Journal of Research in Dental and Maxillofacial Sciences
Volume:1 Issue: 2, Spring 2016

Oral cancer is a serious health problem, mainly in cases with late diagnosis. The objective of this study was to investigate the role of community pharmacists, community pharmacy assistants and herbalists in late stage diagnosis of oral cancer. A cross-sectional study by the standardized simulated patient approach was undertaken to investigate the recommendation given to a potential cancer patient at pharmacies and herbalists’ shops in Rasht, Iran. The introductory statement was "My father is 63 years old and he is a smoker who has a painful ulceration on his tongue for about 6 months which wasn’t painful at first but is painful now. What would be your recommendation? "All the responses were noted and transferred to data sheets. The recommendations were analyzed separately and then grouped. Recommended therapies and their administrations were also recorded. The results showed that 73% of community pharmacies referred patients to primary medical care systems. Community pharmacists and community pharmacy assistants had closely equal roles (74.3% and 72.5%, respectively). Contrariwise, only 7.1% of herbalists referred patients with oral ulcers to a physician or a dentist. Almost 10% of the pharmacies recommended OTC drugs only and 11% prescribed medications combined with referral to a medical or dental practitioner for consultation. In reverse, 78.6% of herbalists recommended an OTC remedy and none of them advised patients to visit a GP or dentist accompanied by prescribing an herbal remedy. Herbalists have a potential role in diagnostic delay in patients with oral cancer.

Oral infections and dental caries are considered as two serious public health problems, which inflict a costly burden on health care services worldwide, especially in the developing countries. The aim of this study was to evaluate the antibacterial activity of Iranian Licorice aqueous root extract on Lactobacillus Acidophilus in comparison with Chlorhexidine. In this in-vitro experimental study, we evaluated the antibacterial activity of Licorice aqueous root extract and Chlorhexidine against Lactobacillus Acidophilus using Disk Diffusion Method, determining the Minimum Inhibitory Concentration (MIC) by Broth Micro & Macro Dilution Methods and the Minimum Bactericidal Concentration (MBC) by Agar Dilution Method. Research was repeated 3 times and data were analyzed by ANOVA test. The P value of ≤ 0.01 was considered as the level of significance. Chlorhexidine showed significantly higher levels of antibacterial activity against Lactobacillus Acidophilus in comparison with Licorice aqueous root extract (P < 0.01). Although Licorice aqueous root extract is beneficial, Chlorhexidine is more efficient in the prevention of dental caries and oral infections.

Considering the widespread development of implants in dental treatment plans, linear measurements on panoramic radiography are of especial importance. In the present study we investigated the effect of head misalignment up to 15° around vertical and horizontal axes on the magnification rate of digital panoramic radiography in each part of upper and lower jaws. In this in vitro experimental study, five edentulous human skulls were used. Steel globes with 4mm diameter were placed inside each dental socket. Each skull was exposed twice at standard panoramic position and at 5, 10 and 15° upward, downward, left and right deviated positions with NewTom GIANO radiographic system with the least amount of kVp and mAs. All 50 images were saved in true size and the maximum horizontal and vertical diameter of each globe was measured by an oral and maxillofacial radiologist using linear measurement software. Data were statistically analyzed by Chi- square and ANOVA tests. At standard panoramic position, linear measurements in both horizontal and vertical dimensions showed magnification and the results indicated 12-13% magnification in vertical dimension in all parts of both jaws. The least rate of horizontal magnification was seen in the molar area of both jaws (6%). (p<0.05) At lateral head rotation, linear measurements in vertical dimension were less affected. (p>0.05) Linear measurements in horizontal dimension showed the highest variations especially in the posterior parts of the jaws. (p>0.05) At upward and downward chin rotations, vertical measurements showed magnification rate comparable with that of standard panoramic position while horizontal measurements showed increased magnification at upward rotation and decreased magnification during downward rotation. (p>0.05) Vertical and horizontal linear measurements show magnification at standard panoramic position and also at lateral head rotation around Y-axis and at upward and downward rotations. Furthermore, even at deviations up to 15°, no minimized measurements were recorded in the obtained panoramic radiographs.

Increased rate of micronucleus in buccal mucosa cells and its correlation with carcinogenesis is worth consideration. Recently, occupation in dental laboratories has been proposed as a predisposing factor. Therefore, the present study aimed to evaluate the effect of occupational exposure on buccal mucosa cells of dental laboratory technicians. This historical-cohort study was conducted on 16 male dental laboratory technicians and 16 males were selected as the control group. All samples were matched according to age. The samples neither had any recent viral diseases nor were consumers of any specific medications. Cigarette smokers and alcoholics, individuals with risky occupations or with a history of radiotherapy were excluded. Buccal mucosa cells were sampled by use of a plastic spatula and were stained with Papanicolaou stain. Micronucleus frequency was evaluated under light microscope (400×). T-test was used for statistical analysis. Significance level was set at 0.05. Micronucleus frequency equaled 69±70 and 27±8.6 in case and control samples, respectively; which is 2.6 times higher in the case group. T-test showed that the difference in micronucleus frequency was significant between the two groups. (P<0.001) the present study showed that the frequency of micronucleated cells in buccal mucosa of dental laboratory technicians is 2.6 times higher than that of the control subjects. Therefore, the mentioned occupation may increase the risk of induction of oral malignant transformations.

Resin cements are used widely in restorative dentistry regardless of their biocompatibility. The aim of this study was to compare the cytotoxicity of two categories of dental cements consisting of three chemically set cements (Fuji I, Fuji PLUS and Harvard) and two dual curing cements (BisCem and Duo-Link) by use of MTT assay. In this experimental study, four round-shaped samples of each specimen were placed in DMEM culture medium for 24, 48 and 72 hours. The extracts from each sample were applied on L929 mouse fibroblasts. At the end of each period, MTT assay was carried out to estimate the mitochondrial respiration. Data were analyzed by one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test. The degree of cytotoxicity for each sample was determined according to the reference value of the control group. Fuji I cement showed the least cytotoxicity while Harvard and BisCem cements showed the highest cytotoxic effect. The differences were not significant compared to the positive control (distilled water). This study showed that dental cements are capable of eliciting biological response in gingival and pulpal cells. They present a potential risk of tissue damage which depends on the cement's brand and curing modes.

Secondary caries are a common challenge for dentists. Many researchers have evaluated the accuracy of digital radiographic systems in the detection of secondary caries and have reported controversial results. Therefore, the aim of this in vivo study was to determine the diagnostic accuracy of digital radiography in the detection of secondary caries in anterior teeth. In this diagnostic in vivo study, 34 patients were selected from among the individuals who wished to replace their anterior teeth restorations. The restorations in need of replacement were class III or class IV composite resin restorations which were at least 5 years aged with either a crack in the restoration body or with more than 0.5mm marginal maladaptation or marginal discoloration. Digital radiographs were obtained and were observed randomly by four oral and maxillofacial radiologists. Caries detection was classified using a 5-point Likert scale. Statistics were computed to assess Kappa coefficients. According to the data, observer reliability for PSP sensor was between 0.79 and 0.88 which is an indicator of the high accuracy of PSP sensor. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90, 77, 86, 85 and 86 % respectively. The results suggest that in vivo digital radiography with PSP sensors is sufficiently accurate in the detection of secondary caries.

Odontogenic tumors are derived from the epithelial and/or mesenchymal remnants of the tooth-forming apparatus. Therefore, they are found exclusively in tooth-bearing areas. Similar to other neoplasms in the body, odontogenic tumors tend to histologically mimic the cell or tissue of origin. A 5-year-old boy presented with a chief complaint of pain in the mandible which started 3 months ago. Oral examination revealed bony expansion and a radiopaque mass fused with the roots of deciduous second molar was detected during radiographic examination. After surgical excision of the lesion and the involved tooth, microscopic examination revealed neoplastic tissue consisted of trabeculae of mineralized material with irregular lacunae and prominent basophilic reversal lines. Each trabecula was lined by prominent cells surrounded by cellular connective tissue. The lesion infiltrated the pulp chamber and root canals. According to the clinical and radiographic findings, bone-producing tumors, odontogenic tumors with calcifications and reactive lesions were included in the differential diagnosis. However, based on histopathology and radiographic data, final diagnosis of Cementoblastoma, a benign odontogenic tumor, was confirmed. Patient follow-up revealed no recurrence of the lesion.