Micronutrients status as a contributing factor in secondary burning mouth syndrome: A review of the literature

Background and Aims

Patients with burning mouth syndrome (BMS) experience an annoying feeling without clinical evidence of any mucosal lesion. Deficiency or excess of micronutrients is a common feature in secondary BMS. There is limited knowledge among oral healthcare providers regarding the significance of micronutrients in oral health, so the current review focuses on the critical role of these elements in oral health implications as secondary BMS.

Methods

For the data collection, the authors searched for key terms without time limitation (1900-2021) in databases comprised of PubMed, Google Scholar, Scopus, Web of Science (SCI), and Embase.

Results

The total number of matched articles with inclusion criteria involved in this review article was 59 original articles. Among these, 20 randomized clinical trials (RCT), 31 case-control or Crossectional, and 8 case reports/series are reviewed in this review article.

Conclusion

One of the important etiological factors in patients with secondary BMS is micronutrient imbalance. The iron, zinc, vitamin B family, vitamin D deficiency and increased levels of homocysteine and oxidant agents were examined in secondary BMS patients. In addition, oral medicine specialists must consider the possible toxic effects of some elements in restorations and dental prostheses. Further studies, such as RCTs in the future, are recommended.

Saliva Levels of Adrenergic Receptors in Relation to Psychological Factors in Patients with Oral Lichen Planus

OBJECTIVE

To evaluate the saliva level of α1 and β1 adrenergic receptors (ARs) in oral lichen planus (OLP) patients.

METHODS

This case-control study included unstimulated saliva samples from 33 OLP patients (14 erosive, 19 non-erosive) and 33 healthy controls. All participants were evaluated on psychological conditions via the Depression, Anxiety and Stress Scale - 21 items (DASS 21). The saliva levels of α1 and β1 ARs was measured by enzyme-linked immunosorbent assay (ELISA). Data were analysed with a t test using SPSS 25 (IBM, Armonk, NY, USA).

RESULTS

The saliva levels of α1 and β1 ARs of OLP patients (both erosive and non-erosive forms) were significantly higher than in healthy controls. Stress levels in patients with both forms of OLP were significantly higher than in the healthy group. There was a positive correlation between salivary α1 and β1 ARs and stress, and this positive correlation was also seen for saliva β1 ARs between anxiety or depression. The saliva level of α1 ARs was inversely correlated with unstimulated salivary flow rates (r = -0.246; P = 0.046).

CONCLUSION

This study indicated that OLP patients with both erosive and non-erosive forms have higher psychological stress and saliva levels of α1 and β1 ARs than healthy controls; however, the role of α1 and β1 ARs as salivary markers with regard to the development, severity of symptoms and outcome of OLP needs further investigation.

Clinical practice guideline adaptation for risk-based caries management in 18-55 year-old Iranian adults

PURPOSE

To adapt an evidence-based clinical practice guideline (CPG) for risk-based management of caries in 18-55 year-old Iranian adults.

METHODS

A multidisciplinary adaptation team reviewed evidence-based guidelines such as the NICE, SIGN, and ADA according to the defined clinical questions. In addition, databases such as the PubMed and Google Scholar were searched and CPGs were screened and appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) tool. Clinical scenarios were developed and their level of evidence, clinical advantage and adaptability were assessed. Following a two-round ranking by experts, the final recommendations were selected using the RAND-UCLA appropriateness method.

RESULTS

Of 17 CPGs, 5 were selected as the source guidelines for adaptation. To assess the risk of caries in the adult population, reduced Cariogram (without saliva tests) and CAMBRA were suggested as diagnostic tools. In addition, 53 risk-based recommendations on the preventive care (including the use of fluoride toothpaste, fluoride, and chlorhexidine mouthwash, at home and in-office fluoride gel, fluoride varnish, mouth buffering, and sealant), operative intervention threshold, and follow-up interval were adapted for Iranian adults.

CONCLUSIONS

A guideline was adapted for risk-based management of dental caries in Iranian adults. This helps local dentists in decision making and promoting oral health of adults. Further research is needed to assess the external validity and feasibility of the adapted guideline in the Iranian population.

Serum level of estrogen in Iranian patients with oral lichen planus

Background

Oral lichen planus (OLP) is one of the most common diseases in the oral cavity and has a chronic inflammatory nature. The etiology of this disease remains unclear. OLP is more prevalent in women, but to our knowledge, no study yet evaluated estrogen levels in women with OLP.

Objectives

To determine the serum level of estrogen in female patients with OLP.

Methods

This case-control observational study was conducted in patients who were referred to the Department of Oral and Maxillofacial Medicine at the Tehran University of Medical Sciences. After clinical and histopathological confirmation of OLP diagnosis, and according to exclusion and inclusion criteria, 47 women with OLP and 47 healthy women (10 premenopausal and 37 postmenopausal) were included, as case and control groups, respectively. We obtained blood samples (5 mL) from each participant to measure the serum level of 17β-estradiol. Data were analyzed by Spearman rank correlation coefficients and a two-way analysis of variance with Bonferroni post hoc tests.

Results

Serum estrogen level in women with OLP was significantly higher than that in healthy women (P = 0.002), and it was also significantly higher in premenopausal women than postmenopausal women (P < 0.001). The severity of OLP lesions correlated with estrogen level in postmenopausal women (r = 0.650; P < 0.001); in premenopausal women (r = 0.618; P = 0.008), and in all women with OLP (r = 0.535; P < 0.001).

Conclusion

OLP, like other autoimmune diseases, is affected by the serum level of sex hormones such as estrogen.

Micronutrients Profile in Oral Lichen Planus: a Review Literature

Oral lichen planus (OLP) is a relatively common chronic inflammatory disease. The micronutrients are critical factors in health of oral mucous and proper function of immune system. There have not been any review articles for evaluating trace element levels before and after standard treatments of OLP. The purpose of this study is to provide complete review of the association of micronutrients with OLP. Databases including PubMed, Google Scholar, Scopus, and Embase (Ovid) with keywords of oral lichen planus, OLP, oral disorder, micronutrients, trace element, nutrient element, antioxidant, oxidative stress, malnutrition, and essential trace elements, without time limitation (1900-2019) were searched to collect data on related articles. Total number of 58 original articles including 12 randomized clinical trials, 41 case-control, 4 case reports, and 1 cell line research were reviewed in this study. Lower levels of iron and its associated markers, such as hemoglobin and ferritin, increased levels of TIBC; reduced levels of zinc, calcium, vitamin D, vitamin B12, folic acid, and antioxidants such as vitamins C and E; and increased levels of oxidants and homocysteine, have been reported in OLP patients.

α1 adrenergic receptors in serum and saliva of patients with oral squamous cell carcinoma

BACKGROUND

Neurotransmitters released from the sympathetic nervous system attach to the adrenergic receptors on the surface of tumoral cells in response to stress, and alter the expression of genes programming cellular activity. This study aimed to assess the expression of α1 adrenergic receptors in the serum and saliva of patients with oral squamous cell carcinoma (OSCC) compared with healthy controls.

MATERIALS AND METHODS

In this case-control study, serum and stimulated and unstimulated saliva samples were collected from 26 OSCC patients and 26 healthy controls. ELISA kits were used for measurement of the serum and salivary levels of α1 adrenergic receptors.

RESULTS

The level of α1 adrenergic receptors was significantly higher in the stimulated and unstimulated saliva of OSCC patients than healthy controls (P = 0.000). However, their serum level was not significantly different between the two groups (P = 0.389). The serum level of α1 adrenergic receptors significantly increased by an increase in OSCC grade. No significant correlation was noted between the serum and salivary levels of α1 adrenergic receptors in OSCC patients. The salivary level of α1 adrenergic receptors was significantly higher in patients with tumors located in the gingiva, compared with other sites.

CONCLUSION

Significantly higher salivary level of α1 adrenergic receptors in OSCC patients compared with healthy controls, and no significant difference in their serum level between the two groups may indirectly indicate the over-expression of these receptors in OSCC cells, compared with normal oral mucosa. Further studies and particularly histological analyses are required to confirm this finding.

Serum and salivary levels of lactate dehydrogenase in oral squamous cell carcinoma, oral lichen planus and oral lichenoid reaction

BACKGROUND

Increased levels of lactate dehydrogenase (LDH) as a tumor marker have been reported in malignant and some premalignant oral lesions such as oral lichen planus (OLP) and oral lichenoid reactions (OLRs). This study aimed to assess the level of total LDH in the saliva and serum of patients with oral squamous cell carcinoma (OSCC), OLP and OLRs.

METHODS

In this case-control study, the participants were divided into four groups (n = 25) of healthy controls, OLP, OLRs, and OSCC. The serum and stimulated/unstimulated salivary levels of LDH were spectrophotometrically measured using standard LDH kits (Pars Azmoun). One-way ANOVA, Chi-square test, Pearson's correlation test, and receiver operating characteristic (ROC) analysis were applied to analyze the data.

RESULTS

The serum and salivary levels of LDH in OSCC patients were significantly higher than that the corresponding values in other groups (P = 0.0001). The serum level of LDH in OLR group was significantly higher than that in the control and OLP groups (P = 0.0001), but the difference in salivary level of LDH was not significant. The ROC analysis showed that both the serum and salivary levels of LDH had significant diagnostic ability for detection of OSCC and OLRs. Significant associations were noted between the serum and salivary levels of LDH.

CONCLUSIONS

Patients with OSCC and OLRs had higher serum levels of LDH than OLP and control groups. Further prospective longitudinal studies are required to assess the tissue level of LDH and monitor the transformation of OLRs because they have low rate of malignant transformation compared with other oral premalignant lesions.

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.

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, 15^th and 30^th 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.

Association of MAPK and its regulatory miRNAs (603, 4301, 8485, and 4731) with the malignant transformation of oral lichen planus

Oral lichen planus (OLP) is a potentially malignant oral lesion that may transform into oral squamous cell carcinoma (OSCC). The purpose of this study was to assess the level of expression of MAPK/ERK1/2 gene, and microRNA (miR)-603, 4301, 8485, and 4731 in the MAPK signaling pathway in OLP and OSCC lesions. This case-control study evaluated 26 OSCC, 20 OLP and 20 healthy control tissue specimens. After RNA extraction, the respective miRNA and MAPK/ERK1/2 mRNA levels were assessed by quantitative reverse transcription polymerase chain reaction (RT-PCR). Significant upregulation of MAPK/ERK1/2 gene was noted in the OLP and OSCC specimens compared with healthy controls (p < 0.001). The expression level of miR-4731 was significantly lower in the OLP and OSCC specimens than in the healthy specimens (p < 0.001). The expression of MiR-603 was the lowest in OLP, followed by OSCC and then the control group (p < 0.001). No significant difference was found in miR-4801 levels between OSCC and OLP specimens compared with healthy controls (p = 0.43 and p = 0.86, respectively). In addition, a non-significant decrease in miR-8485 levels was noted in the OSCC and OLP specimens compared with healthy controls (p = 0.98 and p = 0.61, respectively). A significant decrease in level of miR-603 was noted in OLP compared with OSCC group (p < 0.001). The miR-4801 and miR-8485 expression levels were directly correlated with MAPK/ERK1/2 mRNA expression (p = 0.01). Higher expression level of MAPK/ERK1/2, miR-603, miR-4801, and miR-4731, and lower expression level of miR-8485 were correlated with significantly lower overall survival rate in OSCC patients. The increased expression of MAPK/ERK1/2 and decreased expression of miR-603 and miR-4731 are associated with greater risk of OLP malignant transformation and poor histopathological characteristics of OSCC.

The effect of low level laser on number of Candida albicans colonies in-vitro: a new finding

Background

Candida albicans is a commensal organism that causes a wide variety of diseases in humans. One of these diseases is oral candidiasis, which occurs at a high recurrence rate in spite of available treatments. The purpose of this study was to compare the effect of low-level laser therapy (LLLT) with the use of nystatin on in-vitro growth of Candida albicans.

Method

We prepared two samples of Candida albicans at different concentrations: 10⁴ viable cells/ml and 10⁶ viable cells/ml. Specimens from each sample were divided into a control group, a nystatin-treated group, and a group treated with LLLT. The control group was cultured without any intervention. The second group was treated with nystatin and the solution was vibrated for 30 s or 60 s. The third group was irradiated with a gallium-aluminum-argon (Ga-Al-Ar) diode laser (Epic 10; Biolase Inc.)in continuous mode using a wavelength of 940 nm and a power of 1 W for 30 s or 60 s (38 J/cm² and 76 J/cm²). The specimens from the nystatin group and the LLLT group were cultured and the number of colony-forming units (CFU/ml) for each group was counted and compared.

Results

Nystatin completely eliminated the colonies (0 colonies) in all specimens. There was an increase in the number of colonies in the LLLT group for both cell concentrations at 30 s and at 60 s. However, this increase was statistically significant only for a concentration of 10⁴ viable cells/ml at an exposure time of 30s. The increase in the concentration of 10⁶ viable cells/ml at both 30 s and 60 s was statistically significant compared with the control group, although the highest number of colonies remained after an exposure time of 60s.

Conclusion

LLLT led to an increase in the growth of Candida colonies. However, there was no significant difference related to the exposure time between the different cell concentrations.

Predictive factors of survival rate in oral squamous cell carcinoma: A retrospective study in Iran

Objective: Oral cancer as a part of this collection plays an important role in the burden of diseases, especially in South Asia. Despite numerous advances in the treatment of cancers, oral cancer is one of the top ten causes of death due to delayed detection. Given the role of the environmental and climatic conditions in cancers, there is a need for epidemiological studies in different geographic areas. Methods: In present study, data were collected through medical records of the patients with oral cancer during 2009 to 2012 in the archives of the Cancer Department of the Ministry of Health of the Islamic Republic of Iran. The follow-up of 82 cases was possible in the study. Data collection were performed from questionnaire. The data were analyzed by SPSS version 20. The Kaplan Meier survival curves were utilized and, moreover, the corresponding influential factors were examined by using the Cox regression test. Result: The overall five-year survival rate was 40.24% (SE= 5.5). The most widely used treatment method was a combination of three methods of surgery, radiation therapy, and chemotherapy. The gender of 64.63%of patients were male. The mean age of patients were 66.1 years. The age and regular periodic follow-up had a statistically significant relation with the survival rate (P=0.02, P=0.03). Conclusion: Oral cancers require special attention due to high prevalence and overall survival rates. Training oral health care providers, and periodic follow up can be an important step in increasing the survival of these patients.

A comparison of the effect of triamcinolone ointment and mouthwash with or without zinc on the healing process of aphthous stomatitis lesions

Background. Recurrent aphthous stomatitis (RAS) is one of the most common ulcerative diseases of the oral mucosa. Definitive etiology of RAS has not been conclusively established. There is no certain treatment for aphthous stomatitis but some drugs such as steroids are commonly used for the treatment of RAS. Regarding the effect of zinc on the healing process of epithelial layer and cell division, in this research the effect of triamcinolone (with orabase) in combination with a zinc-containing mouthwash and triamcinolone alone on the healing process of RAS lesions was assessed.

Methods. The present study consisted of 20 patients diagnosed with RAS. The patients were instructed to rinse the mouth-wash or placebo three times a day and triamcinolone ointment twice a day for two weeks. The largest dimension of the ulcer was measured by a digital caliper and the severity of pain was assessed by visual analogue scale (VAS). Number, size, duration, ulcer-free period and pain of the lesions were evaluated twice a week for twomonths. Data were analyzed by SPSS 16 using Mann-Whitney U test and t-test.

Results. A decrease was seen in the mean pain severity score (P = 0.631) and the size of the lesions but it was not statistically significant (P = 0.739). Also the difference between the number of lesions (P = 0.739), duration and ulcer-free period (P = 0.873) were not statistically significant.

Conclusion. Zinc mouthwash seems to be as effective on wound healing process as typical treatment modalities for RAS.

Extramedullary Plasmacytoma of the Oral Cavity in a Young Man: a Case Report

Extramedullary plasmacytomas are rare solitary soft tissue tumors that arise from proliferations of malignant transformed monoclonal plasma cells and can be diagnosed through biopsy and histopathologic examination. These lesions are closely associated with multiple myelomas, which should be ruled out in all these cases by necessary laboratory and radiographic examinations. A 25-year-old man was referred to our clinic with a rapidly-growing painless lesion measuring about 2.5×3×3 cm in the palatal side of the left maxillary second and third molar teeth. A diagnosis of solitary plasmacytoma was made on the basis of clinical, radiographic, and histopathological findings. Early diagnosis of extramedullary plasmacytomas is of great importance. Radiotherapy is the common modality of treatment with or without adjuvant chemotherapy. Progression to multiple myeloma is possible; thus, close follow-up of the patient is essential after completion of the therapeutic procedure.

The Relationship between Anger Expression and Its Indices and Oral Lichen Planus

Oral lichen planus (OLP) is a common inflammatory disease with unknown etiology. Depression, stress and anxiety are psychological factors that their influence on the expression of lichen planus by affecting the immune system's function has been confirmed. There is a probable relationship between anger and OLP expression. Therefore, the present study aimed to evaluate the association of "anger" and OLP. In this descriptive study 95 subjects were included in 3 groups. A: patients with oral lichen planus, B: positive control, C: negative control. Anger and its indices were assessed by the State-Trait Anger Expression Inventory-2 (STAXI-2) questionnaire, and pain was measured via the Visual Analogue Scale (VAS). The collected data were analyzed statistically using SPSS 18 software. The lichen planus and positive control groups bore higher total anger index (AX index) values compared with the negative control. Comparing anger expression-in (AXI) among the lichen planus and negative control groups revealed higher grades in lichen planus group. Evaluating the pain severity index (VAS) data and anger indices in lichen planus group, Spearman's Rank Correlation Test revealed a significant correlation between TAngR (reactional anger traits) and pain severity. The findings of this study indicated that there was a significant correlation between anger control and suppression of lichen planus development. On the other hand, the patients with more severe pain mostly expressed their anger physically. Based on the findings, we can make the claim that anger suppression and its control-in (gathering tension) may play a role in the development of lichen planus as a known psychosomatic disorders.

Evaluation of the Relationship between Serum Lipid Profile andOral Lichen Planus

Background and aims. Oral lichen planus (OLP) is an immunologic disorder. A large number of studies have reported that lipid rafts have a key role in receptor signaling of lymphocytes. Here, we explore the potential of lipid rafts as targets for the development of a new class of agents to down-modulate immune responses and treat autoimmune diseases. Materials and methods. The present cross-sectional study evaluated 88 patients referring to the Department of Oral Medicine in 3 groups (Group 1: erosive OLP; Group 2: non-erosive OLP; Group 3: healthy). A total of 3 mL of blood sample was taken from each subject and the serum levels of cholesterol, triglycerides, HDL and LDL were determined. The mean outcomes of each group were compared with each other and analyzed two by two. Results. The results of statistical analyses showed no significant differences in mean HDL and LDL serum levels between the three groups. The results of post hoc LSD test showed that mean serum levels of subjects with erosive and non-erosive lichen planus were higher than those in healthy subjects. In relation to triglyceride serum levels, the mean serum levels of triglycerides were higher in erosive and non-erosive OLP patients compared to healthy subjects. Conclusion. Triglyceride and cholesterol can be considered to have a critical role in the incidence of lichen planus and in its manifestations as predisposing factors.

Treatment of Symptomatic Geographic Tongue with Triamcinolone Acetonide Alone and in Combination with Retinoic Acid: A Randomized Clinical Trial

OBJECTIVES

Geographic tongue or migratory glossitis is an inflammatory disorder with unknown etiology. Considering the accompanied burning pain, taste dysfunction, and lack of definite cure, it is important to treat this condition symptomatically. The objective of the current study was to compare the efficacy of a combination of 0.05% retinoic acid and 0.1% triamcinolone acetonide with that of triamcinolone acetonide alone for treatment of symptomatic geographic tongue.

MATERIALS AND METHODS

This randomized controlled double-blind clinical trial was performed on 28 patients with symptomatic geographic tongue, who were referred to two dental clinics. Participants were randomly divided into two groups and treated with triamcinolone alone or retinoic acid plus triamcinolone for 10 days. Patients were assessed for the level of pain, burning sensation and size of lesion at the beginning and at the end of the study. Participants were followed up for two months after cessation of treatment (at the end of each month). SPSS 11 was applied to compare the two therapeutic modalities.

RESULTS

Twenty-eight participants with a mean age of 40 years were evaluated including Seven (25%) males and 21(75%) females. There was a positive family history of geographic tongue in 21 patients. Despite the diminished pain and burning sensation as well as smaller size of lesions following treatment (P<0.05), no statistically significant differences were found between the two groups (P> 0.05). No side effect was reported.

CONCLUSIONS

The combination of triamcinolone and retinoic acid was not more effective than triamcinolone alone for symptomatic treatment of geographic tongue.

Physicochemical and in vitro mucoadhesive properties of microparticles/discs of betamethasone for the management of oral lichen planus

This study involved the preparation and evaluation of buccal-mucoadhesive microparticles/discs of bethamethasone disodium phosphate (BDSP). The microparticles were prepared using the emulsion solvent diffusion method. Microparticles were prepared and characterized by encapsulation efficiency particle size, Fourier Transform Infra Red (FTIR) spectrums, Differential Scanning Calorimetric (DSC) thermograms and mucoadhesive properties. FTIR studies reported that BDSP was changed to bethamethasone base molecule inside the intact microparticles. The best drug to polymers ratio in microparticles was F₁ containing 50 mg drug, 50 mg HPMC (as non-ionic and hydrophilic polymer) and 50 mg carbomer 934p (an anionic mucoadhesive polymer). The production yield of F1 microparticles was calculated as 78.60% with loading efficiency of about 65.14% and the mean particle size was also measured as 281.84 μm. It was proposed that during the microparticle preparation procedure, water soluble salt of the drug may be converted to the base which could be more effective in the buccal mucosa due to its higher partition coefficient and lipophilicity. The highest and lowest releases resulted from the discs prepared from F₁ and F₄, respectively, compared with the commercial tablet and untreated drug powder (p < 0.05). The data revealed that the discs exhibited good percentage of mucoadhesion (F₁, 326 g/cm²). It may be concluded that drug loaded buccal-mucoadhesive microparticles are a suitable delivery system for BDSP, and may be used in the effective management of lichen planus.

Comparison of Serum Autoantibodies to Desmogleins I, III in Patients with Oral Lichen Planus and Healthy Controls

BACKGROUND & OBJECTIVE

Lichen planus is a mucocutaneous disease which is relatively common and in 30-70% of patients, mucosal lesions can be seen and known as a precancerous lesion but its etiology is not completely understood. Desmogleins I and III are the main desmosomal transmembrane proteins. These proteins have been identified as the autoantigen of the autoimmune disease. The aim of this study was evaluation of serum autoantibodies against desmogleins Ι, ΙΙΙ in oral lichen planus .

METHODS

We attempted to determine the etiology of this disease with evaluation of these serum factors. Thirty-five patients with oral lichen planus and 35 healthy controls were recruited and tested for serum autoantibodies against desmogleins Ι, ΙΙΙ and indirect immunofluorescence also performed. Data were analyzed by statistical-analytical methods (Independent sample t -test) with using the SPSS.15 software.

RESULTS

Serum autoantibody against desmoglein Ι had no significant difference in the two groups ( P =0.31 ) but significant increase in serum autoantibody to desmoglein ΙΙΙ was found in patients with oral lichen planus ( P =0.00) .

CONCLUSION

It seems that autoantibody against desmoglein III has a significant role in the pathogenesis of oral lichen planus.

Evaluation of the serum zinc level in erosive and non-erosive oral lichen planus

STATEMENT OF PROBLEM

Lichen planus is a chronic inflammatory immunologic-based disease involving skin and mucosa. This disease is generally divided into two categories: erosive and non-erosive. Many etiologic factors are deliberated regarding the disease; however, the disorders of immune system and the role of cytotoxic T-lymphocytes and monocytes are more highlighted. Zinc is an imperative element for the growth of epithelium and its deficiency induces the cytotoxic activity of T-helper2 cells, which seems to be associated with lichen planus.

PURPOSE

This study was aimed to evaluate the levels of serum zinc in erosive and non-erosive oral lichen planus (OLP) and to compare it with the healthy control group to find out any feasible inference.

MATERIALS AND METHOD

A total of 22 patients with erosive oral lichen planus, 22 patients with non erosive OLP and 44 healthy individuals as the control group were recruited in this descriptive-comparative study. All the participants were selected from the referees to the department of oral medicine, school of dentistry, Tabriz University of Medical Sciences. Serum zinc level was examined for all the individuals with liquid-stat kit (Beckman Instruments Inc.; Carlsbad, CA). Data were analyzed by adopting the ANOVA and Tukey tests, using SPSS 16 statistical software.

RESULTS

The mean age of patients with erosive and non-erosive LP was 41.7 and 41.3 years, respectively. The mean age of the healthy control group was 34.4 years .The mean serum zinc levels in the erosive and non erosive lichen planus groups and control groups were 8.3 (1.15), 11.15 (0.92) and 15.74 (1.75) μg/dl respectively. The difference was statistically significant (p< 0.05).

CONCLUSION

The serum zinc levels were decreased in patients with erosive oral lichen planus. This finding may probably indicate the promising role of zinc in development of oral lichen planus.

Evaluation of serum nitric oxide level in patients with oral lichen planus

STATEMENT OF PROBLEM

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease with indefinite etiology. In recent researches, free radicals have been deliberated as the possible etiology of inflammatory and autoimmune diseases.

PURPOSE

This study was aimed to evaluate the stress oxidative status with the nitric oxide (NO) index in a sample of Iranian population.

MATERIALS AND METHOD

In this descriptive-comparative study, serum NO level was assessed in 20 OLP patients as the case group and 20 healthy individuals as the control group. Collected data were analyzed by adopting two Sample t-test, using SPSS 16 software. The statistical significance level was set at p< 0.05.

RESULTS

The mean serum NO levels in OLP patients and healthy controls were 17.1±3.4 ng/ml and 14.5±2.7 ng/ml respectively; which revealed a significant statistical difference (p= 0.009).

CONCLUSION

The results of the current study with its limitation may support the premise that higher serum levels of NO in patients with OLP might activate the process of lymphocytes and cellular immunity system; hence, possibly endorsing the effect of serum NO in pathogenesis of lichen planus.

Feasibility of breast cancer screening by PIXE analysis of hair

To reveal the role of key elements present in the hair of breast cancer patients on cancer development, the levels of a number of elements in scalp hair samples of 82 people including healthy individuals, people suffering from benign breast disease, and breast cancer patients were measured by PIXE analysis. Pellets of hair samples were prepared and bombarded by 2.2 MeV proton beam of a 3-MV Van de Graaff accelerator. The number of incident ions hitting the sample was indirectly measured using the RBS spectrum of a thin Ag film placed in the beam path. The concentrations of S, Cl, K, Ca, Fe, and Cu in the hair of healthy individuals were in agreement with those observed in the hair of hyperplasia and cancer patients within standard deviations. However, a lower average level of zinc was found in samples from hyperplasia and breast cancer patients. Strong positive correlations were found between iron and potassium as well as between calcium and potassium in the cancer patients. These results could be of significance in the screening for breast cancer.

Pemphigus Vulgaris Associated with Rheumatoid Arthritis in a Patient not Taking Penicillamine

D-penicillamine is one of the disease-modifying anti-rheumatic drugs (DMARDs). Drug-induced pemphigus is not fre-quently associated with D-penicillamine, and to date, the number of reported cases is about a hundred. Most reports of D-penicillamine-induced pemphigus vulgaris are in patients with rheumatoid arthritis. It has rarely been reported in patients not taking D-penicillamine. We report a case of pemphigus vulgaris in a 48-year-old female patient with rheumatoid arthri-tis, not taking penicillamine.

Relationship between Lichen Planus and Helicobacter pylori Infection

Background and aims

Lichen planus (LP) is a relatively common, chronic dermato-mucosal disease that often affects the oral mucosa. Among bacterial infections affecting LP, Helicobacter pylori has recently been proposed as an important etiologic factor. The present study was designed to evaluate the association of LP and H. pylori infection.

Materials and methods

This study included 30 patients with skin LP, 30 patients with oral LP and 30 healthy individuals without LP as control group. Patients and control group were selected from those referred to a dental and a dermatology clinic. Urea breathing test (UBT) was performed for all subjects. Descriptive statistic (frequency and percentage) were applied and chi-square test was employed to compare mean differences, using SPSS 13.0 computer software.

Results

UBT test were positive in 24 patients (80%) in oral LP group, 22 patients (73.3%) in skin LP group, and 20 individuals (66.7%) in the control group. No significant differences were found in the positive test results between the three groups (P = 0.50).

Conclusion

In this study, no significant association was found between LP and H. Pylori infection.

Oral lichen planus: clinical features, etiology, treatment and management; a review of literature

Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many un-established etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

Evaluation of Relationship between Lichen Planus and HCV Antibody

BACKGROUND AND AIMS

Lichen planus is a relatively common chronic mucocutaneaous disease with an unknown cause, and is considered a manifestation of cell-mediated immune response. Hepatitis C virus (HCV) and its subgroups have been associated with lichen planus in different geographic locations. The present study was undertaken to evaluate the prevalence of HCV antibody in patients with lichen planus in northwest Iran.

MATERIALS AND METHODS

This descriptive analytical study included 30 patients with cutaneous lichen planus, 30 pa-tients with oral lichen planus, and 30 healthy individuals as controls. Anti-HCV test was run for all the subjects. Descriptive statistics as well as chi-square test, to compare means in the three study groups, were applied to the data using SPSS 14.0 computer software.

RESULTS

Age and sex differences between the groups were not significant. No statistically significant differences were ob-served in anti-HCV test results between the groups (P = 0.50).

CONCLUSION

No statistically significant relationships were observed between lichen planus and HCV antibody in the studied samples.

Knowledge and Attitude of Dental Practitioners in Ta-briz Regarding Infection Control Procedures

BACKGROUND AND AIMS

Blood-borne infections such as hepatitis B, hepatitis C and HIV might be transmitted from one individual to another during dental procedures. Therefore, sterilization and personal protection procedures are of utmost significance in dental offices. The importance of awareness of cross-infection and antiseptic principles lies in the fact that in most cases it is not possible to identify patients with hepatitis or AIDS. The aim of the present study was to evaluate awareness of infection control procedures among dental practitioners in Tabriz.

MATERIALS AND METHODS

In this descriptive study, 150 dental practitioners working in clinics and pri-vate offices of Tabriz were randomly selected. Data was collected by means of a self-administered questionnaire, which included respondents' personal profile and questions on infection control and sterilization methods.

RESULTS

There were no statistically significant differences in the level of knowledge between male and female dental practitioners regarding infection control; however, there was a decline in awareness as age increased.

CONCLUSION

The results of the present study suggest that in some cases dental practitioners neglect the principles for personal protection and cross-infection control. Therefore, our society is subject to widespread infection in dental offices and clinics. This potential risk necessitates careful monitoring along with government support of treatment procedures, the inclusion of infection control costs into treatment expenses and an emphasis on continuing education about infection control procedures through seminars and congresses.