Volume 04 Issue 11-2024
31
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
11
P
AGES
:
31-35
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The article presents the clinical experience of diode laser application in the complex treatment of exfoliative cheilitis
in patients with coronavirus infection. It was found that a more pronounced anti-inflammatory effect was noted in the
patients of the main group, where the diode laser was included in the treatment scheme, which is expressed in the
elimination of the inflammatory reaction of the mucous membrane in a shorter time than in the patients of the control
group.
The study showed that the use of diode laser helps stimulate the regeneration of the mucous membrane in the lesion
and can significantly improve the effectiveness of complex therapy, which is reflected in reduced pain, accelerated
epithelialization, increased duration of remission and reducing the number of relapses.
KEYWORDS
exfoliative cheilitis, diode laser, new coronavirus infection COVID-19.
Research Article
NEW APPROACHES IN COMPREHENSIVE TREATMENT OF CHEILITIS IN
PATIENTS WHO HAVE SURVIVED CORONAVIRUS INFECTION
Submission Date:
October 29, 2024,
Accepted Date:
November 03, 2024,
Published Date:
November 30, 2024
Crossref doi:
https://doi.org/10.37547/ajbspi/Volume04Issue11-05
Toshtemirova Mokhira Makhmud kizi
Samarkand State Medical University, Uzbekistan
Jurakulov Abbos G’ofurovich
Assistant of the Department of Therapeutic Dentistry, Uzbekistan
Sirliboyeva Iqbol Murod qizi
Samarkand State Medical University, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ajbspi
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 11-2024
32
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
11
P
AGES
:
31-35
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
INTRODUCTION
A large number of studies conducted around the world
over the past two years have shown that due to the
spread of the new coronavirus infection, the number
of diseases of the oral mucosa caused by COVID-19 is
steadily increasing. Coronavirus can cause not only
pneumonia, but also affect the mucous membrane of
the oral cavity.
The pathogenic agent enters the div thanks to
angiotensin-converting enzyme 2, which is localized
both on the surface of the alveoli and pulmonary
structures, and on the epithelial cells of the oral cavity,
where it begins to actively multiply. There are
publications in the literature that more than 80% of
patients who have suffered coronavirus infection note
changes in the oral mucosa in the form of dryness and
damage to the lips.
Xerostomia can be caused both by taking medications
and by the influence of aggravated systemic diseases.
More than 500 medications can cause xerostomia.
According to researchers, post-Covid syndrome is a
fairly broad diagnosis with psychophysiological
consequences. A separate code has appeared in ICD-10
to describe post-Covid syndrome (U09.9).
Psycho-emotional disturbances (usually in the form of
increased personal anxiety, sleep disorders, anger,
autonomic disorders, asthenic syndrome with
emotional lability), which occurs against the
background of the COVID-19 pandemic, significantly
affect not only the quality of life of patients who have
had COVID-19, but and is a predictor of disease. In this
connection, the dynamics of the occurrence and
development of diseases, in the etiology of which the
main factor is neurogenic nature, is increasing. Such
diseases include cheilitis. According to domestic and
foreign literature, lip diseases are relatively common
and are an important problem in modern dentistry,
since their diagnosis poses significant difficulties, and
the treatment of this pathology is not always
successful.
The most common are inflammatory and destructive
diseases, such as meteorological, exfoliative, actinic
cheilitis and chronic lip fissures. Being under the
constant influence of external and internal factors, the
red border of the lips is the site of manifestation of
various diseases, including dermatoses. In addition, the
mucous membrane of the red border of the lips can be
subject to all sorts of inflammatory processes,
undergoing various transformations, which, in turn,
leads to significant difficulties in making a diagnosis.
Exfoliative cheilitis K13.0 is a chronic disease of the red
border of the lips, characterized by a complex and not
fully understood etiopathogenesis, a variety of trigger
factors and the often insufficient effect of the therapy
used. Exfoliative cheilitis was first described in 1922. by
French scientists Mikulic and Kümmel as “per
sistent
peeling of the lips.”
Volume 04 Issue 11-2024
33
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
11
P
AGES
:
31-35
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Most researchers believe that neurogenic factors
underlie the disease. Patients suffering from it
experience a more or less significant functional
disorder of the nervous system. Various allergens, both
endogenous and exogenous, can also be factors that
support and aggravate the disease. In patients with
exfoliative cheilitis, various types of psycho-emotional
disorders, anxiety reactions, and depressive states
have been identified. There is evidence of the possible
role of immunological factors in the pathogenesis of
the disease.
In addition, the presence of dry mucous membranes
and a decrease in the amount of saliva affects the
development of the disease, since in this case the
balance of oral microorganisms is disrupted. Patients
lick their lips more often, resulting in a red border of
the lips cracks and peels. The disease negatively affects
the aesthetic qualities of the patient, leading to serious
psychological and social disorders due to cosmetic
defects. Treatment of lip diseases is one of the difficult
tasks of modern dentistry.
Based on an analysis of literature sources by domestic
and foreign authors devoted to the study of the
condition of the red border of the lips and treatment
methods, it can be concluded that existing approaches
to the treatment of this pathology are not effective
enough. Despite advances in pharmacology, the
effectiveness of most drugs and treatment methods
remains unsatisfactory.
Currently, there is no single universal approach to the
treatment of cheilitis and most existing methods have
a temporary positive effect. In addition, post-Covid
cheilitis is particularly resistant to therapy and has a
long course. Therefore, it is urgent to search for new
methods of treating exfoliative cheilitis that are highly
effective
with
the
least
possibility
of
complications.This raises the need for further research
to optimize the treatment of lip diseases. At the
moment, one of the modern trends is the use of laser
technologies. The purpose of the study is to increase
the effectiveness of complex treatment of patients
with exfoliative cheilitis who have had COVID-19
infection by including a diode laser in the treatment
regimen.
Research objectives:
1. To study the effect of a diode laser on reducing the
intensity of pain sensitivity in patients with exfoliative
cheilitis.
2. To study the effect of a diode laser on the timing of
mucosal regeneration in patients with exfoliative
cheilitis.
MATERIAL AND METHODS
To achieve this goal, 21 patients aged 22 to 55 years
who had COVID-19 over the past 6 months with a
diagnosis of exfoliative cheilitis K13.0 were examined.
All examined patients were randomized into 2 groups:
the main group consisted of 10 patients, the control
group - 11. All patients had
Volume 04 Issue 11-2024
34
American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
–
2771-2753)
VOLUME
04
ISSUE
11
P
AGES
:
31-35
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The study noted complaints of increased lip size, a
burning sensation, pain when closing the lips, difficulty
eating, dry mouth, and an unpleasant aesthetic
appearance. The red border of the lips is brightly
hyperemic with individual white-honey-colored scales,
the mouth is slightly open.
The clinical picture corresponded to the diagnosis of
K13.0. Pain intensity was assessed on a verbal scale
before and 24 hours after treatment. When analyzing
the dental status of patients, a high value of the
simplified hygiene index OHI-S was revealed: 2.81±0.22
in the main group and 2.78±0.23 in the control groups.
When assessing the factors of unsatisfactory oral
hygiene from the anamnesis, it was noted that the
main reasons are the impossibility and difficulty of
brushing teeth due to the irritating effect of hygiene
products on inflamed and eroded areas. All patients
underwent traditional complex treatment, including
sanitation of the mouth, administration of keratoplasty
ointments, and the use of hygienic lipsticks. When
various changes in the nervous system were detected,
sedatives were prescribed together with a neurologist
or psychotherapist. In addition, the patients of the
main group received a diode laser from Dr. SMILE
(Italy), wavelength 980 nm, procedure power 0.7 W, in
continuous mode, in a distant technique, with a non-
initiated fiber for 1 min. on a lesion area of 1 sq. cm.,
three times, after 2 days.
RESEARCH RESULTS
One day after treatment, all patients in the main group
noted a decrease in pain (pain intensity decreased from
5.2±0.2 before treatment to 0.18±0.12 (p<0.05)); in
patients in the control group, pain intensity decreased
from 5.4±0.3 to 2.9±0.16 (p>0.05).
On the 3rd day after treatment, patients in the main
group experienced a pronounced therapeutic effect,
which was manifested in a decrease or complete
disappearance of the feeling of tightness and
roughness of the lips, a decrease in the intensity of
inflammation, active epithelization of the mucous
membrane, a decrease in pain and discomfort. On the
10th day after treatment, OHI-S in the main group was
0.61±0.22, in the control group 1.1±0.24.
Complete epithelization of elements in the main group
was observed after 14 days, while in the control group
recovery occurred on average 21 days after the start of
treatment. The insignificant effect of the treatment in
the control group contributed to the formation of a
negative psychological attitude towards further
therapy.
CONCLUSIONS
1. It was found that a more pronounced decrease in
pain sensitivity was observed in patients of the main
group, where a diode laser was included in the
treatment regimen.
2. The study showed that the use of laser helped
stimulate the regeneration of the mucous membrane
in the lesions. The period of final epithelization of
Volume 04 Issue 11-2024
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American Journal Of Biomedical Science & Pharmaceutical Innovation
(ISSN
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2771-2753)
VOLUME
04
ISSUE
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P
AGES
:
31-35
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
elements in the main group was 14 days, in the control
group - 21 days.
3. The inclusion of a diode laser in the treatment
regimen for patients with cheilitis is justified and can
significantly increase the effectiveness of complex
therapy, which is expressed in reducing pain,
accelerating epithelialization, increasing the duration
of remission and reducing the number of relapses.
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