Introduction: Recurrent aphthous stomatitis (RAS) is a common condition of the mucosa of oral cavity characterized by recurrent attacks of small, round or oval, painful affecting 5-25% of the general population and rarely involves genital region. These lesions occur most commonly on the nonkeratinized epithelium of oral cavity and ulcers heal within a period of 10-14 days with characteristic feature of pain causing difficulty on chewing, swallowing, and/or speaking. So, the purpose of present study was to evaluate the effectiveness of Amlexanox 5% and Triamcinolone 0.1% for the treatment of recurrent aphthous ulcers. Material and Methods: This double-blinded randomized clinical study done in the Department of Oral Medicine And Radiology, Government dental college Srinagar includes 36 patients suffering from recurrent aphthous ulcers aged between 25 and 55 years old and, having minor aphthous ulcers not more than 48 hours old. Group-1 was administered with Triamcinolone 0.1% (Kenocort 0.1% oral paste, Abbort Laboratories Chicago USA), while the group-2 was administered with Amlexanox 5% (Lexanox 5% oral paste, macleods Pharmaceuticals India). The patients used these pastes four times daily for 7 days. The patients were followed at days 0, 3, 5 and 7 and scores were assessed using visual analog scale. Results: The results showed that in both of the groups, there was reduction of pain and ulcer size significantly at subsequent follow up visits at 3 rd , 5 th and 7 th days (p< 0.01). None of the patients reported with pain in both the groups on 7 th day of treatment. No significant difference was noted between Triamcinolone and Amlexanox for their efficacy on pain relieving effect as well as on tingling in the present study. Conclusion: This study showed that both Amlexanox and Triamcinolone are active treatment options for RAS with no statistically significant difference between Amlexanox and Triamcinolone with regards to pain, tingling and ulcer size reduction.
Early detection and preventing the progression of potentially malignant disorders (PMDs) help in decreasing the incidence and improving the survival of those who develop oral cancer. The content of DNA and RNA is more in dysplasia and in situ carcinoma than the normal surrounding oral epithelium, the use of in vivo staining, by means of toluidine blue dye, is based on the fact that it is an acidophilic dye that selectively stains acidic tissue components such as DNA and RNA. Toluidine blue staining is considered to be sensitive in identifying early oral and oropharyngeal premalignant and malignant lesions. The results of the clinical evaluation, the toluidine blue test and histology, were compared in order to calculate the sensitivity (true-positivity) and specificity (true-negatives). According to the clinical examination, sensitivity was 53% while for toluidine blue staining, it reached 88.4% (p = 0.0007). Specificity was 76% for the clinical examination and 73.6% for toluidine blue staining (p = 0.79). The positive predictive value for clinical examination was 78.9% and 82% for toluidine blue staining (p = 0.85). The negative predictive value for clinical examination was 50% and 82.3% for toluidine blue staining (p = 0.0073). Our observations suggest that toluidine blue can act as a helpful adjuvant for biopsy in clinically suspicious lesions. So that toluidine blue negative lesions need not to be subjected to biopsies thus saving time and resourses. We conclude, toluidine blue stain could be a useful aid for clinically suspicious lesions in order to establish whether the lesions are at high risk of progression to malignancy and to contribute to an early diagnosis of oral and oropharyngeal cancer. Further studies with larger sample sizes have to be done to make the use of toluidine blue more widespread.
The purpose of this clinical prospective study was to determine the location, clinical presentation, and gender distribution of oral lichen planus patients attending the department of oral medicine and radiology, Government dental college Srinagar in Kashmiri population. Materials and Methods: This prospective clinical study included 200 patients reported to the Department of Oral Medicine and Radiology, Government Dental College Srinagar, with the clinical and pathological diagnosis of OLP. Data was compiled for each case, documenting information relating to age, gender, medication, habits(smoking, oral hygiene), anamnesis (reason for consultation, symptomatology, evolution. Results: Out of 200 patients, 116 (58%) were females and 84(42%) were males indicating higher prevalence of OLP in females. Buccal mucosa being the most common site affected in 132 patients (66%), followed by tongue in 46 patients (23%) and the least frequent involved site was palate in 2 patients (1%).The most common clinical presentation was of reticular type in 128 patients (64%), and the least common was bullous type in 3 patients (1.5%). Conclusion:Lichen planus is one of the mucocutaneous disorders which involve skin, scalp, nails and oral mucosa. Lichen planus of skin is known as cutaneous lichen planus that is characterized by most common symptoms of pigmented cutaneous lesions which are pruritic. For a general practitioner it is very important to know the important clinical features, diagnosis and treatment plan for this disease in order to differentiate it from other mucocutaneous lesions and to educate the patient about the premalignant nature of disease.
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