The Effects of NBF Gingival Gel Application in the Treatment of the Erosive Lichen Planus: Case Report

Efficacy and safety of a bioadhesive gel containing propolis extract, nanovitamin C and nanovitamin E on desquamative gingivitis: a double-blind, randomized, clinical trial

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.

Comparative In Vitro Evaluation of Commercial Periodontal Gels on Antibacterial, Biocompatibility and Wound Healing Ability

In the last years, several studies testing commercial periodontal gels that contain chlorhexidine (CHX) or other antibacterial agents, have raised concerns regarding their cytotoxicity in periodontal tissues. We aimed at comparing the biocompatibility but also the efficacy as regards to the antibacterial and wound healing ability of different commercial periodontal gels. In vitro human gingival fibroblasts (GF) and a 3D model of human tissue equivalents of gingiva (GTE) were used under inflammatory conditions to evaluate wound closure, cytotoxicity and gene expression. Antibacterial effects were also investigated on Porphyromonas gingivalis growth, viability and gingipain activity. In GF and in the bacterial study, we found cytotoxic effects on GF and a high inhibition on bacterial growth rate in gels containing CHX, asiaticoside, enoxolone, cetylpyridinium chloride, propolis and eugenol. Of the two gels that were non-cytotoxic, Syntoss Biogel (containing chondrontin sulfate) and Emdogain (EMD, containing amelogenin and propylene glycol alginate), EMD showed the best wound closure, with no effect on P. gingivalis growth but decreased gingipain activity. On the other hand, Syntoss Biogel reduced viability and gingipain activity of P. gingivalis, but lack wound healing capacity. In the 3D GTE, Syntoss Biogel and EMD showed a good biocompatibility. Among all the tested gels, formulations containing CHX, asiaticoside, enoxolone, cetylpyridinium chloride, propolis and eugenol showed high antibacterial effect but also showed high cytotoxicity in eukaryotic cells. EMD was the one with the best biocompatibility and wound healing ability at the conditions tested.

Short-term efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E on peri-implant mucositis: A double-blind, randomized, clinical trial

OBJECTIVE

To determine the efficacy of a gel containing propolis extract, nanovitamin C and nanovitamin E as adjuvant to mechanical debridement in the treatment of peri-implant mucositis (PM).

BACKGROUND

Propolis has anti-inflammatory and antibacterial effect that may improve peri-implant health.

METHODS

A randomized, double-blind study was performed on patients with at least one implant with PM. Participants received a professional prophylaxis and were instructed to use either test or a control gel as toothpaste three times/day for 1 month. Clinical and microbiological parameters were evaluated. PM resolution was considered in absence of bleeding on probing (BOP). Data were analysed with Mann-Whitney U, Wilcoxon signed-rank and chi-square tests.

RESULTS

Forty-six patients participated (23 in each group). After treatment, 26.1% of test patients showed complete PM resolution versus 0% in control group (p = .02). Significant reductions were observed in plaque index (p = .03), BOP (p = .04) and probing depths (p = .027) in test compared with control group. The reduction in Tannerella forsythia was statistically greater in test than in control group at 1-month follow-up (p = .02). Porphyromonas gingivalis was statistically reduced in test group from baseline to 1-month follow-up (p = .05).

CONCLUSION

Test gel clinically improved PM and showed certain antimicrobial effect after 1 month in comparison with control group. Further long-term clinical trials are required to confirm these results.

Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study

BACKGROUND

Propolis has anti-inflammatory, analgesic and healing properties. The purpose of this study was to determine whether a gel containing 2% of propolis extract, 0.2% of ascorbic acid and 0.2% of tocopherol acetate is effective in preventing surgical complications related to impacted lower third molar extractions.

MATERIAL AND METHODS

A randomized, double-blind, split-mouth study was performed. Fifteen patients were recruited who needed bilateral impacted lower third molar extractions with a similar surgical difficulty. A test or placebo gel was administered randomly inside post-extraction sockets. Each patient was instructed to apply the gel 3 times/day in the surgical wound for a week. After a month, the contralateral third molar was extracted, and the opposite gel applied. The following parameters were diagnosed/evaluated and then recorded: alveolar osteitis following Blum's criteria, swelling and trismus at day one, two, three and seven post-intervention, wound healing at day 7 post-intervention, and postoperative pain using a visual analog scale, as well as, the number of analgesic pill intake.

RESULTS

A total of twenty-six surgical procedures were performed in 13 patients (mean age 20.67±2 years). Alveolar osteitis was reported in 3 patients from the placebo group (23.1%) and none in the test group (0%) (p=0.25). No statistically significant differences were reported in swelling, trismus, wound healing or analgesic pill consumption between two groups. But statistically lower postoperative pain during the 7 days after surgical extractions was found according to visual analog scale in test group compared to the placebo group (p=0.007). No side effects were reported.

CONCLUSIONS

The application of this gel may be effective in preventing alveolitis and thus reducing postoperative pain after impacted third molar extractions. More randomized clinical trials with larger sample are needed to confirm these results.

An Unwanted Kiss by Charlie Beetle: An Unusual Case Report

Pederin, a vesicant chemical and one of the most powerful animal toxins in the world, is produced by an endosymbiont bacteria (Pseudomonas spp) found on the beetle Paederus fuscipes. This small, red- and black-striped beetle is also commonly known as the Charlie or rove beetle. Accidental contact with skin causes Paederus dermatitis, with the clinical presentation ranging from mild dermatitis to more severe vesiculobullous lesions. We report a rare case of severe lip destruction caused by the Charlie beetle in a 24-year-old man. Treatment involved intravenous antibiotics in addition to local wound debridement. The thinner stratum corneum on the lips and close proximity to the oral cavity could have resulted in the severe tissue destruction encountered.

Comparison of therapeutic effect of mucoadhesive nano-triamcinolone gel and conventional triamcinolone gel on oral lichen planus

Background:

Oral lichen planus (OLP) is a chronic disease without any definitive treatment. Local corticosteroids are often prescribed, but their efficacy has been questioned by many studies. The purpose of this study was to investigate the effect of nano-based triamcinolone acetonide gel (NT) and compare it with conventional triamcinolone gel (CT) on OLP.

Materials and Methods:

In this triple-blind randomized clinical trial study, 40 patients with Erosive OLP were divided into two groups receiving (CT) and (NT). The patients were requested to apply them four times a day for 2 weeks. The severity of pain was evaluated through visual analog scale, the size of lesions was measured with paper lace, and the appearance of lesions was examined adopting Thongprasom scale . Findings will be significant via independent t-test or Chi-square test with P < 0.05.

Results:

The severity of pain in NT group was 4.9 ± 0.7 cm before the treatment and 1.5 ± 0.9 after that, whereas in CT group, it was 4.9 ± 0.8 and 1.8 ± 0.9, respectively . The mean size of the lesions in NT group was 2.1 ± 1.1 cm before the treatment and 0.8 ± 1.1 afterward, whereas in CT group, was 2.2 ± 1.1 and 1.3 ± 1.1, respectively. The OLP appearance before and after the study in NT group was 4.5 ± 0.5 and 0.8 ± 0.6, respectively, whereas in CT group was 4.6 ± 0.5 and 0.9 ± 0.7 (P = 0.3). Among these variables, only Thongprasom scale on the 6^th and 14^th days had a significant reduction in NT group in comparison with CT group.

Conclusion:

NT has a better impact on OLP in comparison with CT, but this difference is not statistically significant.