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Lan, Yolanda Haruka

University of British Columbia

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 using cyanoacrylate adhesive (CA). The study aimed to determine 1) the magnitude of asymptomatic reactivation compared to symptomatic and 2) the efficacy of CA in limiting the virus transmission in symptomatic oral lesions. Methods: Thirty-three participants were recruited from UBC-Faculty of Dentistry. Oral mucosal (OS) and lesion swabs (LS) were collected and tested for HSV-1 and 2 using polymerase chain reaction (PCR) assay. Asymptomatic participants with possible history of oral HSV lesions (n=17) were followed for three months. Symptomatic lesions (n=11) had OS and LS collected, CA applied and subjected to soft tissue manipulation (STM). CA’s efficacy to alleviate/cause pain was assessed by daily journaling using visual analogue scale (VAS: 0-10). Examiner was blinded to symptomatic LS results and statistical analyses were performed using SPSS 27. Results: Twenty-one participants completed the study. One case of asymptomatic reactivation was detected out of 17 asymptomatic participants (2.0% reactivation rate). Data on 11 lesions were collected. Correlations between various lesion clinical parameters were assessed. Both lesion size and lesion PCR cycle threshold value (Ct) (p=0.04) and lesion day and stage (p<0.001) were positively correlated. Lesion discomfort and lesion stage were negatively correlated (p<0.03). Mean of reported average discomfort was 1.16±1.11, out of 10. Significant differences were detected in Ct of OS and LS (p<0.02), OS and post-STM swab (p<0.03). LS was observed to have lower Ct than post-PA swab. PA was accepted by participants with mean inverse-VAS score of 1.61±1.52. PA remained intact for an average of 25.25±17.63 hours. No adverse reactions to PA were reported. Side-effects include feeling of localized tightness and restriction in mouth-opening. Conclusions: Magnitude of asymptomatic reactivation cannot be determined, as insufficient cases were detected in this study. Observation found majority of LS Ct were lower than post-PA Ct suggests efficacy of CA-PA in limiting HSV transmission. The results suggest CA-PA to be a safe option as oral herpetic lesion barrier in the dental settings.

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2021-09-24

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/79792

Craniofacial Science

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/