Muscarinic cholinergic receptors in minor salivary gland tissues of patients with oral lichen planus: A case-control study.

BACKGROUND: Oral lichen planus (OLP) is a common, chronic immunological and inflammatory condition. Many of the OLP patients complain of xerostomia. The M3 muscarinic cholinergic receptors (MR3) are the main receptors in the salivary glands responsible for water secretion into the saliva. This study aimed to assess the level of M3 muscarinic cholinergic receptors in minor salivary glands of OLP patients. METHODS: This case-control cross-sectional study evaluated 40 OLP patients and 22 controls. All participants completed two questionnaires (xerostomia and xerostomia inventory). Stimulated and unstimulated saliva samples were collected. The saliva flow rate was calculated by dividing the saliva volume (in milliliters) by time (in minutes). Six minor salivary glands were also surgically removed from the lower lip of patients and controls, and weighed using a digital scale with 10-4  g accuracy. They were then frozen at -80°C, and the level of M3 receptors of the glands was determined using the ELISA kit. RESULTS: The unstimulated and stimulated saliva flow rate was significantly lower in OLP patients. The xerostomia inventory score was significantly higher in the OLP group. The level of M3 muscarinic receptors in minor salivary glands of OLP patients was significantly higher than that in controls. CONCLUSIONS: It may be concluded that the reduction in saliva flow significantly increases the number of M3 receptors in an attempt to compensate for this shortage and prevent xerostomia (compensatory upregulation).

Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis.

BACKGROUND: One of the most common causes of hypothyroidism is Hashimoto's Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren's syndrome. MATERIAL AND METHODS: HT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute. RESULTS: Xerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant. CONCLUSIONS: The patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions.

Evaluation of the Effects of Dental Implants on Oral Lesions.

OBJECTIVE: To determine whether dental implants impress oral lesions, and to evaluate the nature of their effect on the lesions. MATERIALS AND METHODS: A comprehensive search was done via Google and PubMed for articles (including case reports and literature reviews) containing the keywords 'oral squamous cell carcinoma' (OSCC), 'oral lichen planus' (OLP), 'lichenoid contact reaction' (LCR), 'osseointegrated implants', and 'dental implants' , in the last 10 years (2002-2012). RESULTS: The study included 24 articles involving patients with dental implants, and some oral lesions (e.g. oral lichen planus and oral squamous cell carcinoma) or with a history of lesions. In these publications, there is evidence suggesting the possibility of emergence, exacerbation, recurrence, or even malignant transformation of the oral lesions after implant placement in some cases. CONCLUSION: Based on our review of the literature, implant treatment does not seem to be completely safe under any circumstances, but may have some complications in subjects with certain diseases (e.g. oral lesions, autoimmune diseases, malignancies, allergic reactions, etc.). Therefore prior to treatment, patients should be fully informed of the risks. CLINICAL SIGNIFICANCE: Implant treatment is best done with caution in patients with cancer or mucocutaneous disorders.

Serum and Saliva MMP-3 in Patients with OLP and Oral SCC.

BACKGROUND: Matrix metalloproteinase-3 (MMP-3) plays a key role in development of cancer. The purpose of this study was to assess MMP-3 in the serum and saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Thirty patients with OLP (8 reticular and 22 erosive forms), and 20 patients with OSCC (6 in low stage and 14 in advanced stage), were enrolled in this study, conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The serum and saliva MMP-3 was assayed by ELISA method. Statistical analysis of the Student's t-test, ANOVA and Pearson correlation coefficient was performed. The mean saliva and serum levels of MMP-3 were significantly higher in patients with OSCC compared with OLP. RESULTS: The serum and saliva MMP-3 concentrations increased from reticular form of OLP to erosive form of OLP, and increased further to low stage of OSCC and advanced stage of OSCC. Serum MMP-3 correlated significantly with unstimulated (r = 0.310, p = 0.038) and stimulated (r = 0.365, p < 0.026) saliva MMP-3. CONCLUSION: Serum and saliva MMP-3 levels appear associated with OLP and OSCC.

Angiofibrolipoma of the retromolar pad region: case report.

Angiofibrolipoma is a rare histopathological variant of lipoma, characterized by mature adipocytes, blood vessels and dense collagenous tissue. It is seldom seen in the oral and maxillofacial region. Diagnosis of angiofibrolipoma is only possible based on its histopathological features. This report presents the case of a 63-year-old male patient with the complaint of a polyp-like mass, felt from the left retromolar pad region. The mass was found as a small prominent lesion that had grown gradually for 1.5 years. Our differential diagnosis was irritation fibroma and fibrous pyogenic granuloma. This report also includes a comprehensive reference to previously reported data, as found through PubMed and Google Search, which revealed this type of case rarely has been documented.

Oral osteosarcoma: a case report and analysis of previously reported cases.

Osteosarcoma is the most common malignancy of mesenchymal cells after hematopoietic neoplasms. Most originate within bones, but the occurrence of this malignancy in the jaw bones is rare. There is controversy about the characteristics of this tumor in the literature. The aim of this paper was to collect the previous reported data and provide a statistical analysis of them. Additionally, we have reported a case of mandibular osteosarcoma.

Unstimulated whole saliva 25-hydroxycholecalciferol in patients with xerostomia in menopausal women.

BACKGROUND AND AIM: The aim of this study was to compare unstimulated whole saliva 25-hydroxycholecalciferol (25(OH)D) in menopausal women with and without oral dryness (OD) feeling, and evaluate the relationship between saliva 25(OH)D and severity of OD feeling. METHODS: A case-control study was carried out on 70 selected menopausal women aged 41-77 years with or without OD feeling (35 as case and 35 as control) conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Unstimulated saliva samples were obtained by expectoration. Xerostomia inventory (XI) score was used as an index of OD feeling severity. The saliva 25(OH)D concentration was measured by ELISA. Statistical analysis of Student's t test and Spearman correlation was used. RESULTS: The mean saliva 25(OH)D level was significantly higher in the case group (897.1 ± 128.9 pg/ml), compared with control (156.7 ± 43.4 pg/ml; P < 0.05). XI score correlated significantly with saliva 25(OH)D concentration (r = 0.457, P < 0.001). CONCLUSIONS: It seems that the level of salivary 25(OH)D concentration may be higher in menopausal women with OD feeling than in the control group, and there is a positive correlation between OD feeling severity and unstimulated whole saliva 25(OH)D.

p53 as a neoplastic biomarker in patients with erosive and plaque like forms of oral lichen planus.

AIM: Unstimulated whole salivary p53 was assessed in patients suffering from erosive and plaque-like form of oral lichen planus (OLP). MATERIALS AND METHODS: Eighteen patients with erosive form, 17 patients suffering from plaque-like form and 38 noninvolvement subjects were enrolled. The unstimulated whole saliva p53 level was assayed by ELISA. RESULTS: The mean concentration of salivary p53 was significantly higher in patients with plaque-like form compared to both patients with erosive form and the control group. CONCLUSION: We conclude that plaque like form of OLP is important in view of the potential for malignancy and is not safety form. CLINICAL SIGNIFICANCE: It seems that all forms of OLP must be considered accurately, should be followed up with biannual examinations, and if possible, assessment of salivary p53 every year.

A torus-like sublingual adenoid cystic carcinoma in a 35-year-old male: Review of literature and case report.

Key Clinical Message: The case report describes an adenoid cystic carcinoma occurring at a rare location and the diagnostic pathway. Swellings of the floor of the mouth, whether painful or without subjective symptoms and regardless of consistency, should be taken seriously. Abstract: Adenoid cystic carcinoma (ADCC) of the sublingual salivary gland only accounts for 2% of all ADCCs. In this study, we report a rare case of ADCC with sublingual salivary gland origin in a 35-year-old man and a comprehensive review of articles published over the past 62 years.

Oxidative stress status and DNA damage in saliva of human subjects with oral lichen planus and oral squamous cell carcinoma.

BACKGROUND: The aim of this study was to evaluate oxidative stress status in the saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). METHODS: Thirty-two patients with OLP, 26 patients with OSCC, and 30 non-involved subjects were enrolled in this study. The study was conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The unstimulated whole saliva malondialdehyde (MDA), as an indicator of lipid peroxidation, the total antioxidant capacity (TAC), and 8-hydroxy-2'-deoxyguanosine (8-OHdG) were assayed by thiobarbituric acid, ferric reducing antioxidant potential (FRAP), and ELISA method, respectively. The TAC/MDA ratio was used as an index of oxidative stress status. Data were analyzed by ANOVA followed by the Tukey's post hoc test. RESULTS AND CONCLUSION: There were no significant differences in saliva TAC and MDA levels between OLP and control, and also between OLP and OSCC patients. MDA and 8-OHdG were significantly higher but TAC was lower in OSCC patients than control. TAC/MDA ratio was significantly lower in patients with OSCC than both OLP patients and control. TAC/MDA ratio was significantly lower but 8-OHdG was higher in patients with OLP compared to control. This suggests that patients with OLP and OSCC are more susceptible to an imbalance of antioxidant-oxidative stress status.

Unstimulated saliva 17ß-estradiol and xerostomia in menopause.

One of the most common oral manifestations of menopause is xerostomia. As gingival tissue is sensitive to changes in the female sex steroids; the aim of this study was to evaluate the relationship between saliva 17ß-estradiol and severity of xerostomia. A case-control study was carried out in 64 selected menopausal women aged 42-75 years with or without xerostomia (32 as case and 32 as control) conducted at the Clinic of Oral Medicine, Tehran university of medical sciences. Xerostomia inventory (XI) score was used as an index of xerostomia severity. The saliva 17ß-estradiol was measured by an enzyme immunoassay kit. The mean unstimulated saliva flow rate and concentration of 17ß-estradiol were significantly lower in case than control. There were significant negative correlation between XI score and unstimulated whole saliva flow rate and also concentration of 17ß-estradiol in menopausal women. It seems that there is a negative correlation between xerostomia severity and saliva 17ß-estradiol in menopausal women.

Relationship of stimulated whole saliva cortisol level with the severity of a feeling of dry mouth in menopausal women.

OBJECTIVES: To evaluate the relationship of stimulated whole saliva cortisol level with the severity of a feeling of dry mouth (DM) in menopausal women. BACKGROUND: A feel of DM is a major complaint for many elderly individuals and strongly associated with the menopause. The exact mechanisms that mediate sensation of DM in menopausal women have not been firmly established. METHODS: A case-control study was carried out on 104 selected menopausal women with/without a feeling of DM, conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia Inventory (XI) score was used as an index of DM severity. Stimulated whole saliva cortisol concentration (stimulated by chewing standard-sized paraffin for 60 s) was measured by ELISA. Statistical analysis by Student's t-test and Spearman correlation was used. RESULTS: The mean cortisol concentration of saliva, but not saliva cortisol output, was significantly higher in the cases than in the controls. There was significant positive correlation between XI score and concentration (r = 0.357, p = 0.000) or output (r = 0.223, p = 0.017) of stimulated whole saliva cortisol. CONCLUSIONS: It appears that stimulated whole saliva cortisol is high in menopausal women with a feeling of DM.

Relationship of serum and saliva calcium, phosphorus and alkaline phosphatase with dry mouth feeling in menopause.

OBJECTIVES: The aim of this study was to compare serum and saliva calcium, phosphorus and alkaline phosphatase of menopausal women with/without dry mouth (DM) feeling. BACKGROUND: The composition of saliva in menopause women with/without DM feeling is different. Some of these differences are in hormones that are related to bone turnover. METHODS: A case-control study was carried out on 60 selected menopausal women aged 45-79 years with or without DM feeling (30 as case, 30 as control), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. The phosphorus concentration was measured by photometrical measurement of the blue colour formed after the addition of ammonium molybdate and stannous chloride; calcium was measured by Arsenazo reaction; and alkaline phosphatase by the pNPP-AMP method. Statistical analysis of Student's t-test was used. RESULTS: The mean serum phosphorus and alkaline phosphatase, stimulated and unstimulated saliva calcium and alkaline phosphatase levels were significantly higher in the menopausal women suffering from DM. There were no significant differences between groups regarding saliva phosphorus and serum calcium concentration. CONCLUSION: Calcium, phosphorus and alkaline phosphatase appear associated with DM feeling in menopause.

Stimulated and unstimulated saliva progesterone in menopausal women with oral dryness feeling.

The aim of this study was to investigate the stimulated and unstimulated salivary progesterone in menopausal women with oral dryness (OD) feeling. A case-control study was carried out on 70 selected menopausal women aged 42-78 years with or without OD feeling (35 as cases with xerostomia and 35 as control without xerostomia), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences (TUMS). Unstimulated and paraffin-stimulated saliva samples were obtained by expectoration. The salivary concentration of progesterone was determined with an enzyme immunoassay kit. Statistical analysis of the Student's t test was used. The mean stimulated and unstimulated whole saliva progesterone concentrations and unstimulated saliva flow, but not stimulated saliva flow rate, was significantly lower in the case than in the control. The results showed that subjects with dry mouth had decreased unstimulated saliva flow and salivary progesterone compared with those without dry mouth. Thus, salivary progesterone level appears associated with OD feeling in menopause.

Unstimulated whole saliva parathyroid hormone in postmenopausal women with xerostomia.

OBJECTIVE: The aim of this study was to evaluate the correlation of xerostomia severity with unstimulated saliva parathyroid hormone (PTH) and to compare unstimulated whole saliva PTH between postmenopausal women with/without xerostomia. METHODS: A case-control study was carried out in 60 (30 as case and 30 as control) selected postmenopausal women with/ without xerostomia conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia inventory (XI) score was also used as an index of xerostomia severity. PTH concentration was analyzed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis of Student's t-test and Spearman correlation was used. RESULTS: The mean unstimulated saliva PTH concentration was significantly higher but flow rate was lower in the case group compared with control. XI score correlated significantly with saliva PTH (r = 0.688, p = 0.001) and flow rate (r = - 0.529, p = 0.001). CONCLUSION: Xerostomia severity correlated positively with unstimulated whole saliva PTH and negatively with saliva flow rate in this group of postmenopausal women. Thus, salivary flow rate and PTH levels appear associated with xerostomia and menopause. CLINICAL SIGNIFICANCE: Salivary PTH level appears to be associated with xerostomia and menopause.

Patch test of dental materials in Oral Lichen Planus with considering the role of saliva.

Lichen planus is the most common skin disease that affects the oral mucosa. Oral Lichen Planus is a T-cell-mediated autoimmune disorder. In the current study, for the first time, an oral cavity condition in skin patch tests with adding saliva is simulated. In addition, the patch results are compared with healthy subjects. Forty-one OLP patients and 63 healthy subjects were enrolled in the study. All participants were provided with patch tests, including allergens, in combination with saliva in chambers. Allergens from the European baseline (standard) series selected according to the most prevalent positive results in the previous study were applied. Positive results of Mercury and Cobalt tests were significantly higher in the case group. In this study, the differentiation of patients with lichen planus and lichenoid was identified according to the Van der Meij & Van der Waal criteria. The patch test was conducted for healthy individuals as well. The most important of all was the use of patients' saliva in the patch test, done for the first time in this field. In the case of OLP, a patch test can help identify positive reactions to dental materials; thus, the replacement of dental restorations may be needed.

In vitro isolation of stem cells derived from human dental pulp.

Stem cells are characterized by the ability to differentiate and to self-renew. Stem cells derived from human dental pulp have been shown to differentiate into osteoblasts serving as a potential source of autologous bone produced in vitro. The purpose of the present study was to isolate mesenchymal stem cells from dental pulp. Dental pulp was gently extracted from 27 intact human permanent third molars of patients aged 18-25. Cow horn forceps were used to isolate intact dental pulp in sterilized condition. The pulps were cultured in a medium containing Dulbecco's modified Eagle's medium-low glucose (DMEM)-LG and Amphotericin 1%. The cells were subsequently expanded by passages, two passages were performed before they were stored in liquid nitrogen for further examination. DMEM + fetal bovine serum (FBS) 10% L-Glutamin 0.1% + Trypsin 2.5% + ethylene diamine tetraacetic acid (EDTA) were used for passage. Light microscope and flow cytometry were used to study the cells. The isolated dental pulp cells expressed mesenchymal stem cell markers. The cells were negative for CD34 and CD31 and CD45 but were positive for CD13, CD44, CD90, CD166, and CD105. These results indicate that dental pulp can be use as a source of stem cells that we can isolate and culture.

Relationship of stimulated saliva 17beta-estradiol and oral dryness feeling in menopause.

OBJECTIVES: The aim of this study was to compare stimulated whole saliva 17beta-estradiol of menopausal women with/without oral dryness (OD) feeling, and evaluate the relationship between saliva 17beta-estradiol and severity of OD feeling. METHODS: A case-control study was carried out in 76 selected menopausal women aged 41-77 years with or without OD feeling (38 as case and 38 as control) conducted at the Clinic of Oral Medicine, Tehran university of medical sciences. Paraffin-stimulated saliva samples were obtained by expectoration. Xerostomia inventory (XI) score was used as an index of OD feeling severity. The saliva 17beta-estradiol concentration was measured by ELISA. Statistical analysis of Student's t-test and Spearman correlation was used. RESULTS: No significant difference was found in stimulated whole saliva flow rate between the two groups, but the mean concentration and output of saliva 17beta-estradiol were significantly lower in case than control. There was significant negative correlation between XI score and stimulated whole saliva concentration (r=-0.391, P=0.004) and output (r=-0.302, P=0.002) of 17beta-estradiol in menopausal women. CONCLUSIONS: It seems that there is a negative correlation between OD feeling severity and stimulated whole saliva 17beta-estradiol in menopausal women.

Correlation of serum and salivary CA15-3 levels in patients with breast cancer.

OBJECTIVES: The aim of this study was to assess the relationship between serum and saliva levels of cancer antigen (CA) 15-3 and to compare them between women with and without breast cancer. STUDY DESIGN: A case-control study was carried out on 61 women aged 28-69 years, including women with and without breast cancer (26 as part of the case study and 35 as part of the control group) conducted at the Emam Khomeini Hospital, Tehran University of Medical Sciences. CA 15-3 levels were assayed in serum and unstimulated whole saliva by EIA. Unpaired t-test, one-way ANOVA and Pearson correlation were used as statistical analysis. RESULTS: The salivary and serological levels of CA 15-3 in the cancer patients were significantly higher (P <0.01) than the salivary and serum levels of healthy controls. They were also higher in stage 2 than in stage 1 in cancer patients. However, the saliva flow rate was significantly lower in the cancer patients (P <0.01). There was a significant positive correlation between serum and saliva CA 15-3 concentration (r = 0.614) and also between serum concentration and saliva output of CA 15-3 (r = 0.541). CONCLUSION: The results of the study suggest that salivary CA 15-3 may have potential use in the initial detection of breast cancer in women.

Correlation of serum and salivary CA125 levels in patients with breast cancer.

AIM: The aim of this study was to examine the relationship between serum and saliva levels of cancer antigen (CA) 125 and compare them among healthy women and patients with treated and untreated breast cancer. METHODS AND MATERIALS: CA125 levels were assayed in serum and unstimulated whole saliva of 25 normal healthy women, 24 patients with untreated breast cancer, and 23 patients with treated breast cancer using enzyme immunoassay (EIA) kits. RESULTS: The mean saliva and serum CA125 levels were significantly higher in untreated cancer women compared to healthy and treated groups. The serum and saliva CA125 levels showed a significant modest positive correlation (r=0.38; p=0.01). CONCLUSION: CA125 level in saliva is higher than in serum with a modest positive correlation between each other. CLINICAL SIGNIFICANCE: Serum and salivary CA125 levels were significantly higher in women with untreated breast cancer than healthy women and women who were treated for breast cancer.