano J, Sanz M, Torres J, Hernández G, López-Pintor RM. Efficacy and safety of a bioadhesive gel containing propolis extract, nanovitamin C and nanovitamin E on desquamative gingivitis: a double-blind, randomized, clinical trial. Clin Oral Investig 2023; 27:879-888. [PMID: 35900605 PMCID: PMC9889524 DOI: 10.1007/s00784-022-04653-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a gel-containing propolis extract, nanovitamin C, and nanovitamin E as adjuvants to professional plaque removal on desquamative gingivitis (DG). MATERIALS AND METHODS A randomized clinical trial was conducted on patients suffering DG due to mucocutaneous diseases. Patients received professional supragingival prophylaxis with oral hygiene instructions and were randomly assigned to use test or control gels as toothpaste and to apply it on DG lesions 3 times/day for 4 weeks. DG clinical score (DGCS), clinical periodontal variables, and visual analog scale (VAS) for pain and oral health impact profile (OHIP-14) were collected at baseline, 2 and 4 weeks. RESULTS Twenty-two patients were randomly assigned to test (n = 11) or control group (n = 11). Eighteen had diagnosis of oral lichen planus and four of mucous membrane pemphigoid. DGCS statistically decreased in both groups after treatment with no significant differences between groups. Clinical periodontal outcomes decreased in both groups, but no significant differences were observed. Periodontal variables statistically improved only in test group after treatment. VAS and OHIP-14 scores decreased in test and control groups without significant differences. However, only one test group showed a statistically significant decrease in VAS and OHIP-14 scores after treatment. No adverse effects were reported. CONCLUSIONS Test gel may alleviate DG and improve quality of life without side effects. CLINICAL RELEVANCE A gel-containing propolis extract, nanovitamin C, and nanovitamin E as adjuvants to mechanical debridement may improve both clinical and patient related outcomes in DG patients without side effects. CLINICAL TRIAL REGISTRATION The study protocol was registered at clinicaltrials.gov with the following number: NCT05124366 on October 16, 2021.
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Affiliation(s)
- José González-Serrano
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Julia Serrano
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Mariano Sanz
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Jesús Torres
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Gonzalo Hernández
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain
| | - Rosa María López-Pintor
- grid.4795.f0000 0001 2157 7667Department of Dental Clinical Specialties, ORALMED Research Group, School of Dentistry, Complutense University of Madrid. Plaza Ramón y Cajal S/N, 28040 Madrid, Spain ,grid.4795.f0000 0001 2157 7667Departamento de Especialidades Clínicas Odontológicas. Facultad de Odontología, Universidad Complutense de Madrid. Plaza Ramón Y Cajal S/N, 28040 Madrid, Spain
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Sciuca AM, Toader MP, Stelea CG, Maftei GA, Ciurcanu OE, Stefanescu OM, Onofrei BA, Popa C. Desquamative Gingivitis in the Context of Autoimmune Bullous Dermatoses and Lichen Planus-Challenges in the Diagnosis and Treatment. Diagnostics (Basel) 2022; 12:1754. [PMID: 35885656 PMCID: PMC9322493 DOI: 10.3390/diagnostics12071754] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Desquamative gingivitis (DG) is a clinical term that describes erythema, desquamation and erosions of the gingiva, of various etiologies. Although the clinical aspect is not specific for a certain disease, an accurate diagnosis of the underlying disorder is necessary because the disease course, prognosis and treatment vary according to the cause. DG may inflict significant oral discomfort, which is why patients typically present to the dentist for a first consultation, rendering it important for these specialists to be informed about this condition. Our paper aims to review the ethiopatogenesis and diagnostic approach of DG, focusing on the most common underlying disorders (autoimmune bullous dermatoses and lichen planus) and on the management of these patients. Potential etiological agents leading to an inflammatory immune response in the oral mucosa and DG appearance include genetic predisposition, metabolic, neuropsychiatric, infectious factors, medication, dental materials, graft-versus-host reaction and autoimmunity. A thorough anamnesis, a careful clinical examination, paraclinical explorations including histopathological exam and direct immunofluorescence are necessary to formulate an appropriate diagnosis. Proper and prompt management of these patients lead to a better prognosis and improved quality of life, and must include management in the dental office with sanitizing the oral cavity, instructing the patient for rigorous oral hygiene, periodic follow-up for bacterial plaque detection and removal, as well as topical and systemic therapy depending on the underlying disorder, based on treatment algorithms. A multidisciplinary approach for the diagnosis and follow-up of DG in the context of pemphigus vulgaris, bullous pemphigoid, cicatricial pemhigoid or lichen planus is necessary, including consultations with dermatologists, oral medicine specialists and dentists.
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Affiliation(s)
- Ana Maria Sciuca
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Mihaela Paula Toader
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Carmen Gabriela Stelea
- Discipline of Oral Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (O.E.C.); (O.M.S.)
| | - George Alexandru Maftei
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Oana Elena Ciurcanu
- Discipline of Oral Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (O.E.C.); (O.M.S.)
| | - Ovidiu Mihail Stefanescu
- Discipline of Oral Surgery, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (O.E.C.); (O.M.S.)
| | - Bianca-Andreea Onofrei
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
| | - Cristina Popa
- Discipline of Oral Medicine, Oral Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania; (A.M.S.); (G.A.M.); (B.-A.O.); (C.P.)
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de Carvalho MM, Hidalgo MAR, Scarel-Caminaga RM, Ribeiro Junior NV, Sperandio FF, Pigossi SC, de Carli ML. Photobiomodulation of gingival lesions resulting from autoimmune diseases: systematic review and meta-analysis. Clin Oral Investig 2022; 26:3949-3964. [PMID: 35024960 PMCID: PMC8755514 DOI: 10.1007/s00784-021-04362-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/29/2021] [Indexed: 12/23/2022]
Abstract
Objectives To evaluate the effects of photobiomodulation (PBM) in gingival lesions resulting from autoimmune diseases; to compare PBM and topical corticosteroid (CS) treatment; and to assess PBM outcome over time of follow-up. Materials and methods A comprehensive electronic search was performed in four electronic databases. Treatment effects were measured through visual analog scale of pain (VAS) and clinical evolution of lesion (Thongprasom scale for oral lichen planus (OLP)). Meta-analysis was performed to compare PBM with topical corticosteroid treatment and to evaluate PBM effect over time of follow-up. Results Seventeen studies were included in this review, of which six were used for the meta-analysis. Meta-analysis results showed no significant differences between PBM and topical CS in pain reduction at baseline (MD = 0.20, 95% CI = − 0.92, 1.32, p = 0.72) and 60-day follow-up (MD = 0.63, 95% CI = − 3.93, 5.19, p = 0.79); however, VAS showed significant pain reduction when compared before and after PBM at 30-day (MD = − 3.52, 95% CI = − 5.40, − 1.64, p = 0.0002) and 60-day (MD = − 5.04, 95% CI = − 5.86, − 4.22, p < 0.00001) follow-up. Thongprasom clinical scale for OLP also showed significant improvement at 30-day follow-up (MD = − 2.50, 95% CI = − 2.92, − 2.08, p < 0.00001) after PBM. Conclusion PBM led to significant reduction of pain and clinical scores of the lesions, not having shown significant differences when compared to topical CS. Clinical relevance PBM has been used in the treatment of autoimmune gingival lesions, but so far there is little strong evidence to support its use.
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Affiliation(s)
- Milena Moraes de Carvalho
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil
| | - Marco Antonio Rimachi Hidalgo
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, FOAr/UNESP), UNESP - São Paulo State University, Araraquara, SP, Brazil
| | - Raquel Mantuaneli Scarel-Caminaga
- Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, School of Dentistry at Araraquara, FOAr/UNESP), UNESP - São Paulo State University, Araraquara, SP, Brazil
| | - Noé Vital Ribeiro Junior
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil
| | - Felipe Fornias Sperandio
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.,Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Suzane Cristina Pigossi
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil
| | - Marina Lara de Carli
- School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700 - Centro, Alfenas, MG, 37130-001, Brazil.
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Li C, Qi Y, Zhou Q, Huang X, Deng X, Yu Y, Shi LE. Betulinic acid promotes the osteogenic differentiation of human periodontal ligament stem cells by upregulating EGR1. Acta Biochim Biophys Sin (Shanghai) 2021; 53:1266-1276. [PMID: 34519779 DOI: 10.1093/abbs/gmab111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Indexed: 12/22/2022] Open
Abstract
Periodontitis is one of the most common chronic inflammations of the oral cavity, which eventually leads to tooth loss. Betulinic acid (BetA) is an organic acid that has anti-inflammatory effects and is derived from fruits and plants, but its effect on the osteogenic differentiation of human periodontal ligament stem cells (hPDLSCs) is still unclear. This study aimed to explore the effect of BetA on the osteogenic differentiation of hPDLSCs and its mechanism. Our results revealed that BetA not only promoted the viability of hPDLSCs but also induced their osteogenic differentiation in a dose-dependent manner. In addition, RNA sequencing was used to screen the differentially expressed genes (DEGs) after hPDLSCs were treated with BetA, and 127 upregulated and 138 downregulated genes were identified. Gene Ontology enrichment analysis showed that DEGs were mainly involved in the response to lithium ions and the positive regulation of macrophage-derived foam cell differentiation. The Kyoto Encyclopedia of Genes and Genomes analysis results revealed that DEGs were enriched in the nuclear factor-κB and interleukin-17 signaling pathways. More importantly, we confirmed that early growth response gene 1 (EGR1), one of the three DEGs involved in bone formation, significantly promoted the expression of osteogenic markers and the mineralization of hPDLSCs. Knockdown of EGR1 obviously limited the effect of BetA on the osteogenic differentiation of hPDLSCs. In conclusion, BetA promoted the osteogenic differentiation of hPDLSCs through upregulating EGR1, and BetA might be a promising candidate in the clinical application of periodontal tissue regeneration.
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Affiliation(s)
- Cheng Li
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Department of Stomatology, Jing’an District Institute of Dantal Diseases, Shanghai 200040, China
| | - Yuesun Qi
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Department of Stomatology, Jinshan Hospital, Fudan University, Shanghai 200540, China
| | - Qin Zhou
- Department of Stomatology, Jing’an District Institute of Dantal Diseases, Shanghai 200040, China
| | - Xin Huang
- Department of Stomatology, Jing’an District Institute of Dantal Diseases, Shanghai 200040, China
| | - Xiaolin Deng
- Department of Stomatology, Jing’an District Institute of Dantal Diseases, Shanghai 200040, China
| | - Youcheng Yu
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - L e Shi
- Department of Stomatology, Jing’an District Institute of Dantal Diseases, Shanghai 200040, China
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9
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Panzarella V, Bartolone A, Coniglio R, Rodolico V, Maniscalco L, Capocasale G, Iurato Carbone M, Campisi G. Diagnostic Concordance between Optical Coherence Tomography and Histological Investigations for Immune-Mediated Desquamative Gingivitis: Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9095. [PMID: 34501683 PMCID: PMC8430736 DOI: 10.3390/ijerph18179095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/21/2021] [Accepted: 08/25/2021] [Indexed: 12/28/2022]
Abstract
Desquamative gingivitis (DG) denotes a heterogeneous immune-mediated disease for which early diagnosis represents a great challenge. The main aim of this study is to validate diagnostic concordance between specific Optical Coherence Tomography (OTC) patterns for DG related to oral Lichen Planus (OLP), Pemphigus Vulgaris (PV), and Mucous Membrane Pemphigoid (MMP) and definitive histological diagnosis. Forty-three patients with suspected immune-mediated DGs, were progressively recruited. Before biopsy, an OCT preliminary evaluation was performed using specific pre-determined OCT diagnostic patterns (i.e., morphology and localization of blisters, status of the basal membrane, epithelial thickness, presence/absence of acantholytic cells into blister and/or inflammatory infiltrate) related to OLP, PV and MMP. After histological confirmation, OCT and histological diagnoses were compared. Using pre-determined patterns, OCT diagnoses of DGs were: 22 (51%) OLP, of which 11 (26%) were with the bullous variant, 4 (9%) PV and 6 (14%) MMP. The same diagnoses were found by histological investigations (with the main OCT discriminatory potential for the bullous variant of OLP). The concordance between the two diagnostic methods was confirmed by the Fisher exact test (p-value < 0.01). These specific OCT patterns show a diagnostic reliability in 100% of the cases investigated, suggesting their accuracy to support the complex diagnosis and management of immune-mediated DGs.
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Affiliation(s)
- Vera Panzarella
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S), University of Palermo, 90127 Palermo, Italy; (A.B.); (M.I.C.); (G.C.)
| | - Alessia Bartolone
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S), University of Palermo, 90127 Palermo, Italy; (A.B.); (M.I.C.); (G.C.)
| | - Rita Coniglio
- Sector of Oral Medicine, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) “Paolo Giaccone” of Palermo, 90127 Palermo, Italy;
| | - Vito Rodolico
- Department ProMISE, University of Palermo, 90127 Palermo, Italy;
| | - Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy;
| | - Giorgia Capocasale
- Department of Surgical Sciences, Paediatrics and Gynaecology, University of Verona, Policlinico “G. B. Rossi” of Verona, 37134 Verona, Italy;
| | - Martina Iurato Carbone
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S), University of Palermo, 90127 Palermo, Italy; (A.B.); (M.I.C.); (G.C.)
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S), University of Palermo, 90127 Palermo, Italy; (A.B.); (M.I.C.); (G.C.)
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10
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Ramesh A, Bhat RM, Madhumita M, Jaganathan P. Desquamative gingivitis in dermatological disorders. Indian J Dermatol Venereol Leprol 2021; 87:446-451. [PMID: 33943058 DOI: 10.25259/ijdvl_130_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 09/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Amitha Ramesh
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University) Mangalore, Karnataka, India
| | - Ramesh M Bhat
- Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India
| | - Monisha Madhumita
- Department of Dermatology, Father Muller Medical College, Mangalore, Karnataka, India
| | - Pavithra Jaganathan
- Department of Periodontics, AB Shetty Memorial Institute of Dental Sciences, NITTE (Deemed to be University) Mangalore, Karnataka, India
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11
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Abstract
Direct immunofluorescence (DIF) remains a valuable tool that may be underused because of perceived challenges in the interpretation, limitations, and processing of DIF specimens. The aim of this review is to provide a practical guide for appropriately incorporating DIF in a variety of clinical diseases, such as autoimmune blistering disorders. In vasculitis, the role of DIF continues to evolve, particularly in the setting of IgA vasculitis. Although typically not indicated for the workup of connective tissue disease, DIF may be helpful in cases with negative serologies, nondiagnostic histologic findings, or scarring alopecia. Practical pearls for biopsy technique, specimen handling, and storage are also discussed.
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12
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Shaqman M, Hamdan A, Karadsheh O, Sawair F, Hassona Y. Desquamative gingivitis: a challenging diagnosis for clinicians. Br Dent J 2020; 229:26-30. [PMID: 32651518 DOI: 10.1038/s41415-020-1848-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction Diagnosis of underlying causes for desquamative gingivitis (DG) is often delayed in clinical settings, but little is known about factors influencing its delayed diagnosis. We investigated the diagnostic patterns and associated factors in a cohort of patients presenting primarily with DG.Materials and methods A total of 41 patients presenting primarily with DG were interviewed to evaluate professional and patient diagnostic delays. Severity of DG was evaluated using the desquamative gingivitis clinical score (DGCS) proposed by Arduino <i>et al.</i> (2017).Results The study sample was composed of 29 females and 12 males. On average, patients waited 10.8 ± 10 months (range 4-20 months) before seeking their first professional consultation (that is, patient delay). Less severe disease and female gender were significantly associated with longer patient delay. Patients consulted an average of 4.1 ± 2 healthcare professionals (range two to six) before a definitive diagnosis was reached, with an average professional delay of 7.3 ± 5 months (range 2-11 months). Professional delay was positively correlated with the number of professional consultations (r = 0.69) and absence of other oral mucosal lesions or extraoral involvement.Conclusions Considerable diagnostic delay is a feature of the natural history of DG. Increased patient knowledge and professional awareness regarding DG symptoms and diagnostic measures is needed to reduce diagnostic delay and improve patients' experience with this disease.
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Affiliation(s)
- Murad Shaqman
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan.
| | - Ahmad Hamdan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Omar Karadsheh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
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13
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Nivolumab-related mucous membrane pemphigoid. Eur J Cancer 2019; 121:172-176. [DOI: 10.1016/j.ejca.2019.08.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 12/11/2022]
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14
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Abstract
Mucocutaneous diseases affecting the oral cavity are predominantly immune mediated or inflammatory. Three of the most common and clinically significant conditions are reviewed in this article: lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid. Because oral manifestations may be the first or only manifestation of mucocutaneous diseases, oral health professionals play a critical role in the early diagnosis and multidisciplinary management of these conditions.
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15
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Pérez-López D, Varela-Centelles P, García-Pola MJ, Castelo-Baz P, García-Caballero L, Seoane-Romero JM. Oral mucosal peeling related to dentifrices and mouthwashes: A systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e452-e460. [PMID: 31246938 PMCID: PMC6667016 DOI: 10.4317/medoral.22939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/18/2019] [Indexed: 12/29/2022] Open
Abstract
Background The aim of this systematic review was to summarise the clinical information available about oral mucosal peeling (OMP) and to explore its aetiopathogenic association with dentifrices and mouthwashes. Material and Methods PICOS outline: Population: subjects diagnosed clinically and/or pathologically. Intervention: exposition to oral hygiene products. Comparisons: patients using products at different concentrations. Outcomes: clinicopathological outcomes (primary) and oral epithelial desquamation (secondary) after use. Study design: any. Exclusion criteria: reports on secondary or unpublished data, in vitro studies. Data were independently extracted by two reviewers. Results Fifteen reports were selected from 410 identified. Descriptive studies mainly showed low bias risk, experimental studies mostly an “unclear risk”. Dentifrices or mouthwashes were linked to OMP, with an unknown origin in 5 subjects. Sodium lauryl-sulphate (SLS) was behind this disorder in 21 subjects, tartar-control dentifrices in 2, and flavouring agents in 1 case. Desquamation extension was linked to SLS concentration. Most cases were painless, leaving normal mucosa after desquamation. Tartar-control dentifrices caused ulcerations more frequently. Conclusions OMP management should consider differential diagnosis with oral desquamative lesions, particularly desquamative gingivitis, with a guided clinical interview together with pathological confirmation while discouraging the use of the product responsible for OMP. Key words:Systematic review, oral mucosal peeling, dentifrices, sodium lauryl-sulphate, oral hygiene products.
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Affiliation(s)
- D Pérez-López
- CS Praza do Ferrol, Praza Ferrol 11, 27001 Lugo, Spain,
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16
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Garcia-Pola MJ, Rodriguez-López S, Fernánz-Vigil A, Bagán L, Garcia-Martín JM. Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e136-e144. [PMID: 30818305 PMCID: PMC6441599 DOI: 10.4317/medoral.22782] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/22/2018] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. Material and Methods The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. Results After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. Conclusions In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis. Key words:Desquamative gingivitis, oral hygiene, oral lichen planus, mucous membrane pemphigoid; pemphigus, plasma cell gingivitis.
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Affiliation(s)
- M-J Garcia-Pola
- Department of Oral Medicine, Faculty of Medicine and Sciences of the Health, Julian Clavería, 33006 Oviedo, Spain,
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17
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Reply to: “Comment on ‘Desquamative gingivitis: Clinical findings and diseases’”. J Am Acad Dermatol 2019; 80:e59. [DOI: 10.1016/j.jaad.2018.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 10/22/2018] [Indexed: 11/21/2022]
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18
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Comment on “Desquamative gingivitis: Clinical findings and diseases”. J Am Acad Dermatol 2019; 80:e57-e58. [DOI: 10.1016/j.jaad.2018.08.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 11/22/2022]
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Fitzpatrick SG, Cohen DM, Clark AN. Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review. Head Neck Pathol 2019; 13:91-102. [PMID: 30701449 PMCID: PMC6405793 DOI: 10.1007/s12105-018-0981-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022]
Abstract
Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.
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Affiliation(s)
- Sarah G Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
| | - Donald M Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Ashley N Clark
- Department of Diagnostic and Biomedical Sciences, University of Texas at Houston Health Science Center School of Dentistry, Houston, TX, USA
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Lopes de Oliveira LM, Batista LHC, Neto APDS, Silva LB, Cimões R, Leão JC, Cintra ML, Ribeiro CMB. Oral Lichenoid Lesion Manifesting as Desquamative Gingivitis: Unlikely Association? Case Report. Open Dent J 2018; 12:679-686. [PMID: 30369977 PMCID: PMC6182885 DOI: 10.2174/1745017901814010679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 07/19/2018] [Accepted: 09/03/2018] [Indexed: 01/13/2023] Open
Abstract
Introduction: The aim of this report is to present a clinical case of oral lichenoid lesions associated with amalgam restorations with the presence of desquamative gingivitis for a nine months follow up period. Case Report: The histopathologic characteristics and direct immunofluorescence were compatible with Oral Lichenoid Lesion (LLO). Diagnosis was based on a synthesis of all available information, including medical history, clinical examination, histopathology and the results of specific tests, such as the patch test, which confirmed allergy to thimerosal, an organic compound of mercury. Discussion: The replacement of amalgam restorations has brought improvements to the instrument, as evidenced by the disappearance of desquamative gingivitis, aspect erythematosus and erosive lesions. The fading does not complete the same, however, indicates the need to continue has been under continuous observation, the patient, having in view the possibility of the existence of an underlying lichen planus.
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Affiliation(s)
- Lívia Maria Lopes de Oliveira
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | | | | | - Luciano Barreto Silva
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Renata Cimões
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Jair Carneiro Leão
- Department of Prosthesis and maxillofacial surgery, Faculty of Dentistry, Federal University of Pernambuco Recife, Brazil
| | - Maria Leticia Cintra
- Medical Sciences College, University of Campinas - FCM UNICAMP, Campinas, Brazil
| | - Camila Maria Béder Ribeiro
- Department of Pathology, Faculty of Dentistry, Cesmac University Center, Cônego Machado, 918, Farol CEP: 57051-160, Maceió, Alagoas, Brazil
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