Two cases of an atypical presentation of necrotizing stomatitis

Magan-Fernandez, Antonio,O'Valle, Francisco,Pozo, Elena,Liebana, Jose,Mesa, Francisco Korean Academy of Periodontology 2015 Journal of Periodontal & Implant Science Vol.45 No.6

Purpose: The purpose of this report was to describe the clinical and microbiological characteristics of two rare cases of necrotizing stomatitis, and the outcomes of a non-invasive treatment protocol applied in both cases. Methods: We report two cases of necrotizing stomatitis in a rare location in the hard palate of a 40-year-old woman and a 28-year-old man. Neither had a relevant medical history and both presented with highly painful ulceration in the palate and gingival margin that was accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to the lesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribed to both patients in addition to two daily oral rinses of 0.2% chlorhexidine. Results: In both cases, radiological examination ruled out bone involvement, and exfoliative cytology revealed a large inflammatory component and the presence of forms compatible with fusobacteria and spirochetes. There was a rapid response to treatment and a major improvement was observed after 48 hours, with almost complete resolution of the ulcerated lesions and detachment of necrotic areas with partial decapitation of gingival papillae. Conclusions: Necrotizing periodontal lesions can hinder periodontal probing and the mechanical removal of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively.

Two cases of an atypical presentation of necrotizing stomatitis

Antonio Magan-Fernandez,Francisco O’Valle,Elena Pozo,Jose Liebana,Francisco Mesa 대한치주과학회 2015 Journal of Periodontal & Implant Science Vol.45 No.6

Purpose: The purpose of this report was to describe the clinical and microbiological characteristicsof two rare cases of necrotizing stomatitis, and the outcomes of a non-invasivetreatment protocol applied in both cases. Methods: We report two cases of necrotizing stomatitis in a rare location in the hard palateof a 40-year-old woman and a 28-year-old man. Neither had a relevant medical historyand both presented with highly painful ulceration in the palate and gingival margin thatwas accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to thelesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribedto both patients in addition to two daily oral rinses of 0.2% chlorhexidine. Results: In both cases, radiological examination ruled out bone involvement, and exfoliativecytology revealed a large inflammatory component and the presence of forms compatiblewith fusobacteria and spirochetes. There was a rapid response to treatment and amajor improvement was observed after 48 hours, with almost complete resolution of theulcerated lesions and detachment of necrotic areas with partial decapitation of gingivalpapillae. Conclusions: Necrotizing periodontal lesions can hinder periodontal probing and the mechanicalremoval of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively.

Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial

Elena Sánchez-Fernández,Antonio Magán-Fernández,Francisco O’Valle,Manuel Bravo,Francisco Mesa 대한치주과학회 2021 Journal of Periodontal & Implant Science Vol.51 No.1

Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)- 1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, −1.66, −0.40 mm; control 2: 95% CI, −1.07, −0.01 mm) and 90 days (control 1: 95% CI, −1.72, −0.54 mm; control 2: 95% CI, −1.13, −0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels. Trial Registration: ClinicalTrials.gov Identifier: NCT03157193

Hyaluronic acid reduces inflammation and crevicular fluid IL-1β concentrations in peri-implantitis: a randomized controlled clinical trial

Sanchez-Fernandez, Elena,Magan-Fernandez, Antonio,O'Valle, Francisco,Bravo, Manuel,Mesa, Francisco Korean Academy of Periodontology 2020 Journal of Periodontal & Implant Science Vol.50 No.-

Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, -1.66, -0.40 mm; control 2: 95% CI, -1.07, -0.01 mm) and 90 days (control 1: 95% CI, -1.72, -0.54 mm; control 2: 95% CI, -1.13, -0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels.

Therapeutic effect of the immunomodulatory drug lenalidomide, but not pomalidomide, in experimental models of rheumatoid arthritis and inflammatory bowel disease

Belen Lopez-Millan,Rafael Diaz de la Guardia,Heleia Roca-Ho,Carmen M García-Herrero,Jessie R Lavoie,Michael Rosu-Myles,Elena Gonzalez-Rey,Francisco O’Valle,Gabriel Criado,Mario Delgado,Pablo Menendez 생화학분자생물학회 2017 Experimental and molecular medicine Vol.49 No.-

Thalidomide is an immunomodulatory drug (IMiD) with proven therapeutic action in several autoimmune/inflammatory diseases; however, its inherent high toxicity has led to the development of more powerful and safer thalidomide analogs, including lenalidomide and pomalidomide. These are new generation IMiDs that exhibit direct antitumor activity as well as anti-inflammatory/immunomodulatory properties, and are FDA-approved for the treatment of several hematological malignances. Here we investigated the potential therapeutic effects of lenalidomide and pomalidomide in several experimental murine models of autoimmune/inflammatory diseases: 2,4,6-trinitrobenzene sulfonic acid- and dextran sulfate sodium-induced inflammatory bowel disease and type II collagen-induced arthritis. Lenalidomide displayed a strong therapeutic effect in all these models of autoimmune/inflammatory diseases, while the effect of pomalidomide was less pronounced. In vitro experiments confirmed the immunosuppressive effect of both IMiDs on the proliferative response of stimulated human lymphocytes and on the balance of secreted cytokines toward an anti-inflammatory profile. We conclude that lenalidomide may offer a therapeutic opportunity against autoimmune/inflammatory diseases.