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Although corticosteroids are still the gold standard, aloe vera shows promising results especially with no adverse effects compared with various adverse effects of corticosteroids. We recommend conducting new randomized clinical trials with larger sample size, sufficiently long follow-up period as well as standardized aloe vera formulations and outcome measures.

Background: Most of the available therapeutics of oral lichen planus are associated with adverse effects and there is no sufficient evidence to support the effectiveness of these modalities over placebo or over each other. Micronutrients including antioxidants modify the immune system function and are considered promising alternatives in management of OLP with negligible side effects. The current trial assessed the effect of adjunctive use of systemic vitamin E in symptomatic oral lichen planus patients. Methods: This randomized controlled clinical trial includes 30 symptomatic (erosive and atrophic ) oral lichen planus patients in two parallel groups (interventiontopical triamcinolone acetonide adhesive paste and vitamin E, control -topical triamcinolone acetonide adhesive paste and placebo), with allocation ratio 1:1. Outcome measures were pain intensity, clinical improvement and salivary level of total antioxidant capacity. Results: Mean amount of pain reduction and clinical improvement were greater in the experimental group with statistically significant difference. Mean amount of total antioxidant capacity upregulation was greater in the control group with no statistical difference. Conclusion: Adjunctive use of systemic vitamin E has shown promising results in management of OLP with no side effects.

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MTHFR 677 gene polymorphism may be a risk factor for the development of the LP, and to predispose these patients to higher risk of CVD.

Objectives: Previous studies have demonstrated that microRNA-21 (miR-21) and total antioxidant capacity (TAC) could be potential diagnostic biomarkers for oral squamous cell carcinoma. Their diagnostic potential in the early stages of carcinogenesis is not clear yet. This study was conducted to determine the salivary levels of miR-21 and TAC in patients with oral hyperplasia and dysplasia. Methods: We assessed expression of miR-21 and TAC in whole unstimulated saliva samples of 30 patients with oral mucosal lesions demonstrating hyperplastic or dysplastic changes and 30 healthy individuals with normal mucosa. Biopsy was taken from the lesions for histopathologic assessment. Statistical analysis was performed with IBM® SPSS® (P ≤ 0.05) and ROC curve analysis was conducted with MedCalc. Results: miR-21 expression varied among the studied groups with significant difference. However, TAC expression varied only between mucosal lesions and normal mucosa with significant difference. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were higher in miR-21 than TAC. Conclusions: Salivary miR-21 are more accurate in detecting oral dysplasia than salivary TAC. Salivary miR-21 could be potential diagnostic biomarker for screening and early detection of oral cancer. More studies are required to validate miR-21.

Aim: There is a deficiency in the data concerning the clinical forms of methotrexate-induced oral ulcers. This study was conducted to stratify clinical forms of methotrexate-induced oral ulcers in rheumatoid arthritis patients. Methods: This study included rheumatoid arthritis patients receiving methotrexate as monotherapy. All eligible patients were subjected to thorough clinical examination and full history to identify oral events. Drug history, dose, and duration of MTX were recorded.Results: Among 794 rheumatoid arthritis patients, mean methotrexate dose and duration were 14.3 mg/week and 5.2 years, respectively. Oral ulcers were detected in 6.2% of the patients and 30% of the patients reported previous oral ulcers. Among the detected oral ulcers, 44.9% manifested as deep irregular ulcers, 30.6% presented as aphthous-like ulcers, 14.3% were diffuse mucositis, and 10.2% appeared as lichenoid reaction. Conclusion: Methotrexate-induced oral ulceration could be localized or generalized. Localized forms were more noticed than generalized forms. Higher doses and longer durations of methotrexate were detected among patients with generalized oral ulcers.