Assessment of Uric Acid Level in the Saliva of Patients with Oral Lichen Planus.

OBJECTIVE: The aim of this study was to evaluate the level of uric acid (UA) in saliva, which is considered to be an antioxidant defense biomarker against oxidative stress in patients with oral lichen planus (OLP). SUBJECTS AND METHODS: In this case-control study, 25 OLP patients were included. The reticular form of OLP was verified by a clinical examination with Wickham striae, and other types (erosive, atrophic, ulcerative) were confirmed by histopathological assessment. Thirty healthy individuals matched for age and gender were selected as the control group. In both groups, the Navazesh technique was used to collect the unstimulated saliva. Then, the amount of UA was measured using a Cobas Mira autoanalyzer with a wavelength of 546 nm. The Student t test was used to analyze the data assuming a significance level at <0.05. RESULTS: Of the 25 patients, the most common type of OLP was erosive (n = 11, 44%), and the most common site of OLP was seen as bilateral in the buccal mucosa (n = 12, 48%). The mean level of salivary UA was significantly lower in the patients with OLP (2.10 ± 0.19 mg/dL) in comparison with the control group (4.80 ± 0.29 mg/dL; p < 0.001). CONCLUSION: In this study, OLP was associated with a decrease in UA levels in the saliva. Salivary UA as a biomarker could be used for monitoring and treating OLP.

Evaluation of Salivary Secretor Status of Blood Group Antigens in Patients with Oral Lichen Planus.

OBJECTIVE: To investigate the relationship between secretion or nonsecretion of blood group antigens into the saliva and oral lichen planus (OLP). SUBJECTS AND METHODS: In this study, 30 patients (women: 22, men: 8) with OLP were examined as the case group and 30 subjects without OLP matched for age and gender as the control group. Diagnosis of OLP was confirmed by clinical and histopathological examinations according to WHO criteria. The control group was randomly selected from healthy individuals without pathological oral changes seeking dental treatment. In both groups, blood group type was determined by hemagglutination, and unstimulated saliva was collected using the Navazesh technique. Establishment of salivary secretor status was carried out using the Wiener agglutination test. The data were analyzed using a Χ2 test, Fisher's exact test, and logistic regression. RESULTS: The patients with OLP (cases), including 22 (36.7%) women and 8 (13.3%) men with a mean age of 51 ± 14.16 years, were compared with healthy subjects (controls), comprised of 25 (41.7%) women and 5 (8.3%) men with a mean age of 50.7 ± 13.56 years. A large majority of the people examined in both groups were secretors of blood group A. On the other hand, most OLP patients were blood group B. In the case group, 25 subjects (84.4%) were secretors and 5 (16.6%) were nonsecretors. In the control group, 24 subjects (80.0%) were secretors and 6 (20.0%) were nonsecretors. There was no significant difference between the case and control groups for secretor status (p = 0.73). CONCLUSION: The present study did not indicate a significant difference in salivary secretor status between OLP patients compared to controls.

Oro-facial manifestations of 100 leprosy patients.

OBJECTIVES: To verify the frequency of oral and facial involvement in diagnosed leprosy patients. STUDY DESIGN: This study was performed on 100 leprosy patients (62 male, 38 female, mean ages 51.86±6.1). After explaining the study design, we studied descriptive information including: patient' s sex, age, job, place of birth, familial history of leprosy, types of disease (lepromatous, borderline and tuberculoid leprosy), ocular and oral lesions, facial involvement and neuropathy. The statistical signification was measured by chi-square test. RESULTS: A total of 46 (23 lepromatous, 15 borderline, and 8 tuberculoid leprosy) out of 100 patients with leprosy had oral lesions. Statistical analysis did not show any significant difference in frequency of oral lesions between different types of disease. Facial lesions were presented in 57 (39 lepromatous, 10 borderline, and 8 tuberculoid leprosy) patients. There was a statistical significant difference in frequency of facial manifestations between different types of leprosy. It has to be mentioned that, atrophy of nasal spine, facial nerve involvement, ocular lesions and facial deformity were seen in 15%, 17%, 22% and 44% of leprosy patients, respectively. CONCLUSION: Examination of leprosy patients should be extended to the oral mucosa because oral mucosa may be a secondary source of M.Leprae transmission and infection.

Does Melissa officinalis consumption improve the salivary antioxidant status of smokers?

BACKGROUND: The aim of this study was to investigate the effects of Melissa officinalis tea on the total antioxidant capacity of saliva among smokers. METHODS: 24 smokers were selected by convenience sampling. Demographic information and duration of smoking were recorded at the beginning of study. Two cups of Melissa officinalis tea were given to the participants with specific instruction for 30 days. The unstimulated saliva was collected on first day, 15th and 30th days. Then, total antioxidant capacity was measured by a special kit. Statistical analysis was conducted by repeated measure ANOVA test. RESULTS: The mean values of total antioxidant capacity of saliva were significantly higher in days 15 and 30 from the baseline. (p<0.0001, P=0.006). In day 30, the mean value of antioxidant was not significantly different from day 15. (P=0.271). CONCLUSION: Melissa officinalis tea consumption increases salivary antioxidants level in smokers.

Secretor Status of ABO Antigens in Saliva of a Defined Group of Iranian Patients with Pemphigus Vulgaris: A Case-Control Study.

INTRODUCTION: Pemphigus is a chronic inflammatory and autoimmune disease which can cause blisters and mucocutaneous erosions. ABO secretor refers to those who secrete ABO blood group antigens based on their blood type in body fluids such as saliva, sweat, tears, semen, and serum. Previous studies showed that nonsecretor people are more prone to certain autoimmune diseases. AIM: The aim of this study was to determine the ABO secretor status in the saliva of patients with pemphigus vulgaris. MATERIALS AND METHODS: This case-control study was conducted on 35 patients with pemphigus vulgaris and 35 healthy controls. The two groups were matched for age and gender. Pemphigus vulgaris diagnosis was confirmed by histopathology and direct immunofluorescence microscopy. ABO blood grouping was done, and 5 ml of unstimulated saliva was collected to determine secretor status. Secretors were recognized from nonsecretors by the Wiener agglutination inhibition test. Results were extracted by using statistical chi-square and Fisher's exact tests. RESULTS: 16 male and 19 female patients aged 49.43 ± .12.37 years were compared with 16 male and 19 female controls aged 46.43 ± 11.88 years. The most frequent blood group among case and control groups was O (54.3% and 60%, respectively). There was no significant difference in blood groups (P=0.73). 90% of the samples were ABO secretors. The patient group included 31 (88.6%) and the control group included 32 (91.4%) ABO secretors; there was no significant difference between the two groups (P=1.000). CONCLUSION: In this study, we observed that the people with nonsecretor status in comparison with the people with secretor status are not more susceptible to develop pemphigus vulgaris.

Phenotypic Investigation of the Antimicrobial Effect of Organic and Hydro-Alcoholic Extracts of Boswellia serrata on Oral Microbiota.

OBJECTIVES: Considering the emergence of resistant microbes and side effects of chemical drugs, in this study, the inhibitory effect of organic and hydro-alcoholic extracts of Boswellia serrata (B. serrata) on some oral microbiota was investigated. MATERIALS AND METHODS: In this experimental study, standard strains of Candida albicans (C. albicans; PTCC 5027), Candida glabrata (C. glabrata; PTCC 5295), Candida krusei (C. krusei; PTCC 5297), and Streptococcus mutans (S. mutans; PTCC 1688) were collected from the Iranian Research Organization for Science and Technology (IROST). Then, the minimum inhibitory concentration (MIC) of organic and hydro-alcoholic extracts of B. serrata was determined based on the CLSI protocol and using the micro-dilution method. The contents of each well were subcultured in Müller-Hinton agar (Candida species) and blood agar (S. mutans). The lowest concentration with no growth was considered as the minimum fungicidal concentration (MFC) or bactericidal concentration (MBC). Statistical analyses were performed using Mann-Whitney test. RESULTS: Hydro-alcoholic extract of B. serrata at the concentration of 50 mg/ml inhibited the growth of C. albicans and S. mutans. It also inhibited the growth of C. krusei and C. glabrata at the concentration of 100 mg/ml. Organic extract of B. serrata at the concentration of 200 mg/ml only inhibited the growth of C. glabrata. CONCLUSION: Hydro-alcoholic extract of B. serrata had a greater inhibitory effect on C. albicans and S. mutans compared to the organic extract.

The Effects of Cinnamaldehyde (Cinnamon Derivatives) and Nystatin on Candida Albicans and Candida Glabrata.

BACKGROUND: Candida species are the most common opportunistic fungal infections. Today, cinnamon plants have been considered for anti-Candida properties. AIM: This study aimed to investigate the effectiveness of cinnamaldehyde extract (from cinnamon derivatives) on Candida albicans and Candida glabrata species and comparison with nystatin. MATERIAL AND METHODS: In this study, cinnamaldehyde and nystatin were used. The specimens included Candida albicans and Candida glabrata. Minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) were measured for each one by the microdilution method. This experiment was repeated three times. RESULTS: Cinnamaldehyde extract at a concentration of 62.5 µl/ml was able to prevent the growth of Candida albicans, at a concentration of 93.7 µl/ml, causing Candida albicans to disappear, at 48.8 µl/ml, to prevent the growth of Candida glabrata, and in the concentration of 62.5 µl/ml, causes the loss of Candida glabrata. In comparison, nystatin at 0.5 µg/ml concentration prevented the growth of Candida albicans, at concentrations of 1 µg/ml causing Candida albicans to be destroyed, at 4 µg/ml concentration to prevent the growth of Candida glabrata, and at a concentration of 8 µg/ml causes the loss of Candida glabrata. The results were the same every three times. CONCLUSIONS: Although cinnamaldehyde extract had an effect on fungal growth in both Candida albicans and Candida glabrata with a fatal effect; the effect on these two species was lower than nystatin.

Orofacial manifestations of adverse drug reactions: a review study.

BACKGROUND: Adverse reaction to medication is common and may have a variety of clinical manifestations in the oral cavity. The present review paper aimed to describe adverse drug reactions (ADRs) which might be encountered by dental practitioners in every discipline. METHODS: In this narrative review article, the specialized databases such as PubMed, PubMed Central, MEDLINE, EBSCO, Science Direct, Scopus, and reference books from the years 2000-2016 were used to find relevant documents by using MeSH terms: Adverse Drug Reaction, Drug induced, Medication Related, Mouth, Oral Manifestation, Tooth, Hard Tissue, Soft Tissue. RESULTS: The data were categorized in 4 groups as follows: saliva and salivary glands involvement, soft tissue (mucosal) involvement, hard tissue involvement, and non specific conditions (taste disorders, halitosis, neuropathies, movement disturbances, and infection). Most articles were about the adverse effect of drugs on the function of salivary glands, which often cause a decrease in saliva secretion. Other reactions were less common; meanwhile, the side effect of bisphosphonate was increasing in the alveolar bone, because of its unlimited prescription. CONCLUSION: Oral health care providers should be familiar with such events, as they will be confronted with them in their practice.

Frequency of craniofacial pain in patients with ischemic heart disease.

BACKGROUND: Referred craniofacial pain of cardiac origin might be the only symptom of ischemic heart accidents. This study aimed to determine the frequency of craniofacial pain in patients with ischemic heart disease. MATERIAL AND METHODS: This cross-sectional study was accomplished on 296 patients who met the criteria of having ischemic heart disease. Data regarding demographics, medical history and referred craniofacial pain were recorded in data forms. In addition, patients underwent oral examination to preclude any source of dental origin. Chi-square test, Student's t-test and backward regression model were used to analyze the data by means of SPSS software version 21. P<0.05 was considered significant. RESULTS: A total of 296 patients were studied comprising of 211 men (71%) and 85 women (29%) with the mean age of 55.8. Craniofacial pain was experienced by 53 patients out of 296, 35 (66%) of whom were male and 18 (34%) were female. None of the patients experienced craniofacial pain solely. The most common sites of craniofacial pain were occipital and posterior neck (52.8%), head (43.3%), throat and anterior neck (41.5%) respectively. We found no relationship between craniofacial pain of cardiac origin with age, diabetes, hypertension, and family history. On the other hand, there was a significant relationship between hyperlipidemia and smoking with craniofacial pain of cardiac origin. CONCLUSIONS: Radiating pain to face and head can be expected quite commonly during a cardiac ischemic event. Dental practitioners should be thoroughly aware of this symptomatology to prevent misdirected dental treatment and delay of medical care. Key words:Craniofacial pain, ischemic heart disease, myocardial infarction, angina pectoris, referred pain.

Frequency of Head and Neck Squamous Cell Carcinomas and Related Variables in Southern Iran (Ahvaz City): 10-Year Retrospective Study

Objective: Squamous cell carcinoma (SCC) is a life threatening lesion but there has been only limited research about its frequency in Iran. The aim of this study was to evaluate the frequency of squamous cell carcinoma of the head and neck in the records of the pathology department of Imam Khomeini hospital in Ahvaz between 2005 and 2015. Methods: The retrospective and cross-sectional study was conducted using 55,708 medical records of cancer throughout the body, accumulated in the pathology department of Imam Khomeini in Ahvaz in the designated period. Information about age, gender, site of involvement, histological characteristics, status of lymph node metastasis, smoking habit, family history, job and education level was extracted and data were analyzed with the Chi-square test with SPSS version 22. Result: Of the total of 55,708 records, 582 patients (1.04%) had head and neck squamous cell carcinomas. The male to female ratio was 2.85. The frequencies in the head, mouth and neck were 28.7%, 22% and 49.3% respectively. Significant relationships between being male and location (neck) (p = 0.002), age (60 to 80 years old) and being a farmer (p = 0.001) was observed. The most important correlated risk factors were: smoking, sunlight exposure, rural residence, job and education level. Conclusion: Head and neck squamous cell carcinomas were found to account for 1.04% of all cancers in Ahvaz, one of the southern provinces of Iran.

Can Salivary Acetylcholinesterase be a Diagnostic Biomarker for Alzheimer?

INTRODUCTION: The loss of brain cholinergic activity is a key phenomenon in the biochemistry of Alzheimer's Disease (AD). Due to the specific biosynthesis of Acetylcholinesterase (AChE) of cholinergic neurons, the enzyme has been proposed as a potential biochemical marker of cholinergic activity. AChE is expressed not only in the Central Nervous System (CNS), Peripheral Nervous System (PNS) and muscles, but also on the surface of blood cells and saliva. AIM: This study aimed to measure salivary AChE activity in AD and to determine the feasibility of creating a simple laboratory test for diagnosing such patients. MATERIALS AND METHODS: In this cross-sectional study, the recorded data were obtained from 15 Alzheimer's patients on memantine therapy and 15 healthy subjects. Unstimulated whole saliva samples were collected from the participants and salivary levels of AChE activity were determined by using the Ellman colorimetric method. The Mann Whitney U test was used to compare the average (median) of AChE activity between AD and controls. In order to adjust for possible confounding factors, partial correlation coefficient and multivariate linear regressions were used. RESULTS: Although the average of AChE activity in the saliva of people with AD was lower compared to the control group, we found no statistically significant differences using Mann Whitney U test (138 in control group vs. 175 in Alzheimer's patients, p value=0.25). Additionally, no significant differences were observed in the activity of this enzyme in both sexes or with increased age or duration of the disease. After adjusting for age and gender, there was no association between AChE activity and AD (regression coefficient ß=0.08; p value= 0.67). CONCLUSION: Saliva AChE activity was not significantly associated with AD. This study might help in introduce a new diagnostic aid for AD or monitor patients with AD.

Does green tea consumption improve the salivary antioxidant status of smokers?

OBJECTIVE: Considering the higher rate of oral cancer, and reduction in salivary antioxidants in smokers as indicated in previous studies, antioxidant- containing nutrients such as green tea, seem to be beneficial in counteracting against oxidative stress in this group. This study assessed the salivary total antioxidant alteration in smokers compared to nonsmokers, after short-tem (7days) and long-term (3 weeks), green tea drinking. DESIGN: In this experimental study, 20 volunteer moderate-to-heavy male smokers, and 20 matched healthy non-smokers were selected to participate, according to the inclusion criteria. Participants were instructed to drink two cups of green tea per day, by dissolving 2g of green tea in 150ml of hot water for each cup. After saliva collection, antioxidant capacity of saliva was measured at baseline, after 7days, and after 21days. Statistical evaluation was done by SPSS 21, using paired samplet tests, one-way ANOVA and Bonferroni tests. RESULTS: At day zero nonsmokers had a higher antioxidant capacity than smokers (686.6±62.22 vs. 338.8±59.9) mM/50µl, P<0.001. There was also a significant difference between two groups in salivary total antioxidant capacity after one week and three weeks of green tea consumption (P<0.001). However, there was an upward trend in both smokers and non-smokers over the study period (after tea drinking). In addition, a significant difference was found in total antioxidant capacity alteration in smokers compared to non-smokers from baseline to day 21. CONCLUSIONS: Results support the effectiveness of green tea consumption in salivary antioxidants enhancement in smokers, in both the short- and long term.

Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

BACKGROUND: Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. AIM: The present study compared the clinical effects of photodynamic therapy to dexamethasone mouthwash in the treatment of oral lichen planus lesions. MATERIALS AND METHODS: In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30s (630nm wavelength and 7.2-14.4J/cm2 dose) for 4 sessions in the days 1, 4, 7, 14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15, 30, 60, 90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. RESULTS: No significant difference existed between the two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. CONCLUSION: Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus. It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects.

Is There a Relation between ABO Blood Groups and Clinical Outcome in Patients with Pemphigoid? A Case-Control Study.

Background. Relationship between blood groups and dermatologic diseases remains controversial and was not yet fully elucidated nor explained clearly. The aim of this study was to examine if any relation exists between different types of pemphigoid diseases and ABO blood group. Methods. In this case-control study, 159 pemphigoid patients and 152 healthy matched-controls were evaluated. All blood group (including Rh status) data for the study was obtained from the hospital medical records. Statistical comparisons were completed with chi-square test and logistic regression. Results. Blood group "O" was found in 32.9% of patients and 38.2% of control group. Blood group "A" was found among 30.8% of patients and 34.2% of control group, while group "B" was reported in 27.4% of cases and 21.1% of controls and "AB" was identified among 8.9% of patients and 6.6% of control group. 84.9% of patients were Rh positive, while in the control group 86.2% of patients were Rh positive. No significant differences were found regarding ABO blood groups (P = 0.46) or Rh (P = 0.76) between pemphigoid patients and control group. Also, older females had the higher risk of developing bullous pemphigoid. Conclusion. We found no relationship between ABO blood groups and pemphigoid disease.

Bimaxillary Aneurismal Bone Cyst in Patient with End Stage Renal Disease and Hyperparathyroidism: A Rare Case Report and Review of the Literature.

Aneurismal bone cyst (ABC) is a rare bony lesion occurring predominantly in long bones. Its jaws' involvement is uncommon and the simultaneous involvement of both jaws is very rare. This report is about a 27-year-old female experiencing renal failure with ABC involving her maxilla and mandible. The progressive lesion was treated surgically and there was no recurrence after 18 months of follow-up.

Extensive Focal Epithelial Hyperplasia: A Case Report.

Focal epithelial hyperplasia (FEH) or Heck's disease is a rare viral infection of the oral mucosa caused by human papilloma virus especially subtypes 13 or 32. The frequency of this disease varies widely from one geographic region and ethnic groups to another. This paper reports an Iranian case of extensive focal epithelial hyperplasia. A 35-year-old man with FEH is described, in whom the lesions had persisted for more than 25 years. The lesion was diagnosed according to both clinical and histopathological features. Dental practitioner should be aware of these types of lesions and histopathological examination together and a careful clinical observation should be carried out for a definitive diagnosis.

Removal of an Extra-large Irritation Fibroma With a Combination of Diode Laser and Scalpel.

INTRODUCTION: Irritation fibroma is the most common tumor like and sub mucosal reactive lesion in the oral cavity. Usually it is measured less than 1.5 cm in diameter; however in rare case it has more than 3 cm in diameter. Different kind of treatment for soft tissue lesions include scalpel excision, electrical surgery, and laser surgery. The diode laser can be more effective than conventional surgery, electrosurgery and cryosurgery in reduction of bleeding and pain. CASE REPORT: We reported a very large irritation fibroma in right lingual side of retromolar pad which was less prone to be traumatized under local irritation, in a woman wearing maxillary complete denture and use of both diode laser and scalpel for its excision.

Effect of Cigarette Smoke on Salivary Total Antioxidant Capacity.

Background and aims. Cigarette smoke can induce oral cancer by its free radicals and oxidative damage. Salivary anti-oxidants system is believed to have an important role in defense mechanisms against oxidative stress. This study was compared total antioxidant capacity (TAoC) of saliva in smokers and nonsmokers. Materials and methods . In this cross-sectional study, 30 male smokers with mean age of 45.23 years and 30 nonsmokers with mean age of 45.30 years participated. Unstimulated whole saliva samples were collected in the morning in two groups by spitting method. TAoC of saliva was measured with the special kit in two groups at the same time. Statistical analysis was performed by covariance test. Results. The mean salivary TAoC in nonsmokers (0.741±0.123 U/ml) was higher than that in smokers (0.529±0.167 U/ml). This difference was statistically significant (P<0.001). Conclusion. Smoking can alter salivary antioxidant capacity.

ABO blood groups in oral cancer: a first case-control study in a defined group of Iranian patients.

The ABO blood group has been recently proposed to influence development of oral cancer. The aim of this study was to evaluate the association between the type of ABO blood group and oral cancer. In a case-control study, 104 patients with oral cancer were compared with 90 blood donors without cancer as controls. Data regarding the patient demographics, blood groups, Rh status, cancer characteristics and oral habits were also compared between two subgroups of squamous and non-squamous oral cancers. For statistical analysis, Chi-square test, t-student Test and Logistic Regression were used to analyze the relationship between ABO blood groups and oral cancer. The frequency of blood group B was significantly higher in oral cancer patients than controls (32% vs 13%) (p value=0.01), but Rh factor did not show significant difference between cases and controls. According to Logistic Regression, people with blood group B and those older than 50 had 3.5 and 19.4 times elevated risk of developing oral cancer, respectively. The frequency of squamous cell cancer was also significantly higher in men and people older than 50. On the other hand, females, people under 50, and those with blood group B were at 5.6, 2.9 and 4.3 times higher risk of developing non-squamous cell oral cancer,respectively. People with blood group B are at a greater risk of developing oral cancer, and female patients under 50 years of age with blood group B have the highest risk to develop non-squamous cell oral cancer.

Effect of vitamin C on salivary total antioxidant capacity in smokers.

This study was designed to elucidate the effect of ascorbic acid on salivary total antioxidant capacity in smokers. In this single blind crossover clinical trial, the whole unstimulated saliva of 30 smokers, who were randomly divided into two groups, was collected. In the first phase after the saliva collection, one group of patients took 500 mg of vitamin C powder, for 3 weeks. Then, saliva of all patients was collected. After a one-week wash-out period, vitamin C was given to the other group. The collection of saliva was done after 3 weeks. Total antioxidant capacity was measured. Statistic evaluation was performed by Repeated Measured ANOVA, Independent sample t-test and Covariate test. The mean of total antioxidant capacity with and without using vitamin C was 0.511 ± 0.155 (U/mL) and 0.555 ± 0.171 (U/mL), respectively. This variability was not significant (p = 0.605). Oxidative stress from cigarette smoke was not decreased significantly with using vitamin C.