Correlating Salivary Levels of Immunoglobin E and Human Eosinophil Cationic Protein in the Aseer Cohort with Recurrent Apthous Stomatitis.

Background: Repeated Aphthous Stomatitis (RAS) is the most prevalent inflammatory disorder of the oral mucosa, characterized by recurrent emergence of single or numerous painful ulcers. RAS usually affects healthy people without systemic illnesses. There is evidence linking atopy to the progression of this illness. Immunoglobulin E (IgE) and human eosinophil cationic protein (HECP) levels in the saliva of individuals with aphthous stomatitis were assessed as allergy-related indicators. Materials and Methods: Sixty people were assessed for this study. 30 patients with RAS were included in the patient group, while 30 healthy individuals made up for the control group. Sixty participants' non-stimulated saliva was taken and IgE and HECP were evaluated using enzyme-linked immunosorbent assay (ELISA). Data were analyzed in SPSS 20 through the Mann-Whitney test and p<0.05 was considered significant. Results: The salivary level of HECP was significantly (p 0.05) higher among cases (0.83 0.70) compared to controls (0.170 0.15), whereas the salivary level of IgE was not significantly (p = 0.41) higher among cases (35.60 11.19) compared to controls (67.42 18.34). Conclusion: Even though this study found a positive correlation between elevated HECP levels and RAS, additional research with larger sample sizes is required to identify the biological mechanisms responsible for the observed associations and to include salivary HECP levels in the RAS patient's evaluation.

Antioxidant effect of spirulina in chronic periodontitis.

BACKGROUND: Production of reactive oxygen species (ROS) by polymorpho nuclear neutrophils occurs in chronic periodontitis. These ROS are mainly involved in bacterial destruction. However, extracellular release of same results in destruction of surrounding tissue. Spirulina, a potent antioxidant when administered sub gingivally in pockets can offer improved results in chronic periodontitis patients. This study was conducted to evaluate the effect of Spirulina when delivered sub gingivally in patients with chronic periodontitis. METHODS: Sixty chronic periodontitis patients were divided into 2 groups. Group I (n = 30) were treated with Scaling and Root planning (SRP) followed by placement of placebo (SRP-P) and in Group II (n = 30) Spirulina microspheres were placed sub gingivally (SRP-S) following SRP. Clinical parameters like bleeding on probing (BOP), clinical attachment level (CAL), gingival index (GI) and probing pocket depth (PPD) were evaluated. Levels of salivary and serum Malondialdehyde (MDA) were estimated using ultra violet spectrophotometer. RESULTS: At baseline, in both groups there was no statistically significant difference in clinical and biochemical parameters. Intra group comparisons of parameters from baseline to 90 days were statistically significant in both groups. After 90 days difference in clinical parameters and salivary MDA levels were statistically significant in SRP-S compared to SRP-P group. Though serum MDA levels were reduced in both groups, they were not significant statistically. CONCLUSIONS: Our study concluded that, local drug delivery of Spirulina adjunctive to SRP has potent antioxidant effect in treatment of chronic periodontitis.

Mucoepidermoid Carcinoma of Minor Salivary Gland in a Patient with Asymptomatic Palatal Swelling - A Case Report.

Incidence of abundant minor salivary gland tissues in the posterior part of hard palate surges the likelihood of salivary gland neoplasm especially in this part of the oral cavity. Minor salivary gland tumor accounts for virtually 15% of all the salivary gland neoplasm, wherein mucoepidermoid carcinoma comprises of 35.9%. Current paper reports a case of mucoepidermoid carcinoma of the posterior part of the hard palate which was an incidental finding. It presented as well-defined smooth swelling, the preliminary radiographic investigation revealed no appreciable bony changes and offered an impression of a benign tumor. Histopathological investigation displayed features of mucoepidermoid carcinoma of intermediate grade. The lesion was surgically excised and the patient was under regular follow up for 3years. The paper focus on the magnitude of swift clinical diagnosis of specific lesions, so increasing the survival rate and reducing the morbidity.

Anxiety and Depression Among Dentists in the Kingdom of Saudi Arabia.

Purpose: Dentists face a great deal of professional stress, in dental school and in practice. Their personal, as well as professional lives, get affected negatively by stress and poor mental health. This study aims to evaluate anxiety and depression among dentists of Abha in kingdom of Saudi Arabia. Materials and Methods: A cross-sectional study was carried out among 246 registered dentists of Abha to assess anxiety and depression. Participants willing to participate, and completely filled questionnaire were included in study. Data regarding demography, work-related characters, lifestyle and self-reported physical and mental status were collected. Mental status was measured by using pre validated questionnaire Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). Data were analyzed using Statistical Package for Social Sciences (SPSS 20) by IBM. Descriptive statistics, Pearson correlation, independent t test and one way ANOVA were used to analyze the data at the significant interval of p≤0.05. Results: Different levels of anxiety and depression were noticed both in males and female dentist. There was no statistical difference in the mean scores between males and females. There was a statistical difference of anxiety and depression scores noticed among dentist working in government institution, with five to ten years of experience. Habits of smoking were shown to significantly affect the risk of anxiety and depression scores. Conclusion: Dentist due to nature of the practice are prone for anxiety and clinical depression. Stress coping methods should be included in dental curriculum which would indirectly improve professional abilities and personal life.

Oral Hygiene Myths and its Association with Gingival Health Status among Patients in Aseer Region of Saudi Arabia: A Cross-sectional Study.

AIM AND OBJECTIVE: The aim of the study is to assess "Myths in dentistry related to Oral Hygiene and its association with Gingival Health Status among patients visiting Institutional diagnostic clinic in Aseer region of Saudi Arabia." MATERIALS AND METHODS: The present study was a cross-sectional study done on 152 subjects attending Institutional diagnostic clinic in Aseer region Saudi Arabia. Myths in dentistry related to oral hygiene were assessed by using a ten-item, multiple-choice, close-ended structured questionnaire and Gingival Health Status was assessed using gingival index described by Loe and Silness on the Ramfjord teeth. For the comparison of proportions, a Chi-Square test was used with continuity correction whenever appropriate. "p" value of <0.05 was taken to be statistically significant for the purpose of analysis. RESULTS: A total of 152 study subjects were included in the study, of which 60.5% were males and the rest 39.5% were females. Eighty-two percent of the study subjects believed that myths do affect the oral hygiene of the person. Combinational use of household ingredients (like apple vinegar, turmeric, lemon, baking soda, coal, honey, and sodium bicarbonate) was seen among 40% of the subjects. A majority of 48% learned from family as a source of information and 53% believed that use of household ingredients would improve the esthetical value (bleaching) of the tooth. Eighty-two percent of the study subjects believed that myths do affect the oral hygiene of the person. 40.8% had some form of gingival health problem. There was no statistically association observed between myths in dentistry related to oral hygiene and gingival health. CONCLUSION: The present study revealed that myths in dentistry related to oral hygiene are quite prevalent in society. The use of household ingredients can influence oral health status and one has to ensure the judicious use if good oral health is to be expected. CLINICAL SIGNIFICANCE: Myths in dentistry related to oral hygiene can influence a lot on oral health and this can augment the health of the individual in any direction. So as a responsible clinician, it is very important to address these issues and bring in more health awareness among the study population to achieve the social goal-"health for all." How to cite this article: Assiri KI, Ajmal M, Al-Ahmari BM, et al. Oral Hygiene Myths and its Association with Gingival Health Status among Patients in Aseer Region of Saudi Arabia: A Cross-sectional Study. J Contemp Dent Pract 2021;22(5):506-510.

Recombinant Human Adenovirus-p53 Therapy for the Treatment of Oral Leukoplakia and Oral Squamous Cell Carcinoma: A Systematic Review.

Background and Objectives: Oral cancer is the 6th most common cancer in the world and oral leukoplakia is an oral potentially malignant disorder that could develop into oral cancer. This systematic review focusses on randomized clinical trials for recombinant adenovirus p-53 (rAD-p53) therapy for the treatment of oral leukoplakia and cancer. Materials and Methods: We searched for research articles on various databases such as Pubmed/Medline, Embase, CNKI (China National Knowledge Infra-structure), Springerlink, cochrane and Web of sciences from 2003 to 2020. MeSH (Medical Subject Headings) terms were used for the search. Inclusion criteria included original research, randomized clinical trials and articles only in English language. Exclusion criteria were any articles that were not research articles, not randomized trials, non-human studies, etc. The articles were further graded on the Jadad scale. Results: 578 articles were assessed from various databases; only 3 articles were found to be appropriate for this review. Thus, meta-analysis was not performed because of heterogeneity and lack of data. In the three studies, whether rAD-p53 was used as a standalone therapy or with other therapies, there was a beneficial effect of the therapy. Furthermore, there were no serious adverse events and the only adverse events reported were fever, pain at the local injection site, flu-like symptoms and lowered WBC count. Conclusions: Thus, we can conclude that this therapy has a potential for beneficial therapeutic effects and further clinical trials with more patients need to be performed to get better understanding of the effect of rAD-p53 therapy, which probably will pave the way to its approval in other parts of the world.

Drug induced oral erythema multiforme: Case report.

INTRODUCTION: Drug induced oral erythema multiforme a rare clinical entity which involves only the lips and oral mucosa without skin involvement. These lesions are difficult in diagnosing with other oral ulcerative lesions with similar clinical manifestations. PATIENT CONCERNS: This article presents 2 case reports of Oral erythema multiforme in which drugs were the precipitating factor. Its etiopathogenesis, differential diagnosis and treatment modalities of the disease is discussed. DIAGNOSIS: Based on patient's complaints, drug history and clinical appearance, provisional diagnosis of drug induced erythema multiforme was considered. INTERVENTION: For case 1, patient was instructed to discontinue usage of drug and prescribed systemic steroid (Prednisolone 10 mg/d) for a week along with germicidal drugs to prevent secondary infection. Medication was tapered to 5 mg/d after first week.For case 2, patient was instructed to discontinue the drug and systemic steroid prednisolone 20 mg /d for 1 week with tapering dose of 10 mg/d for the second week was administered. OUTCOME: For case 1 and case 2 healing of the lesions were evident on third week of follow up. CONCLUSION: Medications should be taken under medical supervision. Over the counter drugs might lead to allergic reactions like drug induced oral erythema multiforme, which is a rare variant and needs to be differentiate from other oral ulcerative lesion for prompt management and follow-up.

Proteomic profiling of various human dental stem cells - a systematic review.

BACKGROUND: The proteomic signature or profile best describes the functional component of a cell during its routine metabolic and survival activities. Additional complexity in differentiation and maturation is observed in stem/progenitor cells. The role of functional proteins at the cellular level has long been attributed to anatomical niches, and stem cells do not deflect from this attribution. Human dental stem cells (hDSCs), on the whole, are a combination of mesenchymal and epithelial coordinates observed throughout craniofacial bones to pulp. AIM: To specify the proteomic profile and compare each type of hDSC with other mesenchymal stem cells (MSCs) of various niches. Furthermore, we analyzed the characteristics of the microenvironment and preconditioning changes associated with the proteomic profile of hDSCs and their influence on committed lineage differentiation. METHODS: Literature searches were performed in PubMed, EMBASE, Scopus, and Web of Science databases, from January 1990 to December 2018. An extra inquiry of the grey literature was completed on Google Scholar, ProQuest, and OpenGrey. Relevant MeSH terms (PubMed) and keywords related to dental stem cells were used independently and in combination. RESULTS: The initial search resulted in 134 articles. Of the 134 full-texts assessed, 96 articles were excluded and 38 articles that met the eligibility criteria were reviewed. The overall assessment of hDSCs and other MSCs suggests that differences in the proteomic profile can be due to stem cellular complexity acquired from varied tissue sources during embryonic development. However, our comparison of the proteomic profile suffered inconsistencies due to the heterogeneity of various hDSCs. We believe that the existence of a heterogeneous population of stem cells at a given niche determines the modalities of regeneration or tissue repair. Added prominences to the differences present between various hDSCs have been reasoned out. CONCLUSION: Systematic review on proteomic studies of various hDSCs are promising as an eye-opener for revisiting the proteomic profile and in-depth analysis to elucidate more refined mechanisms of hDSC functionalities.

Assessment of Oral-Systemic Disease Association amongst Dental Patients: A Retrospective Panoramic Radiographic Study.

AIM: The association between oral health and overall health has been broadly documented in the past few years and is supported by a rapidly growing body of evidence. Interventional studies were able to establish a linkage between dental intervention and its influence on medical situations. This study tried to determine whether the overall health of a subject may be correlated to radiographically noticeable dental pathology. There was a need to test a null theory of whether subjects having good oral health state had fewer systemic illnesses. MATERIALS AND METHODS: This was a retrospective panoramic radiographic study of 400 radiographs of 200 women and 200 men. Subjects were divided into a control group of subjects with no medical history, and a second group with patients who had presented with a medical history. A panoramic radiograph was observed for periapical radiolucency, caries, remaining teeth, remaining root, horizontal, and vertical bone loss. The oral index (OI) was calculated and correlated with the medical status of the patient. RESULTS: Men demonstrated a higher incidence of horizontal bone loss and missing teeth. On the contrary, women showed higher incidences of vertical bone loss, compromised periapical index, and a greater number of root canal treated teeth. Patients having a medical history had a significant percentage of the increased number of periapical lesions, tooth loss, poor quality root canal treatment, and periapical index. Patients with both diabetes mellitus (DM) and hypertension [HTN (61.3%)], anemia (75%), prostate disease (100%), and disabilities such as hearing impairment and mental retardation (100%) had significantly higher percentages of the bad OI. CONCLUSION: Most patients with medical history demonstrated a significantly poor OI than those with no medical history. The present research contributes to scientific works by probing the relationship between oral health and the overall well-being. Increasing the sample size and interventional studies are needed as an extension of the current research. CLINICAL SIGNIFICANCE: Panoramic radiograph is commonly practiced as a screening radiograph in a dental setup. By calculating an OI of each patient based on certain dental conditions, it can help in revealing the burden of medical diseases on oral health and vice versa.

Monostotic Fibrous Dysplasia Involving the Mandible: A Case Report.

Fibrous dysplasia (FD) is a skeletal developmental anomaly, which is non-hereditary and idiopathic in origin. It is characterized by the replacement of normal bone with the excess proliferation of fibrous tissue in irregular bony trabeculae. Patients might complain of swelling, pain, or numbness on the affected side. The incidence of monostotic FD (MFD) is four times more than that of polyostotic fibrous dysplasia. In MFD, the maxilla is more commonly affected than the mandible. The clinical behavior and rapid progression of FD renders the treatment challenging. The malignant potential is 0.5% for untreated cases. Here, we present a case of FD involving the mandible. The clinical diagnostic approach, different imaging modalities, and histological examination methods for definitive diagnosis have been elaborated.

Correlation of Buccal Micronucleus with Disease Activity Score Using Buccal Micronucleus Cytome Analysis (BMCA) in Systemic Lupus Erythematosus.

BACKGROUND: A disease activity score obtained by using systemic lupus erythematosus disease activity index (SLEDAI) has traditionally been a reliable method to assess the SLE status of patients. More recently, a buccal micronucleus cytome assay (BMCA) has been developed for use as a biomarker of DNA damage in patients with SLE. There has been a very limited number of studies pertaining to the oral lesions in Arab population suffering from SLE in Asir region. Hence, it became utmost important to study epidemiological data of oral mucosal lesions in SLE patients. Distribution of oral lesions in SLE patients could also be helpful in better management of oral complications. AIM: The aim of this study was to determine the existence of a correlation between SLEDAI score and the degree of micronuclei (MN) formation using BMCA. MATERIALS AND METHODS: After thorough oral examination of adult Saudi SLE patients of Asir hospital and that of healthy control subjects, the subjects underwent BMCA from normal unaffected bilateral buccal mucosae. RESULTS: Pearson's correlation test showed that MN count did not significantly correlate with either disease activity or duration of SLE. CONCLUSIONS: Controlled state SLE does not lead to a significant increase in MN formation. Thus, the occurrence of premalignant lesions in the oral cavity could be minimized using proper management protocols.

Evaluation of Clinical and Radiographic Parameters as Dental Indicators for Postmenopausal Osteoporosis.

PURPOSE: In the early stages, osteoporosis is relatively a silent disease characterised by low bone density with microarchitectural deterioration of the bone tissue leading to enhanced bone fragility. The objective of this study was to evaluate the relationship between age, body mass index, oral signs, and osteoporosis among postmenopausal women. MATERIALS AND METHODS: The study included postmenopausal women who were divided into two groups of subjects. The osteoporotic group comprised 30 patients with osteoporosis who were diagnosed using dual-energy X-ray absorptiometry, and the non-osteoporotic group (control group) comprised 30 subjects with no evidence of osteoporosis. Panoramic radiography was performed, followed by the acquisition of two direct digital intraoral periapical radiographs from the mandibular premolar-molar region. RESULTS: Chi-square test revealed a statistically significant difference (p = 0.001) in the mandibular cortical shape index between the two groups. However, a statistically non-significant difference in cortical width, the panoramic mandibular index, mandibular alveolar bone resorption degree, fractal dimension, and mean number of teeth was found between the two groups. A statistically significant difference was observed in the mean age between the osteoporotic and non-osteoporotic groups. CONCLUSION: The mandibular cortical index findings (MCI) on panoramic radiograph are effective indicators of osseous changes in postmenopausal osteoporosis, thereby determining early prediction of osteoporotic fracture risk and reducing its related morbidity.

Monoradicular primary mandibular first molar: A rare case in Aseer Province of Saudi Arabia.

Morphological variations can occur in primary and permanent teeth. Genetic and environmental factors could be responsible for various dental anomalies. Anomalous teeth are usually asymptomatic and are diagnosed during routine oral examination. These anomalies may increase caries susceptibility and complicate dental treatment procedures such as extraction or root canal treatment. We report a rare case of mandibular first molar with a single root and a root canal.

Oral hygiene practice and periodontal status among two tribal population of Telangana state, India- an epidemiological study.

BACKGROUND: The tribes of India have poor periodontal health status due to their isolation, awareness and less accessibility to dental resources. They follow traditional methods of oral hygiene practice, which are found to be inadequate and inaccurate to maintain their good oral health. This study aims to assess the oral hygiene practice, oral hygiene and periodontal status of two tribes residing in Bhadrachalam, Telangana, India. METHODS: Based on accessibility the two tribes Koya and Lambada were included in the study. The total study population consisted of 1000 subjects, with 500 subjects in each group. Using a preformed proforma the oral hygiene practices were recorded for two groups and oral examination was done using Oral Hygiene Index (OHI-S) index and Community Periodontal Index (CPI). RESULTS: The OHI-S ranged between 2.5-3.0 in both the groups. The CPI index scores showed that sextants with calculus, shallow pockets, deep pockets and loss of attachment of 4-5 mm were significantly present in both groups. CONCLUSION: To conclude, though practice of poor oral hygiene and compromised periodontal status was seen among both groups. However, it was more prevalent in Koya. Under these circumstances, implementation of a basic awareness of oral health care programme for these tribes should be a high priority.

Hypericum perforatum (St. John's Wort) as a possible therapeutic alternative for the management of trigeminal neuralgia (TN) - A case report.

Hypericum perforatum (St. John's Wort) is an alternative remedy used primarily for depression but also is used for rheumatism, gastroenteritis, headache and neuralgias. The mechanism of action of Hypericum perforatum comprehends a neurotransmitter inhibitory profile, and potential anti-inflammatory and anti-oxidant effects suggesting a role for pain management. In this case report, we describe a 53-year-old Hispanic female patient who came to our orofacial pain clinical service presenting with a history of trigeminal neuralgia (TN). The patient was not able to get an appointment soon enough and decided to take an over the counter homeopathic preparation of Hypericum perforatum since she found on the internet that it was effective for nerve pain. The patient responded dramatically to the Hypericum perforatum preparation. The use of this homeopathic preparation relieved completely the TN pain. The management of TN is often a challenge. Hypericum perforatum may be a promising therapeutic option for TN that deserves to be explored further to solidly support its use in the clinical setting.

Age estimation using third molar teeth: A study on southern Saudi population.

OBJECTIVE: To estimate the age of an individual between 13 and 23 years, using Demirjian method in Saudi male patients in the southern region of the Kingdom of Saudi Arabia. MATERIALS AND METHODS: A total of 360 male patient's digital panoramic radiographs were used to evaluate the morphology of mandibular 3rd molar teeth roots according to the Demirjian method. Using descriptive statistical method, age was calculated. RESULTS: Result showed a strong relation of age with stages of root development of 3rd molar teeth. The standard deviation of mean of root development stages is 1.47 years of age. CONCLUSION: This study suggests that age can be predicted with a statistical significant result for ages between 13 and 23. Further studies with large population are needed for better statistical results and for female age assessment.