Dos and don'ts in designing a computerized oral and lip squamous cell cancer registry.

BACKGROUND: In the last ten years, many countries have started to develop constructive systems for registering common diseases and cancers. In this research, we intended to determine and identify the minimum data set (MDS) required for the design of the oral and lip squamous cell cancer registration system in Iran. METHODS AND MATERIAL: At first, primary information elements related to disease registries were extracted using scientific papers published in reliable databases. After reviewing the books, related main guidelines, and 42 valid articles, the initial draft of a researcher-made questionnaire was compiled. To validate the questionnaire, two focus group meetings were held with 29 expert panel members. The final version of this questionnaire was prepared by extracting different questions and categories and receiving numerous pieces of feedback from specialists. Lastly, a final survey was conducted by the experts who were present at the previous stage. RESULTS: Out of 29 experts participating in the study, 17 (58.62%) were men and 12 (40.37%) were women. The age range of experts varies from 34 to 58 years. One hundred-fourteen items, which are divided into ten main parts, were considered the main information elements of the registry design. The main minimum data sets have pertained to the demographic and clinical information of the patient, information related to the consumed drugs, initial diagnostic evaluations of the patient, biopsy, tumor staging at the time of diagnosis, clinical characteristics of the tumor, surgery, histopathological characteristics of the tumor, pathologic stage classification, radiotherapy details, follow-up information, and disease registry capabilities. The distinctive characteristics of the oral and lip squamous cell cancer registry systems, such as the title of the disease registration programme, the population being studied, the geographic extent of the registration, its primary goals, the definition of the condition, the technique of diagnosis, and the kind of registration, are all included in a model. CONCLUSION: The benefits of designing and implementing disease registries can include timely access to medical records, registration of information related to patient care and follow-up of patients, the existence of standard forms and the existence of standard information elements, and the existence of an integrated information system at the country level.

Comparison of the 1 and 2% pilocarpine mouthwash in a xerostomic population: a randomized clinical trial.

AIMS & BACKGROUND: Pilocarpine is an accepted treatment for xerostomia, but limited research has been conducted on the oral, topical form. The present study aimed to compare the effects of 1 and 2% pilocarpine mouthwash on xerostomic participants. METHODS: In this double-blind clinical trial study, 48 subjects with xerostomia were randomly divided into three groups to measure the effects of 1 and 2% pilocarpine and placebo mouthwashes on saliva levels. The amount of saliva in the 1st and 14th days was measured at 0, 45, 60, and 75 mins, while participants used their mouthwash three times a day for 14 days. On the 1st and 14th days, they filled out the information forms on xerostomia and the medicine's side effects before and after the intervention. RESULTS: On the 1st day, the mean salivary flow at 45, 60, and 75 mins in the 2 and 1% pilocarpine mouthwash were significantly higher than in the placebo mouthwash group (p < 0.05). On the 14th day, the mean salivary flow time at 45 mins in the 2% pilocarpine mouthwash group was significantly higher than in the placebo mouthwash group (p = 0.007). Furthermore, the mean salivary flow at 60 and 75 mins in the 2% (p < 0.001) and 1% pilocarpine mouthwash (p = 0.028) was significantly higher than in the placebo group. Moreover, the salivary flow in the 2% pilocarpine mouthwash group was significantly higher than the 1% pilocarpine mouthwash (p < 0.05) during these two times. No side effects were observed in any of the subjects. CONCLUSIONS: The study showed that 5 ml of 2 and 1% pilocarpine mouthwash for 2 weeks increased salivary flow in xerostomic participants compared to placebo without any side effects.

Comparison of diagnostic effects of infrared imaging and bitewing radiography in proximal caries of permanent teeth.

This study aimed to compare the diagnostic efficacy of VistaCam iX intraoral camera system using infrared light and bitewing radiography for detection of proximal caries in permanent teeth. This in vitro study was performed on 108 teeth. The proximal surfaces of the teeth were examined for caries using ICDAS II criteria, bitewing radiography, and the Proxi head of VistaCam iX. The teeth were then sectioned and histologically analyzed (gold standard). Data were analyzed using SPSS version 25 via the correlation test at P < 0.05 level of significance. The overall and segmental sensitivity and specificity values were calculated for (1) the contact area and higher regions, (2) below the contact area to the cementoenamel junction (CEJ), and (3) below the CEJ. Radiography had the highest specificity. VistaCam had the highest overall and segmental sensitivity for enamel caries. Radiography had the highest segmental sensitivity for dentin. In region 1, VistaCam had the highest sensitivity and lowest specificity, and radiography and ICDAS II had the highest specificity and lowest sensitivity. In region 2, radiography showed the highest sensitivity and specificity. VistaCam had the lowest sensitivity and ICDAS II had the lowest specificity in this region. In region 3, VistaCam did not detect any caries and radiography had a better performance than ICDAS II. The specificity value was equal for both methods. VistaCam had the highest diagnostic efficacy among the three methods for caries in region 1; however, bitewing radiography had a superior efficacy in regions 2 and 3.

Mast cells density in fibrotic capsule of enchondroma and well-differentiated chondrosarcoma: a method for histopathologic differentiation.

BACKGROUND: An enchondroma is a benign and a well-differentiated chondrosarcoma is an invasive chondroid tumor with high recurrence potential. In spite of biologic differences, these two tumors have very similar histopathologic appearance. It has been shown that the biologic nature of the connective tissue around benign and malignant tumors varies in the number of mast cells. The aim of this study was to study the histopathologic distinction of enchondroma and well-differentiated chondrosarcoma using the density of the mast cells in fibrotic capsule. METHODS: Twelve enchondroma and 15 well-differentiated chondrosarcoma were collected from Pathology department of Cancer Institute and Central Pathology department of Imam Khomeini Hospital in Tehran. 3 micron paraffin embedded tissue sections were stained by toluidine blue for mast cells counting. Mast cells were counted in fibrous capsule of all cases. Mast cells counts were accomplished in 10 high power fields. The average number of mast cells in 10HPF was determined as an index for each lesion. Mann-Whitney U test was used for statistical analysis. RESULTS: Mean index in enchondroma and well-differentiated chondrosarcoma groups were 0.1±0.12 and 0.31±0.33 respectively, showing a significant difference between number of mast cells in the fibrotic capsule in these two lesions (p = 0.028). Comparison of the corresponding points in ROC curve, showed a cut-off point = 0.15, with positive predictive value of 61%, negative predictive value 71%, specificity of 33.3% and sensitivity of 66.7%, (p = 0.025). CONCLUSION: Average density of the mast cells in the surrounding fibrotic capsules of enchondroma and well-differentiated chondrosarcoma along with other criterions, could be a beneficial factor for histologically differentiation between these two lesions.

Perception of Laypeople and Dental Professionals of Smile Esthetics.

OBJECTIVES: This study aimed to assess and compare the perception of laypersons and dental professionals of smile esthetics based on two factors namely gingival display and alignment of teeth. MATERIALS AND METHODS: A total of 32 females were randomly selected among dental students in the International Campus of School of Dentistry, Tehran University of Medical Sciences (Tehran, Iran) with no previous history of esthetic dental work. Frontal photographs were obtained and cropped from the subnasal to menton areas of subjects to standardize the size of pictures. Three series of slides were prepared of the pictures using Microsoft PowerPoint software. The first series of slides were shown to familiarize the observers with the images. The second and third series were displayed for the observers and they were then asked to fill out a questionnaire. The group of observers included 10 dental specialists and 10 laypersons. Each observer was given a visual analog scale (VAS) chart for scoring (1-10). After completion of the questionnaires, data were transferred to a computer and the differences in judgments of professionals and laypeople were analyzed using the Mann Whitney test. RESULTS: No significant difference was found in the judgments of professionals and laypeople on evaluating overall smile esthetics, gingival display and alignment of teeth except for the slide showing a reverse smile arc. CONCLUSIONS: Laypeople and professionals had similar perceptions of smile esthetics. Thus, it appears that clinicians can rely on the judgment of laypersons in esthetic dental treatments.

Effects of 15% carbamide peroxide and 40% hydrogen peroxide on the microhardness and color change of composite resins.

OBJECTIVE: The aim of this study was to determine the effects of 40% hydrogen peroxide and 15% carbamide peroxide on microhardness and color change of a silorane-based composite resin in comparison with two methacrylate-based composites. MATERIALS AND METHODS: Fifty-four disc-shaped specimens (A3 shade) were fabricated of Filtek P90 (P90), Filtek Z350XT Enamel (Z350) and Filtek Z250 (Z250) (3MESPE) (n=18). The samples of each composite were randomly divided into three subgroups of 6. The control subgroups were immersed in distilled water; the test groups were exposed to Opalescence Boost (OB) once; and Opalescence PF (OP) (Ultradent) for two weeks. Vickers microhardness testing and a spectrophotometric analysis of the color of samples were performed before and after each intervention. RESULTS: The baseline microhardness of P90 was significantly lower than that of the other two composites (P=0.001), but no difference was found between Z250 and Z350 in this respect (P=0.293). Bleaching treatments significantly decreased the microhardness of Z250 and Z350 (P< 0.001), but no change was observed in P90 test and control subgroups (P> 0.05). No significant difference was detected between the two types of bleaching (P>0.05). After bleaching with OB, ΔE value was measured to be 3.12(1.97), 3.31(1.84) and 3.7(2.11) for P90, Z250 and Z350, respectively. These values were 5.98(2.42), 4.66(2.85) and 4.90(2.78) after bleaching with OP with no significant difference. CONCLUSION: Bleaching decreased the microhardness of methacrylate-based but not silorane-based composites. Although no significant differences were found in ΔE of composites, ΔE of all groups did not remain in the clinically acceptable range after bleaching except for P90 after bleaching with 40% H2O2 (ΔE < 3.3).

The effect of hydro alcoholic extract of seven plants on cariogenic bacteria--an in vitro evaluation.

AIM: To compare the antibacterial effect of hydro alcoholic extract of Salvia officinalis, Pimpinella anisum, Satureja hortensis, Rhus coriaria, Carum copticum, Mentha longifolia, Achillea millefolium against Streptococcus mutans, Lactobacillus rhamnosus and Actinomyces viscosus through two in vitro methods. METHODS: In this experimental study, hydro-alcoholic extracts have been prepared from the shoot of Salvia officinalis, Satureja hortensis, Mentha longifolia and Achillea millefolium, the seed of Pimpinella anisum and Carum copticum and the fruit of Rhus coriaria with maceration method. Their antibacterial activity against Streptococcus mutans, Lactobacillus rhamnosus and Actinomyces viscosus have been evaluated with broth macrodilution and agar diffusion methods. RESULTS: In Broth macrodilution method MIC (Minimum Inhibitory Concentration) of Pimpinella anisum, Salvia officinalis, Mentha longifolia, Achillea millefolium, Satureja hortensis, Carum copticum and Rhus coriaria for Streptococcus mutans were respectively 12.5, 6.25, 12.5, 50, 50, 12.5 and 50 µg/ml, for Lactobacillus rhamnosus 12.5, 1.56, 3.12, 12.5, 6.25, 6.25 and 6.25 µg/ml and for Actinomyces viscosus 50, 12.5, 100, 50, 100, 25 and 25 µg/ml. In Agar diffusion method Pimpinella anisum, Salvia officinalis and Rhus coriaria against Streptococcus mutans, Pimpinella anisum, Carum copticum and Rhus coriaria against Lactobacillus rhamnosus and Mentha longifolia, Rhus coriaria and Carum copticum against Actinomyces viscosus had antibacterial effects. CONCLUSION: All seven extracts had growth inhibitory effects on all three bacteria. Salvia officinalis had the greatest inhibitory effect on growth of all three bacteria. All of the extracts except Carum copticum had bactericidal effect in the range of concentration. By agar diffusion method Rhus coriaria had antibacterial effect against all three cariogenic bacteria.