Human T-Lymphotropic Virus-1 Associated with Adult T-Cell Lymphoma/ Leukemia and Generalized Expansion of Palatal and Jaw Bones: A Rare Case Report.

Human T-lymphotropic virus-1 (HTLV-1) can cause adult T-cell leukemia/ lymphoma (ATL/L), which is a rare and aggressive type of blood cancer. Herein, we report a case of ATL/L in a middle-aged man with unusual jaw presentations. The patient presented with mandibular, maxillary and palatal bony hard expansion, accompanied by generalized tooth mobility six months prior to admission to the Department of Oral Medicine. The panoramic radiograph showed generalized rarefaction of jaw bones. After laboratory examinations and bone marrow aspiration, ATL/L was diagnosed in association with HTLV-1. The patient underwent chemotherapy. Although the majority of infections associated with HTLV-1 are asymptomatic, some patients may develop blood diseases such as ATL/L and neurological disorders, mainly HTLV-1 associated myelopathy and tropical spastic paraparesis. ATL/L is a rare hematological malignancy in oral cavity that should be included in the differential diagnosis of cases with jaw swelling or generalized demineralization. Serum levels of anti-HTLV-1 antibodies should be examined in suspicious patients, particularly in endemic regions.

Removal of refractory erosive-atrophic lichen planus by the CO2 laser.

UNLABELLED: AIM, STUDY AND BACKGROUND: The erosive-atrophic form of Oral lichen Planus (OLP) is often associated with severe pain and burning sensation. This study investigated the efficacy of CO2 laser surgery for management of refractory erosive-atrophic OLP. METHODS: Ten patients with thirteen erosive-atrophic OLP resistant to standard therapy participated in this study. The size and clinical scores of the lesions and the level of pain/discomfort were recorded before treatment. The lesions were then removed with a CO2 laser device (10600 nm, continuous wave, 5 W, slightly defocused). The subjects were evaluated 1 month and 3 months later and the response rate was assessed according to the decrease in pain, sign scores and size of the lesions. RESULTS: There was a significant reduction in pain and lesion size at 1 and 3 months following laser treatment (p<0.05). The sign scores of the lesions were also significantly improved at follow-up periods compared to the pretreatment state (p<0.05). At the end of the follow-up period, 54% of the lesions showed 3 or 4 degrees of improvement in the clinical score and 23% improved 1 or 2 degrees, whereas 23% remained unchanged post-operatively compared to the pretreatment evaluation. CONCLUSION: The present results indicate that the CO2 laser surgery is an effective modality for management of erosive-atrophic OLP and can be considered as a suitable alternative to standard treatment.

Microscopic evaluation of cleaning efficiency of three different nickel-titanium rotary instruments.

INTRODUCTION: This study compared the cleaning efficiency of Mtwo, Race and Medin Nickel-Titanium (NiTi) rotary instruments. MATERIALS AND METHODS: Sixty mandibular molar mesial roots were selected with angle curvatures between 25-35 degrees and divided into three groups; each containing 20 teeth. Canals were prepared with the rotary files and irrigated with 2.5% NaOCl solution after each instrument. Total of 5mL of normal saline was used as the final rinse; subsequently the canals were dried with paper points. The amount of debris and smear layer in three parts of the root canal walls was evaluated using SEM and the data were analyzed by using the Kruskal-Wallis test and the Mann-Whitney U test. RESULTS: The results for remnant debris in the coronal part of root canals were similar, whereas in the middle third, Mtwo instruments achieved significantly better results compared to Race and Medin instruments. In the apical third of the root canals more debris was created by Race instruments. CONCLUSION: Overall, Mtwo instruments had greater success in producing clean canals.

Comparative SEM study of the marginal adaptation of white and grey MTA and Portland cement.

The use of a suitable substance that prevents egress of potential contaminants into the periapical tissues is important in endodontic surgery. The aim of the present study was to compare the marginal adaptation of three root-end filling materials (white mineral trioxide aggregate (MTA), grey MTA and Portland cement), using scanning electron microscopy. Seventy-five single-rooted extracted human teeth were used. The canals were instrumented and filled with gutta-percha. Following root-end resection and cavity preparation, root-end cavities were filled with white MTA, grey MTA or Portland cement. Using a diamond saw, roots were longitudinally sectioned into two halves. Under scanning electron microscopy, the gaps between the material and dentinal wall were measured. The data were analysed using Kruskal-Wallis test. The mean of the gap in grey MTA, white MTA and Portland cement was 211.6, 349 and 326.3 microm, respectively. The results indicate that the gap between grey MTA and the dentinal wall is less than other materials, but there was no significant difference between the materials tested in this study (P > 0.05).