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Pitak-Arnnop P, Subbalekha K, Muangchan C, Auychai P, Sirintawat N, Meningaud JP, Neff A. Angiotensin-Converting Enzyme Inhibitor-Induced Non-allergic Perioral Angioedema: A Case-Based Scoping Review. Korean J Fam Med 2023; 44:2-10. [PMID: 34808742 PMCID: PMC9887447 DOI: 10.4082/kjfm.21.0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 01/31/2023] Open
Abstract
Patients with angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema (ACEIIA) may visit family physicians. The aim of this article was to describe a case of delayed-onset ACEIIA and to present a concise scoping review. Using a case report and a scoping review study design, we report a case of ACEIIA, with clinically confirmed diagnosis. The symptoms resolved after replacing the offending ACEI with another antihypertensive agent. After excluding other causes of perioral swelling and discontinuation of ACEI, the patient was symptom-free within a few days thereafter. Based on this case presentation, we performed a meta-narrative scoping review including up-todate diagnosis and management of ACEIIA, based on published data in English, French, and German from inception to April 1, 2021. Patients with angioedema of unknown origin should be cautiously examined to rule out oral diseases, including allergy to dental materials and drug-induced angioedema. Clinicopathological aspects and current treatment guidelines for ACEI-associated angioedema are also presented.
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Affiliation(s)
- Poramate Pitak-Arnnop
- Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany,Corresponding Author: Poramate Pitak-Arnnop https://orcid.org/0000-0002-7427-3461 Tel: +49-6421-58-63239, Fax: +49-6421-68990, E-mail:
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Chayawee Muangchan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prim Auychai
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nattapong Sirintawat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Jean-Paul Meningaud
- Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, Henri Mondor University Hospital, AP-HP, Faculty of Medicine, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France
| | - Andreas Neff
- Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany
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Porter SR, Crighton A. Obituary of Professor Sir David Mason. Oral Dis 2022. [PMID: 35818834 DOI: 10.1111/odi.14309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Affiliation(s)
- S R Porter
- UCL Eastman Dental Institute, UCL Rockefeller Building, 21 University Street, London
| | - A Crighton
- University of Glasgow Dental School, Glasgow
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3
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Santos DSDA, Galvão GS, Ribas PF, Peres MPSDM, Franco JB. Photodynamic therapy in the treatment of oral lesions caused by paracoccidiomycosis. Photodiagnosis Photodyn Ther 2021; 37:102648. [PMID: 34823032 DOI: 10.1016/j.pdpdt.2021.102648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022]
Abstract
Paracoccidioidomycosis (PCM) is an endemic disease caused by the dimorphic fungus Paracocdioides brasiliensis and Paracoccidioides lutzii. Oral ulcers are usually the first clinical signs of the disease. As it is a systemic fungal disease, local treatments are considered complementary, such as photodynamic therapy (aPDT). We present a patient with ulcerated lesions in the oral cavity of about 6 months duration. The pain complaint in the oropharynx led to a reduction in food acceptance and a weight loss of around 40 kg. He underwent biopsy of the lip lesion, and the histopathological report described yeast with multiple buds compatible with PMC. Our team opted for treatment with aPDT sessions. Two sessions were carried out in the ward and six in the ICU, showing satisfactory results in the remission of ulcerated lesions associated with PCM as well as the painful symptoms in the oral cavity. Also, the patient underwent Amphotericin B and Sulfamethoxazole-trimethoprim. We believe that the association of aPDT with pharmacological therapy possibly accelerated the repair process of oral lesions, as well as providing fungal lesion decontamination, improving progressively the healing of oral lesions.
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Affiliation(s)
| | - Gustavo Souza Galvão
- Department of Dentistry, Central Institute, Clinical Hospital of Medical School of the University of São Paulo, São Paulo, SP, Brazil
| | - Priscila Fernandes Ribas
- Department of Dentistry, Central Institute, Clinical Hospital of Medical School of the University of São Paulo, São Paulo, SP, Brazil.
| | | | - Juliana Bertoldi Franco
- Department of Dentistry, Central Institute, Clinical Hospital of Medical School of the University of São Paulo, São Paulo, SP, Brazil; Department of Dentistry, Auxiliary Hospital of Suzano - Clinical Hospital of Medical School of the University of São Paulo - São Paulo, SP, Brazil.
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4
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Fahy E, Mulvihill C, O'Donoghue G, O'Regan E, Collins M. Neurofibromatosis -1 diagnosed from an intraoral swelling - a case series. Aust Dent J 2020; 66:205-211. [PMID: 32990942 DOI: 10.1111/adj.12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 02/02/2023]
Abstract
The neurofibromatoses [NF 1, NF 2 and schwannomatosis] are a group of genetic disorders that lead to the development of nervous system tumours and have diverse dermatologic, neurologic, ophthalmic, skeletal and vascular effects. The most common is NF 1 (Neurofibromatosis 1) also known as von Recklinghausen's disease, which is one of the most common human genetic diseases. Oral manifestations of NF 1 are reported in 72% of cases and in one of our cases precipitated attendance at a general dental practitioner (GDP), subsequent diagnosis and genetic screening for family members. This disease may go undiagnosed due to its variable expressivity of symptoms. The pivotal importance of a GDP in the discovery and early referral to an oral or oral and maxillofacial surgeon for further investigation and diagnosis of this condition is highlighted. Knowledge of the most common features of neurofibromatosis can facilitate the speedy referral and subsequent diagnosis of generalized neurofibromatosis, local surgical management of benign neoplasms and long term management of its other clinical features. Dentists should be aware of the classic symptoms of this condition and of their role in long-term care in view of the risk of local recurrence and malignant transformation.
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Affiliation(s)
- E Fahy
- Dublin Dental University Hospital, Dublin, Ireland
| | - C Mulvihill
- Dublin Dental University Hospital, Dublin, Ireland
| | - G O'Donoghue
- Dublin Dental University Hospital, Dublin, Ireland
| | - E O'Regan
- Dublin Dental University Hospital, Dublin, Ireland.,Department of Histopathology, St James's Hospital, Dublin, Ireland
| | - M Collins
- Dublin Dental University Hospital, Dublin, Ireland
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Abstract
Leukemic cells are rarely present in the oral cavity, and there are very few reports regarding such cases. However, we identified some reports of leukemic cells infiltrating tissues in the oral cavity, including gingival involvement. Recurrent painful oral ulcerations and prominent generalized periodontal destruction are the most common oral features of neutrophil disorders, and they may even be the initial symptoms of the disease. The ulcers may affect any part of the oral mucosa, including the tongue and palate. The objective of this report is to describe and discuss a case of myeloid sarcoma in the oral cavity of a 48-year-old male patient.
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Affiliation(s)
| | - Felipe Paiva Fonseca
- Universidade Federal de Minas Gerais (UFMG), School of Dentistry, Department of Oral Surgery and Pathology. Belo Horizonte, MG, Brazil
| | | | | | - Luciana Tucunduva
- Hospital Sírio-Libanês, Department of Onco-Hematology and Bone Marrow Transplantation. São Paulo, SP, Brazil
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Ge X, Xie H, Nguyen T, Zhao B, Xu J, Du J. Renin Promotes STAT4 Phosphorylation to Induce IL-17 Production in Keratinocytes of Oral Lichen Planus. iScience 2020; 23:100983. [PMID: 32213463 DOI: 10.1016/j.isci.2020.100983] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/18/2020] [Accepted: 03/08/2020] [Indexed: 01/01/2023] Open
Abstract
Interleukin-17 (IL-17) is highly expressed in the epithelial layer of oral lichen planus (OLP), but the underlying mechanism for IL-17 overexpression remains unknown. Here, we identify renin that is induced by NF-κB pathway contributes to the increase of IL-17 in human oral keratinocytes (HOKs). We describe that the release of cellular renin leads to the phosphorylation of Janus kinase 2 (JAK2) protein. The phosphorylated JAK2 recruits and activates the signal transducer and activator of transcription 4 (STAT4) by phosphorylating STAT4's tyrosine residue 693 (Tyr693). The now-activated STAT4 translocates into nucleus and binds to the promoter region of IL-17 gene in HOKs. Genetic interference of renin restores IL-17 levels in OLP cell models. Collectively, our results reveal that renin upregulates IL-17 expression by enhancing STAT4 phosphorylation. This discovery unveils an underpinning by which IL-17 is increased in oral keratinocytes and provides potential targeted therapies for OLP patients.
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Siqueira JM, Fernandes PM, de Oliveira ACF, Vassallo J, Alves FDA, Jaguar GC. Primary diffuse large B-cell lymphoma of the mandible. Autops Case Rep 2019; 9:e2019109. [PMID: 31528626 PMCID: PMC6709649 DOI: 10.4322/acr.2019.109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/02/2019] [Indexed: 12/26/2022] Open
Abstract
Primary intraosseous non-Hodgkin lymphoma in the mandible is uncommon, representing about 0.6% of all extranodal lymphomas. We present the case of a 51-year-old male with a 4-month complaint of mandibular swelling and paresthesia, which had been previously submitted to an unsuccessful periodontal treatment. The intra-oral evaluation showed an extensive swelling with teeth mobility in the right mandible body. The panoramic radiography and computed tomography images showed an extensive osteolytic lesion. An incisional biopsy was performed and the histopathological and immunohistochemical analysis established the diagnosis of diffuse large B-cell lymphoma. The treatment included six cycles of chemotherapy with complete remission. The patient is under the seventh month of follow-up with no evidence of relapse. Although uncommon in the oral cavity, lymphoma should be considered in the differential diagnosis.
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Affiliation(s)
| | - Patrícia Maria Fernandes
- A.C. Camargo Câncer Center, Stomatology Department. São Paulo, SP, Brazil.,University of Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis. Piracicaba, SP, Brazil
| | | | - José Vassallo
- A.C. Camargo Cancer Center, Pathologic Anatomy Department. São Paulo, SP, Brazil
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Lambert MJ, Vanobbergen JSN, Martens LC, De Visschere LMJ. Socioeconomic inequalities in caries experience, care level and dental attendance in primary school children in Belgium: a cross-sectional survey. BMJ Open 2017; 7:e015042. [PMID: 28729310 PMCID: PMC5541598 DOI: 10.1136/bmjopen-2016-015042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce. AIMS To explore oral health inequalities and to assess the impact of socioeconomic factors on oral health, oral health behaviour and dental compliance of primary school children. METHODS Data collection was executed in 2014 within a sample of 2216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire. Intermutual Agency database was consulted to objectively determine individuals' social state and frequency of utilisation of oral healthcare services. Underprivileged children were compared with more fortunate children for their mean DMFt, DMFs, plaque index, care index (C, restorative index (RI), treatment index (TI), knowledge and attitude. Differences in proportions for dichotomous variables (RI100%, TI100% and being a regular dental attender) were analysed. The present study was approved by the Ethics Committee of the University Hospital Ghent (2010/061). All parents signed an informed consent form prior to data collection. All schools received information about the study protocol and agreed to participate. Children requiring dental treatment or periodic recall were referred to the local dentist. RESULTS Underprivileged children had higher D1MFT (95% CI 0.87 to 1.36), D3MT (95% CI 0.30 to 0.64), plaque scores (95% CI 0.12 to 0.23) and lower care level (p<0.02). In the low-income group, 78.4% was caries-free, compared with 88.4% for the other children. Half of the low-income children could be considered as regular dental attenders, while 12.6% did not have any dental visit during a 5-year period. CONCLUSION Oral health, oral hygiene, oral healthcare level and dental attendance patterns are negatively affected by children's social class, leading to oral health inequalities in Belgian primary school children.
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Affiliation(s)
- Martijn J Lambert
- Department of Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium
| | - Jacques S N Vanobbergen
- Department of Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium
| | - Luc C Martens
- Department of Paediatric Dentistry and Special Care, Paecomedis Research Cluster, Dental School, Ghent University, Ghent, Belgium
| | - Luc M J De Visschere
- Department of Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium
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Saltaji H, Armijo-Olivo S, Cummings GG, Amin M, Flores-Mir C. Methodological characteristics and treatment effect sizes in oral health randomised controlled trials: Is there a relationship? Protocol for a meta-epidemiological study. BMJ Open 2014; 4:e004527. [PMID: 24568962 PMCID: PMC3939646 DOI: 10.1136/bmjopen-2013-004527] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION It is fundamental that randomised controlled trials (RCTs) are properly conducted in order to reach well-supported conclusions. However, there is emerging evidence that RCTs are subject to biases which can overestimate or underestimate the true treatment effect, due to flaws in the study design characteristics of such trials. The extent to which this holds true in oral health RCTs, which have some unique design characteristics compared to RCTs in other health fields, is unclear. As such, we aim to examine the empirical evidence quantifying the extent of bias associated with methodological and non-methodological characteristics in oral health RCTs. METHODS AND ANALYSIS We plan to perform a meta-epidemiological study, where a sample size of 60 meta-analyses (MAs) including approximately 600 RCTs will be selected. The MAs will be randomly obtained from the Oral Health Database of Systematic Reviews using a random number table; and will be considered for inclusion if they include a minimum of five RCTs, and examine a therapeutic intervention related to one of the recognised dental specialties. RCTs identified in selected MAs will be subsequently included if their study design includes a comparison between an intervention group and a placebo group or another intervention group. Data will be extracted from selected trials included in MAs based on a number of methodological and non-methodological characteristics. Moreover, the risk of bias will be assessed using the Cochrane Risk of Bias tool. Effect size estimates and measures of variability for the main outcome will be extracted from each RCT included in selected MAs, and a two-level analysis will be conducted using a meta-meta-analytic approach with a random effects model to allow for intra-MA and inter-MA heterogeneity. ETHICS AND DISSEMINATION The intended audiences of the findings will include dental clinicians, oral health researchers, policymakers and graduate students. The aforementioned will be introduced to the findings through workshops, seminars, round table discussions and targeted individual meetings. Other opportunities for knowledge transfer will be pursued such as key dental conferences. Finally, the results will be published as a scientific report in a dental peer-reviewed journal.
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Affiliation(s)
- Humam Saltaji
- Orthodontic Graduate Program, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Greta G Cummings
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Amin
- Division of Pediatric Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Canada
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Kwa VIH, Algra A, Brundel M, Bouvy W, Kappelle LJ. Microbleeds as a predictor of intracerebral haemorrhage and ischaemic stroke after a TIA or minor ischaemic stroke: a cohort study. BMJ Open 2013; 3:bmjopen-2013-002575. [PMID: 23793658 PMCID: PMC4401818 DOI: 10.1136/bmjopen-2013-002575] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES We examined whether patients with cerebral microbleeds on MRI, who started and continued antithrombotic medication for years, have an increased risk of symptomatic intracerebral haemorrhage (ICH). DESIGN Prospective cohort study. SETTINGS Multicentre outpatient clinics in the Netherlands. PARTICIPANTS We followed 397 patients with newly diagnosed transient ischaemic attack (TIA) or minor ischaemic stroke receiving anticoagulants or antiplatelet drugs. 58% were men. The mean age was 65.3 years. 395 (99%) patients were white Europeans. MRI including a T2*-weighted gradient echo was performed within 3 months after start of medication. 48 (12%) patients had one or more microbleeds. They were followed every 6 months by telephone for a mean of 3.8 years. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was a symptomatic ICH. Secondary outcome were all strokes, ischaemic stroke, myocardial infarct, death from all vascular causes, death from non-vascular causes and death from all causes. RESULTS Five patients (1%) suffered from a symptomatic ICH. One ICH occurred in a patient with microbleeds at baseline (adjusted HR 2.6, 95% CI 0.3 to 27). The incidence of all strokes during follow-up was higher in patients with than without microbleeds (adjusted HR 2.3, 95% CI 1.0 to 5.3), with a dose-response relationship. The incidences of ischaemic stroke, vascular death, non-vascular death and death of all causes were higher in patients with microbleeds, but not statistically significant. CONCLUSIONS In our cohort of patients using antithrombotic drugs after a TIA or minor ischaemic stroke, we found that microbleeds on MRI are associated with an increased risk of future stroke in general, but we did not find an increased risk of symptomatic ICH.
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Affiliation(s)
- Vincent I H Kwa
- Department of Neurology, Onze Lieve Vrouwe Gasthuis,Slotervaart Hospital, Amsterdam, The Netherlands
| | - Ale Algra
- Department of Neurology and Neurosurgery, UMC Utrecht Stroke Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Julius Centre for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - Manon Brundel
- Department of Neurology and Neurosurgery, UMC Utrecht Stroke Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Willem Bouvy
- Department of Neurology and Neurosurgery, UMC Utrecht Stroke Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - L Jaap Kappelle
- Department of Neurology and Neurosurgery, UMC Utrecht Stroke Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
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Mahboobi N, Haghighi Z. Effect of ribavirin therapy on salivary gland function: an oral medicine prespective. Hepat Mon 2011; 11:925-6. [PMID: 22308158 PMCID: PMC3269062 DOI: 10.5812/kowsar.1735143x.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Revised: 10/06/2011] [Accepted: 10/16/2011] [Indexed: 12/11/2022]
Affiliation(s)
- Nima Mahboobi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author at: Nima Mahboobi, Department of Oral and MaxillofacialSurgery, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-2166913292, Fax: +98-2166495948, E-mail:
| | - Zahra Haghighi
- Department of Gastroenterology and Liver Diseases, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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