Science & Technology Development Journal - Health Sciences

Stepwise approach in the management of oral lichen planus

2021-08-03T06:36:27+00:00

Lichen planus is a chronic inflammatory disease in the skin, hair, nails, and mucous membranes. Like in other sites, oral lichen planus (OLP) includes asymptomatic and flare-up or symptomatic periods. The symptomatic period is characterized by erosive, ulcerative, or painful symptoms. In addition, some lesions may have potentially malignant transformation. Despite many molecular-based studies, the OLP etiology is still unclear. Hence, there is no gold-standard therapy for OLP so far. The management of symptomatic lesions is based on each individual’s clinical features, and treatment outcomes are often unpredictable. That explains why most dentists are not confident in dealing with this disease. Nevertheless, there is a consensus among the majority of authors that the pathogenesis of OLP, as an immune-mediated disease, is related to T-lymphocyte immunological dysfunction. Medical treatment, using immunosuppressant therapies or immunomodulators, aims (1) to alleviate painful symptoms, (2) to heal the ulcerative and atrophic lesions, (3) to reduce the risk of malignant transformation, and (4) to prolong the symptom‑free intervals. This review article aims to synthesize current literature evidence and integrate the authors’ experience in suggesting a stepwise approach to manage OLP patients.

Using sodium dithionite as a reducing agent in the synthesis of propacetamol hydrochroride from phenol

2021-07-13T04:20:41+00:00

Propacetamol, a prodrug form of paracetamol, is used in injections for fast and effective pain relief. Propacetamol is water soluble and is used in postoperative care as well as intravenous administration in case the patients cannot take oral or rectal paracetamol. Studies on propacetamol synthesis at laboratory scale as well as industrial scale with safe, simple and economic procedures are crucial. In this study, we synthesized propacetamol from phenol as the starting material. In the first step, phenol was converted to p-nitrosophenol through a nitrosation process. This nitrosation reaction yielded the optimal result as the reaction selectively occured, the product was not plasticized. Next, p-nitrosophenol was reduced to p-aminophenol in the presence of sodium dithionite as the reducing agent. The reaction produced p-aminophenol at a yield of 89,6% with high selectivity and less impurity. After that, paracetamol was obtained through acetylation of p-aminophenol. Ochloroacetylation of paracetamol was performed by using the amount of diethylamine reduced by 2,5 times compared to previous studies to form 4-acetamidophenyl-2-chloroacetate in 85,5% yield. This intermediate was then alkylated to form propacetamol base, followed by treatment with HCl solution in acetone at low temperature to obtain propacetamol hydrochloride in 32,5% yield. The study has shown that propacetamol hydrochloride was successfully achieved with high efficiency and safety from phenol as the starting compound.

Clinical efficacy of enamel matrix derivative in treatment of periodontal intra-bony defects

2021-07-15T09:33:27+00:00

Objective: This study aimed at evaluating the efficacy of enamel matrix derivative (EMD) in the treatment of posterior lower intrabony defects resulted from periodontitis. Method: This split-mouth, randomized clinical trial was conducted on 15 patients with 30 posterior lower teeth with bilateral symmetrical IBD lesions which were randomly assigned into two groups: open flap debridement with EMD (OFD+EMD) and without EMD (OFD). Clinical periodontal parameters were recorded at baseline, 3 and 6 post-operative months, including the plaque index (PlI); gingival index (GI); periodontal pocket depth (PPD); clinical attachment loss (CAL) and gingival recession (GR). Results: In each group, PlI, GI, PPD, CAL decreased significantly (p <0.05) after 3 and 6 postoperative months compared to baseline. Between the two treatment groups, PPD, CAL, and GR in the OFD + EMD group were significantly lower (p <0.001) compared to the OFD group after 3 and 6 post-operative months. Conclusion: The adjunctive use of EMD enhances the efficiency of OFD in treatment of periodontal intra-bony defects because reducing periodontal pocket depth, clinical attachment loss, and gingival recession.

Comparison of platelet rich fibrin and guided tissue regeneration in the treatment of periodontal intrabony defects

2021-07-15T09:30:19+00:00

Aim: To compare the outcomes of the treatment of periodontal intrabony defects with platelet-rich fibrin (PRF) combined with open-flap debridement (OFD) and guided tissue regeneration (GTR). Material and method: Thirty individuals with a total of 60 intrabony defects were randomly assigned to one of the 2 treatment groups: group 1 (n=30): OFD combined with PRF and group 2 (n=30): guided tissue regeneration with collagen membrane. Clinical parameters, including the plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and tooth mobility (TM) were assessed at baseline, 3, 6 and 12 months postsurgery. Radiographic parameters, including bony defect fill (BDF) and alveolar crestal resorption (ACR), were measured at baseline, 6 and 12 months postsurgery and calculated using Sopru imaging 2.38 software. The wound healing index (WHI) was assessed at 7 and 14 days postsurgery. Results : There was a statistically significant improvement in clinical periodontal and radiographic parameters at 6 and 12 months postsurgery in both groups. Between the two groups, the improvement of these parameters was similar, the difference was not statistically significant at 6 and 12 months postsurgery. Both groups had percentages of sites with the wound healing score of 1 between 81% and 100%, but group 1 had a significantly greater number than group 2 at 7 and 14 days postsurgery. Conclusion: latelet-rich fibrin combined with open-flap debridement and guided tissue regeneration with collagen membrane were similarly effective in treatment of periodontal intrabony defects. Using PRF improved better postoperative healing compared to guided tissue regeneration with collagen membrane.

Dental caries status and risk factors among 1–5-year-old children with cleft lip and palate

2021-07-23T23:23:48+00:00

Background: Dental caries is one of the most prevalent oral diseases, and especially more serious in people at risk such as children with cleft lip – palate. Understanding their oral status and the influencing factors will help in preventing tooth decay and improving dental health.

Objective: To determine the prevalence of dental caries and risk factors in children from 1 to 5 years old with cleft lip and palate.

Method: A cross-sectional study was conducted on 174 children from 1 to 5 years old with cleft lip and palate at the hospitals affiliatated with Odonto-Stomatology faculty, University of Medicine and Pharmacy at Ho Chi Minh City. After a child had been examined for dental caries, his or her father/mother was directly interviewed with a questionnaire to investigate factors affecting the condition of dental caries. Descriptive and inferential statistics were performed using logistic regression.

Results: The prevalence of dental caries is 47.1%. The rate of caries in children aged 3-5 years is 3 times higher than that in children aged 1-5 (87.3% and 28.6%, respectively). The percentage of children with caries by geographic region has a statistically significant difference (p <0.05). The highest proportion of dental caries was found in children from the Mekong River Delta (Mekong Delta) (64.2%), the lowest one was those from the South Central Coast (43.5%). The oral hygiene method with gauze after bottle-feeding prevents dental caries 3.3 times better than other methods. Other factors such as cleft form, parents' educational level and socioeconomic status of the family have no effect on children's dental caries.

Conclusion: Children from 1 to 5 years old with cleft lip – palate had high prevalence of dental caries. Attention should be paid to bottle feeding time, oral hygiene method and frequency of sugar consumption to prevent dental caries.

Isolation and storage of Aggregatibacter actinomicetemcomitans from the subgingival plaque of patients with periodontitis

2021-08-05T02:09:44+00:00

Objective: To isolate and identification Aggregatibacter actinomicetemcomitans from clinical subgingival plaques of periodontitis patients. Methods: Selective media was prepared by adding 200 ug/mL of vancomycin and 10 U/mL of bacitracin, 5% sheep blood to Wilkins Chalgren Anaerobic agar. Subgingival samples collected from patients with moderate to severe periodontitis aged 18- 35 were used to recover Aa. The colony was then identified by the MALDI-TOF method and PCR analysis. Results: The Aa was successfully cultured and stored from a clinical sample of the 12th 25 years-old patient who had moderate aggressive periodontitis. Conclusion: Aa is a major putative oral pathogen and concerned with other systemic diseases. This pure bacterial culture will be helpful for other experimental studies in dental and medical areas.

Optic neuritis with normal visual acuity – A case report

2021-07-14T22:45:18+00:00

Background: Optic neuritis is an acquired disorder of the optic nerve due to inflammation or demyelination. Diagnosis of optic neuritis was based mainly on clinical signs and symptoms, ancillary tests only help confirm the diagnosis or follow treatment progress. However, in cases with high visual acuity and with mild or without optic disc edema, the disease can be easily underdiagnosed.

Case report: We report a case of optic neuritis with normal visual acuity. The patient complained of blurring vision and mild pain in her right eye upon gazing; however, her right eye best corrected visual acuity was 20/20. Ishihara color vision test was 20/24 on her right eye and 24/24 on her left eye. Relative afferent pupillary defect was detected, fundus examination revealed mild optic disc edema, and visual field test showed enlarged physiological blind spot on her right eye. The patient received careful follow-up with no corticosteroids treatment. After 3 months, all the signs and symptoms resolved completely.

Conclusion: This case demonstrated that optic neuritis can be easily underdiagnosed; relative afferent pupillary defect check, visual field, magnetic resonance imaging and color vision test should be performed in every suspected cases. Strict follow-up check, instead of corticosteroids may be of priority when patient visual acuity is still good.