IADR Abstract Archives
Dental Management of Herpes Simplex Virus with Cyanoacrylate-Adhesive: Pilot Study
Objectives: Herpes simplex virus (HSV-1, 2) can present as symptomatic oral lesions or asymptomatic shedding. The risk of viral spreading during dental procedures is a safety concern, which we hypothesized may be reduced by using cyanoacrylate adhesive (CA). The aim of the study was two-fold: determine the efficacy of CA in limiting the spreading of symptomatic oral lesions, and the proportion of asymptomatic reactivation as compared to symptomatic.
Methods: 25 participants, aged 18 and ASA-I/II health, were recruited from UBC-Faculty of Dentistry. Oral mucosal (OS) and lesion (LS) swabs were collected and tested for HSV using polymerase chain reaction assay (PCR). Asymptomatic participants had OS collected for three months. Symptomatic lesions had OS and LS collected, CA applied and LS, then soft tissue manipulation followed by LS. Follow-ups: days 3-4, and 17-20. Daily visual analog journaling collected at the final visit. Examiner blinded to symptomatic LS results. Inferential and descriptive analysis performed using SPSS software.
Results: Of the 25 participants, 15 self-reported a history of 11 HSV labialis, 2 intraoral HSV lesions, 2 with labialis and intraoral, and 10 were unaware. All participants had undetectable HSV at baseline OS. One participant had herpes labialis. Post CA application, viral DNA was not detected; PCR cycle threshold increased by 0.31% after soft tissue manipulation. CA was reported tolerable and dislodged within two hours of application. By day 17, the average pain was 0.12/10 (range 0-1). Analytical data will be presented at study completion.
Conclusions: This pilot study requires ongoing recruitment until each arm (symptomatic and asymptomatic) has 15 participants. Due to the irregular frequency of HSV reactivations, preliminary results demonstrated difficulty with detecting asymptomatic reactivation, even in participants with a known history of herpetic lesions. The CA application limited HSV spreading and was reported as tolerable, with low post-application pain. At this time, the hypothesis cannot be confirmed nor rejected.
Methods: 25 participants, aged 18 and ASA-I/II health, were recruited from UBC-Faculty of Dentistry. Oral mucosal (OS) and lesion (LS) swabs were collected and tested for HSV using polymerase chain reaction assay (PCR). Asymptomatic participants had OS collected for three months. Symptomatic lesions had OS and LS collected, CA applied and LS, then soft tissue manipulation followed by LS. Follow-ups: days 3-4, and 17-20. Daily visual analog journaling collected at the final visit. Examiner blinded to symptomatic LS results. Inferential and descriptive analysis performed using SPSS software.
Results: Of the 25 participants, 15 self-reported a history of 11 HSV labialis, 2 intraoral HSV lesions, 2 with labialis and intraoral, and 10 were unaware. All participants had undetectable HSV at baseline OS. One participant had herpes labialis. Post CA application, viral DNA was not detected; PCR cycle threshold increased by 0.31% after soft tissue manipulation. CA was reported tolerable and dislodged within two hours of application. By day 17, the average pain was 0.12/10 (range 0-1). Analytical data will be presented at study completion.
Conclusions: This pilot study requires ongoing recruitment until each arm (symptomatic and asymptomatic) has 15 participants. Due to the irregular frequency of HSV reactivations, preliminary results demonstrated difficulty with detecting asymptomatic reactivation, even in participants with a known history of herpetic lesions. The CA application limited HSV spreading and was reported as tolerable, with low post-application pain. At this time, the hypothesis cannot be confirmed nor rejected.
