A novel formulation for radiotherapy-induced oral mucositis: Triamcinolone acetonide mucoadhesive film.

BACKGROUND: The main purpose of this study was to evaluate the effectiveness of triamcinolone acetonide (TA) mucoadhesive films versus placebo as a preventive and therapeutic intervention of oral mucositis (OM) induced by radiotherapy for head-and-neck cancer (HNC) patients. MATERIALS AND METHODS: In this double-blind, randomized case-controlled clinical trial, 60 HNC patients were randomized to receive TA mucoadhesive films (n = 30) or placebo mucoadhesive films (n = 30) taken four times daily. Mucositis severity was assessed during the course of radiation therapy using the World Health Organization scales, and pain scores were assessed using visual analog scale. Repeated measures ANOVA was used for data analysis. RESULTS: Mean ± standard deviation age of the TA group was 58.53 ± 8.89 years and 60% were male, whereas in the placebo group, it was 56.46 ± 9.36 years and 56.7% were male (P > 0.05). The mean value of pain score was significantly reduced in the TA group (5.36 ± 1.29 vs. 2.20 ± 2.02) compared with the placebo group (5.34 ± 0.78 vs. 4.69 ± 0.77) during 4 weeks (P < 0.001); repeated measures ANOVA analysis showed that the mean value of grade mucositis was significantly reduced in the TA group (2.40 ± 0.49 vs. 0.96 ± 0.81) compared with the placebo group (2.36 ± 0.80 vs. 1.86 ± 0.93) during 4 weeks (P < 0.001). CONCLUSION: TA film could be considered as an effective approach for reducing the mucositis grading and pain score in the patients with OM.

Comparison of clinical indices and therapeutic effect of a mucoadhesive system containing Melissa 1% and triamcinolone 0.1% on lichenoid reactions.

Background: Lichenoid reaction (LR) is a relatively common mucocutaneous disease with an unknown etiology. Since the cause of the LRs is unknown, many drugs have been studied to palliate the symptoms. Previous studies reported that corticosteroids are often effective in the management of several oral inflammatory diseases. The aim of the present study was to compare the effect of Melissa gel and triamcinolone 0.1% paste on clinical indices of oral LRs. Materials and Methods: In this randomized clinical trial, sixty patients with erosive oral LRs were randomly divided into two groups, and each group was treated with Melissa gel or triamcinolone acetonide 0.1% paste, three times a day, for 4 weeks. The recovery rate and severity of pain and burning sensation were assessed after 2 and 4 weeks. Finally, the obtained data were analyzed using SPSS software (version 20, IBM Corp., Armonk, NY, USA) and repeated measures ANCOVA, Mann-Whitney test, Chi-square test, paired t-test, and survival analysis.(α = 0.05). Results: The Visual Analog Scale scores for recovery rate, pain, and burning mouth sensation and objective scoring for oral lichen planus were significantly improved at 2 and 4 weeks in both the groups. However, the pain intensity decreased significantly in the Melissa group, as compared to the triamcinolone 1% group. Conclusion: In general, we showed that Melissa gel has a better effect than triamcinolone on pain intensity. Although Melissa gel is effective in reducing lesion size, triamcinolone significantly showed better results.

Newly formulated chlorhexidine gluconate chewing gum that gives both anti-plaque effectiveness and an acceptable taste: a double blind, randomized, placebo-controlled trial.

OBJECTIVE: In previous investigations the chlorhexidine (CHX) chewing gums tasted unpleasant. The main problem with different CHX formulations is the high incompatibility of CHX with anionic compounds. The purpose of this study is to introduce a new formulation for CHX gum that gives both anti-plaque effectiveness and an acceptable taste. DESIGN: Randomized, double blind, placebo-controlled crossover trial, employing two 5-day trial periods without mechanical oral hygiene. PARTICIPANTS: 18 from 22 volunteer dental students (8 males, 10 females, mean age 22 +/- 2.3 years). INTERVENTION: Active gum, containing 10 mg CHX, and placebo were used for 20 min twice daily. A 7-day washout period between trial periods was used. MAIN OUTCOME MEASURES: Turesky modification of the Quigley and Hein index was used to assess plaque formation. Success of blinding was assessed at the second day of each test period. At the end of each test period, subjects were asked to evaluate the taste of the products used. RESULTS: CHX gum has a significantly higher anti-plaque effect than placebo (95% confidence interval 2.7865 to 3.5302, p < 0.0001). Subjects could not determine the study drug assignment by taste or otherwise (p = 0.6250). The difference between subjective evaluations of the taste of chewing gums was not significant (p = 0.5879). CONCLUSION: CHX can be successfully incorporated in a chewing gum-based delivery system for use as an adjunct to or even short-term replacement for mechanical plaque control. The observation period needs to be extended if this product is anticipated for longer-term use.

Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial.

AIM: Mucositis is a major complication of irradiation in head and neck tumors, the addition of chemotherapy to irradiation may enhance this dose-limiting problem. Licorice is a strong demulcent that had been effectively used in treatment of peptic ulcer. The main purpose of this study was to compare the therapeutic safety and efficacy of triamcinolone acetonide (T) and licorice (L) mucoadhesive films on oral mucositis in terms of pain control and/or ulcer treatment. METHODS: The study was a double-blind, randomized prospective trial of two types of mucoadhesive films in the management of oral mucositis that occurred during head and neck cancer radiotherapy. Oral mucositis was assessed using a quantitative scale (World Health Organization scales) and symptoms were assessed using visual analog scale. Sixty patients were enrolled in the study: 30 patients in the triamcinolone and 30 in the licorice group. RESULTS: With respect to visual analog scores, repeated observations in consecutive weeks showed a meaningful difference (P-value < 0.05), suggesting the efficacy of both T and L in reducing pain during radiotherapy. Comparison of the pain scores between two groups by independent sample t-test, however, demonstrated no meaningful difference in any consecutive week. CONCLUSIONS: We concluded that both triamcinolone and licorice mucoadhesive films are effective in the management of oral mucositis during radiotherapy. Furthermore, comparison of the pain scores between two groups demonstrated no meaningful difference, although an overall trend to reduced oral discomfort was seen in the licorice group.

Salivary levels of interleukin-8 in oral lichen planus and diabetic patients: A biochemical study.

BACKGROUND: This study aimed to assess the salivary levels of interleukin-8 (IL-8) in oral lichen planus (OLP) and diabetes mellitus (DM) patients, and OLP + DM patients in comparison with healthy individuals. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted on 75 patients (30 with OLP, 5 with both OLP and DM, 20 with DM and 20 healthy controls). The salivary levels of IL-8 and fasting blood sugar and 2-h postprandial blood glucose levels were measured in all the subjects. Data were analyzed with one-way ANOVA and post hoc least significant difference tests. RESULTS: The mean salivary level of IL-8 was the highest in OLP + DM patients, followed by DM, OLP and control groups, respectively. Pair-wise comparisons of the groups revealed significant differences in the salivary levels of IL-8 between OLP and control, DM and control, also OLP + DM patients and control (P < 0.05). CONCLUSION: The increasing salivary level of IL-8 in the control, OLP, DM, OLP + DM groups, respectively, indicates the role of this inflammatory cytokine in the pathogenesis of OLP and diabetes.

Hybrid Benzoxazole-Coumarin Compounds Induce Death Receptor-Mediated Switchable Apoptotic and Necroptotic Cell Death on HN-5 Head and Neck Cancer Cell Line.

BACKGROUND: Efficacy of multimodality approaches for the treatment of squamous cell cancer of the head and neck has remained unsatisfactory and further advances are critically required. Targeted cell death induction is a novel therapeutic approach that may help to improve clinical management of Head and Neck cancer patients. OBJECTIVE: The potency of novel hybrid benzoxazole-coumarins on the induction of apoptotic and/or necroptotic cell death were evaluated in a Head and Neck carcinoma cell line, HN-5, and a human skin cell line, AGO1522. METHODS: Quantitative toxicity of the synthesized compounds were elucidated by MTT assay, the specific activity of caspase-3 and -9 were measured by the colorimetric method and zVAD was used to block apoptosis. Expression of cell death related genes were studied using quantitative PCR. RESULTS: All three compounds were revealed IC50 value around 51.96±7.15 microM in HN-5 cells which were significantly lower than observed IC50 for AGO1522, 121.93±3.66 microM (p=0.001). Significant increase expression of FAS, FASL and TRIAL were observed in the treated cells with or without pretreatment with zVAD. In the absence of pretreatment, treatment lead to the induction of apoptosis with a significant increase in caspase-3 gene expression and caspase-3 activity without a significant increase in expression or activity of caspase-9 and other components of the intrinsic apoptotic pathway. However, in the zVAD pretreated cells, necroptotic cell death with a significant increase in expression of RIP1, RIP3, and MLKL genes was observed Conclusion: The novel hybrid benzoxazole-coumarins effectively induce Caspase-3 dependent apoptosis in HN-5 cancer cells, but also could circumvent the blockage of apoptotic cell death by induction of necroptosis.

Systemic toxicity following ingestion of the chlorhexidine gluconate solution: a case report.

The purpose of this article is to discuss possible adverse effects and emergency treatments following the ingestion of chlorhexidine (CHX). In this case a dental student (age 25, male) accidentally swallowed one shot of 20% CHX solution, which is equal to 100 shots of the standard 0.2% CHX mouthwash. Clinical emergency treatment included: washing the oral cavity with 30 g of toothpaste, drinking 100 ml of 5% (w/v) alginate syrup and ingestion of 5 g of cork. The following adverse effects were experienced: headache, euphoria, giddiness, blurred vision (duration = 12 h), stomachache, gastric lavage with demulcents (duration = 24 h) and complete loss of taste sensation (duration = 8 h), which recurred during the next 48 h. No change in plasma aminotransferase level was seen. We used basic chemical information about the incompatibilities of CHX for clinical management of unintentional ingestion. It is known that CHX is a cation, and, therefore, first aid in case of intoxication with CHX involves using anionic materials.

Assessment of IgG Antibodies Against HSV1, HSV2, CMV and EBV in Patients with Pemphigus Vulgaris Versus Healthy People.

OBJECTIVES: Regarding the implication of viruses particularly herpes in pemphigus vulgaris, we sought to assess and compare the level of immunoglobulin G (IgG) antibodies against herpes simplex virus types 1 and 2 (HSV1 and HSV2), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with pemphigus vulgaris and healthy people. MATERIALS AND METHODS: In this cross-sectional study, 25 patients with pemphigus vulgaris and 27 healthy individuals comprised the experimental and control groups, respectively. Serum samples were taken from both groups; the levels of IgG antibodies against HSV1, HSV2, CMV and EBV were measured using ELISA. RESULTS: Immunoglobulin G titer was higher for all four viruses in the patient group in comparison to the control group. This difference was significant for anti-EBV (P= 0.005), anti-CMV (P=0.0001) and anti-HSV2 (P=0.001) but not significant for anti-HSV1 (P= 0.36). CONCLUSION: Viruses including EBV, CMV, and HSV2 probably play a role in the pathogenesis of pemphigus in addition to the effects of genetics, toxins and other predisposing factors. In this study, no statistically significant relationship was observed between HSV1 and pemphigus vulgaris, which was probably due to the high titer of anti-HSV1 IgG in healthy individuals in the community. More studies must be done in this regard.

The effect of mustard gas on salivary trace metals (Zn, Mn, Cu, Mg, Mo, Sr, Cd, Ca, Pb, Rb).

We have determined and compared trace metals concentration in saliva taken from chemical warfare injures who were under the exposure of mustard gas and healthy subjects by means of inductively coupled plasma optical emission spectroscopy (ICP-OES) for the first time. The influence of preliminary operations on the accuracy of ICP-OES analysis, blood contamination, the number of restored teeth in the mouth, salivary flow rate, and daily variations in trace metals concentration in saliva were also considered. Unstimulated saliva was collected at 10:00-11:00 a.m. from 45 subjects in three equal groups. The first group was composed of 15 healthy subjects (group 1); the second group consisted of 15 subjects who, upon chemical warfare injuries, did not use Salbutamol spray, which they would have normally used on a regular basis (group 2); and the third group contained the same number of patients as the second group, but they had taken their regular medicine (Salbutamol spray; group 3). Our results showed that the concentration of Cu in saliva was significantly increased in the chemical warfare injures compared to healthy subjects, as follows: healthy subjects 15.3± 5.45 (p.p.b.), patients (group 2) 45.77±13.65, and patients (Salbutamol spray; group 3) 29 ±8.51 (P <0.02). In contrast, zinc was significantly decreased in the patients, as follows: healthy subjects 37 ± 9.03 (p.p.b.), patients (group 2) 12.2 ± 3.56, and patients (Salbutamol spray; group 3) 20.6 ±10.01 (P < 0.01). It is important to note that direct dilution of saliva samples with ultrapure nitric acid showed the optimum ICP-OES outputs.

Oral focal epithelial hyperplasia: report of three cases.

Focal epithelial hyperplasia or Heck's disease is an infrequent asymptomatic condition caused by human papillomavirus types 13 or 32 affecting the mucous membrane of the mouth and is commonly seen in young individuals. Firstly, it was described in Indians and Eskimos, but it exists in various populations. We present three cases of Heck's disease in an Afghan immigrant family group living in Iran that seem to have familial predominance. The disease was identified as oral focal epithelial hyperplasia on the basis of histopathologic and clinical findings. The lesions were reduced significantly after 4 months of good oral hygiene. Dentists should be familiar with the clinical manifestations of these types of lesions that affect the oral cavity. In fact, histopathologic assessment and clinical observation are necessary to establish the diagnosis.

A histomorphometric study of the effect of doxycycline and erythromycin on bone formation in dental alveolar socket of rat.

BACKGROUND: The aim of the present study was to evaluate whether subantimicrobial doses of doxycycline (DOX) and erythromycin (EM) used for the treatment of peri-implant osteolysis due to their anti-osteoclastogenesis can interfere with the osseous wound healing process in rat alveolar socket. MATERIALS AND METHODS: Forty-five male Wistar rats had their first maxillary right molar extracted and were divided into three groups. DOX and EM at the doses of 5 mg/kg/day orally (p.o.) and 2 mg/kg/day intraperitoneally (i.p.) were administered respectively to two separate groups for 7 days after operation. In the control group the animals received normal saline (5 ml/kg). Five rats were sacrificed at 7, 14 and 21 days post-extraction in each study group. A histomorphometric analysis was used to evaluate new bone formation inside the alveolar socket. Significant level was set at 0.05. RESULTS: The findings showed that the percentage of new bone formation (NBF) enhanced significantly on days 7 and 14. There was no significant difference in the NBF between DOX and EM groups. CONCLUSION: Short-term treatment with both DOX and EM enhanced new bone formation without any advances in favor of each drug.

Extragingival pyogenic granuloma associated with medication: Report of an unusual case.

Pyogenic granuloma (PG) is a well-known benign non-neoplastic overgrowth. It is a response to mild irritation and might be related to hormonal factors and certain kinds of drugs. PG preferentially affects the gingiva, but can be found extragingivally with varying clinical features. The most common treatment is surgical excision. This article describes a case of extragingival PG occurring on the tongue with unusual presentation, with emphasis on non-surgical treatment. Since surgical management had not been successful, an alternative approach was taken. We illustrated how the lesion was successfully treated with a series of intralesional corticosteroid injections.

The Serum and salivary level of malondialdehyde, vitamins A, E, and C in patient with recurrent aphthous stomatitis.

BACKGROUND: Oral recurrent aphthous stomatitis (RAS) is a chronic inflammatory disease affected oral mucosa which has afflicted about 20% of the society. Etiology of this disease is unknown. Three main factors influencing aphthous stomatitis are genetic, hematologic, and immunologic factors. Another proposed factor that may be considered in etiology of aphthous ulcer is oxidant, anti-oxidant imbalance in the body. The purpose of this study was the evaluation of lipid peroxide enzyme as an important oxidant agent and anti-oxidant vitamins in the saliva and serum of the patients suffering from RAS and compare it to healthy people. MATERIALS AND METHODS: In this cross-sectional, descriptive - analytical study, 25 patients suffering from RAS were compared to 24 healthy individuals. Applying enzyme-linked immunosorbent assay method, the amount of malondialdehyde (MDA) as well as Vitamins A, E, and C were measured in the saliva and serum of two groups. The results were analyzed by Statistical Package for the Social Sciences (SPSS) software version (11.5), t-test and χ(2). RESULTS: No significant difference was detected between salivary and serum levels of antioxidant vitamins (A, E, and C) and MDA in both experimental groups (P > 0.05). CONCLUSION: According to the results of this study, RAS is not associated with oxidant-antioxidant imbalance in the body. However, it seems quite necessary to carry out more studies in this area.

Effects of diclofenac and celecoxib on osteoclastogenesis during alveolar bone healing, in vivo.

BACKGROUND: OSTEOCLASTOGENESIS IS COORDINATED BY THE INTERACTION OF MEMBERS OF THE TUMOR NECROSIS FACTOR (TNF) SUPERFAMILY: Receptor activator of nuclear factor-κB ligand (RANKL) and Osteoprotegerin (OPG). The aim of this study was to compare the effect of two different types of non-steroidal anti-inflammatory drugs (NSAIDs) on the RANKL/OPG balance during the healing of the alveolar process. MATERIALS AND METHODS: This was an experimental study, carried on 45 male Wistar rats (200 ± 25 g, 8-10 weeks old). After extraction of the right maxillary first molar, 15 rats received 5 mg/kg/day of diclofenac and 15 rats received 15 mg/kg/day of celecoxib and 15 rats received normal saline. The animals were sacrificed 7, 14 and 21 days after tooth extraction. The number of osteoclasts, OPG and RANKL messenger ribonucleic acid expression were determined by tartrate-resistant acid phosphate (TRAP) staining and polymerase chain reaction (PCR) respectively. The data were analyzed by one-way ANOVA followed by Tukey's post-hoc test. Values of P < 0.05 were considered significant. RESULTS: On days 7, 14 and 21 the ratio of RANKL/OPG in the control group was higher than diclofenac and celecoxib groups. TRAP immunolabeling of the control group was more than diclofenac group on day 7 and was more than celecoxib group on day 14. On day 21, no significant differences were noted among the three studied groups. CONCLUSION: Both drugs affect RANKL/OPG gene expression and also osteoclastogenesis in alveolar socket during the experimental period of 21 days.

Histological assessment of intra-articular versus intra-peritoneal betamethasone L.A on tempromandibular joint arthritis in rat.

BACKGROUND: Pain and dysfunction of the tempromandibular joint (TMJ) are major clinical problems, especially, in arthritis. The aim of this study was to compare the effect of intra-articular (IA) versus intra-peritoneal (IP) injection of betamethasone long acting on TMJ arthritis in rat. MATERIALS AND METHODS: In this experimental study, an inflammation in the left TMJ of 29 rats was induced by injection of complete Freund's adjuvant. After 1 week, rats were divided into 5 groups: Group A: Rats of this group were not treated (n = 5); groups B, C: Rats were injected with a single dose of ½ mg/kg betamethasone L.A IA (n = 6); groups D, E: Rats received a single dose of ½ mg/kg betamethasone L.A IP (n = 6). Rats in groups B and D after 1 week, and in groups C, E and A, at 4 weeks after drug injection were sacrificed. Severity of inflammation was scored from 1 to 11 according to synovial hyperplasia, vascularity, fibrin deposits, and synovial adhesion. Results were analyzed by using Kruskal-Wallis and Mann-Whitney (P < 0/05 was considered significant). RESULTS: Significant differences were existed between groups B, D (P = 0/004) and groups C, E (P = 0/002). The least severity of Inflammation and also evidence of resorbtion in condylar head was seen in group C. CONCLUSION: The best therapeutic response was seen with IA injection of betamethasone L.A in comparison with IP injection.

Assessment of the effect of diode laser therapy on incisional wound healing and expression of iNOS and eNOS on rat oral tissue.

BACKGROUND: The aim of this study was to compare the effects of diode laser irradiation on wound healing in oral rat mucosa and also to measure the amount of inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) on oral wound healing. Healing was assessed by histology and the amounts of eNOS and iNOS were measured by real-time polymerase chain reaction (PCR). MATERIALS AND METHODS: Twenty-four standardized incisions were carried out on the buccal mucosa of 12 male Wistar rats; each rat received two incisions on the opposite sides of the buccal mucosa by using a steel scalpel. On the right side (test side), a diode laser (660 nm) was employed on the incision for 10 seconds on days 1-4 and 6-9. The left side (control side) did not receive any laser. Histological and real-time PCR analysis were done on tissue samples after 2, 7, 14, and 21 days. RESULTS: Histological analysis showed that the tissue healing after seven days on the laser irradiated side was better than the control side, but there was no significant difference between the two sides on days 2, 14, and 21 after surgery. Paired t-test analysis showed that there was no significant difference in the amount of eNOS between the groups. The difference in the amounts of iNOS between the groups was significant; it was more in the laser-irradiated side than the control side. CONCLUSION: Histological findings showed that diode laser needs several repeated irradiations for the acceleration of wound healing. The iNOS amount showed that increases are associated with better healing.

The comparison of salivary level of estrogen and progesterone in 1(st) , 2(nd) and 3(rd) trimester in pregnant women with and without geographic tongue.

BACKGROUND: Geographic tongue (GT) was first reported as a wandering rash of the tongue in 1831; however, its etiopathogenesis remains unclear. Increased prevalence of GT has been documented in the pregnancy. The aim of this study was to compare the level of salivary estrogen and progesterone in pregnant women with and without GT. MATERIALS AND METHODS: This analytical-descriptive study consisted of 26 pregnant women (13 with GT, 13 without GT) with an age range between 18 years and 45 years. The estrogen and progesterone level was measured during 1(st) , 2(nd) and 3(rd) trimester of pregnancy. Saliva sampling was performed to determine the level of sex hormones. The samples were stored at -80°C and determined by Eliza method. The results were analyzed by t-test and repeated measure ANOVA (α = 0.05). RESULTS: The mean level of estrogen for control and case group was 49.4and 52.33 in the 1(st) , 71.05 and 74.12 in the 2(nd) and 109.1 and 112.16 in the 3(rd) trimester respectively. The mean level of progesterone was 0.72 and 0.72 in the 1(st) , 1.14 and 1.21 in the 2(nd) and 1.3 and 1.28 in the 3(rd) trimester of pregnancy for the control and case groups respectively. Even though, there was no significant difference regarding the level of sex hormones between case and control groups (P < 0.05), but the difference between the level of these hormones during 3 trimesters of pregnancy was significant in each group (P = 0.001). CONCLUSION: The level of sex hormones is not the only etiologic factor of GT in pregnant women, but other factors such as genetic potential, human leukocyte antigen marker and stress may aggravate the incidence of this lesion.

The efficacy of Punica granatum extract in the management of recurrent aphthous stomatitis.

OBJECTIVE: Recurrent aphthous stomatitis (RAS) is a common, painful ulcerative disorder of the oral cavity with unknown etiology. No documented cure exists and topical application of medications aims to reduce pain associated with this condition. The aim of this study was to evaluate the efficacy of Punica granatum (PG) extract on the clinical management of RAS. METHODS: A total of 40 patients with RAS participated in this randomized, double-blind, and placebo-controlled study. During three episodes of RAS, the efficacy of topical PG gel (10%) was evaluated. Patients were randomly assigned to use placebo gel or PG gel daily. The time of pain elimination and the time of complete healing were recorded and the pain degree was assessed and recorded by each patients in different time intervals including: Before using the oral gel (day 0), and on days 1, 3, 5, 7 after using the product. Data were analyzed using the repeated measures ANOVA, paired and independent t-test. FINDINGS: Mean time of pain elimination showed a significant difference (P < 0.001) between PG group (3.4 ± 1.09) and placebo group (5.9 ± 0.6). The mean duration of complete healing also showed a significant difference (P < 0.001) between PG group (5.3 ± 0.81) and placebo group (8.6 ± 0.99). The visual analog scale score in PG group was significantly less than the placebo group in all time intervals (day 1 to day 7) (P < 0.001). CONCLUSION: The findings of this study revealed that PG extract in the form of oral gel (10%) may be beneficial in reducing RAS pain and has a positive effect in reducing the overall time period of complete healing. It was concluded that PG is an effective herbal medicine for the management of RAS.

Degranulated mast cells and TNF-α in oral lichen planus and oral lichenoid reactions diseases.

BACKGROUND: The objective of this study was to assess mast cells and TNF-α in oral lichen planus (OLP) and oral lichenoid reactions (OLR) patients as diagnostic marker to the differential diagnosis of OLP and OLR diseases. MATERIALS AND METHODS: In this cross-sectional study, samples were obtained from 30 OLP and 30 OLR patients, between June 2010 and March 2011 in Dental clinic of the University of Isfahan, Iran. Mast cells in the reticular layer of the lamina propria for samples were evaluated using toluidine blue method and immunohistochemical technique. The clinical relevant data taken into account were: demographical data, total number and degranulated mast cells, ratio of degranulated mast cells and TNF-α positive degranulated mast cells. RESULTS: In OLP and OLR, the total mast cells were 21.2 ± 7.9 and 20.3 ± 6.8, degranulated mast cells were 15.5 ± 6.9 and 19.2 ± 6.9, ratio of degranulated mast cells to total mast cells were 0.716 ± 0.067 and 0.946 ± 0.081, and TNF-α positive degranulated mast cells were 13.6 ± 6.3 and 17.1 ± 6.04, respectively. There was no significant difference for the total mast cells. But degranulated mast cells, ratio of degranulated mast cells and TNF-α positive degranulated mast cells in OLR were significantly higher than OLP patients. CONCLUSIONS: Our results showed that the degranulated mast cells, ratio of degranulated mast cells and TNF-α in OLR was significantly more than OLP patients and these may be able to be used as diagnostic markers to the differential diagnosis of OLP and OLR.

Neurofibromatosis type I (von Recklinghausen's disease): A family case report and literature review.

The term neurofibromatosis (NF) is used for a group of genetic disorders that primarily affect the cell growth of neural tissues. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease, is the most common type of NF, and accounts for about 90% of all cases. It is one of the most frequent human genetic diseases, with a prevalence of one case in 3,000 births. The expressivity of NF1 is extremely variable, with manifestations ranging from mild lesions to several complications and functional impairment. Oral manifestations can be found in almost 72% of the NF1 patients. The aim of this article is to report the NF1 in a family with different manifestations and to review the literature.