Oral cancer knowledge among dental patients in Isfahan.

Background: Diagnosis of oral cancer in the early stages is the most effective tool to improve survival and reduce complications caused by the disease. The aim of this study was investigating the dental patients' knowledge of oral cancer in Isfahan. Materials and Methods: This descriptive cross-sectional study was performed on 334 patients referred to dental centers in Isfahan, Shahinshahr, Najafabad, Khomeini Shahr, Harand, and Zarrinshahr cities. Data were collected by a researcher-made 25-item questionnaire. Data analysis was carried out by SPSS (version 26) software using the independent t-test, one-way analysis of variance, and Pearson correlation coefficient (P < 0.05). Results: The patients' mean score of knowledge was 49.3 ± 21.4 in Isfahan city and 53.1 ± 18.4 in the other cities of Isfahan province. There was no significant difference between knowledge of oral cancer and gender, marital status, and residence, but there was a significant difference between employment status and knowledge (P = 0.03). The mean score of knowledge was significantly higher in patients who had a history of oral cancer in relatives than in other patients (P = 0.03). Virtual networks (Telegram, WhatsApp, and Instagram), journals, and books were the most common sources for patients about oral cancers. Conclusion: Dental patients' knowledge of oral cancer in Isfahan province and its cities was moderate, so it is necessary to increase their level of knowledge through more education.

Cyclin D1 and Ki-67 expression and its correlation with histopathological parameters and cervical lymph node metastasis in oral squamous cell carcinoma.

Background: Oral squamous cell carcinoma (OSCC) is the most common malignant tumor among oral cancers. Cyclin D1 and Ki-67 have associated with cell division. The aim of this study was to compare the expression of these markers in OSCC with and without cervical lymph node (LN) metastasis. Materials and Methods: This cross-sectional study was performed on 40 OSCCs with and without cervical LN metastasis (20 in each group) that was recorded in the pathology archive of Ayatollah Kashani Hospital in Isfahan. Clinical information including age, gender, and location was collected. Some histopathological parameters including depth of invasion, lymphovascular invasion (LVI), perineural invasion (PNI), number of LN metastases, histopathological grade, and stage of disease were evaluated. Immunohistochemical staining was performed for cyclin D1 and Ki-67. All data were entered into SPSS24 software and were analyzed by Mann-Whitney, Kruskal-Wallis, Chi-square, Fisher's exact, and t-tests. P < 0.05 was considered statistically significant. Results: Based on LVI and stage of disease, a significant correlation was found between the two groups (P < 0.001). There was a significant difference between the two groups based on cyclin D1 expression (P = 0.05). The expression of the Ki-67 showed a significant difference based on tumor location (P = 0.026) and PNI (P = 0.033). Conclusion: The use of markers should be considered in determining the prognosis of OSCC, and the cyclin D1 marker is one of the useful markers for predictors of cervical LN metastasis.

Histological characteristics of dental pulp in teeth with periodontal problems and healthy teeth.

Background: Chronic periodontitis is the most common type of periodontitis, which is associated with calculus and plaque accumulation. Several studies have indicated that uncured periodontitis can affect the dental pulp. However, this relationship is controversial. This study aimed to compare histopathological results obtained from the dental pulp in teeth with periodontal problems and healthy teeth. Methods: In this study, 23 teeth with periodontal problems and 23 healthy teeth were extracted. After cutting off 2 mm from the root apex, the teeth were sectioned into apical, middle, and coronal thirds. Then, the specimens were evaluated in both groups based on histopathological features. Results: According to the evaluations, in the middle third, the amount of inflammation was only statistically significant in the group that consisted of teeth with periodontal problems (P=0.014). There was no significant difference in fibrosis and blood vessel diameter between the two groups. Necrosis in the middle (P=0.002) and coronal thirds (P=0.004) of teeth with periodontal problems was more than the healthy teeth. The lack of odontoblastic integrity in all the sections of teeth with periodontal problems was more than that in healthy teeth (P=0.0001). Conclusion: Inflammation of the periodontium in chronic periodontitis can lead to histological changes in the pulp, including an increase in inflammation, necrosis, and loss of odontoblastic integrity.

Evaluation of changes in Salivary Lactate Dehydrogenase Level for detection of Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis Study.

Background: Research has examined the relationship between salivary lactate dehydrogenase (LDH) levels and head and neck squamous cell carcinoma (HNSCC) screening and prognosis. Due to biochemical changes in cancer cells and increased production of lactate products in the body. The present systematic review aims to evaluate the changes in salivary LDH levels in HNSCC patients. Methods: The present study is a systematic review and meta-analysis. The data were collected by searching PubMed, Science Direct, Scopus, Web of Science, and Google Scholar from 2000 to 2021. The heterogeneity of the articles was analyzed using I2 and TAU2. Results: After searching the databases, of 988 articles, 665 duplicated articles were excluded by adopting the inclusion and exclusion criteria. So, 25 articles were primarily selected to be reviewed and evaluated for quality. Finally, 19 articles were selected and analyzed according to the Newcastle-Ottawa checklist. A total of 642 HNSCC patients were reviewed. The meta-analysis showed salivary LDH levels in the HNSCC group were higher than the control group (mean difference = 0.675, standard error = 0.058) (P < 0.001). Conclusions: As the research results showed, a significant correlation was observed between salivary LDH levels and HNSCCs. So, LDH can be employed as a valuable and minimally invasive biomarker in head and neck cancer screening and prevention.

Evaluation of Dentists' Attitudes Towards Principles of Professional Ethics.

OBJECTIVE: The aim of this research was to investigate attitudes towards principles of professional ethics (PPE) amongst Iranian dentists working in Isfahan, Iran. METHODS: This pilot cross-sectional study was conducted amongst 273 dentists in Isfahan, Iran. A validated, comprehensive questionnaire including principles of respect for patient autonomy, nonmaleficence, beneficence, and justice was used to evaluate dentistry professional ethics aspects. Age, gender, marital status, type of graduate university, level of education, specialised field of study, work experience, workplace, and participation in ethics workshops and courses were registered from participants. Total and domains scores of used questionnaires were calculated and compared across categories of study participants' characteristics. RESULTS: Mean ± SD age of participants was 35.4 ± 10.7 years, and 57% were female; about 73% graduated from Isfahan University of Medical Sciences, and 65% were general dentists. The attitude total score of dentists towards PPE was 133.02 ± 13.16. Mean total score of the questionnaire and its domains was different significantly (P < .05) across categories of level of education, marital status, and passing the ethical courses. CONCLUSIONS: The attitude of dentists towards PPE was rated at a good level. However, improvement in attitudes of some specific subgroups such as general dentists and newly graduated ones is needed. Conducting specific workshops about professional ethics and incorporating these principles into university curricula can be beneficial.

Evaluation of Epstein-Barr virus expression in oral squamous cell carcinomas.

Background: Oral squamous cell carcinoma (OSCC) is one of the most common cancers. Epstein-Barr virus (EBV) has been related to throat-esophageal and gastric cancers. The aim of this study was to evaluate the prevalence of EBV in OSCC. Materials and Methods: This descriptive-analytical cross-sectional study was performed on 48 samples recorded in the archives of the Oral Pathology Department of Isfahan Dental School with definitive diagnosis of OSCCs prepared by excisional biopsy. Samples were selected in different age groups, locations, and genders. The grade of the tumor malignancy was determined based on Annreroth's classification. The EBV expression was determined by immunohistochemical (IHC) staining. The data were entered into SPSS software and statistically analyzed by t-test, Chi-square, and Fisher's exact test. Significance level was considered P < 0.05. Results: IHC staining for EBV was positive in 25 samples (52%). There was no significant relationship between EBV expression and mean age, gender, clinical feature, and grade of tumor differentiation (P > 0.05). A significant difference was observed between the EBV expression and location (P = 0.035). Furthermore, a significant difference was observed between the grade of tumor and staining intensity distribution index of EBV (P = 0.005). Conclusion: EBV expression was observed in most of the OSCCs, especially in poorly differentiated tumors. The pathogenesis of OSCCs may be related with EBV. OSCCs in buccal mucosa and floor of the mouth have more frequently of EBV expression. Future studies on the mechanisms of EBV and their role in OSCC are required with larger sample sizes.

Efficacy of exenatide, ozone, and methyl prednisolone for the recovery of infraorbital nerve paresthesia after injury in rats.

BACKGROUND: Infraorbital nerve injury often occurs due to zygomatic complex fracture. There is no standard protocol to restore the sensory and motor function of the nerve after injury. Some medications are used to improve nerve function. This histopathological animal study aimed to assess the neurotrophic efficacy of exenatide, ozone, and methyl prednisolone for injured infraorbital nerve. MATERIALS AND METHODS: In this animal study, 60 rats were randomly divided into five groups (n = 12) of control, saline, methyl prednisolone, exenatide, and ozone. Under general anesthesia, a unilateral infraorbital incision was made, and the nerve was compressed with a hemostat for 5 s. Depending on the study group, the rats received the designated medications. All rats were sacrificed after 14 days, and the nerve recovery was evaluated by observing the slides prepared from the area under a light microscope using histological and immunohistochemical parameters. Data were analyzed using Chi-square test and Tukey's least significant difference test (P < 0.05). RESULTS: No inflammation in the peripheral tissue had a significantly higher frequency in the methyl prednisolone group (P < 0.05). Degeneration, intracellular inflammatory infiltrate, muscle injury, fibrosis around the nerve, granulation tissue, vascular proliferation, and infiltration of inflammatory cells around the nerve were more commonly absent in the exenatide group (P < 0.05). CONCLUSION: Exenatide showed superior efficacy for the recovery of infraorbital nerve function after injury. Thus, it may be beneficial for postoperative care following infraorbital nerve injury.

Evaluation of oral pathologic lesions in elderly patients in Isfahan, Iran, 1989-2018 years / Avaliação de lesões patológicas orais em pacientes idosos em Isfahan, Irã, entre 1989 e 2018

Objective: One of the most important alterations in elderly is the destruction and loss of teeth and oral mucosal lesions. The aim of this study was to determine the frequency of biopsed pathologic lesions in elderly registered in the pathology department of Isfahan University of Medical Sciences during 1989 to 2018 years. Material and Methods: This cross-sectional descriptive-analytic study was performed on pathologic lesions in elderly archived in Faculty of Dentistry, Isfahan University of Medical Sciences. In this study, all archived information of elderly over 65 years including gender, age, location of lesion, clinical diagnosis, pathology diagnosis, and diagnosis year were evaluated in last three decades, and were analyzed statistically. Results: The age range of elderly patients was 65 to 90 years with a mean of 72.8 ± 4.9. The highest frequency for location of lesions was related to mandibular vestibule (21.1%). The most clinical diagnosed lesions were squamous cell carcinoma (24.5%) and Epulis Fissuratum (13.4%). The highest pathologic diagnosed lesions were related to reactive lesions group (35.6%). The squamous cell carcinoma malignancies and other malignancies were increased significantly in elderly patients with high age. Conclusion: According to the considerable frequency of oral lesions in elderly and increased frequency of squamous cell carcinoma and other malignancies, attention to oral lesions in elderly and periodic examinations are important to early diagnosis and treatment. (AU)

Objetivo: Uma das alterações mais importantes no idoso é a destruição e perda de dentes; e lesões da mucosa oral. O objetivo deste estudo foi determinar a frequência de lesões patológicas biopsiadas em idosos registrados no departamento de patologia da Universidade de Ciências Médicas de Isfahan durante os anos de 1989 a 2018. Material e métodos: Este estudo transversal descritivo-analítico foi realizado em lesões patológicas em idosos arquivadas na Faculdade de Odontologia da Universidade de Ciências Médicas de Isfahan. Neste estudo, todas as informações arquivadas de idosos com mais de 65 anos, incluindo sexo, idade, localização da lesão, diagnóstico clínico, diagnóstico patológico e ano do diagnóstico foram avaliadas nas últimas três décadas e foram analisadas estatisticamente. Resultados: A faixa etária dos pacientes idosos foi de 65 a 90 anos, com média de 72,8 ± 4,9. A maior frequência de localização das lesões foi relacionada a região vestibular da mandíbula (21,1%). As lesões mais diagnosticadas clinicamente foram carcinoma espinocelular (24,5%) e Epulis Fissuratum (13,4%). As maiores lesões patológicas diagnosticadas foram relacionadas ao grupo de lesões reativas (35,6%). As neoplasias do carcinoma de células escamosas e outras neoplasias aumentaram significativamente em pacientes idosos com alta idade. Conclusão: Devido à considerável frequência de lesões orais em idosos e ao aumento da frequência de carcinoma espinocelular e outras neoplasias, a atenção às lesões orais em idosos e os exames periódicos são importantes para o diagnóstico e tratamento precoces. (AU)

Synthesis of full interpenetrating hemicellulose hydrogel networks.

Two methods with different cross-linking mechanisms for designing hemicellulose-based full interpenetrating polymer networks (IPNs) were developed through the sequential synthesis of full IPNs from O-acetyl-galactoglucomannan (AcGGM) utilizing free-radical polymerization and a thiol-ene click reaction. A faster swelling rate was observed for all IPN formulations compared with the single-network gels. The highly porous structure of the IPNs with small interconnected pores was verified using scanning electron microscopy. A rheological analysis revealed that the AcGGM IPNs fabricated by the free-radical polymerization of acrylamide and N-N'-methylenebisacrylamide (cross-linker) had shear storage modulus (G') values approximately 5 and 2.5 times higher than that of the corresponding precursor single networks of AcGGM. IPNs achieved through thiol-ene reactions between thiolated AcGGM and polyethylene glycol diacrylate had G' values 35-40 times higher than the single-network reference hydrogels.

Thiolated hemicellulose as a versatile platform for one-pot click-type hydrogel synthesis.

A one-pot synthetic methodology for the thiolation of O-acetyl-galactoglucomannan (AcGGM) was developed to merge hemicellulose chemistry with "click" chemistry. This was realized by the AcGGM-mediated nucleophilic ring-opening of γ-thiobutyrolactone via the activation of the polysaccharide pendant hydroxyl groups. The incorporation of thiol functionalities onto the hemicellulose backbone was visualized by (1)H and (13)C NMR spectroscopy and was assessed by an Ellman's reagent assay of the thiol groups. The versatility of the thiolated AcGGM was elaborated and demonstrated by conducting several postmodification reactions together with hydrogel formation utilizing thiol-ene and thiol-Michael addition "click" reactions. The one-pot synthesis of thiolated AcGGM is a straightforward approach that can expand the applications of hemicelluloses derived from biomass by employing "click" chemistry.

Unrefined wood hydrolysates are viable reactants for the reproducible synthesis of highly swellable hydrogels.

A value-adding robust and sequential synthetic pathway was elaborated to produce hydrogel structures with ionic character from crude acetylated galactoglucomannan-rich wood hydrolysate (WH). The WH was first-step liquor originating from a sulphite cracking pulp process for dissolving pulp. The synthetically modified WH fractions were verified at each step by NMR and FTIR, and the hydrogels were characterized with respect to their swelling and mechanical properties. Altering the crosslinking chemistry and the content of ionic moieties resulted in hydrogels with various swelling ratios and mechanical properties. Renewable hydrogel formulations with swelling ratios as high as Qeq=270 were achieved.

Mast cells distribution and variations in epithelium thickness and basement membrane in oral lichen planus lesion and oral lichenoid reaction.

BACKGROUND: Oral lichen planus (OLP) is a chronic mucocutaneous lesion with unknown etiology. Oral lichenoid lesions (OLL) comprise a family of lesions with different etiologies. Both lesions have similar clinical and histopathologic characteristics although their management is different. Differential diagnosis between OLP and OLL has always been a major challenge. MATERIALS AND METHODS: In this prospective analytical study, the role of mast cells in pathogenesis of these lesions was investigated by evaluation of 52 patients with clinical and histopathological diagnosis of OLP (26 cases) and OLL (26 cases) based on WHO criteria, and by applying a more accessible staining methods, Hematoxylin and Eosin, toluidine blue (histochemistry) and Periodic Acid Schiff staining. In order to distinguish these two lesions, number of mast cells and thickness of epithelium and basement membrane were measured using light microscopy. Data were analyzed by SPSS software using t-test method (P<0.001). RESULTS: No significant difference was observed between the total numbers of mast cells of two groups (P=0.148), but a statistically significant difference was detected between degranulated mast cells in two groups (P<0.001). A significant difference was also observed between the thickness of epithelium in two groups (P<0.001), although no difference was seen between basement membrane thickness in these lesions. CONCLUSION: Number of degranulated mast cells in reticular layer of corium in lichenoid lesions was more than that of OLP. This implies that despite the increase in number of these cells, in both groups of diseases, the role of these cells has not been the same in pathogenesis of the diseases. Moreover, the epithelium thickness was lower in lesions of OLP compared to lesions of oral lichenoid, so this parameter may be a useful criterion together with other histopathological and clinical finding to discriminate these lesions. However, discrepancy of basement membrane thickness can not be a reliable criterion. Finally we suggest more accessible staining methods which are reliable for differentiation of these two lesions.