clobetasol and Gingival-Diseases

The aim of this study was to evaluate the therapeutic benefit of minocycline in mucous membrane pemphigoid (MMP) predominantly involving the oral cavity. A descriptive, open clinical study with no control group, including 9 patients, was developed. The diagnosis was confirmed by histopathological examination and direct and salt-split-skin indirect immunofluorescence analysis. Target antigens were sought by immunoblotting. Patients received minocycline (200mg/day) for a variable period. All patients were followed up for at least 2 years after initial diagnosis. Therapeutic response was assessed by clinical improvement in three categories: major response, minor response and no response. A major response was observed in 3 patients (33%), a minor response in 4 (44%) and 2 (22%) patients showed no improvement. Two of the 3 patients with a major response showed no immunoblot reactivity; 80% of patients with circulating autoantibodies (autoAb) against BP180 had a minor or no response. Permanent remission of signs with no relapse was only obtained in one patient. 5 patients (55%) stopped the drug because of adverse effects, such as vertigo and gastralgia. The results revealed temporary clinical benefits in MMP predominantly involving the oral cavity with minocycline, although frequently side effects led to drug withdrawal.

Topics: Administration, Oral; Administration, Topical; Aged; Anti-Bacterial Agents; Clobetasol; Complement C3; Drug Combinations; Female; Fluorescent Antibody Technique, Indirect; Gingival Diseases; Glucocorticoids; Humans; Immunoglobulin A; Immunoglobulin G; Middle Aged; Minocycline; Pemphigoid, Benign Mucous Membrane; Treatment Outcome; Vertigo

Foreign body gingivitis (FBG) is a non-plaque induced chronic inflammatory process involving the marginal and/or attached gingiva. It results from the introduction of foreign particulate material, primarily dental prophylaxis paste and restorative dental materials, into the gingival tissues. Clinical presentation varies from an erythematous to vesiculoerosive-like process that may mimic a localized form of desquamative gingivitis or an erosive lichenoid process. Rarely, it may also present with a granular appearance. We describe the clinical presentation, differential diagnosis and clinical management of a 52-year-old Woman who presented with localized chronic inflammation of the maxillary anterior and left posterior gingiva secondary to the presence of foreign material.

Topics: Anti-Inflammatory Agents; Biopsy; Clobetasol; Diagnosis, Differential; Female; Foreign-Body Reaction; Gingival Diseases; Gingival Hyperplasia; Gingivitis; Glucocorticoids; Granuloma; Humans; Middle Aged

To examine whether oral lichen planus (OLP) affects the success rate of dental implants and if the manifestations of OLP are altered by implant-borne prostheses.. OLP patients, treated in the oral medicine department, with (the study group) and without (control group) dental implants were included. Pocket depth, mobility, bleeding on probing, erythema, pain and radiolucency around the implants, as well as clinical findings and OLP symptoms were recorded. Follow-up ranged from 12-24 months. Ordinal variables and visual analog scale score were compared using the Mann-Whitney test. The significance of the trend within each of the groups was assed using the Friedman test. Categorical variables were compared using Pearson chi-squared test and Fisher's exact test.. Fourteen patients in the study group with 1-15 implants per patient and 15 in the control group were included. No implant failures were recorded. Comparison between the clinical manifestations of OLP in both groups did not reveal any significant differences.. Success of implant rehabilitation among treated OLP patients does not seem to be different from the success rate in the general population. Nor does implant placement influence the disease manifestations.

Topics: Anti-Inflammatory Agents; Case-Control Studies; Clobetasol; Dental Implants; Dental Prosthesis Retention; Dental Prosthesis, Implant-Supported; Dexamethasone; Erythema; Female; Follow-Up Studies; Gingival Diseases; Gingival Hemorrhage; Glucocorticoids; Humans; Lichen Planus, Oral; Male; Middle Aged; Mouth Mucosa; Pain Measurement; Periodontal Pocket; Retrospective Studies; Treatment Outcome; Triamcinolone

The presence of atrophic-erosive lesions among gingival tissues makes oral hygiene procedures difficult for several reasons. Plaque control and rigorous oral hygiene are a fundamental requisite for the treatment of any oromucosal disease.. A patient suffering from a mixed atrophic-erosive form of oral lichen planus (OLP), with serious gingival involvement, was also treated with the topical application of clobetasol propionate 0.05% using gingival trays. The highest hygiene standards of both patient and trays were of fundamental importance.. The management of the patient suffering from gingival atrophic-erosive OLP requires the synergic treatment of both dentist and dental hygienist, whose contribution supports the corticosteroid and/or immunosuppressive treatment.

Topics: Administration, Topical; Anti-Inflammatory Agents; Clobetasol; Dental Care for Chronically Ill; Gingival Diseases; Humans; Lichen Planus, Oral; Male; Middle Aged; Oral Hygiene; Patient Education as Topic; Treatment Outcome

Sarcoidosis is an inflammatory granulomatous systemic disease that rarely affects the oral cavity. Gingival involvement has been reported in only a very limited number of cases, occasionally as the first manifestation of the disease. This article reports a case of sarcoidosis affecting the gingiva and alveolar mucosa in a patient previously treated for the systemic disease and considered under long-term clinical control.. A 57-year-old white female presented with a chief complaint of gingival pain in the maxillary right area lasting 3 years. Clinical examination revealed an erythematous, ill-defined erosive macule on the buccal aspect of the maxillary right gingiva extending from the canine to the third molar. The medical history included a diagnosis of sarcoidosis 16 years prior to presentation, which was considered to be under clinical control for the last 11 years. An incisional biopsy was obtained.. Histopathology indicated the presence of an intense chronic inflammatory infiltrate and focal areas with non-caseating granulomas. Periodic acid-Schiff and Grocott's stains were negative for microorganisms, and the diagnosis was compatible with sarcoidosis. Systemic evaluation showed no involvement of other areas and organs, and the patient was managed with topical steroid therapy using silicone trays in conjunction with conventional periodontal therapy and oral hygiene instructions. Complete response was achieved after 6 months, and the patient remains in clinical follow-up.. Although sarcoidosis is a systemic disease that rarely affects the gingiva, the possibility of gingival involvement as the sole manifestation of the disease should be considered in the differential diagnosis of gingival lesions.

Topics: Administration, Topical; Clobetasol; Diagnosis, Differential; Erythema; Female; Gingival Diseases; Glucocorticoids; Humans; Middle Aged; Mouth Mucosa; Oral Ulcer; Sarcoidosis

Lichen planus pemphigoides (LPP) is a rare, acquired, immunobullous disorder of skin that occasionally involves oral mucous membranes. Clinical, histologic, and immunopathologic findings of the oral manifestations of LPP are described. Clinical features are lichenoid striae, erosions, and ulcerations involving gingiva and buccal mucosae. Histopathologic features are similar to those of ora lichen planus. Direct immunofluorescence demonstrates linear deposits of immunoglobulin G and complement component C3 along the basement membrane with fibrillar deposits of fibrin at the epithelial/lamina propria junction. Fluorescence overlay antigen mapping and laser scanning confocal microscopy of the biopsy specimen exhibits colocalization of in situ antibodies with beta4 integrin, a marker of the keratinocyte basal plasma membrane and upper lamina lucida, consistent with the location of the bullous pemphigoid antigens. This case report describes a case of LPP that presented exclusively as an oral condition. Lichen planus pemphigoides should be considered in the clinical differential diagnosis of vesiculoerosive oral mucosal diseases.

Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Chlorhexidine; Clobetasol; Complement C3; Doxycycline; Female; Fluorescent Antibody Technique; Gingival Diseases; Humans; Immunoglobulin G; Keratinocytes; Lichen Planus, Oral; Microscopy, Confocal; Middle Aged; Mouth Mucosa; Ointments; Oral Ulcer; Pemphigoid, Bullous

Lichen planus with simultaneous oral and genital involvement in males is a quite rare condition and often difficult to diagnose. The prevalence, treatment options, and management for this condition are far from being established, and research in this area primarily relies on anecdotes. We present the clinical features of eight cases of peno-gingival lichen planus and propose a management algorithm for this condition based on the best available published evidence.. Personal medical history was collected for all cases. Following careful examination of the oral and genital mucosae, pathology was obtained, previous treatments and duration of mucosal lesions ascertained, treatment initiated, and response evaluated at 8 weeks on both oral and genital lesions. The first-line drug was topical clobetasol propionate 0.05% cream in all cases; in case of failure, topical cyclosporin was used. A review of the literature on treatment options for this rare condition was performed based upon standard literature review practices.. Five cases presented gingival lesions that clinically resembled lichen planus. Glans penis was involved in all patients. All patients responded to treatment except for one. Oral candidiasis was the only observed side effect.. Genital lichen planus may be suspected in males when atrophic-erosive gingival lichen planus is found. A thorough multidisciplinary medical management and active early treatment are necessary to improve symptoms and prevent genital sequelae and, given the risk of squamous cell carcinoma, as a preventative strategy, although this area still needs investigation. Therapeutic trials relating to the treatment of peno-gingival lichen planus may be undertaken considering that current management relies exclusively on observations of case reports.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Candidiasis, Oral; Cheek; Clobetasol; Cohort Studies; Follow-Up Studies; Gingival Diseases; Glucocorticoids; Humans; Lichen Planus; Lichen Planus, Oral; Lip Diseases; Male; Medical History Taking; Middle Aged; Penile Diseases; Remission Induction; Tongue Diseases; Treatment Outcome

We sought to describe the response of patients with severe erosive gingival lesions to treatment with clobetasol propionate in Orabase paste administered in trays. The adverse effects were also recorded.. A descriptive pretest/posttest clinical study with no control group (33 patients total) was developed. All patients received repeated applications of 0.05% clobetasol propionate plus 100,000 IU/cc of nystatin in Orabase paste. Over the 48-week period, the pain levels, ulcerations, presence of atrophy, and the patients' daily activities were recorded, and Likert scales were used to classify each outcome as either a complete recovery, excellent, good, poor, or failed. The presence of any adverse effect was also noted.. At the end of the study period, the pain and ulceration had disappeared (complete response) in 100% of the sample (33/33; 95% confidence interval = 89.4%-100%), and there was a complete recovery of daily activities and remission of atrophy in 93.9% (31/33; 95% confidence interval = 79.8%-99.3%) and 21.2% (7/33; 95% confidence interval = 9.0%-38.9%) of the patients, respectively. No adverse effects related to the treatment were observed.. The application of an Orabase paste of 0.05% clobetasol 17-propionate plus 100,000 IU/cc of nystatin by means of a tray appears to be an efficacious treatment for severe erosive gingival lesions.

Topics: Activities of Daily Living; Administration, Topical; Adult; Aged; Anti-Bacterial Agents; Anti-Inflammatory Agents; Autoimmune Diseases; Clobetasol; Confidence Intervals; Drug Combinations; Female; Follow-Up Studies; Gingival Diseases; Glucocorticoids; Humans; Lichen Planus, Oral; Male; Middle Aged; Nystatin; Pain Measurement; Patient Satisfaction; Pemphigoid, Benign Mucous Membrane; Stomatitis, Aphthous