Salivary level of microRNA-146a and microRNA-155 biomarkers in patients with oral lichen planus versus oral squamous cell carcinoma.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa, which has potential for malignant transformation. MicroRNAs play an important role in immunopathogenesis of OLP, and may be used for prediction of its malignant transformation. This study aimed to assess the salivary level of microRNA-146a and microRNA-155 biomarkers in patients with OLP and oral squamous cell carcinoma (OSCC). METHODS: In this case-control study, unstimulated saliva samples were collected from 60 patients, including 15 patients with dysplastic OLP, 15 OLP patients without dysplasia, 15 patients with OSCC, and 15 healthy controls according to the Navazesh technique. After RNA extraction, the expression of microRNA-146a and microRNA-155 was quantified by real-time quantitative polymerase chain reaction (RT-qPCR). The data were analyzed by the Kruskal-Wallis and Dunn-Bonferroni tests. RESULTS: The difference in expression of microRNA-146a and microRNA-155 among the four groups was significant (P < 0.05). Pairwise comparisons of the groups showed significantly higher expression of microRNA-146a in OLP (P = 0.004) and dysplastic OLP (P = 0.046) patients compared with the control group. Up-regulation of this biomarker in OSCC patients was not significant compared with the control group (P = 0.076). Up-regulation of micro-RNA-155 was only significant in OLP group, compared with the control group (P = 0.009). No other significant differences were found (P > 0.05). CONCLUSION: Considering the altered expression of MicroRNA-146a and microRNA-155 in dysplastic OLP and OSCC, their altered expression may serve as an alarming sign of malignancy. However, further investigations are still required.

Central Granular Cell Odontogenic Tumor: Case Report with Literature Review of Cases Reported in the Last 71 years.

The central granular cell odontogenic tumor (CGCOT) is a rare, benign, slowly growing, odontogenic neoplasm. CGCOT was not considered as a distinct entity in the WHO classification reported on 2017. This study reports a rare case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white woman. In addition, to better delineate the clinical, radiographic, histopathologic and immunohistochemical characteristics of CGCOT, a literature review of all published cases (in PubMed/ Google Scholar/ MEDLINE/Scopus) of CGCOT is provided. CGCOT is a very uncommon tumor, with only 51 reported cases in the literature. The present case is interesting regarding to its rarity for being in the maxillary anterior region, which has not been previously reported in Asia. The immunohistochemical findings of the current case and other cases in the literature review, verified the mesenchymal origin of granular cells and odontogenic nature of the epithelium islands, which can be a possible promise for placing this lesion in the future WHO odontogenic tumor classification.

Central Granular Cell Odontogenic Tumor: A Literature Review of Cases Reported in the Last 71 Years with a New Case Report.

Central granular cell odontogenic tumors (CGCOTs) are rare, benign, slowly growing odontogenic neoplasms. Due to their uncertain histogenesis, CGCOTs are still not included as a distinct entity in the WHO classification (2017) of odontogenic tumors. We report a case of CGCOT involving the right side of maxillary anterior region of a 39-year-old white female. Immunohistochemical staining showed that granular cells positively expressed CD68 and vimentin, and negatively expressed S-100 protein. Meanwhile, we searched PubMed, Google Scholar, and Scopus databases to summary the clinico-pathological features of 51 reported cases of CGCOT. The results showed that the granular cells of 28.6% cases were immunopositive for vimentin and CD68, and odontogenic epithelial cells were positive immunoreactivity for cytokeratin. These findings reinforced the mesenchymal origin of granular cells and the odontogenic nature of epithelium islands.

Mandibular Arteriovenous Malformation with Unusual Radiographic Appearance.

Arteriovenous malformation of head and neck is a rare vascular anomaly but when present, it is persistent and progressive in nature. It can also represent a lethal benign disease due to massive hemorrhage. There are several indications for treatment including age, location, extension and type of vascular malformation. Endovascular therapy can effectively cure most lesions with limited tissue involvement. Surgery can be used in selected cases in combination with embolization. Here, we present a rare case of arteriovenous malformation of mandible with floating tooth appearance in an 11-year-old boy patient. Given the spectrum of imaging presentations seen and the crossover with other lesions, microscopic histopathological examination is the gold standard for diagnosis.

Primary melanoma of submandibular gland: case report and literature review of a very rare entity.

BACKGROUND: Cutaneous melanomas account for more than 95% of all cases of primary melanoma, making non-cutaneous primary melanomas truly rare. Cases of primary mucosal melanomas of the oral cavity have been widely described; however, instances of primary melanomas arising from salivary glands have been rarely described. To date, this is only the second case of primary melanoma of the submandibular gland. CASE PRESENTATION: This is a report of a case of a 36-year-old healthy male patient, who was referred to us with the chief complaint of a growing swelling on the left side of his lower jaw. Evaluations revealed an evident facial asymmetry in the frontal view with a firm, non-tender swelling. Initial orthopantomogram did not reveal any alterations in the trabeculation or morphology of the jaws and the surrounding structures. A soft tissue ultrasonography of the left submandibular gland and anterior region of mandible revealed a hypoechoic cystic mass with numerous micro-echoes. Further para-clinical examinations yielded the definitive diagnosis of primary melanoma of the submandibular gland. Moreover, no evidence of distant osteometastasis was observed in whole-body scans. Subsequent surgical management with the approach of excising the submandibular salivary gland and concurrent selective neck dissection was implemented. CONCLUSIONS: This report emphasizes the importance of thorough examination and prompt referral to designated specialists in cases with suspicious behaviors which are unresponsive to treatments. It can be further concluded that melanoma can mimic a range of benign pathologies; therefore, putting it in the list differential diagnosis of similar lesions seems plausible.

Aggressive fibromatosis in the submandibular region of a child.

Aggressive fibromatosis is proliferation of well-differentiated fibroblasts. Submandibular region is rare location for fibromatosis. We report a case of a rapidly growing mass in submandibular region of 5-year-old girl, excised surgically and ascertained to be aggressive fibromatosis on histological examination. Recovery was uneventful, and she was disease-free in 6-month follow-up.

Extrafollicular Cystic Adenomatoid Odontogenic Tumor Misdiagnosed as Glandular Odontogenic Cyst.

Adenomatoid odontogenic tumor (AOT) is a benign slow-growing, asymptomatic epithelial odontogenic neoplasm. This lesion has been known for its varied clinical and histoarchitec-tural patterns. Most AOTs occur intra-osseously in the anterior maxilla associated with the unerupted tooth. Clinically, AOT is sometimes misdiagnosed as an odontogenic cyst. Alt-hough enucleation and curettage for AOT is the most common treatment modality, accurate histopathological diagnosis is essential to avoid unnecessary extensive surgery. Here, we present a rare challenging case of an extrafollicular cystic adenomatoid odontogenic tumor occurring in the body of the mandible in a 23-year-old female patient, which was diagnosed clinically and radiographically as glandular odontogenic cyst. The diagnosis of adenomatoid odontogenic tumor was confirmed through histopathological examination.

Immunoexpression of C4 Binding Protein in Oral Leukoplakia and Oral Squamous Cell Carcinoma.

BACKGROUND: The immune evasion of dysplastic cells plays an important role in suppressing the immune response and progression of malignancy. The role of the complement inhibitors in the development of oral epithelial dysplastic lesions and squamous cell carcinoma (SCC) is still unclear. OBJECTIVE: This study aimed to assess the expression of C4 binding protein (C4BP) as a complement inhibitor in oral squamous cell carcinoma and leukoplakia. METHODS: In this study, 94 samples were classified into four groups: leukoplakia with mild to moderate dysplasia, leukoplakia with severe dysplasia or carcinoma in situ, early invasive SCC, and invasive SCC. The expression of C4BP marker was evaluated by immunohistochemistry (IHC) and real-time PCR. The results were analyzed by the Kruskal-Wallis, Bonferroni adjusted Dunn's multiple comparison, and one-way ANOVA tests. RESULTS: The results of IHC revealed the expression patterns of C4BP in oral dysplasia and SCC, and indicated that the C4BP expression was not significantly different between different histopathological grades in epithelial cells and vessels (P=0.157 and P=0.123, respectively) but, it was significantly different in fibroblasts and lymphocytes (P=0.017 and P=0.043, respectively). The real-time PCR showed a significant correlation between the dysplasia grade and expression of C4BP (P<0.05). CONCLUSION: According to the results, C4BP is expressed in the cancerous tissue by the tumor cells and their surrounding stroma. In addition, upregulation of the C4BP gene as an inhibitor of the complement system is a possible strategy adopted by the tumor cells to evade the immune system.

Association of IL-10 -1082A>G, -819C>T, and -592C>A polymorphisms with susceptibility to chronic and aggressive periodontitis: a systematic review and meta-analysis.

OBJECTIVES: Several epidemiological studies have evaluated association of interleukin 10 (IL-10) polymorphisms with risk of periodontitis. However, the results remain conflicting and inconclusive. Here, we carried out a comprehensive systematic review and meta-analysis to evaluate the association of IL-10 -1082A>G, -819C>T, and -592C>A polymorphisms with risk of chronic (CP) and aggressive (CP) periodontitis. METHODS: Electronic databases including PubMed, Science Direct, SciELO, and CNKI were systematically searched to identify all relevant studies published up to 01 June 2020. RESULTS: A total of 60 case-control studies with 5313 cases and 6528 controls met our inclusion criteria. Overall, the pooled data showed that the IL-10 -592C>A polymorphism was statistically associated with increased risk of periodontitis in the overall population, while no significant association was identified for IL-10 -1082A>G and IL-10 -819C>T polymorphisms. The subgroup analysis by ethnicity revealed that the IL-10 -1082A>G polymorphism was significantly associated with periodontitis risk in Caucasians, IL-10 -819C>T polymorphism in mixed population, and IL-10 -592C>A polymorphism in both Asians and mixed populations. When further analyzed by periodontitis type, only the IL-10 -592C>A polymorphism was associated with CP risk, but not AgP; and the IL-10 -1082A>G and -819C>T polymorphisms have not positive association neither in the CP and AgP. CONCLUSIONS: The current meta-analysis showed that the IL-10 -592C>A polymorphism was statistically associated with periodontitis risk in the overall population. Moreover, the IL-10 -1082A>G, IL-10 -819C>T, and IL-10 -592C>A polymorphisms were associated with periodontitis risk by ethnicity. Therefore, the IL-10 polymorphisms are of high clinical relevance by ethnicity and would be a useful marker to identify patients who are at higher risk for periodontitis.

Juvenile trabecular ossifying fibroma of the maxilla: Case report of a diagnostic dilemma.

Ossifying fibromas (OFs) are benign, well-demarcated lesions in the craniofacial region, particularly in the jaws, with clinical, radiographic, and histopathological similarities to other lesions, which make their diagnosis challenging. Herein, we report a case of a fibro-osseous lesion in the anterior maxilla of a 13-year-old boy, consisting of an intraosseous and an extra-osseous part, which created a diagnostic dilemma.

Formulation of a Jasmine Grandiflorum containing mucoadhesive and evaluation of its healing effect on oral biopsy ulcers.

OBJECTIVES: The present research aimed to explore the effect of a mucoadhesive containing Jasminum grandiflorum leaves on the process of oral wound healing in animal samples. MATERIALS AND METHODS: The present double-blinded research was conducted on animals. To this aim, 28 rats were randomly selected and assigned to groups of control and experiment. The lesion was created by punch no. 3 in the midline of the mandibular labial mucosa of all mice. Each group received either a medicine or a placebo exclusively coded. The extent of contraction and wound healing was clinically assessed. To compare the two research groups, chi-squared test, repeated-measure ANOVA, and Mann-Whitney U test were run. SPSS software was used to do the statistical analyses. RESULTS: Statistically significant differences were found between the percentage of wound contraction on the 3rd day (40.91% vs. 16.5%, p = 0.04) and the 7th day (92.9% vs. 69.2%, p = 0.05), wound recovery (57.1% vs. 21.4%, p = 0.05) and degree of inflammation on the 7th day (p = 0.00), type (p = 0.04) and thickness of epithelium (p = 0.00) and type of connective tissue (p = 0.00) on the 14th day. CONCLUSION: Investigations showed that the drug was more effective than the placebo in accelerating wound healing in clinical and histopathological terms. CLINICAL RELEVANCE: Accelerating wound healing in dental treatments and oral ulcers can also affect the quality of life of individuals.

The Effect of Zinc and Vitamin D Nutrition on Reducing Morphine Side Effects and Development of Dental Anomalies in Rats Newborns.

INTRODUCTION: The use of opioids such as morphine has anti-pain effects along with some side effects on body organs. Opioids such as morphine can be transferred from mother to child through the placenta and or breastfeeding. This study aimed to assess the effect of morphine on mineral content and histological changes of incisor teeth of rats born to morphine-addicted mothers. METHODS: In this experimental animal study, 24 pregnant rats were randomly divided into 6 groups of control, morphine, zinc, vitamin D, morphine plus zinc, and morphine plus vitamin D. After completion of the breastfeeding period, two babies were randomly selected among the newborns of each mother rat. Mineral content was analyzed using the Rontec device. The obtained data were analyzed by Newman-Keuls multiple comparisons test in Prism 5. RESULTS: Results showed a significant reduction in fluorine content in the experimental groups compared with the control group (P<0.05). The magnesium content in the experimental groups was significantly higher than that in the control group (P<0.05). Microscopic assessment of the slides showed a significantly less enamel maturation in the experimental groups compared with the control group (P<0.05). CONCLUSION: Morphine use by mothers decreased the fluorine content of tooth structure and retarded the maturity of the enamel of infants.

Excision of Different Oral Benign Exophytic Lesions With a Diode Laser: A Clinical Case Series.

Introduction: Lasers are becoming the standard of care for many dental procedures, and are being introduced as a high-tech instrument. They are also becoming more routine in dentistry through the advent of office-based lasers, which are also simple to use within the oral cavity. Many studies have shown the competencies of laser technology for the management of benign oral lesions as these techniques allow for painless and bloodless oral surgery. Cases Report: Nine patients attending the Department of oral and maxillofacial Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran, underwent laser outpatient procedures for the surgical removal of a wide range of benign oral lesions. Regarding the history, present illnesses and clinical figures of all reported cases, the clinician ensured that the lesions were benign and after taking informed consent from every patient, he did complete the excision of lesions with diode lasers. Following the injection of local anesthesia, an 810 nm diode laser was applied for the excisional biopsy of oral lesions. The specimens were sent for histopathological evaluations and the patients were assessed on intraoperative and postoperative complications. The patients were followed up for postoperative complications at one week and 2 weeks post-treatment. Conclusions: According to our findings, a diode laser can be a choice for the outpatient treatment of oral mucosal benign lesions as this technique provides painless and almost bloodless treatment.

Huge central intravascular papillary endothelial hyperplasia of the mandible: a case report and review of the literature.

Masson's tumor or intravascular papillary endothelial hyperplasia is an inflammatory soft tissue lesion that rarely occurs in the maxillofacial region and skeletal system. Precise clinical and para-clinical investigation is necessary for the accurate diagnosis and correct treatment of this lesion. This paper presents a massive intravascular papillary endothelial hyperplasia lesion in the bony tissue of the mandible. Histopathology features, clinical appearance, and suitable management are discussed, with a complete review of the literature. The patient underwent composite resection of the lesion as well as reconstruction. No recurrence was observed during 6 years of follow-up. To the best of our knowledge, this is the fourth case of Masson's tumor in mandibular skeletal tissue, which has unique and distinctive features due to its size and location. A rare occurrence in skeletal tissue, complex clinical presentations, and complicated histopathologic findings present diagnostic challenges for treatment of this lesion.

Association of MMP-2-753C>T and MMP-9-1562C>T Polymorphisms with Chronic/Aggressive Periodontitis Risk: A Systematic Review and Meta-Analysis.

BACKGROUND: Two functional polymorphisms in the matrix metalloproteinase-2 and -9 (MMP-2 and MMP-9) genes may contribute to periodontitis pathogenesis. However, the results were inconsistent and inconclusive. Therefore, to clarify precise associations of MMP-2-753 C>T and MMP-9-1562C>T polymorphisms with chronic (CP) and aggressive (AgP) periodontitis, we performed a systematic review and meta-analysis. METHODS: A literature search was conducted using PubMed, Google Scholar, Embase, and Web of Science databases until 5 July 2017. The data were analyzed with CMA software, and risk estimates are expressed as odds ratios (ORs) and 95% confidence intervals (95% CIs). RESULTS: Nineteen case-control studies in ten publications with 2089 periodontitis cases and 2345 controls met the criteria. The pooled ORs indicated that MMP-2-753C>T and MMP-9-1562C>T polymorphisms were not significantly associated with risk of periodontitis in overall analysis. Stratified analyses by ethnicity and periodontitis type indicated that the MMP-9-1562C>T polymorphism showed a significant association with the risk of periodontitis among Caucasians and CP/AgP subgroup, whereas MMP-2-753C>T polymorphism was significantly associated with periodontitis risk only among Asians. CONCLUSION: MMP-2-753C>T and MMP-9-1562C>T polymorphisms may not be associated with risk of periodontitis in overall population. However, MMP-2-753C>T and MMP-9-1562C>T polymorphisms might have influence on the susceptibility of periodontitis by ethnicity.

Histologic and Histomorphometric Assessment of Xenograft Bone Substitute versus Synthetic Nonceramic Hydroxyapatite for Canine Tooth-Socket Preservation.

This study sought to histologically and histomorphometrically assess and compare application of xenograft bone substitute and synthetic nonceramic hydroxyapatite for tooth-socket preservation in dogs. This split-mouth clinical trial was conducted in five hybrid dogs, using four tooth sockets in each dog, with a total of 20 sockets for evaluation. Group 1 received xenografts, and group 2 received synthetic nonceramic hydroxyapatite in the sockets. In group 3 (positive controls), sockets remained empty. All sockets were covered with collagen resorbable membrane, and the flap was stitched using nonresorbable sutures. In group 4 (negative control), sockets were without membrane, left empty, and sutured. After 12 wk, 8-mm-high bone core biopsies were harvested from inside the sockets, using a trephine bur with an internal diameter of 2 mm. We assessed the tissue in terms of percentage of newly formed viable bone, percentage of remaining particles, degree of inflammation, and type of connective tissue. Data were statistically analyzed. The percentage of newly formed viable bone was 34.98% in group 1 and 41.30% in group 2, and this difference was not statistically significant (p = 0.710). The percentage of remaining particles was 15.95% in group 1 and 14.14% in group 2; this difference was also not statistically significant (p = 0.902). Both synthetic nonceramic hydroxyapatite and xenograft bone substitute showed similar efficacy, histologically and histomorphometrically, when used with resorbable collagen membrane for tooth-socket preservation in dogs.

Histopathological Evaluation of Dental Pulp of Primary Teeth Pulpotomized with Formocresol with/without a Capping Agent: A Randomized Clinical Trial.

OBJECTIVES: This study aimed to assess the reaction of dental pulp of pulpotomized teeth with/without applying a capping agent. This study was performed as randomized clinical trial. MATERIALS AND METHODS: This split-mouth clinical trial was conducted on eight pairs of primary canine teeth scheduled for extraction as part of orthodontic treatment. The teeth were randomly assigned to the intervention and control groups. In the intervention group, canine teeth were restored with amalgam after pulpotomy with formocresol. In the control group, zinc oxide eugenol paste was applied as the capping agent after pulpotomy with formocresol, and the teeth were then restored with amalgam. After 1 month, the teeth were extracted in both groups and stained with hematoxylin and eosin for histological analysis. Pulp reaction was assessed in terms of pathological parameters. Data were analyzed using the Mann-Whitney U-test and Fisher's exact test. The statistical analysis software was SPSS 16. RESULTS: No significant difference was found between the two groups in terms of inflammation, vitality, internal resorption, bleeding, presence of osteoclasts and dentinoclasts, and internal regeneration. Dentinal bridge did not form in any group. CONCLUSION: According to the results of this study, formocresol pulpotomy of primary teeth can be completed without the application of a capping agent.

Association between tooth impaction and odontogenic lesions: A matched case-control study.

Background: Impacted tooth is common in dental practice. Dentists usually remove them if they are associated with any pathologic sign or symptom. The challenge is whether to extract the asymptomatic tooth or not. This study was conducted to determine the association between developmental odontogenic cysts and tumors and impacted and unerupted teeth, if left untreated. Methods: In this matched case-control study, 262 participants were recruited in case and control groups to evaluate the association between the presence of odontogenic cyst and tumors and unerupted and impacted teeth in patient records in the School of Dentistry, Shahid Beheshti University of Medical Sciences during 2000-2002. The controls referred to a dental radiology center for routine OPG. We also recorded the data on age, gender, the involved jaw, and type of lesion. All patients' records were reviewed by the research director and an oral pathologist separately. The variables that were matched as confounders were age, gender, and the site of the involved jaw. Results: Results of conditional logistic regression analysis showed that the presence of odontogenic lesions was associated with impacted teeth (OR = 6.9), and not associated with the involved jaw and unerupted teeth. Conclusion: Impacted teeth could be considered as a potential risk factor for the presence of odontogenic lesions.

Association of vitamin D receptor BsmI, TaqI, FokI, and ApaI polymorphisms with susceptibility of chronic periodontitis: A systematic review and meta-analysis based on 38 case -control studies.

BACKGROUND: There has been increasing interest in the study of the association between Vitamin D receptor (VDR) gene polymorphisms and risk of chronic periodontitis. However, the results remain inconclusive. To better understand the roles of VDR polymorphisms (BsmI, TaqI, FokI, and ApaI) in chronic periodontitis susceptibility, we conducted this systematic review and meta-analysis. MATERIALS AND METHODS: The PubMed, Google Scholar, and Web of Science database were systemically searched to determine all the eligible studies about VDR polymorphisms and risk of chronic periodontitis up to April 2017. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the associations between VDR polymorphisms and chronic periodontitis risk. All the statistical analyses were performed by Comprehensive Meta-Analysis. All P values were two-tailed with a significant level at 0.05. RESULTS: Finally, a total of 38 case-control studies in 19 publications were identified which met our inclusion criteria. There are ten studies with 866 chronic periodontitis cases and 786 controls for BsmI, 16 studies with 1570 chronic periodontitis cases and 1676 controls for TaqI, five studies with 374 chronic periodontitis cases and 382 controls for FokI, and seven studies with 632 chronic periodontitis cases and 604 controls for ApaI. Overall, no significant association was observed between VDR gene BsmI, TaqI, FokI, and ApaI polymorphisms and risk of chronic periodontitis in any genetic model. Subgroup analysis stratified by ethnicity suggested a significant association between BsmI polymorphism and chronic periodontitis risk in the Caucasian subgroup under allele model (A vs. G: OR = 1.747, 95% CI = 1.099-2.778, P = 0.018). Further, no significant associations were observed when stratified by Hardy-Weinberg equilibrium status for BsmI, TaqI, and ApaI. CONCLUSION: Our results suggest that BsmI, TaqI, FokI, and ApaI polymorphisms in the VDR gene might not be associated with risk of chronic periodontitis in overall population.

Histologic comparison of direct pulp capping of rat molars with MTA and different concentrations of simvastatin gel.

Previous in vitro studies have suggested that simvastatin can be used as a direct pulp capping material due to its ability to induce odontoblastic differentiation and angiogenesis. The aim of this animal study was to evaluate the pulpal response to mineral trioxide aggregate (MTA) and four concentrations of simvastatin/MTA in combination. The study was conducted in two stages using four different simvastatin concentrations and MTA as a capping material for rat maxillary molars. The grades of inflammation and continuity of dentin formation were evaluated in hematoxylin and eosin (HE)-stained samples. Dentin thickness was determined by histomorphometric analysis, and the data were subjected to statistical analysis. On day 3, mild inflammation was observed in all groups. On day 7, the simvastatin groups showed a slightly higher rate of chronic inflammation. Inflammation was not present on day 30. Discontinuous dentin was present in all methylcellulose (control) samples. Continuous dentin was formed in all of the samples treated with 1.5% simvastatin. The greatest dentin thickness was observed after treatment with 1.5% simvastatin and MTA, followed by 0.5% simvastatin. Statistical analysis demonstrated no significant differences in dentin thickness and continuity between MTA and simvastatin at 0.5% and 1.5% (P > 0.05).