Abstract Background: With ageing, the number of systemic diseases and the consumption of drugs increase. Moreover, some oral lesions, especially denture-related lesions, are commonly observed. Aim and Objective: The purpose of this study was to determine the frequency of systemic diseases and oral lesions in the elderly in the Mashhad Geriatric Institutes. Methods: Institutionalized elderly people, who could cooperate for oral examination, enrolled in this descriptive cross-sectional study. The frequency of oral lesions and their systemic diseases were recorded in the self-made checklist. For statistical analysis, Student’s t -test and Chi-square test were utilized. The significance level was considered to be 0.05. Results: During the study, 224 elderly subjects with a mean age of 75.63 ± 11.22 years were evaluated. The mean duration of residency in the elderly nursing centres was 1.87 ± 1.37 years. Hypertension, Alzheimer’s disease and diabetes were the most common systemic diseases, and about 47% of the patients had two or multiple concurrent diseases. Among participants, 97.1% had at least one oral lesion. The most common oral lesions were fissured tongue (75%), sublingual varicosity (68.3%) and hairy or coated tongue (38.4%), respectively, which are classified as normal variations of oral mucosa. The most common pathological lesions were denture stomatitis, frictional keratosis and lichenoid reactions. Conclusion: Regarding to the high frequency of oral lesions among ageing people, regular examination of the oral mucosa for early detection of oral lesions and appropriate treatments is recommended.
Squamous cell carcinoma (SCC) is the most common type of oral cancer, and it is important for it to be diagnosed in early stages. Researchers are interested in exploring the possibility of using biomarkers in the diagnosis of SCC in early stages. One of the detectable biomarkers in the serum is glutathione. Glutathione includes two forms: reduced form (or GSH) and oxidized form (or GSSG). The GSH/GSSG ratio tends to decrease in severe oxidative stress. The aim of this study was to assess the serum levels of GSH and GSSG as well as GSH/GSSG as total antioxidant capacity in patients with head and neck SCC (HNSCC) and to subsequently compare them with healthy controls.Twenty HNSCC patients as well as twenty healthy controls were included in the study. A blood sample of 5 ml was obtained from both the case and control groups. GSH, GSSG, and total antioxidant capacity were measured spectrophotometrically.No significant difference in the level of GSSG was observed in the patients from the case and control groups (P = 0.796), whereas the level of GSH and GSH/GSSG was significantly lower in the case group (P = 0.002, P = 0.011, respectively). There was no significant relationship between the level of GSH, GSSG, and total antioxidant capacity, on the one hand, and the stage and grade of the tumor, on the other hand.Since the levels of GSH and GSH/GSSG were significantly lower in the case group, GSH/GSSG could be used as a prognostic factor for the early diagnosis of HNSCC.
Background: Lichen planus is an autoimmune disorder and is associated with other autoimmune diseases. There is, however, little evidence of the association of oral lichen planus with celiac disease. The aim of this work was to investigate, for the first time, such an association in patients in the city of Mashhad, Iran. Methods: This case-control study was performed during October 2017 to March 2018 in the department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Mashhad University of Medical Sciences, in Iran. All participants were evaluated for Anti-TTG (IgA) and Total IgA, and in some cases for Anti-TTG IgG. Data were analyzed using SPSS software v.20. Results: A total of 96 subjects were considered in the study; 32 in the case group, and the rest in the control group. The mean value of Anti-TTG IgA was 0.12 ± 1.51 Au/ml in the oral lichen planus group, while it was 0.57 ± 1.20 Au/ml in the control group with no significant difference (P=0.167). The mean value of the Total IgA was 134.96 ± 42.86 mg/dl in the lichen planus group, and it was 129.85 ± 55.28 mg/dl in the control group, as they differ negligibly either (P=0.639). Moreover, celiac disease was not present in the population. Conclusions: We showed that there was no celiac disease present in the oral lichen planus patients as well as healthy subjects. Further studies are required to imply or to rule out the association of oral lichen planus and celiac disease.
Kindler syndrome (KS) is a rare, autosomal recessive genodermatosis characterized by skin blistering and photosensitivity in infancy, progressive poikiloderma, and diffuse cutaneous atrophy. It affects the skin, mucous membranes, and oral cavity and is caused by mutations in the KIND1 gene on 20p12.3. The first case of KS associated with periodontitis was reported in 1996, and have been infrequently reported since. Here we present a case of KS with classic clinical presentations involving skin, mucous membranes, and the periodontium in a patient from Iran.
Dear Editor,
About one out of three patients referred to dental clinics have a medical problem with most common being cardiac, respiratory, and cerebrovascular diseases.[1],[2]
As a health care provider, dentists must be prepared for prevention, diagnosis and treatment of medical emergencies (MEs) in dental office, by means of basic recommended emergency equipments, emergency drugs and an appropriate knowledge. To assess the knowledge and preparedness of Mashhad (in north east of Iran) general dentists about common MEs in dental settings, a cross sectional, analytical study was performed using a self-stablished questionnaire. The validity and reliability of the questionnaire was approved by Research Association of Mashhad Dental School. We randomly selected 186 dentists (p=0.5, α=0.05) using a randomization software (Available at:HTTP://WWW.Randomization.com). With the exception of name, other demographic data such as sex, age and graduating university were obtained. The Ethics Committee of Mashhad University of Medical Sciences approved the study protocol. The first section of questionnaire consisted of 20 knowledgebased questions; with one score given for each correct answer. The maximum possible score for the knowledge component of the questionnaire was 20. The scores of knowledge were classified to excellent (17- 20), good (14-17), moderate (10-14) and poor (0-10).
The participants’ preparedness towards MEs was assessed with 20 questions with 0.5 to 2 degree given for correct answer based on importance of questions. The total score was 30 and scores of preparedness were classified to excellent (25-30), good (20-24), moderate (15-19) and poor (0-14). The collected results were analysed using SPSS software (version 15, Chicago, IL, USA). Descriptive statistics and analysis of variance were carried out, and a value of p< 0.05 was considered significant. Among 186 general dentists, 31.7% were female and 68.3% were male .The mean age was 40.92±8.22 years. (F: 38.48±7.55 and M: 42.05±8.30 years). Most of dentists were graduated from Mashhad Dental School (77.7%) and the remained from other universities. Regarding medical emergencies, the dentists’ knowledge was poor. Only 1.1% of them had excellent knowledge (17-20 degrees). Of the reminder, 4.3% had good, 29.3% had moderate and 65.2% had poor knowledge. The female dentists’ knowledge was higher than males (p=0.019) (Figure 1). There was a negative correlation between age and knowledge (p=0.001) and with an increase in age, the knowledge decreased. Most of dentists (66.7%) had a poor preparedness about MEs .Only in 0.5% of dentists, their preparedness was excellent, 4.3% had good and 28.5% had moderate preparedness. Males had significantly higher preparedness for management of medical emergencies than females (p=0.010). Seventy one percent of dentists received nitroglycerin in dental clinics. Other emergency drugs were defined in less quantities (aromatic ammoniac was seldom used). The most common equipment was syringe and needle for injection (63.4%) and ambubag was used only by 6.5% of dentists.
Fig. 1:
Different levelof knowledge about Medical Emergencies among general dentists.
Our study denoted to a poor knowledge about MEs in Mashhad general dentists. The best knowledge was about diabetic emergencies and asthma and the worst knowledge was about adrenal insufficiency and foreign body aspiration. Birang et al. showed that the knowledge score of Esfahan dentists was 5.42/10.[3] Mollashahi et al. demonstrated that the knowledge of 96.8% of Zahedan dentists was from moderate to good.[4] In Behnia and Roshad study, the knowledge of 56.7% of Tehran dentists was from good to excellent.[5] So the knowledge of Mashhad dentists was lower than other provinces of Iran. This necessitates a rigorous revision in educational programs and a re-evaluation in dentistry course plans.
The preparedness was poor in 66.7% of our dentists. In other studies such as Timermann,[6] 50% of participants were able to manage medical emergencies. Gonzana study revealed that 59% of dentists judged themselves to be able to define CPR. Although only 46% had a correct concept; 54% were able to perform CPR.[7] These results highlight a need for higher educational plans on ME.
Fortunately, important emergency drugs such as oxygen, adrenaline and nitroglycerin are available in most of emergency kits of Mashhad dental clinics based on self reports of dentists. These results are similar to Mesgarzadeh study in Tabriz (Northwest of Iran).[8] It should be emphasized that lack of knowledge on EM, has mde these drug useless. So educational programs and materials such as posters and pamphlets on MEs can be of great benefit.
Objectives: Current treatments of oral lichen planus are palliative, not curative.Because psychiatric disorders significantly influence the development and severity of oral lichen planus, the use of psychiatric drug therapy may be an adjunct in treatment.The purpose of this study was to determine the efficacy of drug therapy of psychiatric disorders in oral lichen planus.Study design: Our controlled clinical study consisted of forty-six patients with oral lichen planus and psychiatric disorders who were randomly divided into two groups.Both groups were given topical corticosteroids and the study group received additional psychiatric drug therapy.Patients were monitored for a period of 6 months.Response to treatment was evaluated in each group and was compared with the other group using Mann-Whitney tests.We evaluated the correlation between psychiatric disorders and the recovery of oral lesions using Spearman's correlation coefficient analysis.Results: Decrease in the size of the lesions was significantly greater in the study group after six months, but this difference was not significant in relationship to the pain experienced and the kind of lesion.Spearman's correlation coefficient analysis demonstrated that, in the sixth month, there was a significant and direct relationship between recovery from the psychiatric disorders and response to treatment of OLP lesions, particularly as it pertained to the kind of lesion.Conclusion: The present study indicates that the combination of psychiatric drug therapy and routine treatment methods were effective in reducing the size of the lesions, but did not have any significant effect on the symptoms.
Opiorphin is a pentapeptide, which could be isolated from human fluids and has a decreasing effect on pain. Aim: Since lichen planus is a chronic mucocutaneous disease, which causes pain or burning feeling in the oral mucosa, this study aimed to compare salivary opiorphin levels of oral lichen planus (OLP) patients with healthy subjects. Methods: This case-control study, was performed on 24 patients with OLP lesions and 21 healthy subjects. After collecting unstimulated saliva, opiorphin levels were compared between two groups through statistical analyses. Results: There was not any significant difference between OLP patients and healthy subjects according to salivary opiorphin concentration (p=0.378). Also, in the OLP group, opiorphin concentration was not significantly different between males and females (p=0.601). Analytical analysis could not show any remarkable difference between various severity of OLP lesions regarding to salivary opiorphin levels (p=0.653). Conclusion: In this study, salivary opiorphin levels was not significantly different between patients with OLP and healthy subjects; however, more studies are suggested for better assessment of salivary opiorphin levels in various types of OLP lesions and its correlation with pain severity.
'%3e%3cg id='e'%3e%3cg id='c' fill='none' stroke='%23fff' stroke-width='2'%3e%3cpath id='b' d='M0 1h26M1 10V5h8v4h8V5h-5M4 9h2m20 0h-5V5h8m0-5v9h8V0m-4 0v9' transform='scale(1.4)'/%3e%3cpath id='a' d='M0 7h9m1 0h9' transform='scale(2.8)'/%3e%3cuse xlink:href='%23a' y='120'/%3e%3cuse xlink:href='%23b' y='145.2'/%3e%3c/g%3e%3cg id='d'%3e%3cuse xlink:href='%23c' x='56'/%3e%3cuse xlink:href='%23c' x='112'/%3e%3cuse xlink:href='%23c' x='168'/%3e%3c/g%3e%3c/g%3e%3cuse xlink:href='%23d' x='168'/%3e%3cuse xlink:href='%23e' x='392'/%3e%3c/g%3e%3cg fill='%23da0000' transform='matrix(45 0 0 45 315 180)'%3e%3cg id='f'%3e%3cpath d='M-.548.836A.912.912 0 0 0 .329-.722 1 1 0 0 1-.548.836'/%3e%3cpath d='M.618.661A.764.764 0 0 0 .422-.74 1 1 0 0 1 .618.661M0 1l-.05-1L0-.787a.31.31 0 0 0 .118.099V-.1l-.04.993zM-.02-.85 0-.831a.144.144 0 0 0 .252-.137A.136.136 0 0 1 0-.925'/%3e%3c/g%3e%3cuse xlink:href='%23f' transform='scale(-1 1)'/%3e%3c/g%3e%3c/svg%3e)