Comparison of Transalar Suture Technique and External Wedge Resection for Alar Base Narrowing.

BACKGROUND: Alar narrowing is indicated in some rhinoplasty operations. This study compared transalar sutures and external wedge resection for alar narrowing in patients undergoing rhinoplasty. METHODS: This study was a single-blind randomized controlled trial with a parallel design. Participants were allocated randomly to the transalar suturing technique group or the external wedge resection group (one-to-one allocation ratio). Primary outcomes were scar formation and satisfaction score (Rhinoplasty Outcome Evaluation questionnaire and patient component of Patient Scar Assessment Questionnaire) after 12 months. Secondary outcomes were the duration of procedure, amount of bleeding, and need for bleeding control. RESULTS: In total, 44 and 46 patients completed the study in the transalar suture and external wedge resection groups, respectively. The postoperative assessment showed a significantly lower scar formation rate in the transalar suture group (75.0% versus 37.0%; P < 0.001). The Rhinoplasty Outcome Evaluation questionnaire revealed no statistically significant difference in patient satisfaction between two groups. The Patient Scar Assessment Questionnaire results showed that patients who received transalar sutures had a lower overall score (1; interquartile range, 1 to 1) compared with the external wedge resection group (2; interquartile range, 1 to 4.50) ( P < 0.001). The duration of the procedure ( P < 0.001), amount of bleeding ( P < 0.001), and need for bleeding control ( P = 0.009) were significantly lower in the transalar suture group than in the external wedge resection group. CONCLUSIONS: Transalar sutures result in high postoperative patient satisfaction. This approach has a decreased incidence of scarring, operation time, bleeding, and necessity for bleeding control. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Comparison of apoptotic bodies' count & mitotic index in oral squamous cell carcinoma with regional lymph node involvement.

BACKGROUND & OBJECTIVES: In early stages of oral cancers, 20-40 per cent of cases have occult metastasis in cervical lymph nodes. Biologic imbalance between cellular proliferation and death culminates in metastasis. The importance of cell cycle dysregulation in relation to lymph node involvement in oral squamous cell carcinoma (OSCC) has not been established yet. The aim was to determine the association between apoptotic bodies count and mitotic index in relation to regional lymph node involvement in OSCC. METHODS: Thirty two methyl green-pyronin stained slides from paraffin-embedded sections of OSCC were evaluated for apoptotic bodies count and mitotic index in relation to regional lymph node involvement using light microscopy. Number of apoptotic bodies and mitotic figures were counted in 10 randomly selected hot spot areas (×400). Average count of apoptotic bodies and mitotic figures were determined and compared with regard to the presence/absence of lymph node involvement. RESULTS: The count of apoptotic bodies in cases without metastasis to the regional lymph node was significantly higher than in cases with regional lymph node involvement. The mitotic index was not significantly different between groups in terms of regional lymph node involvement (P=0.24). No significant correlation was found between the apoptotic bodies count (r=-0.094, P=0.72) and mitotic index (r=-0.08, P=0.75) to the number of regional lymph nodes involved. INTERPRETATION & CONCLUSIONS: Based on the results, it is suggested that apoptotic cell count can be a good parameter for showing the possibility of regional lymph node involvement in people with OSCC who do not have clinical symptoms of lymph node involvement.

Comparison of Repair Index in Cigarette and Waterpipe Smokers: A Bio-Monitoring Assessment Using Human Exfoliated Buccal Mucosa Cells.

Background: Repair index (RI) using DNA changes reveals the activity of carcinogenesis. Cigarette and waterpipe smoking are important contributors to oral cavity malignancy. The RI in cigarette and waterpipe smokers has not been compared so far. The aim of this study was to compare the RI in cigarette and waterpipe smokers using the human exfoliated buccal mucosa cells. Methods: The exfoliated buccal mucosa cells of 60 cigarette and waterpipe smokers and 20 nonsmokers were evaluated in a case-control study. The number of micronuclei (MN), broken egg (BE), karyorrhexis (KR), and karyolysis (KL) were counted in 1000 cells from randomly selected fields. The RI = (KL + KR)/(MN + BE) was calculated and compared between subjects and controls. Data were analyzed by one-way analysis of variance (ANOVA), Tukey's Honest Significant Difference (HSD), and Spearman's correlation coefficient test at P < 0.05 probability level. Results: The difference of MN (P < 0.0001), BE (P < 0.0001), KR (P < 0.0001), and KL (P < 0.0001) count was significant between cigarette smokers, waterpipe smokers, and nonsmokers. The RI was significantly different between groups (P = 0.007). The RI was significantly higher in cigarette smokers compared to waterpipe smokers (P = 0.04) and nonsmokers (P = 0.009). Conclusions: The RI was significantly higher in cigarette smokers compared to waterpipe smokers. The finding suggests that due to higher interrupted cellular hemostasis, the risk of carcinoma in waterpipe smokers can be greater than that in cigarette smokers.

A survey on osteogenic effect of collagen-membrane derived from Rutilus kutum swim bladder in rat calvaria.

BACKGROUND: The collagen membrane which obtained from bovine pericardium and human skin in Guided Bone Regeneration (GBR) is costly and may even cause transmission of diseases. Replacing conventional collagen membranes with a more easily accessible and cheaper ones will have economic benefits. The aim was to determine the osteogenic effect of collagen-membrane derived from Rutilus kutum swim bladder on rat calvaria. MATERIALS AND METHODS: The study was experimental. Thirty-six male albino rats of the Wistar strain were included in the study. The 5 mm surgical defects were created on calvarias and filled with allograft bone material and covered by R. kutum swim bladder (Group I), bovine derived pericardial membrane (Group II) and without membrane cover (Group III).The specimen were euthanized after 3, 5 and 8 weeks. The surrounding connective tissue was evaluated in term of osseous formation. Kruskal-Wallis, Univariant analysis of variance, and post hoc tests were used for statistical analysis. The P < 0.05 was considered statistically significant. RESULTS: A significant differences between groups in terms of osseous formation (P = 0.001) was noted. The difference of osseous formation was significantly higher in 5 and 8 weeks than 3 weeks after operation in all groups (P = 0.03 and P = 0.006, respectively). The osseous formation in Group I and II were significantly higher than Group III (P = 0.023 and P = 0.001). CONCLUSION: The R. kutum swim bladder had osteogenic effect on rat calvaria. R. kutum swim bladder can be a new source in natural derived collagen membrane in GBR.

Micronucleus Assay of Buccal Mucosa Cells in Waterpipe (Hookah) Smokers: A Cytologic Study.

BACKGROUND & OBJECTIVE: Micronucleus assay of buccal mucosa cells is a simple bio- monitoring method for diagnosing the genetic damages of toxic agents. The aim was to study the genotoxic effect of waterpipe smoking on buccal mucosa cells using micronucleus assay. METHODS: This was a case control. A total of 30 male waterpipe smokers and 30 non-smokers were included in the study. The exfoliated buccal mucosa cells were scrapped using wooden spatula and were spread over glass slides. The mean number of micronuclei was determined using Feulgen-stained slides. The number of micronuclei per 1000 cells was calculated and compared between the two groups of smokers and non-smokers. RESULTS: The mean number of micronuclei in waterpipe smokers and non-smokers was 1.94±0.39 and 1.68±0.35, respectively. The micronuclei count in waterpipe smokers was significantly higher than non-smokers (P=0). The difference between the number of waterpipe smoking and micronuclei count was significantly different (P=0). CONCLUSION: The mean number of micronuclei in buccal mucosa cells of waterpipe smokers was significantly higher than non-smokers. The genotoxicity effect of waterpipe was dose-dependent.

A retrospective institutional study of histopathologic pattern of Oral Squamous Cell Carcinoma (OSCC) in Tehran, Iran during 2006-2015.

BACKGROUND: Despite the available data on demographic information of oral squamous cell carcinoma (OSCC), the changing trend of histopathologic pattern of OSCC has not conducted yet, in Iran. The aim was to investigate the pattern of histopathologic features of OSCC in Iran by analyzing the patients referred to Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, during 2006-2015. MATERIALS AND METHODS: The study was a retrospective institutional study. The pathology records with the diagnosis of OSCC were retrieved from Iran National Tumor Bank, Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran, during 2006-2015. The demographic characteristics and histopathologic features were recorded and analyzed for possible trend. Descriptive analysis was used for statistical interpretation. RESULTS: The data showed an increasing number of moderately and poorly differentiated OSCC. Accordingly, higher increasing rate in tumor size and vascular, perineural invasion was detected. CONCLUSION: On the basis of histopathologic features, moderately differentiated OSCC with increasing rate of tumor size and vascular, perineural invasion was indicated in recent decade. Based on the findings, lower differentiation potentially is compatible with worsen prognosis.

The antibacterial effect of aquatic and methanolic extract of Myrtus communis on Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia.

BACKGROUND AND OBJECTIVES: Anaerobic Gram negative bacteria are the main cause of periodontal destruction. It has been shown that Myrtus communis have anti-bacterial activity on Gram positive and Gram negative bacteria. The aim of this study was to determine the antibacterial effect of aquatic and methanolic extract of Myrtus communis on some of the oral Gram-negative bacteria. MATERIALS AND METHODS: The antibacterial effect of aquatic and methanolic extracts of Myrtus communis was determined using disk diffusion method at different concentrations from 10 to 500 mg/ml. The diameter of inhibition zones were determined. The MIC was defined using the standard broth macrodilution method. The results of the study were reported descriptively. RESULTS: The aquatic extract of Myrtus communis from 20 to 500 mg/ml had antibacterial effect on Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia. The methanolic extract from 10 to 500 mg/ml had antibacterial effect on A. actinomycetemcomitans, P. gingivalis and P. intermediate. The MIC was achieved at 10 mg/ml, 10 mg/ml and 10 mg/ml for aquatic and methanolic extracts of Myrtus communis on A. Actinomycetemcomitans, P. Gingivalis and P. Intermediate, respectively. CONCLUSION: Aquatic and methanolic extracts of Myrtus communis had antibacterial effect on P. gingivalis, A. actinomycetemcomitans and P. intermediate. Most concentrations of aqueous extract were effective on bacteria, so, providing an alcoholic extract, that is a time consuming and costly method, does not seem necessary.

Comparison of Cytotoxic Effect of Cigarette and Waterpipe Smoking on Human Buccal Mucosa.

BACKGROUND: The evidences on cytotoxic effect of cigarette and waterpipe smoking are very rare and controversial. The aim was to compare the cytotoxic effect of cigarette and waterpipe smoking on human buccal mucosa cells. METHODS: The study was case-control. Feulgen-stained samples of exfoliated buccal mucosa cells were evaluated. The cytology slides of 25 cigarette smoker, 25 waterpipe smoker, and 25 individuals in the never smoked were examined. The number of pyknosis, karyorrhexis, and karyolysis in 1000 cells/subject were counted. Exposing to cigarette and waterpipe smoke was considered by the number of pack × years. RESULTS: There were significant differences among the groups in terms of karyolysis and pyknosis while there was no significant difference among the cigarette smokers group and waterpipe smokers group in terms of karyorrhexis (P ≤ 0. 01). The cytotoxicity effect of cigarette smoking was not significantly correlated to time exposure (r = 0.099, P = 0.637). The cytotoxicity effect of waterpipe smoking was significantly correlated to time exposure (r = -370, P = 0.044). CONCLUSIONS: The cytotoxic effect of cigarette and waterpipe smoking on buccal mucosa cells was significantly higher than nonsmokers. The effect of cigarette smoking on cellular death was higher than waterpipe. The cytotoxic effect of waterpipe smoking was dose dependent.

The Relationship Between Cytokeratins 7 and 20 Expression, and Prognostic Factors in Colon Adenocarcinoma: An Immunohistochemical Study.

BACKGROUND & OBJECTIVE: The role of synchronized expression pattern of cytokeratin (CK) 7 and CK20 in the prognosis of colon adenocarcinoma is unclear. The current study aimed at determining the relationship between the expression of cytokeratins 7 and 20 and prognostic factors in colon adenocarcinoma. METHODS: In the current cross sectional Study, 52 archival samples of colon adenocarcinoma with different histopathologic differentiation were examined immunohistochemically to analyze the expression of Ck7 and Ck20. The relationship between cytokeratin expression and prognostic factors, such as histopathologic differentiation, lymph node involvement, and depth of invasion, were assessed. RESULTS: CK7-/CK20+ was the most prevalent pattern in the current study. The difference among histopathologic grade, lymph node involvement, and depth of invasion in different CK7/CK20 expression patterns was insignificant (P=0.26, P=0.46, and P=0.22, respectively). CONCLUSION: No relationship was observed between CK7/CK20 expression and prognostic factors in colon adenocarcinoma, in the current study.

The Effect of Smoking on Mast Cells Density and Angiogenesis in Chronic Periodontitis.

BACKGROUND AND OBJECTIVE: Gingival bleeding reduction in smokers has been associated with decreased blood vessel density. The mechanism of suppressive effect of cigarette smoking on blood vessel density is not precisely defined. The aim of this study was to evaluate the impact of smoking on angiogenesis by assessing mast cells density and VEGF expression in chronic periodontitis. MATERIALS& METHODS: 52 paraffin embedded block of gingiva tissues with periodontitis obtained from 30 nonsmokers and 22 smokers undergoing flap surgery were examined immunohistochemically for VEGF expression. Mast cell counts was completed on toluidine blue stained slides. Exposure to cigarette smoking was calculated by the number of packs × year. Patients were classified into 4 groups based on the number of smoked cigarettes. The correlation between VEGF expression and mast cell counts was evaluated and compared in nonsmokers and smokers. RESULTS: The mean number of mast cells (p=0.004) and average value of VEGF expression (p = 0.000) in nonsmokers was significantly higher than smokers. No correlation was noted between VEGF expression / mast cell counts and number of smoked cigarettes in four groups of smokers (p=0.29,0.12 , 0.20 and 0.11, respectively). CONCLUSION: Mast cells and VEGF expression may account for suppressive effect of cigarette smoking on blood vessels in periodontitis.

Vascular endothelial growth factor expression and vascular density in oral squamous cell carcinoma (OSCC): A study on clinical and histopathologic significance.

BACKGROUND: New blood vessels formation is a critical step in tumor progression. Vascular density affects the clinical outcome and prognosis of malignant tumors. The aim of this study was to investigate the relation between the Vascular Endothelial Growth Factor (VEGF) expression and vascular density with the clinical and histopathologic features in oral squamous cell carcinoma (OSCC). METHODS: In this retrospective study, 22 paraffin embedded block of well-differentiated OSCC were examined immunohistochemically for VEGF expression. Vascular density was determined by counting the blood vessels in 6 fields with 100 (HPF) on hematoxylin-eosin stained slides. The relation between the VEGF expression and vascular density with clinical and histopathologic features were analyzed by t-test, ANOVA, and Chi-square tests. RESULTS: A significant relation between gender (P=0.06) and tumor size (p=0.05) with vascular density was obtained. The relation between VEGF expression and gender (p=0.41), age (p=0.35), lymph node involvement (p=0.38), tumor size (p=0.15) and tumor differentiation (p=0.34) was not significant. The relation between vascular density and age (p=0.55), lymph node involvement (p=0.20), and tumor differentiation (p=0.80) was not significant. CONCLUSION: Blood vessels formation relates to tumor size. Controlling the tumor size by manipulating the blood vessels formation may contribute to the inhibition of tumor progression in malignant tumors.

The antibacterial activity of methanolic Anacyclus pyrethrum and Pistacia lentiscus L. extract on Escherichia coli.

BACKGROUND AND OBJECTIVES: Antibiotic therapy is the main choice in treatment of Escherichia coli induced infections. Using herbal medication is an alternative choice in treatment of diseases. The aim of this study was to determine the antibacterial activity of two traditionally used herbs in Iranian medicine, Anacyclus pyrethrum and Pistacia lentiscus L., on Escherichia coli. MATERIALS AND METHODS: The antibacterial effect of methanolic extract of Anacyclus pyrethrum and Pistacia lentiscus L. were examined in disk diffusion and skipped wells methods by measuring the diameter of inhibition zones around wells containing different concentrations of extracts from (10-1000 mg/ml) using standard broth macrodilution, method the MIC and MBC were defined. RESULTS: The methanolic extract of Anacyclus pyrethrum from 300 to 1000 mg/ml and the methanolic extract of Pistacia lentiscus L. from 30 to 1000 mg/ml showed antibacterial activity on Escherichia coli. The MIC of Anacyclus pyrethrum and Pistacia lentiscus L. methanolic based extract were 800 and 1000 mg/ml, respectively. The MBC was achieved at 800 mg/ml for methanolic extract of Anacyclus pyrethrum and Pistacia lentiscus L. CONCLUSION: The methanolic extract of Anacyclus pyrethrum and Pistacia lentiscus L. have antibacterial effect on Escherichia coli bacteria. This activity is dose-dependent.

The Impact of Smoking on Gingiva: a Histopathological Study.

BACKGROUND AND OBJECTIVE: Smoking can be associated with the decreasing gingival blood flow and epithelial changes. The aim of this study was to evaluate the histopathological changes of gingival epithelium and connective tissue in smokers . METHODS: The study was case-control. Sixty male patients ( 28 smokers and 32 non smokers) suffering chronic periodontitis were participated in the study . Periodontal parameters consisting the gingival (GI) and periodontal (PI) indexes were registered. Tissue samples were taken during flap surgery. The hemotoxylin and eosin stained slides were assessed for blood vessel density, inflammatory cells infiltration and epithelial changes. The histopathological findings were compared between smokers and nonsmokers. Data analyzed using t -test and chi-square tests. RESULTS: Smokers had lower GI (1.35 ± 0.48) and higher PI (2.87±0.68) than nonsmokers (2.72 ±0.31 and 1.87±0.25, respectively). The mean count of blood vessels with ≤ 0.5µ diameter was 18.78±10.06 and 5.90±2.93 in smokers, nonsmokers, respectively. The mean inflammatory cells infiltration in smokers, and nonsmokers were 0.89±1.03 and 70±0.46 that showed significant difference between two groups ( P = 0.001, SD=1.21). The difference of epithelial hyperkeratosis, atrophy and acanthosis was not different in smokers and nonsmokers. Loss of normal epithelium pattern comprising of bulbous rete ridges, loss of polarity and increased parabasal cells was seen in 23(82.14%) of smokers and 2(6.25%) of nonsmokers. CONCLUSION: Despite the normal appearance of gingiva in smokers, smoking increasing the epithelial changes resemble to early phases of dysplasia and decreasing inflammatory reaction.

A study on the relationship between clinical features with Ki67 expression and eosinophil cells infiltration in oral squamous cell carcinoma.

BACKGROUND: Cell proliferation is one of the most critical factors in metastasis and prognosis of the malignant tumors.Recent investigations show that the eosinophil granolosytes have an important role in developing of malignant tumors. The relation between cell proliferation and eosinophilic infiltration in oral squamous cell carcinoma (OSCS) with prognosis is unclear. The aim of this study was to investigate the relationship between the Ki67 expression and eosinophilic infiltration with the clinical features on OSCC. METHODS: This study was cross sectional in which 24 paraffined embeded block of OSCC selected from the Imam Khomeini hospital; cancer institute's archive. 4 micron sections were prepared and studied for Ki67 antigen immunohistochemically. The labeling index (LI: positive epithelial cells/1000 epithelial cells) of Ki67 positive cells were obtained. In each section eosinophilic cells were counted in 10 fields with 400 (HPF). The relations between the eosinophil cells and Ki67 positive cells counts with clinical features and histopathological differentiation were achived by the linear regression and spirman statistical tests. RESULTS: There were no any significant relationship between gender, histopathological differentiation and the number of eosinophils and Ki67 positive cells counts (p= 0.33 and p=0.73). A significant relationship between lymph node involvement and the number of eosinophils and the Ki67 positive cells counts was found (p=0.04).There was a positive relationship between the number of Ki67 positive cells and the number of eosinophil cells (p= 0.05). CONCLUSION: A significant relationship between lymph node involvement with eosinophilc cells and Ki67 positive cells counts were exist.

Reactive lesions of the oral cavity: A retrospective study on 2068 cases.

BACKGROUND: Reactive lesions of the oral cavity are non-neoplastic proliferations with very similar clinical appearance to benign neoplastic proliferation. This similarity is troublesome in the differential diagnosis. The aim of this study was to determine the frequency and distribution of oral cavity reactive lesions. MATERIALS AND METHODS: The study was a retrospective archive review. The medical records of 2068 patients with histopathologic diagnosis of oral cavity reactive lesions were studied. The patients' clinical data were registered and evaluated retrospectively. The obtained frequency of patients' age, gender, and anatomic location were analyzed. Descriptive statistics were used for evaluating the registered data. RESULTS: Peripheral giant cell granuloma was the most prevalent lesion (n=623, 30.12%). This was followed by pyogenic granuloma (n=365, 17.65%), epulis fissuratum (n=327, 15.81%), irritation fibroma (n=288, 13.93%), cemento-ossifying fibroma (n=277, 13.40%), inflammatory fibrous hyperplasia (n=177, 8.56%), and inflammatory papillary hyperplasia (n=11, 0.53%). The age ranged from 2 to 85 years, with a mean of 39.56 years. The lesions were more common in males (n=1219, 58.95%) than in females (n=849, 41.05%). Attached gingiva with 1331 (64.36%) cases was the most frequent place of reactive lesions. CONCLUSION: Peripheral giant cell granuloma was the most prevalent reactive lesion of the oral cavity. The reactive lesions were more common in males, gingival, and the third decade. Some differences have been found between the findings of the present study and previous reports.

Vascular endothelial growth factor and ki-67 antigen expression in relation to age and gender in oral squamous cell carcinoma.

BACKGROUND AND AIMS: Vascular endothelial growth factor (VEGF) and Ki-67 antigen are contributing factors in this process cell proliferation and new blood vessels formation in tumor progression. This study was conducted to examine the relationship between the expression of VEGF and Ki-67 and gender and age of patients with oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Twenty-three archival samples of well-differentiated OSCC were examined immunohisto-chemically and assessed by obtaining Total Score (TS = proportion score × staining index). For statistical analysis, t-test and Pearson's correlation were employed. P≤0.05 was considered statistically significant. RESULTS: The differences in VEGF expression between males and females (P = 0.43) and different ages (P = 0.88) were not significant. The differences in Ki-67 expression was between males and females (P = 0.67) and different ages (P = 0.88) were also not significant. A positive correlation of VEGF and Ki-67 expression was observed in males and females in addi-tion to ≤ 60 years age group (r = 0.22, r = 0.008, and r = 0.58, respectively; P < 0.05). The expression of VEGF had a nega-tive relation to Ki-67 in > 60 years group (r = -0.48, P < 0.05). CONCLUSION: The expression of VEGF and Ki-67 between males and females and different ages were not significant among oral squamous cell carcinoma cases evaluated.