Objective: To evaluate and compare the effectiveness of a mouth rinse with hydrogen peroxide (H 2 O 2 ) and hyaluronic acid (HA) versus a placebo mouth rinse on gingivitis.Material and methods: This was a 21-day, double blind, randomized, two-arm parallel allocation placebo-controlled trial of 50 study participants with a diagnosis of plaqueinduced gingivitis. Patients were randomly allocated to the test group or the placebo group and were assessed at three time points over the course of the study by the same operator, at baseline (T0), 7 days (T1), and 21 days follow-up (T2). Primary outcomes of the trial were improvement in gingivitis and plaque accumulation.Results: In both groups there was a decrease in gingival and plaque indices but the combination of the two actives (H 2 O 2 /HA) proved to be more effective against gingivitis (p = 0.001). Regarding plaque index, the differences between the test product and placebo were not statistically significant (p = 0.084). Besides, the new mouthwash was considered palatable, no adverse events were registered over the 21-day period. Conclusions:The H 2 O 2 + HA product was more effective in reducing gingivitis when compared to a placebo while no differences were observed for plaque accumulation.

No abstract

It was previously shown that the antitumor and cytotoxic activity of the essential oil (EO) extracted from the aerial parts of Glandora rosmarinifolia appears to involve a pro-oxidant mechanism in hepatocellular carcinoma (HCC) and in triple-negative breast cancer (TNBC) cell lines. Its most abundant compound is a hydroxy-methyl-naphthoquinone isomer. Important pharmacological activities, such as antitumor, antibacterial, antifungal, antiviral and antiparasitic activities, are attributed to naphthoquinones, probably due to their pro-oxidant or electrophilic potential; for some naphthoquinones, a mechanism of action of topoisomerase inhibition has been reported, in which they appear to act both as catalytic inhibitors and as topoisomerase II poisons. Our aim was to evaluate the cytotoxic activity of the essential oil on an acute myeloid leukemia cell line HL-60 and on its multidrug-resistant (MDR) variant HL-60R and verify its ability to interfere with topoisomerase II activity. MTS assay showed that G. rosmarinifolia EO induced a decrease in tumor cell viability equivalent in the two cell lines; this antitumor effect could depend on the pro-oxidant activity of EO in both cell lines. Furthermore, G. rosmarinifolia EO reduced the activity of Topo II in the nuclear extracts of HL-60 and HL-60R cells, as inferred from the inability to convert the kinetoplast DNA into the decatenated form and then not inducing linear kDNA. Confirming this result, flow cytometric analysis proved that EO induced a G0-G1 phase arrest, with cell reduction in the S-phase. In addition, the combination of EO with etoposide showed a good potentiation effect in terms of cytotoxicity in both cell lines. Our results highlight the antitumor activity of EO in the HL-60 cell line and its MDR variant with a peculiar mechanism as a Topo II modulator. Unlike etoposide, EO does not cause stabilization of a covalent Topo II-DNA intermediate but acts as a catalytic inhibitor. These data make G. rosmarinifolia EO a potential anticancer drug candidate due to its cytotoxic action, which is not affected by multidrug resistance.

Background. Recurrent aphthous ulcer is a common mucosal disease and encompasses diverse interventions for its management of symptoms like pain and discomfort. Since new therapies keep evolving with better outcomes as compared to traditional interventions, one such therapy using hyaluronic acid has been recently explored using clinical studies based on advances in dental therapeutics. Therefore, we designed this clinical study which is double blinded and randomized using minor recurrent aphthous cases. Objective. To evaluate the efficacy of hyaluronic acid topical oral gel in the treatment of minor RAS ulcers, with regard to pain relief and reduction in ulcer size. Design. A double-blind randomized controlled clinical trial was designed to conduct an experimental research at IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan. The participants were recruited from the unit of oral maxillofacial surgery and randomly assigned to test (hyaluronic acid gel) and control groups (placebo gel). 1 : 1 computer-generated random sequence was prepared, and opaque closed envelopes were used for allocation concealment. Participants and clinical investigators were blinded. The outcome measures included ulcer size (mm) and the visual analogue scale for pain and healing as a secondary outcome measure (efficacy index). Results. The mean baseline score for ulcer size for the test group was 1.85 ± 1 and the placebo group was 1.85 ± 1.2 . At day 7, the test group was 1 ± 1.5 and the placebo group was 2 ± 1.5 ( p < 0.001 ). There was significant reduction in ulcer size as compared to the placebo group. In addition, there was significant improvement in pain levels ( p < 0.01 ) in the test group as compared to the control group. Conclusion. In conclusion, there was significant decrease in the size of the ulcer in the test group as compared to the placebo group. Hyaluronic acid seems to have promising effects on the ulcer size and pain relief associated with minor aphthous ulcers. Trial Registration. The protocol of this clinical trial was registered with the Clinical Trial Registry of ISRCTN with study ID ISRCTN16509838, registered 30 June 2020. It can be accessed on this URL: 10.1186/ISRCTN16509838