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Considering the chemical and structural properties of dentin, this study was aimed at evaluating the effect of dentin matrix alone or combined with mesenchymal stromal cells (MSC) on postextraction alveolar bone regeneration.Wistar rats were subjected to tooth extraction with osteotomy and allocated into groups according to the graft inserted: (1) Gelita-SponThe Bio-Oss group showed less bone than Gelita-Spon and Dentin/MSC; no other significant differences were seen in HE analysis. The Bio-Oss group showed higher expression of collagen type I compared to the Dentin and Dentin/MSC groups and also higher osteocalcin expression than the Dentin/MSC group. There was a tendency of higher expression of osteopontin in the MSC, Dentin, and Dentin/MSC groups and higher VEGF in the MSC group. On micro-CT analysis, the Bio-Oss and the Dentin/MSC groups exhibited greater bone volume than the Control. Serum calcium and phosphorus levels did not significantly differ between the groups. SEM analysis depicted particles of Bio-Oss and dentin in the respective groups, as well as significant cellularity in the MSC group.Autogenous nondemineralized dentin is an alternative for alveolar bone grafting, which can be improved by combination with MSC.This work provides support for the clinical applicability of dentin graft alone or combined with MSC.

We aimed to evaluate the effects of the deoxycholic acid (DCA) in the submental and subplantar regions of rats, and to histologically analyze the changes caused in the submandibular glands, soft tissues of the paw, and inguinal adipose tissue.Sixty male Wistar rats were divided into DCA and control (CG) groups. DCA was injected in the submental, inguinal, and subplantar regions, and saline was injected in the CG. The animals were euthanized after 24 h and at 7 and 21 days.The DCA group showed edema in the submental region in 24 h and in the paw in all experimental times. In the paw there were also erythema and ulceration in 7 days, and alopecia after 21 days. At 21 days, a few animals also showed erythema and ulceration in paw; however, there was no significant difference from CG. Histological analysis of the paw showed an intense inflammatory process, with a predominance of neutrophils, lymphocytes, and plasma cells in 24 h and 7 days. In the adipose tissue, we observed loss of architecture and inflammatory infiltrate, followed with a lower number of adipose cells, and at 21 days, fibroplasia. In the submandibular glands we observed inflammatory infiltration, loss of tissue architecture, and fibrosis.DCA produces a significant inflammatory process in the structures. It can cause skin ulcerations and, in salivary glands, it causes loss of tissue architecture and fibrosis.There has been growing increase in the use of DCA for aesthetic purposes by health care providers. Due to the presence of important anatomical structures in the submental region, constant vigilance is required to report new adverse effects.

Introduction: Oral cytopathology is able to detect incipient cellular alterations, but it is not routinely applied to this purpose. We aimed to establish a model to screen individuals with no oral lesion exposed to smoking/alcohol, by means of the nuclear area, cell proliferation rate, and analysis of genetic damage. Methods: In this cross-sectional pilot study, 90 patients were allocated into 3 groups: oral cancer group (patients with oral squamous cell carcinoma), tobacco/alcohol group (patients without oral lesions and exposed to these risk factors), and control group (individuals with no lesion and not exposed to tobacco and alcohol). The cytological smears performed in these individuals were stained with Papanicolaou, a silver-staining and a Feulgen reaction. The nuclei of cells were measured, and AgNORs/nucleus and micronuclei (MN) were quantified. The cutoff values were stipulated evaluating the healthy mucosa (control group) and the cancerization field mucosa (oral cancer group). Results: Cutoff values for the screening of individuals exposed to carcinogens were ≥8% of nuclei larger than 100 μm2, ≥3.38 AgNOR/nucleus, and ≥3 MN per 1,000 cells. Conclusions: Nuclear area measurement and AgNORs/nucleus and MN quantification identified the incipient phase of oral carcinogenesis. A screening model for individuals without oral lesion exposed to smoking/alcohol was proposed.

BACKGROUND Both zoledronic acid, a potent bisphosphonate, and the antiangiogenic drug sunitinib are included in anticancer protocols and have also been associated with jaw osteonecrosis. Our aim was to compare the effect of these drugs on tissue repair at tooth extraction sites. METHODS Wistar rats were allocated into four groups: (1) sunitinib; (2) sunitinib/zoledronic acid; (3) zoledronic acid; (4) control group. The animals underwent tooth extractions and maxillae were macro- and microscopically analyzed. RESULTS On macroscopic evaluation, the zoledronic acid group showed a significantly higher frequency of oral mucosal lesion; lesions in the sunitinib/zoledronic acid group were larger, albeit not significantly so. The sunitinib/zoledronic acid group had significantly less epithelium than the zoledronic acid and control group, but showed no significant difference compared to the sunitinib group. The sunitinib/zoledronic acid and zoledronic acid groups did not differ from each other, but had significantly less connective tissue and more non-vital bone and microbial colonies than sunitinib and control groups, whereas these latter two groups did not significantly differ from each other. Vital bone and inflammatory infiltrate did not significantly differ between groups. CONCLUSION Sunitinib alone is not associated with non-vital bone, whereas the sunitinib/zoledronic acid combination and zoledronic acid alone are.

Objective The aim of this study was to evaluate the effect of nystatin on the efficacy of chlorhexidine against Streptococcus mutans in planktonic cells and mixed biofilm with Candida albicans. Material and methods S. mutans ATCC 25,175 in suspension and also combined with C. albicans ATCC 18,804 in biofilm were cultured. Minimum inhibitory concentration (MIC), crystal violet colorimetric assay, and colony-forming unit counting (CFUs/mL) were performed. Results An increased MIC of chlorhexidine against S. mutans was observed when the drugs were administered mixed in a single formulation and with time intervals in between, except for the 30-min interval. The biofilm optical density (OD) in treatments using chlorhexidine and nystatin combined did not significantly differ from chlorhexidine alone. Either in biofilm colorimetric assay or determination of CFUs, the combined treatments with nystatin administered before chlorhexidine had less effect on chlorhexidine efficacy. Conclusions Nystatin interferes with the action of chlorhexidine against S. mutans. The antimicrobial effectiveness of the combined drugs depends on their concentration, time interval used, and the planktonic or biofilm behavior of the microorganisms. Clinical relevance In view of the great number of patients that can receive a prescription of chlorhexidine and nystatin concomitantly, this study contributes to the knowledge about the effect of the combined drugs. Given the high prevalence of prescriptions of chlorhexidine and nystatin in dentistry, dental professionals should be aware of their possible antagonistic effect.

In the Odontology field, the modeling process of alveolar bone has been a topic of investigation for the last years since the lost bone after tooth extraction can preclude aesthetic and function. In this practice, the volume of the tissue to be modeled depends on, among other factors, the serum levels of calcium and phosphorus, and it is of interest to monitor these elements to better understand the mechanism of tissue regeneration. These elements are routinely analyzed for clinical purposes, as serum constituents, by UV-VIS spectrophotometry after chromogenic reactions for each metal with different reagents. Depending on the analytical demands and work objectives, it is necessary to have methods based on technologies that allow multi-element quantification in a single experiment. In this context, ICP-MS has been considered a powerful tool for rapid multi-element analysis due to its high selectivity and sensitivity. However, it has been reported that samples with high content of salts and proteins, such as serum samples, cause matrix-induced interferences due to weak sample preparation and the presence of polyatomic ions. The present study aimed to identify and mitigate matrix effects in rat serum samples during the simultaneous quantification of calcium and phosphate using ICP-MS and evaluate its capability of differentiating element levels from Wistar rats subjected to tooth extraction with and without alveolar bone grafting. In addition, the optimized method can be used for more comprehensive mineralomics studies related to the bone modeling process in future studies.

The aim of this study was to evaluate morphological and immunohistochemical features of tooth extraction sites in rats subjected to different antiresorptive drugs. Wistar rats were allocated into 4 groups according to the treatment: (1) alendronate, (2) raloxifene, (3) strontium ranelate, and (4) control. The animals underwent tooth extraction (60th day of treatment) and afterwards were euthanized (90th day of treatment). Tooth extraction sites were analyzed by means of scanning electron microscopy (SEM), hematoxylin-eosin staining (H&E), and immunohistochemical staining (RANKL and OPG). On H&E analysis, the alendronate group showed greater amounts of non-vital bone, biofilm, inflammatory infiltrate and root fragment, and smaller amount of vital bone. The strontium ranelate group showed great amount of non-vital bone. This group also had lower levels of OPG, while the alendronate group showed lower OPG and RANKL than the other groups. On SEM analysis, the alendronate group showed a considerable number of microcracks on the alveolar bone surface and few Howship lacunae and lack of bone cells as well. The raloxifene, strontium ranelate, and control groups showed a large number of bone cells and Howship lacunae on the bone surface and few microcracks. Alendronate therapy is associated with macro- and microscopic features of medication-related osteonecrosis of the jaw at tooth extraction sites, whereas raloxifene therapy is not, and strontium ranelate therapy is associated with non-vital bone. Osteonecrosis of the jaws is a serious side effect of alendronate therapy, where tooth extraction is a major risk factor. Considering the significant number of patients undergoing antiresorptive therapies worldwide, the present study investigated whether raloxifene and strontium ranelate interfere with bone repair after tooth extraction in a similar way to bisphosphonates.

La actinomicosis es una enfermedad infecciosa muy infrecuente de tipo crónico y supurativo que afecta al área cervicofacial e el tracto gastrointestinal. El presente trabajo tuvo como objetivo, revisar informaciones importantes en cuanto etiopatogenia, presentación clínica y tratamiento de la actinomicosis cervicofacial. Se puede clasificar de tres maneras a depender del sitio anatómico: cervicofacial (50%), torácica (30%) y abdominal (20%). Presentamos una revisión de la literatura con foco en aspectos importantes de la actinomicosis cervicofacial. Aunque micosis, la enfermedad es causada por bacterias grampositivas del género Actinomyces, siendo que A. israelli es el agente etiológico más frecuente, cuales son microorganismos comensales de la boca. Sin embargo, si la integridad de la mucosa es violada, ellos se tornan patogénicos. La actinomicosis es lentamente progresiva y frecuentemente imita otras condiciones clínicas como malignidades. El tratamiento consiste en terapia antibiótica y puede durar 12 meses en casos más graves. El conocimiento de los profesionales de salud acerca de esa enfermedad es fundamental para promover su prevención, diagnóstico precoz y tratamiento correcto.

This study evaluated the effect of laser photobiomodulation (PBM) on oral leukoplakia and squamous cell carcinomas (OSCC) in a model of oral carcinogenesis.Forty-one C57Bl/6 female mice were distributed in control group, 4-NQO group, Laser group 1.5 J and Laser group 9 J. Oral cancer was induced on the tongue by nitroquinoline oxide (4-NQO), diluted in the water for 16 weeks. In the 18th and 19th weeks, PBM with a diode laser, 0.028 cmAll animals exposed to carcinogen developed clinical and histological alterations such as leukoplakia and OSCC on the tongue. There was no significant difference among Laser groups 1.5 and 9 J and 4-NQO group (not irradiated) regarding the area of leukoplakia and carcinomas (P 0.05) or thickness of epithelial tissue and keratin (P 0.05). There were also no association between PBM and histologic classification of the lesions (P = 0.87), frequency of OSCC (P = 0.57), grade of tumor differentiation (P = 0.88) or depth of invasion (P = 0.45).Laser PBM, in both parameters used, does not influence on clinical and histological characteristics of oral leukoplakia and OSCC.Results suggest that PBM may be a safe treatment for adverse effects of antineoplastic therapies in patients with leukoplakia and OSCC.

Background Syphilis is an infectious, sexually transmitted disease with varied oral manifestations, that can mimic other lesions. This study aimed to conduct an epidemiological survey of cases of syphilis, diagnosed from oral manifestations, establishing the sociodemographic profile of patients and clinical characteristics of oral lesions. Methods The medical records of patients with oral lesions of syphilis acquired were reviewed, and 109 cases were selected. Results The mean age of the patients was 34.4 years and, of these, 51% were male. In 105 cases, the disease was diagnosed in the secondary stage; in three cases, in the primary stage; and, in one case, in the tertiary stage. The cases of primary syphilis presented as single and ulcerated nodules, and the case of tertiary syphilis, as a necrotic lesion in the palate. In 86% of cases of secondary syphilis, there were multicentric lesions, presenting as grayish-white plaques (85%), associated or not with erosive and/or ulcerated lesions (33%), mostly affecting the labial mucosa and tongue. In 91.7% of cases painful symptoms were reported. Conclusion Considering the increase in syphilis, it is extremely important that dentists recognize its oral manifestations, because early diagnosis and treatment can minimize the risks of complications and transmission.

Background The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. Material and Methods A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly patients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. Results The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reactive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). Conclusions Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary. Key words:Oral mucosa, aged, oral medicine, elderly, oral lesions.

Background Deoxycholic acid (DCA) was developed by the pharmaceutical industry for aesthetical use in submental fat reduction. It represents the first lipolytic substance approved by the Food and Drug Administration (FDA) for fat reduction in that area. Aims This study presents an update of properties and the use of DCA, as well as adverse events and possible complications. Methods A search in MEDLINE/PubMed, Cochrane, and Bireme/LILACS databases was performed using the terms: "deoxycholic acid" OR "ATX-101" AND "injection" NOT "amphotericin" NOT "biliary" NOT "bile." Experimental studies developed in animals, clinical trials, literature reviews, case reports, and letters to the editor that included the DCA mechanism of action, dose, manner of use, adverse effects, and complications were selected. Results The most frequent adverse events are edema, local pain, bruise, and numbness, which usually spontaneously regress. However, complications, including, skin necrosis, nerve injury, alopecia, and vascular events, can occur, demanding complex management without specific protocols. Conclusion Although DCA is beneficial for lysis of adipose tissue, clinicians should be aware about the adverse effects and risks involved with the use of this substance. The knowledge of local anatomy, properties, and adverse effects are fundamental to treatment with DCA.

Head and neck radiotherapy can cause hypofunction of the salivary glands. Many studies report that laser photobiomodulation (PBM) is able to minimize radiation-induced hyposalivation, yet there is no consensus about its effects.To carry out a meta-analysis of controlled clinical trials that used PBM to prevent radiation-induced hyposalivation.A systematic search was performed through Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, LILACS and Web of Science databases. The strategy included comparisons of the effect of PBM with placebo/clinical follow-up on unstimulated and/or stimulated salivary flow in patients undergoing head and neck radiotherapy.Six clinical trials were included, five of which were used for meta-analysis. Evidence was observed between the use of PBM and increased unstimulated salivary flow (MD 0.20 mL/min, 95 % Cl 0.10-0.30, I² = 96 %, p0.00001) and in stimulated salivary flow (MD 0.27 mL/min, 95 % CI 0.08-0.46, I² = 95 %, p0.00001).PBM appears to minimize radiation-induced hyposalivation.

The aim of this paper was to review the current literature with regard to the use of chlorhexidine and povidone-iodine in the treatment of oral wounds.Oral mucosa is continuously subjected to physical or chemical injuries, where it becomes a common site for the occurrence of ulcerated lesions. These lesions are susceptible to infections that may delay healing.A search of the medical and dental literature was conducted in Medline/Pubmed and Scielo using a combination of the terms oral ulcer, oral wound, wound healing, povidone-iodine and chlorhexidine, to review their mechanism of action and their use in the healing of oral wounds.The use of chlorhexidine and povidone-iodine is effective in the control of local infection in a concentration-dependent manner, exerting a positive influence on the tissue repair process. Oral antiseptics appear be a good alternative in the management of these lesions, since there is a low risk of systemic toxicity and allergies, and less clinical evidence of bacterial resistance.

Xerostomia and hyposalivation are frequent conditions in patients undergoing head and neck radiotherapy, which usually lead to a worsening of quality of life. This study aimed to assess whether photobiomodulation (PBM) can minimize hyposalivation, xerostomia and qualitative changes on saliva and improve quality of life in patients undergoing radiotherapy in short-term follow-up. Twenty-one patients were randomly divided into two groups: sham group (SG) and laser group (LG). A diode laser was used for intra- (660 nm, 10 J/cm2, 0.28 J per point, 40 mW) and extra-oral (810 nm, 25 J/cm2, 0.7 J per point, 40 mW) applications over the salivary glands, three times a week, during the entire radiotherapy period. In SG, the tip of the instrument was sealed with blue rubber to prevent the passage of light. Xerostomia and pH were evaluated and unstimulated and stimulated salivary flow was determined before the start of radiotherapy (T1), after the 15th session (T2), after the end of radiotherapy (T3) and 60 days after radiotherapy (T4). Concentrations of calcium, total proteins, chloride, sodium, potassium and amylase and catalase activities were evaluated in stimulated saliva samples. Quality of life was assessed at times T1 and T4. Generalized estimating equations were used to assess differences in the outcome between times and groups. All patients showed worsening in unstimulated (p = .003) and stimulated (p

Gardner syndrome is a hereditary disease in which patients develop gastrointestinal polyps, osteomas, desmoid tumors, epidermoid cysts, fibromas, lipomas, and retinal lesions. Dental abnormalities such as supernumerary or impacted teeth, odontomas and dentigerous cysts are also reported. The most serious concern in this syndrome is the extremely high risk of gastrointestinal polyps undergoing malignant transformation. Since the maxillofacial findings usually precede gastrointestinal polyps, the dentist plays a crucial role in the diagnosis of Gardner syndrome, and panoramic radiography is an important tool in the diagnosis of the disease. We report here a case of Gardner syndrome in a patient showing mandibular osteomas and impacted teeth. Also, cases of Gardner syndrome with maxillofacial manifestations reported in the literature were reviewed and compared with ours. According to the findings, osteomas are important manifestations of this syndrome, and regardless of the absence of family history of intestinal polyposis, their occurrence should prompt diagnostic evaluation for this disease.

The effects of cannabidiol (CBD), the main non-psychotropic component of Cannabis sativa, were assessed on oral wound healing in an in vivo model. Standardized ulcers were induced in 60 Wistar rats using a 5-mm biopsy punch on the midline of the ventral tongue. Animals received intraperitoneal injections of CBD at doses of 0 (control), 5, and 10 mg/kg daily. Animals were weighed daily, and wound healing was clinically and histologically evaluated after 3 and 7 days of treatment. CBD treatment did not influence the wound area of ulcerative lesions at either observation time. Conversely, microscopic findings revealed that at Day 3 postwounding, CBD-treated lesions exhibited significantly lower inflammatory scores than those in the control group. However, this difference was not observed at Day 7. Collectively, these findings indicate that CBD exert an antiinflammatory effect in early phase of wound healing process although it was not sufficient promote clinical improvement of oral traumatic ulcerative lesions.

Objectives The aim of this work was to review the scientific literature on the properties, indications and pitfalls related to nystatin and chlorhexidine in oral medicine and also to compare these to other topical antifungal agents, considering the elderly population. Background Nystatin is a polyene antifungal widely used as a topical formulation to treat candidiasis, whereas chlorhexidine is a wide-spectrum antimicrobial, especially used against bacteria, but also effective in treating some fungal infections including those caused by Candida spp. These compounds have been prescribed for immunocompromised patients, hospitalized or not, some of them undergoing head and neck radiation therapy and/or chemotherapy, including elderly patients. Materials and methods Dental and medical literature concerning the use of nystatin and chlorhexidine in oral medicine were selected and reviewed. Results Nystatin and chlorhexidine are gold-standard antimicrobial mouthrinses respectively for Candida spp. and bacteria. Although recognized as effective in cotrolling oral infections, both nystatin and chlorhexidine are just complementary to systemic therapy in cases of systemic infections already established. The prescriber should also take into account that some commercial nystatin and chlorhexidine formulations contain compounds such as sugar and ethanol, which can be associated with side effects. Meanwhile, alternative formulations in which these compounds are absent are available and should be considered. Conclusions Further studies investigating new drugs and interactions of drug combinations are necessary to improve the therapeutic management of oral infections.

Oral cavity metastases are rare events and occur mainly in the jaws compared with the soft tissues. A 69-year-old Caucasian woman was referred to the stomatology service complaining of a bleeding oral lesion, which developed 4 months before the appointment. The patient had a renal adenocarcinoma, which was treated with right radical nephrectomy and chemotherapy. Immunotherapy with nivolumab was started 1 month before the lesion appearance. On examination, we observed an erythematous, pediculated mass, about 1.5 cm in diameter, with ulcerative surface on the right buccal mucosa. An incisional biopsy was performed, and the microscopic exam revealed the presence of clear epithelial cells and intense vascular neoformation. Immunohistochemical analysis was positive for cytokeratins AE1 and AE3 and PAX8, confirming the diagnosis of metastatic clear cell from the renal adenocarcinoma. The patient died in the same year, as the result of the disease progression.

Objective To evaluate the effect of cannabidiol (CBD) on the healing of rats’ oral wounds. Study Design Traumatic ulcers were induced in 60 Wistar rats using a 5-mm biopsy punch on the midline of the ventral tongue. Animals received daily intraperitoneal (ip) injections of CBD at doses of 0 (control), 5 or 10 mg/kg. Rats were weighed daily and sacrificed after 3 and 7 days of treatment. Clinical (ulcer area and weight variation) and histopathologic (inflammation scores) analyses were performed. Data were analyzed statistically at the significance level of 5%. Results CBD was unable to clinically influence the size of ulcerative lesions. However, treatment with CBD in both tested concentrations decreased inflammatory scores after 3 days post-wounding (P Conclusions Five and 10 mg/kg CBD exerted promising anti-inflammatory effect in oral ulcerative lesions, not being enough to accelerate clinical wound healing at 3 and 7 days.

The high frequency and painful profile of inflammatory oral lesions and the lack of an effective drug protocol for their management stimulate the search for pharmacological alternatives for the treatment of these conditions. Cannabidiol is the major non-psychotropic constituent of Cannabis sativa, receiving lately scientific interest because of its potential in the treatment of inflammatory disorders such as asthma, colitis and arthritis. There is little published in the current literature about the use of cannabidiol in oral health. Among its many protective functions, the ability to attenuate inflammation through the modulation of cytokines and its antiedema and analgesic effects may be important features in the treatment of oral lesions. In this review, we suggest that cannabidiol can be useful in the management of oral inflammatory disorders.

Multiple myeloma is a multifocal plasma cell proliferation in the bone marrow. Its occurrence in the jaws is frequent; however, oral lesions rarely appear as a primary manifestation of the disease. A 66-year-old man complained of a painful swelling in his mouth, which had evolved over 4 months. At the examination, an extensive lesion in the left mandibular region was observed. The computed tomography demonstrated an osteolytic lesion measuring 4 × 2.5 cm, associated with a pathologic fracture of the mandible body. A biopsy revealed a malignant neoplasia with proliferation of lymphoid and plasmacytoid cells. Immunohistochemical examination was positive for antibodies CD138, CD56, Ki-67, and lambda light chains. Confirmation of the diagnosis of multiple myeloma occurred with the observation of osteolytic areas in multiple regions of the skull. The patient was referred to the oncology department; however, he died before starting the treatment.

A 70-year-old Caucasian female presented with multiple small, firm, yellowish nodules in the mucosa of the lower and upper lips, buccal mucosa, and dorsal and ventral surfaces of the tongue. Medical history of the patient included carpal tunnel syndrome surgery, systemic arterial hypertension, osteoarthritis, osteoporosis, and hypercholesterolemia. Laboratory tests showed serum levels of thyroid-stimulating hormone (TSH) at 6.56 UI/µmL, leukocyte count of 3,400/mm³, and erythrocyte sedimentation rate of 36 mm/1 h. A biopsy of the oral lesions was performed, and the histopathologic examination revealed connective tissue with deposits compatible with amyloid material, which was also observed in the Congo red examination. Concurrently, chest radiograph, serum protein electrophoresis, C-reactive protein, urea and creatinine, and urinalysis were performed and did not reveal any alterations. The patient was referred to the rheumatologist and is now undergoing follow-up.

Objective To evaluate the effect of topical application of 10% chamomile extract and 2% curcumin gel in the oral ulcers of the rats. Study Design Thirty-nine Wistar rats were divided into 3 groups: the chamomile group, the curcumin group, and the control group. A 5-mm circular excision wound was made with sterile punch in the tongue of rats; Chamomile extract, curcumin, and vehicle gel were applied 2 times per day for 5 days on the oral ulcers, all animals were euthanized on the sixth day postoperatively. Results There was no significant difference between the groups in relation to area of residual ulcer (P = .20), newly formed epithelium (P = .97), and intensity of inflammatory infiltrate (P = .724). Conclusions Chamomile and curcumin had no effect on accelerating the healing of oral ulcers or reducing the inflammatory process.

A 29-year-old male patient was referred to a specialized service with gingival lesions that lasted 10 years. The medical history showed untreated Crohn disease. Intraoral examination detected firm nodules at the vestibular retromolar region of the right and left mandibular molar, red in color, recovered by ulcerated mucosa, and both measuring 2 cm. The buccal mucosa revealed a swollen, cobllestone appearance and showed deep linear ulcerations. Incisional biopsy was performed, and histopathologic analysis showed a connective tissue with intense chronic inflammatory infiltrate and neutrophils, blood vessel neoformation, and epithelioid cells. We recommended the use of 0.12% topical chlorhexidine. Because of persistent oral lesions, the patient was redirected to a gastroenterologist for further investigations and systemic treatment. Clinical control remains for 2 months. Approximately one-third of Crohn disease patients develop extraintestinal manifestations. Treatment of oral lesions included treatment of the intestinal disease and cooperation between gastroenterologists and specialists in oral medicine.

Uremic stomatitis represents an unusual condition associated with uremia in patients with renal failure. A 29-year-old man with chronic renal failure on hemodialysis was referred by nephrology service because of complaint of multiple painful oral lesions. The patient had been hospitalized for fever associated with severe pancytopenia and elevated levels of creatinine and urea (16.10 mg/dL and 251 mg/dL, respectively). On physical examination, the patient presented with whitish plaques interspersed by reddish areas of atrophy and epithelial erosion and few ulcerated areas dispersed in the upper and lower labial mucosa, bilateral buccal mucosa, bilateral tongue border, ventral surface of tongue, floor of the mouth, labial commissures, soft palate, and lower lip vermillion. Chlorhexidine 0.12% mouthwash was prescribed to assist in oral antisepsis. Laser therapy was performed periodically for local analgesia. The oral lesions regressed spontaneously as the serum levels of urea decreased with hemodialysis.