Oral surgery, oral medicine, and oral pathology
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Oral Surg. Oral Med. Oral Pathol. · Feb 1994
Randomized Controlled Trial Clinical TrialTopical application of capsaicin for treatment of oral neuropathic pain and trigeminal neuralgia.
Neuropathic pain may be a major cause of pain in the head and neck. Trigeminal neuralgia may appear as intraoral pain. This article reviews a series of 24 consecutive cases of oral pain treated with topical capsaicin. ⋯ Trigeminal neuralgia with an intraoral trigger was less responsive to topical therapy than neuropathic pain. Further study is needed to clarify the efficacy of topical capsaicin in neuropathic and neuralgic pain and the effect of differing dosages and frequency of application. On the basis of the findings in this open-label clinical trial, controlled clinical study of capsaicin in neuropathic oral pain states appears warranted.
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Oral Surg. Oral Med. Oral Pathol. · Oct 1993
Randomized Controlled Trial Clinical TrialEffects of chlorhexidine during immunosuppressive chemotherapy. A preliminary report.
Immunosuppressive chemotherapy and bone marrow transplantation are increasingly used to treat and, in some cases, cure numerous malignant conditions. The systemic sequelae as a result of these immunosuppressive techniques lead to a host of oral and dental complications. The direct and indirect stomatotoxic effects lead to development of ulcerative, hemorrhagic, or infectious complications that potentially can lead to increased mortality and morbidity. ⋯ Our double-blind randomized study revealed that chlorhexidine versus controls had considerable effect in the bone marrow transplant cohort. Patients who received chlorhexidine while undergoing bone marrow transplantation were found to exhibit fewer and less painful mucositis lesions. This study supports prophylactic use of chlorhexidine in patients who undergo bone marrow transplantation.
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Oral Surg. Oral Med. Oral Pathol. · May 1993
Randomized Controlled Trial Clinical TrialNarcotic receptor blockade and its effect on the analgesic response to placebo and ibuprofen after oral surgery.
The purpose of this study was to evaluate the contribution of endogenous opiates to the analgesic response after treatment with placebo, codeine, and ibuprofen after oral surgery. Eighty-one patients undergoing complicated dental extractions were pretreated with either a placebo or the narcotic antagonist naltrexone 50 mg, 30 minutes before surgery. After surgery, patients self administered one of three possible postsurgical medications, which included placebo, codeine 60 mg, and ibuprofen 400 mg, when their pain reached a moderate or severe intensity. ⋯ The administration of naltrexone before surgery reduced the analgesic response to both placebo and codeine. Pretreatment with naltrexone did not diminish the peak analgesic response to ibuprofen, but surprisingly prolonged (p < .05) the duration of its action. The results suggest that a blockade of endogenous opiates by naltrexone diminished the placebo response, but that naltrexone may prolong ibuprofen analgesia by some unknown mechanism.
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Oral Surg. Oral Med. Oral Pathol. · Jun 1992
Randomized Controlled Trial Clinical TrialEfficacy of chlorhexidine and nystatin rinses in prevention of oral complications in leukemia and bone marrow transplantation.
The goal of reducing oral complications during chemotherapy and bone marrow transplantation has received attention at several centers. The current randomized study of 86 adults with leukemia treated with chemotherapy or bone marrow transplantation assessed the potential role of chlorhexidine, nystatin, and saline solution rinses to reduce the findings of oral mucositis, gingivitis, and oral infection. The results of this study did not show a reduction in mucositis with the use of these rinses. However, potential bacterial and fungal pathogens were identified less frequently in the patients using chlorhexidine rinse.
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Oral Surg. Oral Med. Oral Pathol. · Mar 1990
Randomized Controlled Trial Clinical TrialChlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial.
Patients receiving cytotoxic antineoplastic therapy often have treatment-associated stomatitis. A 0.12% chlorhexidine digluconate mouthrinse was evaluated (15 ml, three times a day) in a prospective, double-blind randomized trial as prophylaxis against cytotoxic therapy-induced damage to oral soft tissues. Seventy subjects, forty inpatients receiving high-dose chemotherapy and thirty outpatients receiving high-dose head and neck radiation therapy, were evaluated. ⋯ Although no differences were observed in oral mucositis between the control and chlorhexidine groups of patients undergoing high-dose radiotherapy, similar reductions of oral microflora to those seen in the chemotherapy population were also noted for patients undergoing radiation therapy who received chlorhexidine. Although generally not significant, some increase in gram-negative bacilli was noted in the chlorhexidine-treated patients in both the chemotherapy and radiotherapy groups, but there was no correlation with increased systemic infection. Prophylactic chlorhexidine mouthrinse reduces oral mucositis and microbial burden in patients with cancer undergoing intensive chemotherapy.