The inhibitory effects of carvacrol, nystatin, and their combination on oral candidiasis isolates.

BACKGROUND: Candida, a common oral microbiota, can cause opportunistic fungal infections. With rising Candida infections and limited effective antifungals, new treatments are needed. This study investigates carvacrol essential oil's effect on oral candidiasis, alone and with nystatin, compared to nystatin alone. MATERIALS AND METHODS: In this study, oral samples were collected from dental clinic patients, especially denture users. The presence of Candida was confirmed and cultured from these samples. Candidiasis was detected by observing Candida colonies. Drug sensitivity was tested on 100 positive samples. The minimum concentration of inhibition and lethality of each isolate was evaluated using nystatin and carvacrol. The results were compared using two-way analysis of variance. Finally, the minimum inhibitory concentration (MIC) of nystatin and carvacrol was calculated individually and in combination. RESULTS: The present study found that Candida albicans and non-albicans species were equally prevalent. Carvacrol showed significant biological activity against all Candida species, with an average MTT of 50.01%. The average MIC value of carvacrol was 24.96 µg/ml, indicating its potential to inhibit Candida growth. The mean Minimum Fungicidal Concentration (MFC) value of carvacrol was 23.48 µg/ml, suggesting its effectiveness in killing the fungi. CONCLUSION: The study's findings reveal that the MIC of carvacrol was significantly lower than that of nystatin and the combination of nystatin and carvacrol. This suggests that carvacrol holds potential as an effective herbal remedy for candidiasis.

Is bruxism associated with temporomandibular joint disorders? A systematic review and meta-analysis.

OBJECTIVES: The aim of this review is to examine and quantify the association between bruxism and temporomandibular joint disorders in a systematic review and meta-analysis. METHODS: Electronic searches were performed in PubMed/Medline, Embase, Cochrane, Wiley, ProQuest, Web of Science, and Scopus databases for articles published up to March 2022. Two independent reviewers assessed the quality of the studies using the Newcastle-Ottawa Scale. A random-effects model was used to estimate the pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) for each study. RESULTS: The search retrieved 1651 studies, and 20 studies were eligible for meta-analysis. The results of the study showed that there is a significant relationship between bruxism and TMD, with the presence of bruxism increasing the odds of TMD by 2.25 times (OR = 2.25, 95% CI (1.94-2.56)). Based on the type of bruxism, awake bruxism was found to increase the odds of TMD by 2.51 times (OR = 2.51, 95% CI: (2.02-2.99)), while sleep bruxism increased the odds of TMD by 2.06 times (OR = 2.06, 95% CI: (1.82-2.30)). Analysis of the results from studies that reported both types of bruxism showed that bruxism increases the odds of TMD by 2.17 times (OR = 2.17, 95% CI: (2.30-3.05)). CONCLUSION: The available data demonstrate a positive relationship between bruxism and TMD, with the presence of bruxism increasing the likelihood of developing TMD in the future.

Salivary anti-cyclic citrullinated peptide as a screening tool for rheumatoid arthritis.

Objectives: This study aims to evaluate the sensitivity and specificity of salivary anti-cyclic citrullinated peptide 3 (anti-CCP3) for the early diagnosis of rheumatoid arthritis. Patients and methods: Between June 2017 and April 2019, a total of 63 patients with rheumatoid arthritis (10 males, 53 females; mean age: 50.4±9.5 years; range, 27 to 74 years) and 49 healthy controls (8 males, 41 females; mean age: 49.3±9.3 years; range 27 to 67 years) were included. Salivary samples were collected by passive drooling. Anti-cyclic citrullinated peptide analyses of salivary and serum samples were performed. Results: The mean polyclonal immunoglobulin (Ig)G-IgA anti-CCP3 salivary levels were significantly different in patients (149.2±134.2) compared to healthy controls (28.5±23.9). The mean polyclonal IgG-IgA anti-CCP3 serum levels were measured as 254.0±169.5 in patients and 3.8±3.6 in healthy individuals. The diagnostic accuracy analysis of salivary IgG-IgA anti-CCP3 results in an area under the curve (AUC) of 0.818, as well as 91.84% specificity and 61.90% sensitivity. Conclusion: Salivary anti-CCP3 may be considered as an additional screening test for rheumatoid arthritis.

The relation between serum levels of interleukin 10 and interferon-gamma with oral candidiasis in type 2 diabetes mellitus patients.

BACKGROUND: Type 2 Diabetes mellitus (T2DM) is one of the most common endocrine diseases that weakens the immune system. Candida albicans, is part of the natural oral flora and increases in cases of compromised immune systems. The exact cause of the increased prevalence of candidiasis in patients with T2DM is still unclear. The study aimed to correlate serum interleukin 10 (IL-10) and interferon-gamma cytokines (IFN-γ) with oral candidiasis in T2DM. METHODS: In this case-control study, 81 patients with T2DM and 41 non-diabetic individuals aged 30 to 70 years participated. Demographic information, a Blood sample (for blood glucose and cytokine tests), and an oral cotton swab sample from each individual were obtained. The samples were then incubated in a Sabroud dextrose agar medium. Colony growth was calculated and the type of yeast species in individuals with oral candidiasis was identified by culture in CHROMagar Candida medium. IL-10 and IFN-γ were measured by ELISA kit and the data were analyzed using SPSS-18. RESULTS: An overall of 122 participants comprised 73.77% females and 26.22% males. An increase in interleukin-10 by 40% and a decrease in IFN-γ by 6% can increase oral candidiasis prevalence among diabetic patients. Candida albicans was the most prevalent Candida species (spp.) in the diabetic and non-diabetic groups. The presence of oral candidiasis was not associated with HbA1c or FBS levels in both groups. CONCLUSION: In the diabetic population, an increase in IL-10 or a decrease in IFN-γ may be associated with an increased risk of oral candidiasis.

Serum and salivary tissue transglutaminase IGA (tTG-IGA) level in celiac patients.

BACKGROUND: Celiac disease (CD) is a genetically determined autoimmune disease triggered by gluten consumption. Patients with these conditions have intraepithelial lymphocytosis, crypt hyperplasia, and severe intestinal atrophy. Gluten elimination is the only way to reduce this chronic inflammation. The diagnosis of CD is usually made by analyzing anti-tTG, anti-DGP, or EMA serological tests, and it is confirmed by biopsy of the duodenum. In people with CD, xerostomia or dry mouth is a common complication. This condition causes the salivary glands to malfunction and, in turn, may result in oral plaque and periodontal disease. By comparing salivary and serum levels of tissue transglutaminase IgA (tTG-IgA), this study aims to suggest a non-invasive method for diagnosis of CD. Furthermore, the present study evaluates the severity of xerostomia symptoms in people with CD. METHODS: In this case-control study, participants were patients referred to the internal ward of Sayyad Shirazi hospital. The control group was selected from healthy people who attended Gorgan Dental College. In this study, an analysis of serum was performed following consent from patients. This was followed by a salivary test, and the results of both tests were compared. The Xerostomia Inventory questionnaire was also used to determine the severity of xerostomia. As part of this study, examination of factors such as total protein concentration of saliva, albumin concentration, amylase level, pH, sodium, calcium, potassium, phosphorus, and interleukin (6, 18, and 21) were conducted. RESULTS: A total of 78 people were studied (aged 15 to 68), 26 were male (33.3%) and 52 were female (66.7%). In comparisons of the serum and saliva of people with and without CD, the level of amylase was higher in the latter group. The average levels of IL-6، IL-18 ،IL-21, and salivary and serum tTG were higher in people with CD. Additionally, CD patients were more likely to develop xerostomia. CONCLUSION: Study findings showed that CD can reduce certain salivary enzymes and elements, as well as increase inflammatory cytokines, salivary, and serum tTG. The management of dry mouth should also be recommended for celiac disease patients in order to prevent its complications.

Personality traits and anxiety in patients with temporomandibular disorders.

BACKGROUND: Temporomandibular disorders (TMD) have long been suggested to result from psychological factors. Recent studies, however, tend to consider TMD a chronic psychosomatic illness. The present study was designed to explore the association between TMD and personality profile. The Minnesota Multiphasic Personality Inventory-2-Reconstructed form (MMPI-2-RF) was used to evaluate the association for the first time. METHODS: A total of 258 subjects participated in this case-control study. TMD cases as detected by the Helkimo index were questioned regarding their personality characteristics and anxiety levels using MMPI-2-RF and Spielberger state and trait anxiety inventory. RESULTS: Patients with TMD scored higher on all personality characteristics except for Aberrant Experiences. The psychological profile of TMD showed no significant difference between theoretical and experimental Ideas of Persecution means. Patients with TMD reported significantly higher mean levels of state and trait anxiety than controls. The most frequently found anxiety levels in TMD cases have been mild state and trait anxiety (77.5% versus 74.4%). CONCLUSION: Personality characteristic scores were considerably higher in TMD patients. TMD cases detected by Helkimo index manifest both trait and state anxiety as common findings.

COVID-19 prognostic modeling using CT radiomic features and machine learning algorithms: Analysis of a multi-institutional dataset of 14,339 patients.

BACKGROUND: We aimed to analyze the prognostic power of CT-based radiomics models using data of 14,339 COVID-19 patients. METHODS: Whole lung segmentations were performed automatically using a deep learning-based model to extract 107 intensity and texture radiomics features. We used four feature selection algorithms and seven classifiers. We evaluated the models using ten different splitting and cross-validation strategies, including non-harmonized and ComBat-harmonized datasets. The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were reported. RESULTS: In the test dataset (4,301) consisting of CT and/or RT-PCR positive cases, AUC, sensitivity, and specificity of 0.83 ± 0.01 (CI95%: 0.81-0.85), 0.81, and 0.72, respectively, were obtained by ANOVA feature selector + Random Forest (RF) classifier. Similar results were achieved in RT-PCR-only positive test sets (3,644). In ComBat harmonized dataset, Relief feature selector + RF classifier resulted in the highest performance of AUC, reaching 0.83 ± 0.01 (CI95%: 0.81-0.85), with a sensitivity and specificity of 0.77 and 0.74, respectively. ComBat harmonization did not depict statistically significant improvement compared to a non-harmonized dataset. In leave-one-center-out, the combination of ANOVA feature selector and RF classifier resulted in the highest performance. CONCLUSION: Lung CT radiomics features can be used for robust prognostic modeling of COVID-19. The predictive power of the proposed CT radiomics model is more reliable when using a large multicentric heterogeneous dataset, and may be used prospectively in clinical setting to manage COVID-19 patients.

Topographic Features of Five K-file Brands in Iranian Market: A Scanning Electron Microscopic Study.

INTRODUCTION: Endodontic files which are used to clean and shape the root canal space differ from each other regarding technical specifications. Recently, K-type files are repeatedly studied on their cutting efficiency. This study aims to evaluate the tip design and cutting efficiency of 5 brands of K-files, available in Iran dental market (naming Dentsply, Thomas, Mani, Perfect and Larmrose). METHODS AND MATERIALS: In this descriptive study, topographic features of file tips were investigated by the scanning electron microscope (SEM). Those features included tip symmetry, tip design, tip angle, and the distance from the tip to the lowest flute. SEM images (×250 magnification) of files were prepared. Statistical tests (Fisher's exact test, Chi-square, ANOVA, and t test) were used and P<0.05 was considered as significant. RESULTS: Dentsply files had the most number of morphologically pyramidal sharp tips and the greatest tip angles. However, Larmrose files were the most frequent files having cutting sharp tips. Symmetrical tips existed among 100% of Dentsply and Mani brands. No significant differences were found with respect to distance from the file tip to the lowermost flute between different file brands of this study (P=0.2, One way ANOVA). CONCLUSION: Dentsply and Mani files possessed the most symmetrical tips and greatest tip angles. With respect to tip length, all 5 brands were satisfactory. However, neither of 5 brands evaluated topographically were outstanding in every aspect.

Evaluation of the Prevalence of Temporomandibular Joint Involvement in Rheumatoid Arthritis Using Research Diagnostic Criteria for Temporomandibular Disorders.

OBJECTIVES: Temporomandibular joint (TMJ) disorders, known as TMDs, are significant public health problems and may result in pain and disability. In order to determine the prevalence of clinical/subjective TMD in rheumatoid arthritis (RA), we used the research diagnostic criteria (RDC)/TMD axes. We assessed the anti-cyclic citrullinated protein (anti-CCP)-related TMD in RA for the first time. MATERIALS AND METHODS: Fifty-two RA patients were compared to 47 healthy controls with regard to complete blood count (CBC), serology, acute phase reactants (APR), and TMJ dysfunction. RESULTS: The anti-CCP antibody showed a significant correlation with the development of clinical TMD (P=0.001, 95% confidence interval (CI)=12.4%-35.6%). A prevalence of 50% was calculated through the RDC/TMD for such disorders. In RA patients, statistically significant differences were observed between the groups with and without clinical TMD regarding psychological depression and physical symptoms. CONCLUSIONS: According to the results, a significant correlation was found between the anti-CCP antibody and TMD. Therefore, when this antibody is detected in the blood serum, the treatment must be initiated. The RDC/TMD used in this study assessed the prevalence of TMJ dysfunction in conformity with RA-associated TMJ findings previously obtained through other conventional methods.

Salivary oxidative stress in oral lichen planus treated with triamcinolone mouthrinse.

BACKGROUND: Total antioxidant capacity (TAC) and malondialdehyde (MDA) levels have not been reported in oral lichen planus (OLP) patients treated with a topical corticosteroid. This study evaluates TAC and MDA levels in unstimulated saliva of OLP patients. Such measurements may need to be supported by clinical observation. MATERIALS AND METHODS: Twenty patients with OLP participated in a study conducted at the Department of Oral Medicine, Tehran University of Medical Sciences. Salivary TAC and MDA were determined by biochemical analyses before and after 5-week triamcinolone acetonide (0.2%) mouthrinse treatment. Subjective symptoms as well as lesion status pre- and post-treatment were measured using visual analog scale (VAS) and clinical scoring system, respectively. Wilcoxon signed rank test was used for the evaluation of MDA and TAC parameters, VASs, and rates of clinical scores. Spearman's rank correlation was used to determine the relationship between different variables. RESULTS: A statistically significant increase in salivary TAC was found after treatment. There was no significant difference in the reduction of salivary MDA levels in OLP patients after treatment. CONCLUSION: Posttreatment analyses revealed a significant degree of recovery and pain relief of OLP lesions. Hence, triamcinolon mouthrinse by reducing oxidative stress is an appropriate treatment in OLP patients.

Palisaded Encapsulated Neuroma of the Tongue Clinically Mimicking a Pyogenic Granuloma: A Case Report and Review of Literature.

Palisaded encapsulated (solitary circumscribed) neuromas (PENs) are relatively common intraoral neurogenic tumors, which occur most frequently on the hard palate. Herein, we describe the clinicopathological characteristics of a palisaded encapsulated neuroma of the tongue. This tumor was an exophytic sessile mass measuring 0.3× 0.4 cm with rubbery consistency on the anterior one-third of the dorsum of the tongue. The tumor was excised under the impression of a pyogenic granuloma (PG). No recurrence was reported at 12 months postoperatively. Histopathological examination showed a well-circumscribed mass that composed of interlacing fascicles of spindle cells. The cells were S-100 positive. The nuclei, showing parallel orientation within the fascicles, were wavy and pointed and showed no sign of mitotic activity. Giemsa staining revealed no mast cells within the stroma.

Prophylactic intraligamentary injection of piroxicam (feldene) for the management of post-endodontic pain in molar teeth with irreversible pulpitis.

The purpose of this prospective research was to evaluate the post-endodontic pain-reducing effect of piroxicam (feldene), a non-selective non-steroidal anti-inflammatory drug. Pain following endodontic treatment is often linked to the inflammatory process as well as additional central mechanisms. The effects of intraligamentary injection of piroxicam have not previously been studied. Sixty-five patients with irreversible pulpitis were randomly divided into two groups. The active group received intraligamentary injections totalling 0.4 mL of piroxicam, while the placebo group received the same amount of lidocaine. One-appointment endodontic therapy was performed by a single endodontist. Visual Analogue Scale was used to record pain before treatment and 4, 8, 12, 24 and 48 h postoperatively. The decrease in the intensity of post-treatment pain between the two groups was very significant. Intraligamentary injection of piroxicam can be considered an effective method for reducing post-endodontic pain.