Effects of fixed orthodontic treatment with and without chlorhexidine mouthwash on vitality of oral mucosal cells reflected by cell nuclear indexes: A preliminary 3-phase before-after clinical trial

INTRODUCTION

Effects of mouthwashes on the vitality of oral mucosal cells have not been determined in orthodontic patients. We aimed to assess, for the first time, the effects of fixed orthodontic treatment with and without chlorhexidine (CHX) mouthwash on the oral mucosal cell vitality.

MATERIALS AND METHODS

All patients meeting the eligibility criteria were consecutively included until the desired sample size was reached. Oral buccal mucosal cell samples were taken immediately before orthodontic treatment. For each patient, 20 metal brackets and 4 bands were installed on the teeth. Cell samples were recollected after one month of treatment. Then, the patients used an ethanol-free 0.12% CHX mouthwash two times a week for one month. Sampling was repeated at the end of the second month. Papanicolaou staining was used for micronucleus screening of the indexes: micronucleus (MIC), karyorrhexis (KR), karyolysis (KL), and broken eggs (BE). The repair index (RI) was calculated as RI=KR+KL/BE+MIC. Comparisons of nuclear changes over 3 intervals were done using the Friedman and Dunn-Bonferroni tests (α=0.05, β<0.05).

RESULTS

This prospective before-after clinical trial was performed on 408 observations of 34 patients (14 males, 20 females, mean age: 16.68±3.75 years) at 3 intervals (×4 parameters each). The means of MIC, KR, KL, BE, and RI were respectively 1.312±1.219, 0.241±0.564, 0.426±0.657, 0.115±0.224, and 0.476±0.360 before treatment. They were 1.348±1.171, 0.215±0.236, 0.406±0.369, 0.124±0.187, and 0.511±0.310 at the first interval and 1.909±1.263, 0.368±0.174, 0.615±0.269, 0.253±0.150, and 0.529±0.195 at the second interval. Friedman showed significant time-dependent changes for all variables (P<0.0005) except RI. Dunn-Bonferroni showed that except MIC (P=0.017), KR/KL/BE changed insignificantly after orthodontic treatment (P≥0.974). MIC/KR/KL/BE increased significantly after the addition of CHX (P<0.0005).

CONCLUSION

CHX mouthwash, together with orthodontic treatment, has a strong deteriorating effect on nuclear indexes associated with the vitality of buccal mucosal cells. Nuclear changes caused by orthodontic treatment alone might be negligible.

Isolation and characterization of apical papilla cells from root end of human third molar and their differentiation into cementoblast cells: an in vitro study

BACKGROUND

Periodontal regeneration, treatment of periodontal-related diseases and improving the function of implants are global therapeutic challenges. The differentiation of human stem cells from apical papilla into cementoblasts may provide a strategy for periodontitis treatment. This study aimed to evaluate the differentiation of primary human stem cells apical papilla (hSCAPs) to cementoblast cells.

MATERIAL AND METHODS

SCAPs cells were isolated from human third molar and then incubated for 21 days in a differentiation microenvironment. Alkaline phosphatase (ALP) and Alizarin red S staining assays were performed to evaluate the calcium deposition and formation of hydroxyapatite in the cultured hSCAPs microenvironment. Real-time polymerase chain reaction (RT-PCR) assay was performed for cementum protein 1 (CEMP1), collagen type I (COL1), F-Spondin (SPON1), osteocalcin (OCN), and osteopontin (OPN) as specific markers of cementoblasts and their progenitors.

RESULTS

ALP phosphatase activity in day 21 of treatment demonstrated a significant increase in ALP compared to the control. Alizarin red S staining assay showed that the differentiated hSCAPs offered a great amount of calcium deposition nodules compared to the control. The increased expression level of CEMP1, OCN, OPN, COL1 and Spon1 was observed in days 7, 14 and 21 compared to the control, while greatest expression level was observed in day 21.

CONCLUSION

In conclusion, the differentiation microenviroment is convenient and useful for promoting the differentiation of hSCAPs into cementoblast.

The influence of harvest time on total phenolic and flavonoid contents, antioxidant, antibacterial and cytotoxicity of Rheum khorasanicum root extract

INTRODUCTION

For many centuries, medicinal herbs and their derivatives have been used to treat or prevent various diseases. However, environmental factors such as the season for collection of plant may change the therapeutic efficacy. The present work investigates seasonal variations of phenolic, flavonoid content, antioxidant, antibacterial, and cytotoxic potential of hydroalcoholic extract of Rheum khorasanicum (HER).

METHODS

R. khorasanicum was collected in three different months: December, February, and April. The Folin-Ciocalteu assay was applied to measure the total phenolic content of HER. Antioxidant activities (DPPH and FRAP) were also determined. Next, the extracts were evaluated for antibacterial potential against some Gram-positive and Gram-negative strains. The minimal inhibitory concentration (MIC) was determined by the microdilution method. Finally, the effect of extracts on the viability of C6, A549, and HT-29 cells was evaluated via the MTT assay.

RESULTS

All three extracts contained considerable phenolic and flavonoid contents and showed desirable antioxidant activity. The April sample exhibited the greatest phenolic and flavonoid content and significant antioxidant activity potential in the FRAP test. In addition, the April sample had the highest antibacterial activity and cytotoxic effect on the cancerous cell lines.

CONCLUSION

The April extract showed more antioxidant, antibacterial and cytotoxic effect, probably because of its higher phenolic and flavonoid contents than other samples. These results demonstrate that the harvest timing of R. khorasanicum affects the plant's phenolic content and its antioxidant and cytotoxicity activities.

Comparison of healing time and the histopathology of bone formation following tooth extraction using freeze-dried bone allograft:A randomized controlled clinical trial

Background. A decrease in the width and height of the alveolar ridge is inevitable following tooth extraction. This study aimed to histologically evaluate the amount of newly formed bone after using a freeze-dried bone allograft (FDBA) at two different intervals in the tooth socket grafting. Methods. Forty patients were selected, who required a single-rooted tooth extraction and were candidates for implant placement, with no indication for an immediate implant. Extraction sockets were preserved using a cortical FDBA allograft in two regeneration interval groups: 3 months (group A) and 4 months (group B). At the time of implant placement, a bone sample was collected from each grafted socket. Histomorphometric analyses were performed to determine the percentage of newly formed bone and the residual graft material. Changes in histological indices, i.e., inflammation rate, percentage of ossification, and the amount of remaining biomaterial, were evaluated. Results. There were no significant differences in the amount of newly formed bone and residual graft material between the two groups. In general, the average of new bone formation and remaining graft particles in groups A and B was: %33.89 and %12.59 vs. %39.83 and %14.07, respectively. Conclusion. Bone parameters in group A were better compared to group B. However, due to the lack of significant differences in the results, it is suggested that implant placement in grafted sockets with mineralized allografts be expedited.

Determining the Cause of Death Among Drug Addicts in Residential Rehab Campuses in Tehran

Background: Determining the cause of death among drug addicts in Residential Rehab Campuses (RRCs) is of paramount importance, since it may prevent and reduce morbidity and mortality rates. Therefore, the present study was done to investigate the cause of death among drug addicts in RRCs in Kahrizak Dissection Hall, Tehran Province, Iran, from September 2011 to September 2019. Methods: In this descriptive cross-sectional study, a total number of 166 drug addicts, who had died in the RRCs located in Tehran, Iran were examined, and the findings were analyzed using the SPSS v. 26. Moreover, the Chi-square test was utilized to compare the results. Results: In this study, the most important causes of death, were infections, drug side effects, Myocardial Infarction (MI), and drowning, respectively. The highest frequency of death had occurred in the 31-40-year-old age group and was mostly observed in unmarried individuals. The most common causes of death were infection among the single and divorced ones and were MI for married cases. Toxicological results were generally negative in 60.84% of the cases. Also, 86.74% of the cases were non-pathological with regard to the brain tissue samples and 65.66% of the individuals had no pathological cardiac lesions. Besides, the most common microscopic findings of the lungs were associated with pulmonary edema. In the trauma group and also drug side effects and drowning groups, the most frequent pathological findings were pulmonary hemorrhage and pulmonary edema, respectively. As a whole, 69.87% of the deaths had occurred in the RRCs and 55.42% of them were assumed natural in terms of mode of occurrence. Conclusion: The majority of the deaths in the RRCs should not have occurred if the given centers were authorized and the illegal centers were closed. Moreover, these centers should have proper management with the presence of resident physicians and trained medical staff as well as necessary medical equipment, proper nutrition, no access to drugs and other illicit substances, along with adherence to hygienic principles to minimize mortality rates among the drug addicts living in the RRCs.

Micronucleus Assay in Cell Phone Users: Importance of Oral Mucosa Screening

Background:

One of the concerns of cell phone users is prolonged exposure to harmful and potentially carcinogenic waves. This study was aimed to investigate the correlation between amount of cell phone use and related factors with percentage of micronucleus containing cells.

Methods:

This descriptive study was conducted on selected patients referring to Islamic Azad University Faculty of Dentistry using cell phones regarding related inclusion and exclusion criteria. Papanicolaou staining method was approached for mucosal smears of samples and frequency of micronucleus containing cells and also, frequency of micronucleus in each cell were recorded for each sample; then, correlation of these findings with amount of daily cell phone usage was statistically analyzed using the calculation of Pearson correlation coefficient and preparation of regression analysis (backward) with significant level of lower than 0.05.

Results:

Of 100 samples, the frequency of micronucleus containing cells was 2.94% ± 1.89% and the frequency of micronucleus in each cell was 1.02% ± 1.68%. The amount of cell phone usage was significantly correlated with the frequency of micronucleus containing cells (r = 0.70, P = 0.0001) and also with the frequency of micronucleus in each cell (r = 0.57, P = 0.0001). Also, age and sex were not significantly correlated with the frequency of micronucleus containing cells (P = 0.47 and 0.32) and also with the frequency of micronucleus in each cell, respectively (P = 0.16 and 0.27).

Conclusions:

The present study showed that the increased amount of cell phone usage had a strong and significant correlation with the higher frequency of the micronucleus containing cells and the higher frequency of micronucleus in each cell in the buccal mucosa. Also, the related factors as age and sex were not significantly correlated with the frequency of micronucleus containing buccal mucosa cells.

Correlation between WHO and Modified WHO Classification Systems in the Histopathologic Diagnosis of Oral Lichen Planus Using Intraobserver and Interobserver Variability

Background

Oral lichen planus (OLP) is a relatively common chronic autoimmune disease. In the present study, we tried to correlate the histopathological criteria of WHO and modified WHO (mod.WHO) classification systems using two methods, namely, intraobserver and interobserver observations in these samples.

Methods

This cross-sectional study was performed on 64 microscopic slides with the diagnosis of the OLP lesions, based on both clinical and histopathological features. At first, each pathologist individually (as intraobserver) examined microscopic slides based on both histopathologic diagnostic criteria. Later, three pathologists in a group (as interobserver) reevaluated microscopic slides 2 months later in the second phase of the study, based on both systems. Eventually, the findings were statistically analyzed with Cohen's kappa coefficient (κ) and reported.

Results

According to the results, the lichen planus was detected in 8 cases using the WHO method, and in 41 cases using the Mod.WHO method. Intrarater Kappa coefficients were κ = 0.114, P = 0.299; κ = 0.181, P = 0.012; and κ = 0.062, P = 0.424 for three pathologists, respectively. The findings showed no reproducibility (κ = 0.148, P = 0.024) and there was no correlation between the two systems. Statistical analysis revealed that the histopathological criteria of the WHO classification for detecting the lichen planus microscopy were more sensitive but the Mod.WHO classification criteria were more specific for detecting the lichen planus.

Conclusions

Due to the higher specificity of the histopathological criteria of Mod.WHO classification rather than WHO classification, it seems that Mod.WHO classification has more important and useful criteria for histopathological diagnosis. Finally, we can conclude that the use histopathologic criteria of the Mod.WHO classification is more useful in the diagnosis of lichen planus, although it should be in combination with clinical information.

1112 The 100 Most Influential Papers in Nail Bed Injury: A Bibliometric Analysis

Aim

Nail bed injuries are the commonest paediatric hand injuries. Optimal management is essential to restoring form and function of the nail and fingertip, however high-level evidence of nail bed injury management is lacking, leading to large discrepancies in clinical practice. This paper evaluates the 100 most cited papers in nail bed injury and analyses their study characteristics to assess current research focus and evidence levels.

Method

A Web of Science search was carried out using the search term “nail bed injury”. All article types were included, and no language or publication date restrictions were applied. Results were ranked by overall citation number. All abstracts were screened for study relevance and the top 100 eligible studies were analysed for study type, main study theme, journal, and year of publication.

Result

The three most common study types included retrospective studies (n = 33), literature reviews (n = 25), case reports/series (n = 20). The three main study themes included evaluation of repair techniques (n = 72), aetiology and epidemiology of nail bed injuries (n = 12), and anatomical assessments (n = 7). The most frequently represented journals include Journal of Hand Surgery (n = 30), Plastic and Reconstructive Surgery (n = 7) and Hand Clinics (n = 4).

Conclusions

The most influential papers in nail bed injury are those describing repair techniques. There remains a lack of high level evidence with most papers presenting level 3-5 evidence. This paper demonstrates a continued need for more higher level robust evidence in the field of nail bed injuries.

Angiogenesis in odontogenic keratocyst and dentigerous cyst: Evaluation of JunB and VEGF expression

BACKGROUND

Nowadays, different clinical behaviors of odontogenic cysts, little information about their biological agents, importance of diagnosis, and early diagnosis of these lesions have encouraged the researchers to conduct new studies. JunB acts as a regulator of vascular endothelial growth factor (VEGF) protein production and affects vessel proliferation and tissue angiogenesis. Hence, this study was conducted to compare angiogenesis through VEGF and JunB expression in odontogenic keratocysts (OKCs) and dentigerous cysts (DCs).

MATERIALS AND METHODS

A total of 25 paraffin blocks of OKCs and 25 DCs were included in this experimental descriptive cross-sectional study, and immunohistochemical expression of VEGF and JunB was evaluated. Percentage and score of expression were recorded for each sample, and independent t-test, Mann-Whitney U, and Spearman statistical tests were run to analyze the data. The statistical significance level was set at <0.05.

RESULTS

From 50 studied samples, 39.6% belonged to women and 60.4% belonged to men, with mean age of 34.2 ± 1.7 years. The mean percentages of JunB expression were 52.88 ± 17.35 and 74.6 ± 18.55 for DC and OKC samples, respectively. This expression was significantly higher in OKC than DC, and it had significantly higher scores as well (P = P = 0.0001 and 0.00033, respectively). The means of VEGF were 20.2% ±11.86 and 52.6% ±19.98 in DC and OKC samples, respectively. The mean VEGF expression was significantly higher in OKC than DC (P = 0.045), and it had significantly higher scores, too (P = 0.000). Furthermore, there was a significant correlation between VEGF and JunB expression in the studied samples (r_s = 0.3 and P = 0.005).

CONCLUSION

Based on the results of this study, it seems evaluation of angiogenesis through JunB expression can be helpful in the prediction of more aggressive behavior in pathologic lesions such as OKC.

The Effect of Hookah Use on Buccal Mucosa: Evaluation of Repair Index

Background and aim:

Cigarettes, hookah, and tobacco are the most important etiologic factors for oral cancers and dysplastic lesions. This study was undertaken to determine the correlation between hookah use and the percentage of cells with micronucleus, karyorrhexis, karyolysis, and broken egg in the buccal mucosa; and secondly to compare hookah user and non-user in terms of repair index.

Materials and methods:

The present historical cohort study was carried out on 72 samples taken from 36 hookah users and 36 control subjects. Smear samples were obtained from participants’ buccal mucosa for cytological evaluation using Papanicolaou technique. Then, the percentages of cells with micronucleus, karyorrhexis, karyolysis, and broken egg were recorded and the repair index was calculated. Data were analyzed using Mann-Whitney U test.

Results:

A total of 72 samples taken from 36 hookah users and 36 control subjects were evaluated. The means of micronucleus scores in the buccal mucosa cells of hookah users and controls were 10.7±2.6 and 5.8±2.0, the karyorrhexis scores in the hookah users and controls were 0.1±0.06 and 0.04±0.06, and the karyolysis scores in hookah users and controls were 0.16±0.05 and 0.08±0.06, respectively. These differences were statistically significant between hookah users and controls (P<0.001). The broken egg score was 0.66±0.07 for the hookah users and 0.03±0.04 for the control group, revealing a statistically significant difference (P<0.036). Finally, the repair index values were 0.03±0.01 and 0.05±0.13 in hookah users and controls, respectively. This difference was also significant (P<0.026).

Conclusion:

The percentages of cells with micronucleus, karyorrhexis, karyolysis, and broken egg in the buccal mucosa of hookah users were significantly higher than those in control group; in addition, the repair index of the buccal mucosa cells in hookah users was significantly lower than that in the control group.

Micronucleus Assay of Buccal Mucosal Cells in Hairdressers: The Importance of Occupational Exposure

Background and objective: Today, the chemical materials available in hair dyes are considered risk factors for many cancers, particularly oral cancer. This study was performed to study the effect of occupational exposure on micronucleus (MN) frequency of buccal mucosa cells in hairdressers. Materials and methods: This historical cohort study was performed on 28 hairdressers and 28 control samples. To eliminate the gender variable, all the samples were women and they were matched by age. Buccal mucosa cells were removed using a wet spatula and after fixation, Papanicolaou staining method was applied. The percentage of the cells containing MN was registered. T-test was used to compare the results between the two groups. Results: The mean percentages of MN in buccal mucosa cells of hairdresser’s and control sample were 16.61±4.95 and 8.84±4.74, respectively, with a significant difference (P<0.001). In addition, higher MN mean percentage was reported in subjects working more than 60 hours weekly compared with those working 60 hours and less; however, the difference was not statistically significant (P=0.14). Conclusion: In the present study, hairdressers demonstrate significantly higher average of MN in buccal mucosa cells. Also, it seems increment in their working time can increase MN frequency in these studied samples.

Repair Index in Examination of Nuclear Changes in the Buccal Mucosa of Smokers: A Useful Method for Screening of Oral Cancer

Background: Smoking is one of the major risk factors for cancers, especially in the oral cavity. Nuclear changes occur in the early stages of cancer. The aim of this study was therefore to investigate nuclear changes and calculate a “repair index” for the buccal mucosa of smokers. Material and Methods: This historical cohort study was conducted by selecting samples including smokers and non-smokers. In addition, the smoker group were divided into 2 subgroups with a smoking history of >10 and ≤10 years. Buccal mucosa smears were obtained and Papanicolaou staining was employed to detect nuclear changes. Micronuclei, karyorrhexis and karyolysis were assessed and eventually a repair index was calculated. Statistical analysis was performed using the t-test. Results: In the 60 samples studied, differences were significant in smopkers vs. nonsmokers for micronuclei, (P=0.002) but not karyorrhexis or karyolysis. (P=0.789 and P=0.578, respectively). Also, the repair index demonstrated no statistically significant variation (P=0.107). Comparison of the two subgroups of smokers demonstrated that the frequency of micronuclei in those with a history >10 years was significantly higher and the RI was significantly lower than with ≤10 years (P=0.0001 and 0.04, respectively). While karyorrhexis and karyolysis were also higher in the longer exposure individuals the differences were not significant (P=0.07 and 0.78, respectively). Conclusion: Among the nuclear changes investigated, micronuclei proved the more reliable indicator to assess the adverse effects of smoking on the oral mucosa, becoming prominent with increase in smoking history. In addition, while a “repair index” may have benefits for assessment of nuclear damage caused by smoking, further research is necessary in this field.

Angiogenesis concept in odontogenic keratocyst: A comparative study

CONTEXT

Recent reports have indicated that angiogenesis possibly affects the biologic behavior of the lesions.

AIM

Given the different clinical behaviors of odontogenic keratocyst (OKC), the present study was undertaken to evaluate the concept of angiogenesis in pathogenesis and clinical behavior of OKC.

SETTING AND DESIGN

This experimental study was carried out on 22 and 24 samples of OKCs and dentigerous cysts (DCs), respectively.

METHODS

Immunohistochemical staining was approached using CD34 and vascular endothelial growth factor (VEGF) antibodies. The expression of VEGF was first reported by determining the counts of stained cells, including epithelial cells, fibroblasts, and endothelial cells, followed by the percentage of stained cells in each sample based on a 0-2 scoring system. The counts of CD34+ cells were reported in each group in the form of means ± standard deviations. In addition, the patterns of blood vessels in the samples prepared from the walls of both cysts were evaluated.

STATISTICAL ANALYSIS USED

Mann-Whitney U-test, Chi-squared test, and t-test were used for analysis of data, and statistical significance was defined at p < 0.05.

RESULTS

The expression percentage and scores of VEGF and the mean expression rate of CD34 were significantly higher in OKCs than DCs (p = 0.045, 0.000, and p = 0.58). Finally, there was a strong correlation between the expressions of the two markers in the samples (Correlation coefficient = 0.766).

CONCLUSION

The present results indicate the angiogenesis may play an important role in the pathogenesis and the unique clinical behavior of OKC.

Expression of Vascular Endothelial Growth Factor in Odontogenic Cysts: Is There Any Impression on Clinical Outcome?

Background:

The recent scientific reports have shown that angiogenesis can affect biological behavior of pathologic lesions.

Objective:

Regarding unique clinical outcome of Odontogenic keratocyst (OKC), the present study was aimed to compare angiogenesis in Odontogenic keratocyst and Dentigerous cyst (DC).

Method:

In this experimental study, tissue sections of 46 samples of OKC and DC were stained through immunohistochemical method using Vascular Endothelial Growth Factor (VEGF) antibody. VEGF expression was evaluated in epithelial cells, fibroblasts and endothelial cells. The average percentage of stained cells in any samples was categorized to 3 groups as follows: SCORE 0: 10% of cells or less are positive. SCORE 1: 10 to 50% of cells are positive. SCORE 2: more than 50% of cells are positive. Mann-U-Whitney, T-test and chi-square was used for statistical analysis.

Result:

The average of VEGF expression in 24 samples of DC was 20.2% and in 22 samples of OKC was 52.6%, respectively. The average of VEGF expression in these two cysts had statistical significant differences. (PV= 0.045). There was significant statistical differences between two cysts in the terms of VEGF SCORE (PV= 0.000). OKC samples had significantly higher SCORE for the purpose of VEGF incidence than DC. Also, there were no differences between VEGF expression in epithelial cells of two cysts (PV= 0.268) there were significant statistical differences between two cysts in terms of endothelial cell staining. The endothelial cell staining was significantly higher in OKC than DC (PV= 0.037%).

Conclusion:

Regarding higher expression of Vascular Endothelial Growth factor in OKC than DC, it seems that angiogenesis may have great impression on clinical outcome of OKC.

Giant sialoliths of Wharton duct: Report of two rare cases and review of literature

Sialolithiasis is a common disease of the major salivary glands, characterized by the obstruction of a salivary gland or its excretory duct due to the formation of calcareous concretions. Sialoliths usually measure from 1 mm to <10 mm. They rarely measure more than 15 mm, and infrequently giant salivary gland calculi >15 mm have been reported in the literature. The submandibular gland and its duct appear to be the most susceptible sites for this disease. In this article, we report two unique cases, including a giant bilateral case, measuring 50 mm in length and 5 mm in width on the right side and one, 30 mm in length, and 5 mm in width on the left side; and another case, measuring 83 mm in length. The diagnostic and therapeutic approaches consisted of transocclusal radiography with the conservative transoral surgical technique in both cases. The follow-up showed the normal function of the relevant salivary glands. To the best of our knowledge and belief, similar cases have not been reported in the literature.

Evaluation of Microvascularity by CD34 Expression in Esophagus and Oral Squamous Cell Carcinoma

AIM

The present study was scheduled to evaluate microvascularity by CD34 expression in esophagus and oral squamous cell carcinoma.

MATERIALS AND METHODS

This study was scheduled using 40 paraffin blocked samples including 20 of oral SCC and 20 of esophagus ones and Immunohistochemical staining was conducted using CD34 monoclonal antibody. Exact fisher test was used to evaluate frequency of expression between two studied groups.

RESULTS

There was significant correlation between age and tumor size with CD34 expression in oral SCC samples (p < 0.05) and no significant correlation between sex and tumor differentiation level (grading) (p > 0.05). Also, there was no significant correlation between age, sex, tumor size and tumor differentiation level (grading) with CD34 expression in esophagus SCC samples (p > 0.05). There was no significant difference of CD34 expression frequency in oral and esophagus SCC (p = 0/583). Finally, CD34 expression was reported 'high' for major cases of esophagus and oral SCCs.

CONCLUSION

It seems, other angiogenetic or nonangiogenetic factors except CD34 may play more important role and explain the different clinical behavior of SCC at recent different locations.

CLINICAL SIGNIFICANCE

Other factors would be considered along with CD34 expression to interpret different clinical behavior of SCC at recent different locations.

Head and neck metastatic tumors: a retrospective survey of Iranian patients

STATEMENT OF THE PROBLEM

The head and neck region is an uncommon site for metastatic involvement, but it can be the first and only symptom of primary cancer. The incidence of these tumors and their primary origins are limited in Iranian patients.

PURPOSE

Therefore, this retrospective study aimed to investigate the frequency and the common related clinical manifestations, as well as, the most common types of cancers and the prevalent sites of the primary tumor.

MATERIALS AND METHOD

All medical records related to patients with history of head and neck tumors between 1991 and 2011 at Iran Cancer Institute were evaluated and the essential information was statistically analyzed.

RESULTS

Sixty cases of cervical lymph node metastasis (0.36%) and 26 cases of head and neck metastatic tumors (0.16%) including 17 cases of distant cancer (0.10%) were recorded among all 16232 registered cancers. Out of all distant head and neck metastatic tumors, 4 cases were related to oral and maxillofacial area. Pain, swelling of neck, oral mucosa ulcer and dryness were the chief complaints. Squamous cell carcinoma and adenocarcinoma were the most frequent types of cancers. The most common metastatic sites were cervical musculature, scalp and parotid gland, and the most prevalent sites of primary tumor in females were breast and lung in males.

CONCLUSION

According to these cases, the incidence rate of head and neck metastatic tumors seems to be low. However, feasible similarity of clinical presentation of oral metastatic lesions to benign lesions might result in misdiagnosis. Hence, biopsy is mandatory in any case with unusual clinical presentation, especially in patients with a known malignant disease.

Oral health related quality of life in diabetic patients

Background and aims. Diabetic patients display an increased risk of oral disorders, and oral health related quality of life (OHRQL) might affect their management and treatment modalities. The aim of the present study was to determine OHRQL and associated parameters in patients with diabetes. Materials and methods. In this study two hundred patients were recruited from the diabetes clinic in Mustafa Khomeini Hospital in Tehran, Iran. OHRQL was assessed using Oral Health Impact Profile Questionnaire (OHIP-20). Also, another questionnaire was designed which contained questions regarding participants' knowledge about oral complications of diabetes and oral health behavior. OHRQL was categorized as low and good. Data were analyzed using logistic regression at P = 0.05. Results. Of the diabetic patients assessed, 77.5% were in good and 22.5% were in low categories of OHRQL. This quality was significantly associated with age (OR = 4.03, 95% CI = 1.63-11.29), knowledge about diabetes oral complications (OR = 18.17 95% CI = 4.42-158.6), educational level (OR = 26.31 95% CI = 4.2-1080.3), referred for dental visit by physician (OR = 3.16 95% CI = 1.48-6.69), frequency of brushing (OR = 10.29 95% CI = 3.96-31.2) and length of time diagnosed with diabetes (OR = 6.21 95% CI = 2.86-13.63). Conclusion. Oral health related quality of life was not negatively affected by diabetes mellitus in the assessed sample.

The correlation between p16 expression and INK4a locus mutation with grades and stages in oral squamous cell carcinoma

OBJECTIVE

p16INK4a is a tumor suppressor gene playing a critical role. Researches have indicated the gene to be altered in oral squamous cell carcinoma. Present studies have tried to assess the correlation between p16INK4a expression and INK4a locus mutation in relation to grades and stages of this tumor.

MATERIALS AND METHODS

Expression of p16INK4a was studied immunohistochemically in 58 oral squamous sell carcinoma samples and INK4a locus mutation was determined by polymerase chain reaction (PCR) and conformation sensitive gel electrophoresis (CSGE).

RESULTS

Expression of p16INK4a was higher in stage1 compared to stage 2, 3, and 4 (P = 0.234). The difference was not significant in grade 1, 2, and 3 (P = 0.671). The average values of total score (TS) were significantly higher in stage1 compared to stage 2, 3, and 4 (P = 0.035). The average values of complete score (CS) were higher in stage 1 compared to stage 2, 3, and 4 (P = 0.061). The research did not show a significant correlation between lymph node involvement and p16INK4a expression (P = 0.491). It seems that 5.1% (3/58) of samples have mutation in INK4a locus.

CONCLUSION

Loss of p16INK4a expression occurred in initial stages of oral squamous cell carcinoma. Evaluation of TS and CS for p16INK4a might be a useful clinical indicator concerning the tumor. However, gene mutation is believed to have minor rate of genetic alteration in carcinogenesis.

Micronucleus assay of buccal mucosa cells in smokers with the history of smoking less and more than 10 years

INTRODUCTION AND AIM

Cigarette smoking causes severe health problems such as cancer. Micronuclei are structures that present after genomic damages to the cells. The present study is aimed at evaluating the micronucleus assay of buccal mucosa cells in smokers who smoked less or more than 10 years.

MATERIALS AND METHODS

The present study has been a historical cohort study. The smokers were divided into two groups: First group include individuals with a smoking history less than 10 years (14 samples) and second group with the smoking history of more than 10 years (26 samples).The control group consisted of nonsmokers (23 samples). The exfoliated buccal mucosa cells were scrapped using spatula and were spread over the glass slide. Feulgen method was used for micronucleus staining. 500 cells per subjects were counted. The presence of micronucleus in all subjects and the mean percentage of micronucleus in nuclei were determined. Data were subjected to statistical analysis using T-test.

RESULTS

The mean number of micronucleus of buccal mucosa cells in nonsmokers, first group (smoking history less than 10 years) and second group (smoking history more than 10 years) was 0.94±0.94, 1.89±0.62 and 2.01±0.93 respectively. The difference was statistically significant (P<0.002). Considering the number of micronuclei of the buccal mucosa cells, the difference between groups 1 and 2 was not significant (P<0.6). The mean percentage of micronucleated cells in nonsmokers, group 1 and group 2 was 2.26±2.17%, 13.9±5.90 and 14.3±7.97, respectively. The difference was statistically significant (P<0.001).The difference between the percentage of the cells with micronucleus in smokers with a smoking history of less or more than 10 years was not significant (P<0.6).

CONCLUSION

The mean number of micronuclei in buccal mucosa cells of the nonsmokers was significantly lower than that of the smokers. However, the mean number of micronucleus of buccal mucosa cells in smokers who smoked more than 10 years was higher than smokers who smoked less than 10 years. Increasing the smoking duration could heighten the frequency of micronucleus; however, the difference was not significant.

Efficacy of Pilocarpine and Bromhexine in Improving Radiotherapy-induced Xerostomia

Background and aims. Xerostomia is one of the most common complications of head and neck radiotherapy. The aim of this study was to evaluate and compare the efficacy of pilocarpine and bromhexine in improving radiotherapy-induced xerostomia and its associated symptoms.

Materials and methods. In this single-blind, randomized crossover study, pilocarpine and bromhexine tablets were used by twenty-five patients suffered from xerostomia, with a medical history of head and neck radiotherapy. At step A, the patients were treated with pilocarpine for 2 weeks. In addition, they were asked to take bromhexine for 2 weeks with a one-week washout period. At step B, the inverse process was conducted (first bromhexine, then pilocarpine). Whole resting saliva was collected from patients before and after receiving each medication by precise measurements. Then, efficacy of the two drugs in the treatment of xerostomia and its related oral complications was evaluated using questionnaires by Dichotomous format. The results were statistically analyzed using t-student and Fisher’s exact and chi-squared tests. Statistical significance was set at P<0.05.

Results. The difference between saliva secretion rates before and after medications was not significant for bromhexine users at two steps of the study (P=0.35); however, it was significant for pilocarpine users (P=0.0001). Users of both drugs showed significant differences in improvement of xerostomia, chewing, swallowing, tasting and mouth burning.

Conclusion. Pilocarpine is probably more effective in improving xerostomia and its associated problems compared with bromhexine, although the use of the latter was also shown to ease some of the consequences of radiotherapy in the head and neck region.

Comparison of the effect of three cements on prevention of enamel demineralization adjacent to orthodontic bands

Background and aims

This in vitro study was designed to compare enamel demineralization depths adjacent to bands cemented with zinc polycarboxylate, glass ionomer (GI) and resin-modified glass ionomer (RMGI), in order to achieve minimal enamel demineralization during orthodontic treatment.

Materials and methods

Sixty fully developed extracted third molars were randomly divided into three testgroups each containing 20 samples, used to cement orthodontic bands with zinc polycarboxylate, GI and RMGI. All samples were demineralized using White method using hydroxyapatite, latic acid and Carbapol for in vitro caries simulation, and then, immersed in 10% solution of methylene blue. The mean depth of dye penetration was assessed up to 0.1 millimeter, reflect-ing the depth of enamel demineralization. One way ANOVA and LSD statistical tests were employed to evaluate significant differences among groups.

Results

The highest dye penetration depth was seen in zinc polycarboxylate group, followed by GI, and RMGI groups, respectively, with significant differences among each two groups (P < 0.05).

Conclusion

The use of RMGI cement seems to present significantly better prevention of enamel demineralization adja-cent to orthodontics bands.

Ossifying fibroma of the ethmoid sinus: Report of a rare case and review of literature

Ossifying fibroma (OF) is a benign fibro-osseous lesion which was first described by Menzel in 1872. It is commonly seen in the head and neck regions and represents an aggressive pattern when the midface and paranasal sinuses are involved. We report a 36 years old white woman with OF in the right ethmoid sinus. Computed Tomography (CT) scan images showed a hyperdense mass. Transnasal endoscopic resection was performed and histopathological examination confirmed the diagnosis of OF. The present case is notable because involvement of the ethmoid sinus is rare in this condition with only 48 cases reported in the literature until June 2011.

Superhydrophobic surfaces: are they really ice-repellent?

This work investigates the anti-ice performance of various superhydrophobic surfaces under different conditions. The adhesion strength of glaze ice (similar to that deposited during "freezing rain") is used as a measure of ice-releasing properties. The results show that the ice-repellent properties of the materials deteriorate during icing/deicing cycles, as surface asperities appear to be gradually damaged. It is also shown that the anti-icing efficiency of superhydrophobic surfaces is significantly lower in a humid atmosphere, as water condensation both on top of and between surface asperities takes place, leading to significantly larger values of ice adhesion strength. This work thus shows that superhydrophobic surfaces are not always ice-repellent and their use as anti-ice materials may therefore be limited.