Mariela Dutra Gontijo Moura

Efficacy of Brazilian propolis gel for the management of denture stomatitis: a pilot study

Denture stomatitis presents as a chronic disease in denture‐bearing patients, especially under maxillary prosthesis. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Propolis, a natural bee product, possesses well‐documented antifungal and anti‐inflammatory activities. The purpose of this study was to evaluate the clinical efficacy of a new Brazilian propolis gel formulation in patients diagnosed with denture stomatitis. Thirty complete‐denture wearers with denture stomatitis were enrolled in this pilot study. At baseline, clinical evaluation was performed by a single clinician and instructions for denture hygiene were provided. Fifteen patients received Daktarin® (Miconazole gel) and 15 received Brazilian propolis gel. All patients were recommended to apply the product four times a day during one week. Clinical evaluation was repeated by the same clinician after treatment. All patients treated with Brazilian propolis gel and Daktarin® had complete clinical remission of palatal edema and erythema. This new Brazilian propolis gel formulation had efficacy comparable to Daktarin® and could be an alternative topical choice for the treatment of denture stomatitis. Copyright

Oral Mucosal Conditions in Chronic Hepatitis C Brazilian Patients: A Cross‐Sectional Study

OBJECTIVE Our purpose was to carry out an epidemiological study to assess the prevalence of oral mucosal conditions in Brazilian patients with chronic hepatitis C. METHODS A cross-sectional survey was carried out on 215 patients with chronic hepatitis C who were examined for oral mucosal conditions, including oral mucosal lesions and variations of normality. RESULTS The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent (207 patients). Oral mucosal lesions were present in 147 patients (68.4 percent), whereas variations of normality were observed in 173 patients (80.5 percent). The most common lesions included cheek biting in 42 cases (19.5 percent), candidiasis in 39 cases (18.1 percent), and leukoplakia in 28 cases (13.0 percent). The association of oral lichen planus with hepatitis C virus (HCV) infection proved to be statistically significant (P = 0.002). The most frequent variations of normality included Fordyces spots in 96 cases (44.7 percent), lingual varicosities in 67 cases (31.2 percent), and fissured tongue in 60 cases (27.9 percent). CONCLUSION The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent. Despite this high prevalence, only the association between oral lichen planus and hepatitis C showed statistical significance. Considering that HCV infection may be associated with extrahepatic disorders, such as oral manifestations, efforts should be made to clarify the possible relation between oral conditions and HCV infection. This may be helpful in the earlier diagnosis of the infection mainly in asymptomatic patients.

A new topical treatment protocol for oral hairy leukoplakia

OBJECTIVE The aim of this study was to present a new topical treatment protocol for oral hairy leukoplakia (OHL), consisting of a 25% podophyllin resin with a 1% penciclovir cream (PP), and to compare this topical treatment protocols efficacy with that of 2 other topical treatment protocols: a 25% podophyllin resin (P) and a 25% podophyllin resin with a 5% acyclovir cream (PA). STUDY DESIGN Forty-two human immunodeficiency virus-positive patients with 69 OHL lesions were randomly treated using P, PA, or PP (14 patients in each topical treatment protocol). Clinical healing was determined when the white plaque could no longer be seen in the primary location of the lesion. Topical treatment performance was evaluated by clinical healing within each week of topical treatment protocol as well as by the recurrence of the lesion. Statistical survival analysis was performed using a Cox proportional hazards model. RESULTS Approximately 55% of the patients presented with clinical healing of OHL within 7-8 weeks of each topical treatment protocol. After the sixth week, the PA treatment protocol presented a faster clinical healing rate of OHL. Recurrence was observed in 3 and 7 OHL lesions treated with P and PP treatment protocols, respectively. CONCLUSIONS The PP treatment protocol proved to be effective; however, the PA treatment protocol was more effective in the clinical healing rate for OHL than P and PP after the sixth week of treatment, and no recurrent OHL was observed in the PA treatment group.

Oral Hairy Leukoplakia

Oral hairy leukoplakia (OHL) and oral candidiasis (OC) are the most common Human Immunodeficiency Virus (HIV) infection-associated oral diseases, and can act as a marker for immunosuppression. Patients with a prolonged immunodeficiency caused by HIV infection tend to develop OHL and OC, as a progression of Acquired Immune Deficiency Syndrome (AIDS). Few studies describe the joint manifestation of OHL and OC, and its findings are enigmatic. Lower CD4 count and smoking in HIV-infected patients can be independent risk factors for joint manifestation of OHL and OC. OC can be a primary disease or a secondary lesion superimposed on OHL. OHL is a benign oral lesion related to the infection of oral epithelium by Epstein-Barr virus (EBV). It is commonly related with AIDS, but it may also be observed in patients with other immunosuppressed states. OHL is an asymptomatic white plaque on the lateral borders of the tongue and a flat, corrugated, or hairy surface that is not removable when scraped. EBV can be identified through electronic microscopy techniques, in situ hybridization, immunohistochemistry, and polymerase chain reaction; however, the exfoliative cytology can also be used to diagnose OHL. Treatment for OHL is not necessary in most of the patients. Topical treatment such as retinoid, podophyllin, podophyllin with penciclovir, podophyllin with acyclovir, acyclovir, and gentian violet is most commonly recommended for patients with OHL; but there are other options of treatment such as surgical excision, cryotherapy, and systemic therapy with antiviral drugs.