Oral lichen planus: therapy and phenotype

BACKGROUND

Lichen planus (LP) is a mucocutaneous disease of chronic inflammatory nature. Although many therapeutic options are available, none are curative. The aim of this article was to describe a therapeutic algorithm that take into consideration the clinical futures of oral LP (OLP).

METHODS

Patients affected by symptomatic OLP were enrolled into three groups to receive cyclosporine mouthwash, retinoic acid lotion 0.05%, and autologous platelet-rich plasma (PRP) gel in the treatment of reticular, plaque-like, and erosive-type respectively. The products were applied as follows: retinoic acid BID for 8 weeks, cyclosporine mouthwash OD for 8 weeks, PRP once a week for 8 weeks. Patients were assessed at 2, 4, 8, and 12 weeks. Improvement was evaluated as complete response, partial response and no response.

RESULTS

A total of 20 Caucasian patients, 8 male and 12 female, mean age 56 years (range 40-74) concluded the study. Seven patients showed a complete response, 7 patients a partial response, and 6 patients no response.

CONCLUSIONS

We propose a therapeutic algorithm that take into consideration the clinical features and symptoms of OLP. Long-term experience on larger series of cases are necessary to confirm our data.

Cyclosporine: a novel therapeutic approach for Burning Mouth Syndrome

BACKGROUND

The aim of this paper was to evaluate the efficacy and safety of topical cyclosporine applied as mouthwash in the treatment of burning mouth syndrome (BMS).

METHODS

This was a prospective and pilot study conducted by the Department of Dermatology of the University of Rome Tor Vergata. Patients were treated with cyclosporine topically applied as mouthwash for 4 weeks. Clinical improvement was assessed using a 5 grade clinical evaluation scale and a visual analogue scale from 0 to 10 was also used to evaluate the burning symptoms.

RESULTS

Fifteen patients between 22-85 years (61.1±19.3), 11 female and 4 male, with a mean duration of BMS of 12.5 months, completed the study. Five out of 15 patients presented a marked improvement, 6 patients showed a moderate response, 3 patients had a slight improvement and 1 patient did not show any change. The VAS showed a reduction from 8.7 to 3.5. Adverse events were not reported.

CONCLUSIONS

Cyclosporine mouthwash appeared to be safe and beneficial for reducing the burning sensation in patients with BMS representing an alternative therapy in this condition.

A combined technique for correction of the prominent ear

PURPOSE

The literature illustrates a large number of different techniques for the correction of the prominent ear, and the great variety available is indicative of how difficult it is to achieve satisfactory results in all cases. This report describes a procedure for successfully treating such patients.

PATIENTS AND METHODS

Forty patients were treated with a surgical procedure creating a new anthelical plica based on the Stenström and Mustardé method and producing an anatomic cavity in the mastoid region where the concha can be repositioned according to the Furnas method. The tension of the "cartilage spring," which is a likely cause of relapse, was relieved by dissecting a triangular portion of cartilage from the root of the inferior crus.

RESULTS

No major complications were observed with this technique and a good esthetic result was achieved in all cases.

CONCLUSIONS

This surgical technique is suitable for correction of all cases of prominent ear.

[Evolution of maxillo-malar osteotomy. Clinical experience]

Zygomaticomaxillary osteotomy is indicated in patients who have midfacial deficiency, a class III skeletal malocclusion and normal nasal projection. Many surgical procedures using an intraoral and an extraoral approach of the intraoral approach alone have been described. We prefer the intraoral approach because of the good aesthetic and functional results and the very low incidence of operative and postsurgical complications. As an alternative to these methods some authors have proposed a Le Fort I osteotomy associated with bone or alloplastic grafts in the malar region and a "high" Le Fort I osteotomy called quadrangular Le Fort I osteotomy. These techniques envisage total mobilization of the maxilla including the infraorbital rim. In our experience patients who have a scleral-show can undergo an osteotomy with infraorbital rim mobilization; patients who don't need a protection of the inferior sclera, instead, are advantageously treated without mobilizing the intraorbital rim. We illustrate our experience by reporting two out of 48 patients operated on using the intraoral approach.

[Non-Hodgkin's lymphomas of the oromaxillofacial area. A clinical contribution]

The authors present a clinico-statistical review (January 1987-December 1994) of 19 patients with non-Hodgkin's lymphoma of the oro-maxillo-facial region, diagnosed in the Dentistry Department of the University of Verona in collaboration with the Haematology Department. Particular attention has been devoted to the localisation, symptomatology, diagnosis and histological typing of non-Hodgkin's lymphoma of the maxillofacial region, stressing the importance of diagnosis and staging, based on a multidisciplinary approach, in order to be able to plan the most appropriate therapeutic management of patients with the disease.

[Myositis ossificans of the pterygoid and temporal muscles with metachronous contralateral involvement]

After reviewing the literature, the authors report a case of myositis ossificans of the right pterygoid and temporalis muscles in a patient undergoing surgery to remove the left medial pterygoid muscle owing to the same pathology. The metachronous localisation in contralateral masticatory muscles compared to the primary site leads the authors to emphasize the post-traumatic and iatrogenic etiology of this rare pathology. In the light of their experience, they underline the importance of a precise diagnosis and surgical exeresis, followed by cautious rehabilitation with the least trauma, if necessary backed by appropriate medical treatment.