Journal of Dental School
Volume:25 Issue: 1, 2007

Advantages in the use (easy access and non-invasive collection) have caused saliva to be a unique fluid as a diagnostic medium during recent years. By the other hand, one of the most complaints of menopausal women is xerostomia. This study determined and compared the stimulated whole saliva biochemical parameters in female healthy dental students of Tehran University of Medical Sciences living in the students’ dormitory and healthy menopausal women. Methods & Materials: In a cross sectional study, five ml stimulated whole saliva samples were obtained by expectoration of 20 girl students (mean age 22 years) and 20 menopausal women (mean age 56.8 years). Sodium concentration measured by Flame-photometry method and the other saliva composition were measured by spectrophotometer and affiliated kits as follow: total protein by the Biuret method, phosphorus by ammonium molybdate and stannous chloride complex, Ca++ by Arsenazo reaction and magnesium by the xylidyl blue complex methods. The data was analysed for mean, standard deviation and standard error mean using SPSS program. Student’s unpaired t-test was used for comparison of stimulated saliva compositions between two groups. Stimulated whole saliva concentrations of total protein, magnesium, calcium and sodium were 3.73±0.44 mg/ml, 1.75±0.13, 2.03±0.17, 18.15±0.96 mmol/l in students respectively and they were 8.17±0.57 mg/ml, 0.52±0.05, 2.12±0.12, 19.71±1.99 mmol/l in menopausal women respectively. There were no significant differences in the stimulated whole saliva sodium and calcium in the two groups, while stimulated whole saliva magnesium levels in students and total protein in menopausal women were significantly higher.

Cinnamol mouth wash have deodorant antimicrobial effects. Cinnamol – the basis of this product - can incite allergic stomatitis (lip swelling, bulb, keratosis, oral ulcer and squamous cell carcinoma). The aim of this study was to detect cinnamol mouth wash side effects. Methods & Materials: This double blind clinical trial study was done on 50 dental students of Yazd dental faculty. After oral examination, subjects were entered into a randomized double blind study. Exclusion criteria were systemic disorders, allergic symptoms, multiple drug use and recurrent oral ulcers. 25 cases were asked to rinse with cinnamol and 25 with placebo (peppermint) for 10 days. Oral manifestations were examined during and at the end of the study. Data were analysed by chi-square test. Fifty subjects (18 women and 32 men) were examined. The mean age was 26.1 (age range: 21-44). No significant problem was seen in the control group. In the case group, only one lip swelling was observed. No adverse effect was observed with the use of cinnamol mouth wash. Maybe less cinnamol concentration in cinnamol mouth wash in addition to short time use and short time rinse is the susceptible cause of this finding. Long term studies with greater sample size are recommended.

Human telomerase has been associated with most malignant tumors such as squamous cell carcinoma (SCC) of the oral cavity. One simple non-aggressive method for early diagnosis of oral SCC is taking smears. The aim of this study was to assess the frequency of telomerase expression in smears of oral SCC, compared with normal mucosa. Methods & Materials: Smears were obtained from 18 subjects with SCC of different sites in the oral cavity, presenting with various degrees of malignancy. Control samples were taken from the contra-lateral normal epithelium of the same subjects. The expression of hTERT, the most reliable marker of telomerase activity, was registered by extracting RNA, performing RT-PCR and then nested PCR by specific primers. Fisher's exact test was used to analyze the data. Positive expression of telomerase was detected in 8 of the 18 cases, while the normal epithelial samples demonstrated no such expression of telomerase. A significant difference in the expression of telomerase was reported between the two groups by Fisher’s Exact test (P<0.003). There is a potential for telomerase enzyme activity to act as a simple non – aggressive diagnostic tool in detection of oral SCC using smears of the lesion.Keywords:

Determining chronological age of individuals is an investigation key in legal medicine, to recognize the age of those without the date of birth or of those who have problems in birth registration and also the age of criminals under or above 18. The aim of this study was to compare between two developmental staging methods of third molars (Demirjian vs. Engstrom) and their correlation with chronological age of population. Methods & Materials: This cross-sectional and diagnostic study was accomplished in department of radiology, faculty of dentistry, university of Shaheed Beheshti in Tehran (1383–1384). Samples were composed of 350 young adults, 15–25 year–old, attending department of radiology. The radiographs were studied by a legal medicine resident and an oral and maxillofacial radiologist in order to determine developmental stages of third molars according to two methods of Demirjian and Engstrom. Statistical calculations were carried out by Levene, T, Wilcoxon’s signed rank, Mann–whitney, Friedman tests and Kendal correlation coefficients (tau-b). The frequency of different developmental stages of Demirjian and Engstrom methods was increased by development of third molars. In Demirjian method there is only a significant statistical difference between males and females in case of the left mandibular third molar, in a way that males were in a higher developmental rank. In Engstrom method, in case of the right and left mandibular third molars, the males were in a higher developmental rank, and in maxillary third molars there were no difference between males and females. According to Calton system about correlational coefficients, the relation between Demirjian method and age was average in maxillary third molars, and was strong in mandibular third molars. These results were similar to the results of Engstrom method but correlational coefficients in case of each tooth, were lower in Engstrom method in comparison to Demirjian. In order to determine the chronological age, Demirjian method was better than Engstrom.

Trigeminal neuralgia (TN) is one of the symptoms of M.S diseases which is seen in 1.9% of affected population. In 0.3% of the cases it can be the first symptom of the disease. Due to no report available in Iran, the present study was done to determine the prevalence of TN in MS patients. Methods & Materials: In this descriptive and case – series study, 125 patients with MS were randomly selected from the Iranian Society of M.S patients. The patients were interviewed and the following data regarding the age of the disease occurrence, the first sign of the illness, when the illness diagnosed and who diagnosed it, and finally the maxillofacial manifestations of the disease were collected and registered in related questionnaire. Supplemental information was also derived from the patient’s files. Chi-square test was used for data analysis. Of the studied patients, 72 were women and 53 men. The mean age of disease onset was 26.5 years old. The most common symptom of the disease was optical disturbances (36%). Regarding the manifestations of the maxillofacial area, 11.2 % of the patients had experienced TN, 40.8 % trigeminal neuropathy and 20% facial palsy. The presence of TN was bilateral in 50% of the patients and in 2 patients (1.6%) was the first symptom of the illness. The maxillary and mandibular branches of trigeminal nerve were the most affected. Statistical analysis showed a significant relation between age and sex with TN. TN was more common among the woman with multiple sclerosis (p=0.002) and the mean age was lower in these patients (p=0.000). The dentists should be familiar with this kind of facial pain to avoid unnecessary treatments. Also in encountering a young patient with TN, they should mind MS and if TN occurs as the first manifestation of disease, to promote the right time of treatment.

Squamous cell carcinoma (SCC) of oral mucosa is the most prevalent malignant tumor among oral cancers with 95 % incidence. Verrucous Carcinoma of oral mucosa is a unique and well differentiated form of SCC which is diagnosed with some difficulty from SCC specially when SCC shows warty appearance and/or, shows high differentiation in histopathologic view. In addition when verrucous carcinoma shows higher displasia, it must be differentiated from early invasive SCC. So, when verrucous carcinoma is diagnosed before changing to SCC, unnecessary treatments can be avoided. The aim of this study was to evaluate the mean number of Argirophilic nuclear organized regions (mAgNor) in SCC and Verrucous carcinoma for differential diagnosis between them. Methods & Materials: Twenty formalin fixed parrafin embeded blocks including ten SCC and ten Verrucous, were analyzed for AgNor parameters. AgNOR expression was measured by microphotometry by silver stain. T and Mann – whitney U tests were used to compare the data. mAgNor in SCC patients was 2.80±0.48 comparing with 1.95±0.28 in Verrucous carcinoma patients (P<0.001). Since the mAgNor in SCC was statistically more than the mAgNor in Verrucous carcinoma, so, the AgNor staining technique can be applied for early diagnosis of Verrucous carcinoma from well differentiated SCC.

On time diagnosis of jaw lesions is too important to achieve proper treatment plan by dentist, and the way to improve this aim is identifying of epidemiological, clinical and paraclinical characterization of lesions. Giant cell lesions are the group of oral and maxillary lesions that could be destructive. The aim of the present study was to determine the prevalence of oral giant cell lesions in period of 22 years in Shaheed Beheshti University Dental Faculty, Oral Pathology Department. Methods & Materials: This cross sectional and retrospective study was carried on descriptively on existing data. The study included patient's files with oral giant cell lesions in oral and maxillofacial pathology department in Shaheed Beheshti Dental School during 1981 till 2003. Data were analysed with Excell software by chi-square test. Out of 3390 studied files in period of 22 years, 325 cases (9.5%) were giant cell lesions. The most prevalent lesion was peripheral giant cell granoluma (PGCG) and the prevalent ones were central giant cell granoluma, aneurysmal bone cyst, giant cell tumor and Brown tumor. Prevalence of lesions in female were 58.2% and 41.8% in the male. Radiolucency was the most observed radiographic view. In 44.8% of cases primary clinical diagnosis were correct. The prevalence of oral giant cell lesions was 9.5%. PGCG was the most prevalent. Calculus and dental plaque are the etiological factors of this lesion, which determines that hygienic instructions are the main components of dental performance. On the other hand, 39.3% of the discussed lesions had incorrect clinical diagnosis which emphasized the microscopic evaluation of biopsies for correct diagnostic process of oral giant cell lesions.

Lymphoma is a group of cancers that originates in the lymphatic system, but extranodal regions may be involved. As the head and neck areas are in the field of dentistry so a dentist has an important role in early diagnosis. The aim of this study was to evaluate the prevalence of lymphoma and involvement of cervico-facial tissues in patients with Hodgkin disease and non-Hodgkin's lymphoma. Methods & Materials: This descriptive study was conducted on medical records of 55 patients presented lymphoma, 9 cases with Hodgkin’s disease (HD) and 46 cases with Non Hodgkin’s Lymphoma (NHL), mainly for involvement of cervico-facial tissues and lymphadenopathy in cancer department of Iman Khomaini Hospital (2003). Data was analysed by using SPSS 11 statistical software. Data revealed that the mean age in patients with HD was 47±7.18 and in NHL, 55±18 years old. The most site of lymphadenopathy was observed in the neck (88.8 in HD and 56.5 in NHL). In 17.4% of patients with NHL, lymphadenopathy was found in submandibular, parotid and submental regions. According to the staging, 61% of patients were in stages I and II. The most common diagnostic method was incisional biobsy. Attention to cervico-facial and oral manifestation of lymphoma is effective in early diagnosis.

Global approach to the herbal medicine has resulted in research activities to be focused on the findings of scientific documents in this field. The aim of this study was to investigate the antibacterial and antifungal effects of three herbal mouth washes (Persica, Matrica, Iralwex) and two chlorohexidine - based commercially available mouth washes. Methods & Materials: The microbial ssp tests were performed using catalase, optochin, bacitracin and gram staining. Cellular suspensions with a concentration of 0.5 Mc Farland were prepared. The inhibition zone was assessed by Disk diffusion method. The minimum inhibitory concentration (MIC) of each mouth wash for each micro-organism was determined by using Dilution Tube Technique. The results were analyzed and compared using ANOVA at a significance level of (p<0.05). The results showed that the effect of the herbal mouth washes on the micro- organism was less than the two other chlorhexidine-based mouth washes (P<0.01). The antibacterial effects of the herbal Matrica compared to the two other herbal mouth washes were significant. The comparison between the herbal and chlorehexidine-based mouth washes showed that the antibacterial effects of the herbal Matrica compared to the two other herbal mouth washes was significant. More research is needed for improvement of the herbal mouth washes.

Many research studies regarding dental occupational dangers were performed and conflicted results have been obtained. The aim of this study was to determine the awareness and practice of active dentists practicing in their offices in Kerman city. Methods & Materials: The present study was a descriptive and cross-sectional one. A questionnaire was prepared, which after determining the validity and reliability was distributed among 140 dentists. One hundred and three dentists participated in this study. Data was analyzed by SPSS software. Results showed that dentists had good awareness about hepatitis B (HBV). Mean score of awareness was 5.44 (out of 7). Seventy-eight percent of all awareness questions were answered correctly. Regarding dental practice, 90.2% had complete vaccination against HBV, however, antibody titer measurement was performed by only 43.9% of them. Meanwhile, dentists who had more than 40 years old and 10 years experience of dental practice and more than 30 hours practice per week had better practice regarding antibody titer measurement (p<0.05). General practitioners had more complete vaccination against HBV than specialists in dentistry (p<0.05). This study showed that the knowledge of dentists was good. Older dentists had better practice and general practitioners had better vaccination in comparison with dental specialists. Keywords:

Normal saliva has a critical role in maintenance of oral and dental health. Saliva is the first biologic fluid to confront the inhaled cigarette smoke. Chemical compounds in cigarette may change the amount and activity of salivary proteins and enzymes. The aim of this study was to compare the total protein concentration and amylase activity in smoker and nonsmoker men before dental practice. Methods & Materials: In a case – control study, 30 smoker men with mean age of 36 years and 30 nonsmoker men with mean age of 34 years who referred to Babol dental school were studied. After completing the questionnaire and before performing any dental work salivary samples were obtained. Their salivary samples were stored in -20◦C and after centrifuge of saliva specimens, a modified Biuret method was used for measurement of total protein concentration. Caraway starch - iodine method was used to determine α-amylase activity on supernatants. Data were analyzed with SPSS software and t-test. The mean salivary α-amylase activity in smokers (121.47±22.41 IU/lit) was lower than in nonsmokers (133.52±18.73 IU/lit), but total protein concentration in smokers (257.43±49.18 mg/dl) was higher than nonsmokers (193.24±31.75 mg/dl). Although the mean α-amylase activity and total protein concentration were different in saliva of smoking and nonsmoking groups, but the difference wasn’t statistically significant which suggests that smoking can not significantly change salivary total protein and α-amylase activity in smokers in comparison with nonsmokers.

Malignant Fibrous Histiocytoma (MFH), is the most common soft tissue sarcoma in adults and is frequently seen is elderly. This lesion is so rare in bones and if seen, is common in long bones and the incidence of the lesion in maxillofacial bones is uncommon. In addition, maxilla is an unusual site for Malignant Fibrous Histiocytoma (MFH). The aim of this article was to report a case with MFH in maxilla and to review the literature. Report of the Case: The patient was a 37 year-old man with MFH in maxilla who was referred to oral and maxillofacial surgery ambulatory ward of Taleghani hospital (2002). The specific characterization of the patient was the incidence of MFH in maxilla (which is an unusual site for this lesion) in a young age. In this article, the clinical, radiographic and histopathologic characteristics, treatment and prognosis of Malignant Fibrous Histiocytoma (MFH) are discussed. A review of related articles is also done for this rare lesion. With regards to different reported results of MFH follow up, the very poor prognosis of MFH in jaws, regular patient follow up after surgery due to its recurrence, is necessary.

Hepatitis C virus (HCV) infection is an important factor in the development of chronic liver diseases and hepatocellular carcinoma. The natural history of HCV infection is difficult to assess because of the usually silent onset of the acute phase and the few symptoms seen during the early stages of chronic infection. Acute infection leads to chronic infection in the majority of persons (up 80%). In recent years it is known that HCV induces various extrahepatic manifestations including the oral lichen planus. Also oral lichen planus has been associated with liver disease, particularly HCV infection. The purpose of this study is to review the literature to determine the relation between the oral lichen planus and hepatitis C virus at different countries. Such that, the probable relation between these two diseases is distinguished and consequently, a better treatment for curing will be presented. The most investigations done at different countries show that the prevalence of HCV infection in patients with lichen planus is greater than in the control series. Therefore, it is appropriate to screen all patients with lichen planus for HCV infection and liver function tests.

The cephalometric analysis should be done for patients seeking orthognathic surgical treatments to diagnose dentoalveolar relationships properly. Finding a landmark for the analysis must be time consuming and depends on individual experience or errors and further needs more training. The aim of this study was to develop and evaluate a software for automatically locating of the cephalometric landmarks. Methods & Materials: A software was designed and developed by programmers group using 140 cephalometric radiographs as databases. Further to cephalograms were grabbed by a digital camera (Sony cybershot 1000X1200) in JPEG format and displayed on LCD monitor (Toshiba, 1600X1200 UXGA) for three expert orthodontists and asked them to locate 10 landmarks. The statistic analysis was based on Paired t test. The results showed 51% of the assigned points by software locating were within 1mm accuracy, 63% within 2 mm and 92% within 4mm accuracy. The mean distance from reference (the mean distance of three observers’ points) of seven out of ten points was less than maximum difference between observers. For B point the mean distance difference in computer locating (0.4mm) was less than mean distance observers’ points (3.1mm). For S point the mean distance difference from reference point was 3.4mm in computer locating which was greater than the mean distance difference between observers (0.6mm). The study showed that landmark locating errors by computer were not greater than errors of individuals so, perhaps, computer could be a proper substitute for individuals for locating and analysis of cephalometric landmarks.