Journal of Advanced Clinical and Research Insights

Vol. 2 | No.6 | November-December 2015 Issue

1.EDITORIAL

Pharmacotherapeutics in dentistry

Karthikeya Patil

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:229–230 | No. of Hits: 294


ABSTRACT

The focus of pharmacotherapeutics, the study of the therapeutic uses and effects of drugs in patients is primarily the patient. A thorough understanding of pharmaceutical sciences cannot be overemphasized in providing appropriate pharmacotherapy, and in anticipating and avoiding drug interactions.[1]

How to cite this article: Patil K. Pharmacotherapeutics in dentistry. J Adv Clin Res Insights 2015;2:229-230.


2.ORIGINAL ARTICLE

Clinical efficacy of allicin - A novel alternative therapeutic agent in the management of minor recurrent aphthous stomatitis

Priya K. Nair, Sujatha Dyasanoor

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:231–236 | No. of Hits: 195


Background: Recurrent aphthous ulceration is one of the most common inflammatory, ulcerative oral mucosal conditions. Most of the currently available treatments aim at symptomatic relief, thereby improving the quality of life.

Aims and Objectives: To evaluate the efficacy of allicin in mouthrinse and systemic form in the management of minor recurrent aphthous stomatitis (RAS).

Materials and Methods: A total of 42 patients with minor RAS were randomly divided into Group A (allicin mouth rinse-21) and Group B (allicin capsules-21). The baseline parameters of the ulcer, i.e., size, pain, and erythema were recorded on the day 1, day 4, and day 7, respectively. The recurrence rate of the ulcer was evaluated for 6 months at monthly intervals.

Results: In both groups, the marked improvement was observed in the parameters during the follow-up visits. Both forms of allicin were proved to be effective but no statistically significant difference was observed. Recurrence was observed in both the groups.

Conclusion: Both forms of allicin were found to be equally effective in the management of minor RAS with a good safety record. Both were not found to be effective in preventing the recurrence.

Keywords Allicin, efficacy, recurrent aphthous stomatitis, visual analog scale

How to cite this article: Nair PK, Dyasanoor S. Clinical efficacy of allicin - A novel alternative therapeutic agent in the management of minor recurrent aphthous stomatitis. J Adv Clin Res Insights 2015;2:231-236.


3.ORIGINAL ARTICLE

Evaluation of efficacy of indigenously prepared formulation of Aloe vera, licorice and sesame oil in treatment of oral lichen planus: An in vivo study

Harshada Inamdar, D. M. Sable, Arun V. Subramaniam, Tulsi Subramaniam, Asha Choudhery

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:237–241 | No. of Hits: 984


Background: Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease characterized by eruptions on the skin and oral mucous membranes. Various therapies have been tried for the treatment of lichen planus with varying results. Aloe barbadensis, Aloe capensis is scientific name for Aloe vera (AV). AV is a very versatile plant that has many different uses. AV is a promising herb with its various clinical applications in medicine and dentistry.

Objectives: To assess decrease in pain, burning sensation, erythema, functional disturbances and recurrence in patients diagnosed with lichen planus treated with the prepared formulation of AV and licorice and sesame oil.

Materials and Methods: A total of 30 adult patients who came to Dr. D.Y. Patil Dental College and Hospital, Pimpri, Pune and were diagnosed with OLP were included in the study. Each patient was administered 50 ml prepared formulation of AV and licorice and sesame oil in the form of a gargle which was swished for a minimum of 5 min in the oral cavity twice daily for a period of 6-week.

Results: After evaluation with Tukey’s test and Wincoxin test it was found that there is a decrease in pain, erythema, burning sensation, functional disturbance after using prepared formulation.

Keywords Aloe capensis, apoptosis, autoimmune, basal keratinocytes, corticosteroids, oral lichen planus

How to cite this article: namdar H, Sable DM, Subramaniam AV, Subramaniam T, Choudhery A. Evaluation of efficacy of indigenously prepared formulation of Aloe vera, licorice and sesame oil in the treatment of oral lichen planus: An in vivo study. J Adv Clin Res Insights 2015;2:237-241.


4.ORIGINAL ARTICLE

Attitude of dentists toward pharmacovigilance and reporting adverse drug reactions: A cross-sectional study

S. Sudhakar, Abhishek Madhavan, Senthil Balasubramani

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:242–247 | No. of Hits: 286


Background: Adverse drug reaction (ADR) and intentional reporting accentuate the success of pharmacovigilance. However, a literature review suggests that globally under-reporting is on the rise, and it is among all the health care professionals including dentists.

Aims and Objectives: To evaluate the attitude of dentist’s toward pharmacovigilance and ADR reporting.

Materials and Methods: A cross-sectional study was done utilizing a pre-tested questionnaire. The participants were selected randomly and included on a voluntary basis. The questionnaire was structured; close ended and the participants were asked to select the options of their choice. The data obtained were subjected to statistical analysis.

Results: A total of 120 questionnaires were distributed, and the response rate was 83.3%. An overall level of consensus of about 45% was observed. 64% strongly agreed that reporting ADR is necessary, and 51% disagreed that reporting of only serious and unexpected reaction is necessary. There was no significance difference between gender and experience of the dentists.

Conclusion: Regardless of gender, qualification, and experience, there was a moderate level of attitude among the dentists toward ADR reporting.

Keywords Adverse drug reaction, dentist, pharmacovigilance, reporting

How to cite this article: Sudhakar S, Madhavan A, Balasubramani S. Attitude of dentists toward pharmacovigilance and reporting adverse drug reactions: A cross-sectional study. J Adv Clin Res Insights 2015;2:242-24 7.


5.ORIGINAL ARTICLE

Use of chitosan mouth-wash in radio-chemotherapy induced oral mucositis: A case-control study

V. G. Mahima, Karthikeya Patil, P. K. Kulkarni, Srishti Tayal, Deepika Keshari

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:248–252 | No. of Hits: 418


Background: Oral mucositis (OM) is a common dose-limiting and potentially serious complication of radio-chemotherapy which leads to atrophy and ulceration of the mucosa and an increased risk of infection in immunosuppressed patients. Chitosan is a cationic polysaccharide commercially extracted from the shells of shrimps and crab. Chitosan has beneficial biological and antimicrobial properties with high potential for wound healing. It is biocompatible, biodegradable, non-toxic, anti-microbial, anti-fungal, and a hydrating mucoadhesive agent.

Aims: To evaluate the efficacy and safety of chitosan mouthwash in the treatment of OM and if it could be used as a routine protocol for the treatment of OM.

Subjects and Methods: The study was conducted on 20 patients (10 cases and 10 controls) diagnosed with OM following radiochemotherapy. The study group received 1% freshly prepared chitosan mouthwash, and the control group received chlorhexidine mouthwash. Signs and symptoms were assessed using numerical rating scale (NRS), the WHO and OM Assessment Scale at 0, 10 and 20 days. Statistical analysis: Descriptive statistics, Friedman’s and Mann–Whitney U test were performed.

Results: Statistically significant differences were seen in the NRS (P = 0), ulceration (P = 0.007), and WHO (P = 0.029) scores.

Conclusions: Chitosan was found to be a more effective than chlorhexidine in the alleviation of symptoms of OM.

Keywords Biopolymer, chemotherapy, chitosan, oral mucositis, radiotherapy

How to cite this article: Mahima VG, Patil K, Kulkarni PK, Tayal S, Keshari D. Use of chitosan mouth-wash in radio-chemotherapy induced oral mucositis: A case-control study. J Adv Clin Res Insights 2015;2:248-252.


6.ORIGINAL ARTICLE

Effect of subgingivally delivered simvastatin in postmenopausal women with chronic periodontitis: A randomized controlled trial

Shivali S. Gaekwad, Sheela Kumar Gujjari, T. M. Pramod Kumar, S. Devishree

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:253–258 | No. of Hits: 921 [No. of Citation: 2]


Background and Objectives: The deficiency of estrogen at menopause is a contributing factor that increases susceptibility to resorption due to periodontal infl ammation. Statins have been used successfully in postmenopausal osteopenia. Simvastatin has antiinfl ammatory and antiresorptive properties. This study assessed subgingivally delivered 1.2 mg simvastatin in situ gel in postmenopausal women with chronic periodontitis.

Materials and Methods: A total of 40 bilateral pockets (>=4 mm) in 20 systemically healthy postmenopausal subjects were randomized as site A and B, which received either the simvastatin in situ gel or placebo gel after scaling and root planing. Site-specific indices, probing depth (PD), and clinical attachment level (CAL) were recorded at baseline, 3 and 6 months. The data were analyzed using descriptive statistics, repeated measure ANOVA, paired and independent samples t-test.

Results: A statistically significant (P < 0.05) decrease in PD and improved CAL was observed in both groups over 3 and 6 months. The comparisons of clinical parameters showed statistically signifi cant (P < 0.05) improvements in test sites over the control sites.

Conclusion: Simvastatin in situ gel showed improvements in clinical parameters and prolonged anti-inflammatory effects. The results encourage the use of simvastatin in situ gel for the predictable treatment of chronic periodontitis in postmenopausal women.

Keywords Estrogen, postmenopause, simvastatin

How to cite this article: Gaekwad SS, Gujjari SK, Kumar TMP, Devishree S. Effect of subgingivally delivered simvastatin in postmenopausal women with chronic periodontitis: A randomized controlled trial. J Adv Clin Res Insights 2015;2:253-258.


7.ORIGINAL ARTICLE

Phonophoresis in temporomandibular joint disorders: A clinical trial

K. R. Vijayalakshmi, Mubeen, Preeti Rajguru

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:259–264 | No. of Hits: 820


Background and Objective: Temporomandibular joint disorders (TMDs) are identified as a major cause of non-dental pain in the orofacial region. An effective drug delivery into this complex joint can result in a good prognosis. Phonophoresis is a novel phenomenon that exponentially increases the absorption of topical pharmacological compounds and achieves effective therapeutic drug concentration at the target site. Hence, this study is designed to assess the feasibility and effectiveness of aceclofenac gel phonophoresis in the management of TMDs.

Methods: Selected 60 patients were randomly divided into two equal groups. Group A were treated with aceclofenac gel phonophoresis and Group B with that of its topical application for 15 days. The scores of visual analog scale (VAS), maximum mouth opening, lateral and protrusive excursion, Helkimo anamnestic and clinical dysfunction index, erythrocyte sedimentation rate, and C-reactive protein were evaluated at baseline and 15 days after treatment.

Results: Statistically significant increase in mean maximum mouth opening, lateral excursion and a significant reduction in scores of VAS, Helkimo anamnestic, and clinical dysfunction index were observed post-treatment in Group A as compared to Group B.

Conclusions: Aceclofenac gel phonophoresis is feasible and effective in reduction of signs and symptoms of TMDs.

Keywords Phonophoresis, temporomandibular joint disorders, ultrasound

How to cite this article: Vijayalakshmi KR, Khan M, Rajguru P. Phonophoresis in temporomandibular joint disorders: A clinical trial. J Adv Clin Res Insights 2015;2:259-264.


8.ORIGINAL ARTICLE

Popping pills - When to put a full stop?

Mukta Motwani, Shweta Gupta, Neha Iyer, Nilufer Pajnigara, Trupti Sarda

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:265–268 | No. of Hits: 271


Background: Dental practitioners regularly prescribe antibiotics for therapeutic or prophylactic purposes to manage oral infections. There are limited indications for the use of systemic antibiotics in dentistry since oral hygiene measures, and operative interventions are the primary treatment modalities. However, inappropriate prescription and excessive antibiotic usage have been identifi ed as major factors in the emergence of antibiotic resistance.

Aim: To know the pattern and rationality of antimicrobial prescription by dentists in Nagpur city.

Materials and Methods: A questionnaire-based cross-sectional study was conducted in Nagpur city where 200 questionnaires were distributed to dentists which sought answers to the relevance of antibiotic prescription in dentistry.

Results: Majority of dentists would prescribe antibiotics for patients with systemic involvement. However, many respondents would consider an antibiotic prescription for acute periapical infection (83%), cellulitis (92%), pericoronitis (87%), routine dental extraction, and for non-specifi c diagnosis, the patient expectation for a prescription, and time constraint of dentists. The study revealed that use of antibiotics is more among specialists as compared to general practitioners.

Conclusion: Judicious use of antimicrobials by prescribing the standard drug dosage, and ordering for a culture and sensitivity test should be a priority. These eff orts will reduce the risk of antimicrobial resistance and prevent the transformation of microorganisms into deadly strains.

Keywords Antibiotics, dental practitioners, resistance

How to cite this article: Motwani M, Gupta S, Iyer N, Pajnigara N, Sarda T. Popping pills - When to put a full stop? J Adv Clin Res Insights 2015;2:265-268.


9.REVIEW ARTICLE

Topical drug delivery: An essential aid in the management of oral diseases

Shilpa Padar Shastry, C. J. Sanjay, Rachna Kaul, V. G. Mahima, Nagabhushana Doggalli

Year:2015 | Month:November-December | Volume:2 | Number:6 | Pages No:269–275 | No. of Hits: 553 [No. of Citation: 1]


Topical medications play an important role in the management of oral lesions. Various topical medications ranging from topical anesthetics to topical antineoplastics have been widely used in dentistry. Topical medications have been extensively used as the first line of therapy in many conditions such as vesiculobullous diseases, oral infections like candidiasis, herpes simplex, potentially malignant disorders, neuropathic pain, and oral mucositis. Topical drug therapy provides targeted and a more efficient drug delivery options for the local oral lesions as compared to systemic therapy. While accessibility, lower systemic side effects, and many other advantages are associated with the usage of topical oral medications, several challenges are also faced such as taste alterations, poor penetration, and limited surface area. The objective of this review is to provide insight into the mechanism of topical drug delivery, summary of various topical medications used in oral lesions, advantages and disadvantages, characteristic of oral mucosa and various challenges faced in delivering topical medications.

Keywords Local drug delivery, oral diseases, oral lesions, oral mucosa, topical drugs

How to cite this article: Shastry SP, Sanjay CJ, Kaul R, Mahima VG, Doggalli N. Topical drug delivery: An essential aid in the management of oral diseases. J Adv Clin Res Insights 2015;2:269-275.