Frank E. Beube

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.

Factors in the repair of alveolar bone and cementum

Abstract 1. 1. A bone powder preparation is described which is effective in accelerating the healing process in certain experimental and clinical lesions of the alveolar bone and cementum. 2. 2. An experimental series showing the stages of regeneration of bone and cementum in simulated lesions, with and without the use of boiled cow-bone powder, was prepared in serial steps in dogs covering the entire cycle of repair. 3. 3. Bone powder implants were clinically effective in stimulating regeneration of bone in cysts and rarefied areas at apices of teeth (chronic alveolar abscesses or granulomas). Bilateral cases, in which one side was treated conventionally and the other with bone powder, showed consistently a hastening of the repair process in the sides where the implanted bone powder was utilized. 4. 4. The factors which contribute to the repair of bone and cementum injuries may account for the healing singly or more probably in conjunction with the others. The sequence appears to be: Increased blood supply; rarefaction of nonviable bone particles; retention locally of calcium salts or other ingredients in the bone powder in connective tissue bed by means of fibrin; cellular function through enzymatic or other activity, which result in deposition of calcium at site of rarefied bone. 5. 5. Where extra calcium is provided, deposition extends more rapidly over the entire area. Where excess calcium is not available, bone growth is delayed. The delay in animals extended up to thirty-five days, and that of the human subjects up to six months. 6. 6. Processes involved in repair of bone and cementum can be described without the necessity of postulating specific osteoblastic or cementoblastic functions as specialized cells.

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.