Charles L. Berman

Triamcinolone acetonide in the treatment of acute and chronic lesions of the oral mucous membranes: Preliminary report☆

Abstract Triamcinolone acetonide was administered in a new vehicle adhesive to fifty-six patients with various acute and chronic lesions of the oral mucous membranes. Trimacinolone acetonide therapy was undertaken in many instances after relatively prolonged unsuccessful therapy with numerous other agents and/or placebos. The patients treated included six with erosive lichen planus, six with denture stomatitis, four with oral erythema multiforme, four with geographic tongue, three with orolingual paresthesias, eight with desquamative gingivitis or stomatitis, thirteen with recurrent ulcerative stomatitis, eight with denture irritations or other traumatic ulcers. two with chronic inflammatory lesions of unknown etiology, and two with postradiation (cancer therapy) stomatitis. Triamcinolone acetonide in the adhesive vehicle was found to have either (1) suppressant, (2) ameliorative, or (3) curative effects on the various oral mucosal lesions enumerated above, with the exception of the three patients with idiopathic orolingual paresthesia and the four patients with geographic tongue. Further studies with this agent in acute and chronic lesions of the oral mucous membranes, especially when combined with the new adhesive vehicle, seem indicated. Since triamcinolone acetonide is a powerful corticosteroid which is fully active systemically, the total dose administered and the duration of therapy must be considered carefully. It is also essential that, where possible, therapy be of a discontinuous nature and that particular advantage be taken of the adhesive vehicles ability to maintain a drug at the site of application.

A new vehicle (orabase) for the application of drugs to the oral mucous membranes.

Abstract A new vehicle for the application of therapeutic agents to the oral mucous membranes is described. Various clinical tests were undertaken on a total of 119 patients (784 applications) in order to study the usefulness of this material as a vehicle for the prolonged application of medications to the oral mucous membranes. The findings indicate that when approximately 60 mg. (Group I), 250 mg. (Groups II and III), and 125 mg. (Group IV) of this vehicle adhesive are applied to various sites of the oral cavity, the average duration of maintenance was as follows: dorsum of the tongue—twenty-five, fifty-eight, and fifteen minutes for Groups I, II, and IV, respectively; hard palate—twenty-three, eighty-one, and thirty-three minutes for Groups I, II, and IV, respectively; anterior labial gingivae—twenty-four, 109, ninety-four, and fifty-six minutes for Groups I, II, and III, and IV; lower lingual anterior—eighty-five, sixty-four, and thirty-four minutes for Groups II, III, and IV; mucosa of the cheek—twenty-five, ninety-one, and forty-five minutes for Groups I, II, and IV; inner surface of the lower lip—103 minutes for Group II; and mucobuccal fold—152, and 108 minutes for Groups II and III, respectively. In no instance was there observed any evidence of irritation or other side reaction or toxicity, either local or systemic, due to the vehicle being studied. These data indicate a potential usefulness of this material as a vehicle for topical oral medications and mechanical protection in the oral cavity.

Antibiotic levels in saliva obtained with a new antibiotic: Thiostrepton troche studies☆

Abstract In order to study the saliva levels of a new antibiotic, Thiostrepton, which might be obtained following the administration of troches containing 10 mg. of this antibacterial substance, salivary specimens were assayed before, during, and after the administration of Thiostrepton troches to twelve adult male volunteer subjects. Our findings suggest that, in terms of the minimum inhibitory concentration of Thiostrepton against various susceptible microorganisms, saliva levels far in excess of this minimum inhibitory level are obtained during the period in which the troche is not yet completely dissolved and that the saliva Thiostrepton levels some thirty-five minutes after the troche had dissolved were also well in excess of the minimum inhibitory concentration in at least nine of the twelve subjects.