Dental Research Journal
Volume:9 Issue: 4, Jul 2012

Dysphagia is defined as difficulty in swallowing food (semi-solid or solid), liquid, or both. Difficulty in swallowing affects approximately 7% of population, with risk incidence increasing with age. There are many disorder conditions predisposing to dysphagia such as mechanical strokes or esophageal diseases even if neurological diseases represent the principal one. Cerebrovascular pathology is today the leading cause of death in developing countries, and it occurs most frequently in individuals who are at least 60 years old. Swallowing disorders related to a stroke event are common occurrences. The incidence ranging is estimated from 18% to 81% in the acute phase and with a prevalence of 12% among such patients. Cerebral, cerebellar, or brain stem strokes can influence swallowing physiology while cerebral lesions can interrupt voluntary control of mastication and bolus transport during the oral phase. Among the most frequent complications of dysphagia are increased mortality and pulmonary risks such as aspiration pneumonia, dehydration, malnutrition, and long-term hospitalization. This review article discusses the epidemiology of dysphagia, the normal swallowing process, pathophysiology, signs and symptoms, diagnostics, and dental management of patients affected.

The mouth serves as a mirror to general health and also as a portal for disease to the rest of the body. Since the old wives’ tale of “the loss of a tooth for every pregnancy”, oral health during pregnancy has long been a focus of interest. In the past decade, there has been mounting scientific evidence suggesting that periodontal disease may play an important role as a risk factor for adverse pregnancy outcomes. Considering all the above stated factors this systematic review is aimed to focus on the association of periodontal diseases to preterm and low-birth weight (LBW) babies. In view of the large body of literature the review is limited to studies identified by computer searching. Hand searching of journals and gathering of unpublished reports and conference proceedings was outside the scope of the review. The PubMed database was searched using the search terms: periodontitis, preterm, LBW. The titles, authors, and abstracts from all studies identified by the electronic search were printed and reviewed independently on the basis of keywords, title and abstract, to determine whether these met the inclusion criteria. The electronic search identified 68 papers. After review of the study title, keywords and abstracts, 62 papers were identified potentially meeting inclusion criteria. Generally, all the studies reviewed in the paper suggest that periodontal disease may be a potential risk factor for preterm LBW babies.

Aphthous ulcer is one of the most common diseases of the oral cavity with no known effective treatment so far, which could cause severe discomfort in patients. Aloe vera (A.V.) is a tropical plant with anti-inflammatory and immunostimulant effects, which could be of benefit in a diversity of wound healing conditions. The aim of this study is to evaluate topically administered A.V. gel on oral cavity minor aphthous healing. As a double-blind (case control) clinical trial, 40 patients with oral minor aphthous lesions were randomly allocated in either the case group (A.V. gel) or the control (placebo) group. The healing time (days after gel application), patient’s pain score; the lesion and its surrounding inflammation diameters were recorded for 2 weeks. The obtained results were analyzed by either “Fishers exact” or t-student test using SPSS software. The mean (±SD) of patients’ age was 29.25 ± 8.48 and 27.95 ± 7.96 years in the control and A.V.-treated groups, respectively, which were not significantly different (P > 0.05). The duration of complete wound healing, pain score, wound size and inflammation zone diameter in the A.V.- treated group were significantly lower than the control group (P ≤ 0.05) on specific time points after treatment. It seems likely that A.V. 2% oral gel is not only effective in decreasing the recurrent aphthous stomatitis patients’ pain score and wound size but also decreases the aphthous wound healing period.

The aim of this study was to assess the oral health knowledge, attitude and practices among the health care professionals working at KFMC, Riyadh. A cross-sectional study of 161 health professionals consisting of doctors, nurses, pharmacists, technicians and medical students was carried out using a structured, self-administered, close-ended questionnaire. Responses were collected and descriptive statistics, ANOVA, Chi square tests and z-tests were performed. Doctors showed a high mean knowledge score as compared with other health professionals. Comparison of oral health knowledge scores among the different types of health professionals yielded statistically significant differences (P < 0.05). The attitude toward visit to the dentist varied; 52.7% of nurses and 50% of technicians said that they would like to visit the dentist regularly. 66.7% of the medical students visit the dentist whenever they get pain in their tooth. 54.5% doctors and 45.8% pharmacists are likely to visit the dentist occasionally. For 60% medical students, tooth ache was the driving factor for their last visit. Majority of the health professionals said that the fear of drilling was the main reason for avoiding the dentist. Almost all the health professionals said that they cleaned their tooth by toothbrush and toothpaste. Less than 50% of the health professionals used mouth wash and dental floss. Less than 10% used Miswak and toothpick as part of their oral hygiene. Oral health knowledge among the health professionals working in KFMC, Riyadh was lower than what would be expected of these groups, which had higher literacy levels in health care, but they showed a positive attitude toward professional dental care.

This study assessed the genotoxic and cytotoxic potential of three different glass ionomer cements used in Orthodontics (Vidrion C, OptiBand, and Band-Lok). The tested cements were exposed in vitro to mouse fibroblast cells for 1 h at 37ºC. The genotoxicity and cytotoxicity were evaluated by means of the single cell gel (Comet Assay) and the trypan blue exclusion test, respectively. All data were assessed by the Kruskal–Wallis non-parametric test, followed by Dunn’s test. P < 0.05 was considered for statistical significance. Significant statistically differences (P < 0.05) in cytotoxicity were observed for both Vidrion C powder and liquid at the tested concentrations, with exception to the group presenting the lowest powder concentration. OptiBand similarly presented induced cellular death at the highest tested concentration for paste A (P < 0.05). Band-Lok paste B was also able to induce cytotoxicity at the highest tested concentration. Regarding the comet assay, Band-Lok paste B and OptiBand paste A resulted in increased DNA injury (P < 0.05). The obtained results support the thought that some glass ionomer cement components present both genotoxic and cytotoxic effects when in high concentrations. Since DNA damage and cellular death are important events during oncogenesis, this study represents relevant contribution to estimate the real risks induced by these materials upon cellular systems.

A few studies have investigated the effect of saliva contamination of cured or uncured adhesive systems. The aim of this study was to compare the effect of different decontamination methods on the shear bond strength of composite to enamel and dentin using an adhesive contaminated after light activation. In this in vitro experimental study, 80 extracted sound human teeth, 40 premolars and 40 central incisors were selected for dentin and enamel specimen preparation. Within each of the two test groups, the teeth were randomly subdivided into five groups. The materials used consisted of single bond (3M) and Z250 (3M). Except group 1 (Control), in Groups 2-5, cured adhesive was contaminated with saliva (20 s). Decontaminating procedures were rinsing, blot-drying, rebonding (Group 2), rinsing, air-drying, rebonding (Group 3), etching, rinsing, blotdrying, rebonding (Group 4) and etching, rinsing, blot-drying (Group 5). Then, composite resin was inserted on the treated surfaces and cured. The results were subjected to one-way ANOVA and Tukey honestly significant difference (HSD) tests. Group 5 (etching, rinsing, blot drying) resulted in significantly lower bond strength to both enamel and dentin surfaces in comparison with the other groups (P < 0.05). When the adhesive was re-applied, all decontamination methods in this study seemed sufficient to decrease the adverse effect of saliva

Gingival recession is a common occurrence and patients often report to dental clinic with associated problems such as root surface hypersensitivity, esthetic concerns, cervical root abrasions, and root caries that make it a concern for patients. Based upon the fact that gingival recession is an enigma for clinicians because of multitude of etiological factors and plethora of treatment modalities present for its treatment, a survey was conducted to assess knowledge as well as opinion about most common etiology, classification, and preferred treatment of gingival recession and to evaluate the interest and satisfaction of dentists in practicing periodontics. Study design consisted of a cross-sectional online survey, conducted among dentists practicing in state of Punjab, India, in the month of April 2011. A structured online questionnaire consisting of 17 questions evaluating the interest of dentists in periodontics based on knowledge about gingival recession (most of them giving the possibility of multiple choices of answers) was sent to about 300 dentists. Pearson Chi-Square and Mann-Whitney U tests were used for statistical analysis of data collected. P ≤ 0.05 was considered as statistically significant and P ≤ 0.01 considered as highly significant. A greater proportion of periodontists had better knowledge about etiology (P = 0.07), classification (P = 0.000), and treatment of gingival recession (P = 0.000). A greater number of periodontists opted for the surgical modalities to correct the defects produced by gingival recession as compared to non-periodontists and had better interest (P = 0.000) and satisfaction (P = 0.000) in practicing periodontics. The results elucidated that periodontists had better interest and satisfaction in practicing periodontics, and were more inclined towards surgical correction of gingival recession as compared to non-periodontists.

Recently, various modifications in transorally placed miniplates for direct fixation of the mandibular fracture are gaining popularity. The modifications have various advantages like more rigidity, less foreign material, less time in application, etc. Among the various modifications of miniplates, three-dimensional (3-D) plating system is also gaining popularity. Thus, in the present study, we tried to evaluate the efficacy and postoperative complications of 3-D titanium miniplates in the treatment of mandibular fractures. A prospective study was conducted on 40 patients with non-comminuted mandibular fractures. They were treated using a 2-mm 3-D titanium miniplate through intraoral approach. All patients were systematically monitored 6 months postoperatively. Outcome parameters like infection, hardware failure, wound dehiscence, sensory disturbance of the inferior alveolar nerve, occlusion, and 3-D plate stability were recorded. The statistical tests used in study were mean, standard deviation, and Chi-square test. P values less than 0.05 were considered significant and values less than 0.001 were considered very highly significant. Two patients had a postoperative infection with no consequences. All patients had normal sensory function 3 months after surgery. Plate fracture had not occurred in any patient. Occlusal was normal and wound dehiscence was not reported. 3-D plate was stable in all the patients. It was seen that 3-D titanium miniplates were effective in the treatment of mandibular fractures and overall complication rates were lesser. In symphysis and parasymphysis regions, 3-D plating system uses lesser foreign material than the conventional miniplates using Champy’s principle.

Various types of materials are used in bone regeneration procedures. The aim of this study was to investigate the use of the enamel matrix derivative (EMD), deproteinized bovine bone mineral (Bio-Oss), and a combination of Bio-Oss plus EMD in the treatment of bone defects created in the rabbits’ calvaria. Twenty New Zealand white rabbits were included in this experimental randomized single blind study. Four equal cranial bone defects (3 × 6 × 0.5 mm3) were created in frontal and parietal bone and randomly grafted with Bio-Oss (Group 1), EMD (Group 2), EMD + Bio-Oss (Group 3) and one of them was left unfilled to serve as a control group (Group 4). After 2, 4, 8, and 12 weeks the defects were evaluated by using histological and histomorphometric analysis. Data were analyzed by the Bonferroni test using SPSS 13 statistical software. P value <0.05 considered as statistically significant level. Bone formation in the EMD + Bio-Oss group after 2 weeks was diminished when statistically compared to the other groups (P < 0.05). Bone augmentation after 4 weeks from the lowest to the highest were found in groups 1, 3, 2, and 4, respectively, and these differences were statistically significant (P < 0.05). Using EMD with Bio-Oss increased bone formation in the noncritical defects in the rabbit calvaria during 8 and 12 weeks (P < 0.05). Boosting of EMD plus Bio-Oss seems to have synergic effect on bone regeneration in bone defects.

Many environmental and genetic factors are known as factors that increase the susceptibility to periodontitis. As IL-8 is a chemokine that mediate the inflammatory process in periodontal disease, we decided to evaluate the effect of its polymorphism on chronic and aggressive periodontitis. In this cross-sectional study DNA was isolated from the whole blood of 107 periodontitis patients and 199 healthy individuals. All samples were genotyped for the IL-8 polymorphisms using the polymerase chain reaction with sequence specific primers. The distribution of the interleukin-8 genotype and allele frequencies in control and disease groups was analyzed by the Chi-square test and a P-value of < 0.05 was considered statistically significant. The findings revealed that the allele and genotype frequencies of A2767T, T11722T2, and C781T polymorphism of IL-8 gene were not significantly differed between controls and patients. However, there was a significant difference in the genotype frequencies of IL-8 A251T (P < 0.0001), G396T (P < 0.0001), and C1633T (P < 0.0001) gene polymorphism between the patient and the control groups. Additionally, there was a significant difference in the genotype frequencies of C1633T (P < 0.05) polymorphism of IL-8 gene between the aggressive and chronic periodontitis. IL-8 gene polymorphism may be protective against periodontitis.

Implant surgery requires local anesthesia and drilling. This surgery may affect the blood circulation of the adjacent teeth. In this study, we evaluated the blood oxygen saturation of the healthy adjacent tooth with a pulse oximeter, during implant surgery. In this clinical trial study, 15 healthy adult patients, who were candidates for anterior implant surgery and had healthy anterior adjacent teeth, were selected. Blood oxygen saturation of the adjacent tooth and index finger was measured with a pulse oximeter, before and after local anesthetic injection, and also immediately and one hour after completion of surgery. The collected data were analyzed with a Paired Samples Test and Spearman’s Correlation Coefficient. (the significance level was at alpha P < 0.05). The mean value of peripheral finger blood Spo2 before local anesthetic injection was 98.2% and remained stable during surgery. In the adjacent tooth, the mean values of the pulpal Spo, before and after local anesthesia, were 87.73 and 79.27%, respectively; immediately after surgery it was 86.13% and one hour after surgery was 86.4%. The decrease in the value of pulpal Spo2 after local anesthesia compared to before the injection was significant. Also there was an inverse relationship between the numbers of utilized local anesthetic cartridges and the value of pulpal Spo2 after local anesthesia. After giving local anesthesia, the mean value of Spo2 in the adjacent tooth, because of the vasoconstructive effect of epinephrine, was decreased to about 8%. According to this study, the effect of the local anesthetic drug, containing epinephrine, on the blood circulation in the adjacent tooth was significantly more than the trauma from the implant surgery. We wonder if this temporary decrease in blood flow in the adjacent toot is clinically important or not. To answer this question more studies are required.

Local anesthesia (LA) with epinephrine have an important role in pain and bleeding control. However, most clinicians believe LA + epinephrine may cause rapid raise in blood pressure (BP) and heart rate (HR). The aim of this research was to compare the changes in HR and BP after administration of lidocaine with and without epinephrine 1/80000 in two infiltration (INF) and inferior alveolar nerve block methods (IANB). The study was a randomized double-blind experimental clinical trial. Forty subjects were divided into two equal groups and two subgroups. In one group, INF and in the other group, IANB were used and, further, in one subgroup lidocaine and in another subgroup, lidocaine plus epinephrine were used. BP and HR were recorded before and 10 min after. The paired t-test for intragroup differences and independent t-test for intergroup analysis were used at the significant level of P≤0.05. The mean BP and HR values were reduced after injection of lidocaine in both INF and IANB compared with baseline. The differences were statistically significant (P < 0.05), but, on comparing these values between the two injection methods, the differences were not statically significant (P = 0.089 and 0.066, respectively). The mean BP and HR values were increased after injection of lidocaine plus epinephrine in both INF and IANB compared with baseline, and these were statistically significant (P < 0.05) but, on comparing these values between the two methods, the differences were not statically significant (P = 0.071 and 0.092, respectively). The rise in BP and HR following injection of lidocaine plus epinephrine was statistically significant compared with baseline in both INF and IANB, but this was not clinically and numerically considerable.

Color change of composite restorations in different color media during the time is a common problem in esthetic dentistry, causing the need to replace the restoration, and spending a great deal of cost and time to patients. The aim of this study is to investigate the effects of different common drinks consumed by patients on one of the widely used composites in dentistry. Sixty-five disk-shaped specimens were prepared with a light-cured composite (Z100-shade A2) and divided into five groups of 13 specimens. Samples of each group were immersed in staining solutions (tea, coffee, lemonade, and cola) and distilled water (as control). Color values (L*, a*, b*) were measured relative to the standard illuminant D65 over a white background, using the CIE L*a*b* system. Color change values were calculated before and after 1, 7, and 14 days of immersion. Repeated measures and one-way analysis of variance (ANOVA) and paired t tests were applied for statistical analysis. Tea and coffee produced the most discoloration, whereas, water exhibited the least color change after immersion for 14 days in Z100 (P < 0.05). After one day of immersion, coffee caused the lowest discoloration in the test composite, compared to tea, cola, distilled water, and lemonade (P < 0.05). Staining solutions and immersion time are significant factors that affect color stability of composite resins.

The possibility of mini-screws reuse would reduce treatment cost. The aim of this study is to introduce a new method (application of phosphoric acid 37% for 10 minutes followed by sodium hypochlorite 5.25% for 30 minutes) for cleansing of mini-screws and assessing the efficacy of this method. The effects of this processing on the insertion, removal, and fracture torques of mini-screws were evaluated. This experimental study was done in two parts. In part I the amount of calcium ion on mini-screws surfaces as an index of tissue remnants was assessed. In part II of this study, the effects of previous use, processing method, and resterilization on the insertion, removal, and fracture torques of mini-screws were assessed. Each part of this study had 3 groups; nonprocessed used (NP), processed used (P), and as-received (C). Each group had 16 samples in part I and 20 samples. Non parametric statistical tests were used in part I and one way ANOVA in part II. The mean amount of calcium ion in groups non-processed (NP1), processed (P1), and control (C1) were 4.7, 0.43, and 0.02 ppm, respectively. The amount of calcium ion in group NP1 was significantly greater than in the other groups (P = 0.000), but the difference between groups P1 and C1 was not significant (P = 0.087). The mean insertion torque of group NP2 was lower than that of other groups (P < 0.05) but P2 and C2 did not have significant differences (P = 0.988). The mean of removal and fracture torque did not have significant differences among all groups. Cleaning of used mini-screws with phosphoric acid 37% (10 minutes) and sodium hypochlorite 5.25% (30 minutes) reduces tissue remnants to the level of as-received miniscrews. So it can be suggested as a processing method of used mini-screws. Previous insertion of mini-screws into the bone and above-mentioned processing method and resterilization with autoclave had no adverse effects on insertion, removal, and fracture torque values as mechanical properties indices

The perfect sealing of the tooth/restoration interface is important to prevent bacteria penetration that may lead to secondary caries and also, when dentin is involved, prevent excessive fluid movement in the dentinal tubules that may cause hypersensitivity. The aim of this study was to evaluate the effect of deproteinization and application of reducing agent on the marginal integrity of composite restorations using three different bonding agents (Prime & Bond NT, AdheSE and G-Bond). Class V cavities were prepared on the buccal surface of 90 recently extracted human premolars and were divided into three groups (I, II, and III) based on the adhesives. Each group was subdivided into three subgroups of 10 each according to the surface treatment: application according to clinical protocol; etching with 37% phosphoric acid for 15 seconds/5% NaOCl; 10% sodium ascorbate after etching/NaOCl. The cavities were restored with Filtek Z 350 nanocomposite. The specimens were sectioned and evaluated under stereomicroscope. The morphology of the resin-dentin interface was visualized using SEM. Statistical analysis was done using Kruskal-Wallis one-way ANOVA followed by a Mann-Whitney U- test (P<0.05). Group I showed significantly least microleakage among the groups. No significant difference in microleakage was found between groups I and II. Within the subgroups for each group, no significant difference in microleakage scores was observed. SEM micrographs presented gap free areas in group I and varying degrees of gaps in the other two groups. Etch and rinse adhesives were tenable for deproteinization than self etch adhesives.

Regarding the importance of sealing ability of restorative dental materials, this study was done to assess the microleakage of class V cavities restored with a new self-adhesive flowable composite resin and compare to different flowable materials. Seventy standardized class V cavities were prepared on the buccal surface of maxillary premolars teeth. The occlusal and the gingival margins of the cavities were located on the enamel and cementum/dentin, respectively. Teeth were randomly assigned into five groups (n = 14) and restored with different flowable materials following the manufacturer’s instructions: groups I and II: EMBRACE WetBond flowable composite resin with and without acid etching and bonding agent, respectively; group III: flowable compomer (Dyract Flow); and IV and V: microhybrid (Tetric Flow) and nanofilled (Premise Flowable) flowable composite resins, respectively. After finishing and polishing, the teeth were stored in distilled water at 37°C, thermocycled, coated with nail varnish, and immersed in a basic fuchsin, and then longitudinally sectioned. Dye penetration was examined with a stereomicroscope and scored separately for occlusal and gingival on a 0-3 ordinal scale. Data were analyzed with Kruskal-Wallis, Mann-Whitney and Wilcoxon tests (a=0.05). EMBRACE WetBond with acid etching and bonding agent had significantly less microleakage at the occlusal margins than those without, but not at cervical margins. Also cavities restored with EMBRACE WetBond without acid etching and bonding agent showed significantly greater microleakage scores than other groups at occlusal margin, but there was no significant difference at the cervical margin. The application of acid etching and bonding agent with EMBRACE WetBond provided better occlusal marginal sealing than those without at class V cavities.

The aim of this study was to evaluate the antimicrobial activity of Mineral Trioxide Aggregate (MTA) and Calcium Enrich Mixture) CEM (mixed with different concentrations of chlorhexidine (CHX). Cements used in this in vitro study included Gray proRoot MTA and CEM with the microorganisms being entrococcus faecalis, streptococcus muntas, Candida albicans, Actinomyces, Escherichia coli, and a mixture of these microorganisms. CHX was used in the form of liquid at 0.2%, 2%, and 0.12% concentrations. Contact dilution and colony count method was used to evaluate the antibacterial activity of these cements. After 0, 24, 48, 72, and 96-hour intervals, we cultured the samples on blood agar medium. Colonies were counted after incubation at 37°. Data were statistically analyzed by a Kruskal-Wallis test to compare the antimicrobial activity of MTA and CEM. All concentrations of CHX were mixed with MTA and the CEM had antibacterial activities on all microorganisms’ strains except for the Enterococcus faecalis and the mixture group. MTA had better antibacterial activity than the CEM, but this difference was not significant (P = 0.13). The mixing of MTA and the CEM with CHX significantly increased the antibacterial properties of both cements (P < 0.03). There was no statistically significant difference between the different concentrations of CHX. The antibacterial activity of the materials increased through time. The mixture of MTA and CEM with different concentration of CHX significantly increased the antibacterial activity.

Several studies have shown that laser-etching of enamel for bonding orthodontic brackets could be an appropriate alternative for acid conditioning, since a potential advantage of laser could or might be caries prevention. This study compared enamel resistance to demineralization following etching with acid phosphoric or Er:YAG laser for bonding orthodontic brackets. Fifty sound human premolars were divided into two equal groups. In the first group, enamel was etched with 37% phosphoric acid for 15 seconds. In the second group, Er:YAG laser (wavelength, 2 940 nm; 300 mJ/pulse, 10 pulses per second, 10 seconds) was used for tooth conditioning. The teeth were subjected to 4-day PH-cycling process to induce caries-like lesions. The teeth were then sectioned and the surface area of the lesion was calculated in each microphotograph and expressed in pixel. The total surface of each specimen was 196 608 pixels. Mean lesion areas were 7 171 and 7532 pixels for Laser-etched and Acid-etched groups, respectively. The two sample t-test showed that there was no significant difference in lesion area between the two groups (P = 0.914). Although Er:YAG laser seems promising for etching enamel before bonding orthodontic brackets, it does not reduce enamel demineralization when exposed to acid challenge.

General anesthesia (GA) allows dental treatment to be rendered under optimal conditions, theoretically ensuring ideal outcomes. The aim of this study was to determine the efficacy of restorative dental procedures performed under GA. In this cross-sectional retrospective study, 305 pediatric patients who had been treated under GA 6 to 24 months before our survey at Isfahan’s hospitalized dentistry center were examined. The examination was performed on dental chair with oral mirror and dental probe. The results were recorded in a special form for each patient for statistical analysis and evaluation of restorations to be successful or failed. Statistical analysis was performed by chisquare and fisher exact tests for comparison between success rates of restorations and Kendall’s tau-b test for evaluating the effect of time on success rates of them (P < 0.05). Stainless steel crown restorations had significantly better results vs class I and class II amalgam and class I and class II tooth color restorations. All types of posterior tooth color restorations had statistically same results with amalgam restorations. Anterior composite resin build-up represented significantly low success rates. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up (P = 0.344 and P = 0.091, respectively). Stainless steel crown restorations had significantly better results vs other posterior restorations. The failure rates of stainless steel crown and anterior composite resin build-up restorations did not correlate with the time of follow-up in comparison of other restorations.

The term neurofibromatosis (NF) is used for a group of genetic disorders that primarily affect the cell growth of neural tissues. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen’s disease, is the most common type of NF, and accounts for about 90% of all cases. It is one of the most frequent human genetic diseases, with a prevalence of one case in 3,000 births. The expressivity of NF1 is extremely variable, with manifestations ranging from mild lesions to several complications and functional impairment. Oral manifestations can be found in almost 72% of the NF1 patients. The aim of this article is to report the NF1 in a family with different manifestations and to review the literature.

This paper presents a case with dentinogenesis imperfecta (DI) associated with osteogenesis imperfecta. Systemic and dental manifestations of OI and its medical and dental treatments are discussed in this paper. A 5-year-old child with the diagnosis of OI was referred to the Dental School of Shaid Beheshti University of Medical Sciences. On clinical examination yellow/brown discoloration of primary teeth with the attrition of the exposed dentin and class III malocclusion was observed. Enamel of first permanent molars was hypoplastic. Radiographic examinations confirmed the diagnosis of DI. A histological study was performed on one of the exfoliating teeth, which showed abnormal dentin. Primary teeth with DI were more severely affected compared topermanent teeth; enamel disintegration occurred in teeth with DI, demonstrating the need for restricts recalls for these patients

Pindborg tumor, the eponymous counterpart of calcifying epithelial odontogenic tumor (CEOT), is a rare benign odontogenic neoplasm that was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955 and accounts for approximately 1% of all odontogenic tumors. Its origin as well as its malignant potential is controversial. This neoplasm is possibly of stratum intermedium origin and occurring predominantly in the mandible of adults. We hereby report a case of Pindborg tumor arising in the premaxilla which is seldom (9 out of 200 cases) documented in the scientific literature

Polymorphous low-grade adenocarcinoma is a rare type of minor salivary gland malignancy. The characteristic features of these tumors are the varied histomorphology and the malignant, albeit indolent behavior. It occurs commonly in the minor salivary glands, with the palate (58.5%) being the most common intra oral site. Maxillary area (2%), mandibular mucosal area (1.5%) and posterior trigone region (0.5%) are the least affected areas. An occasional case has been reported arising from an intraosseous location i.e the maxilla, and only two cases have been reported in the English literature originating from the mandible. One such very rare case of polymorphous low-grade adenocarcinoma of the mandible, which radiographically has a soap bubble appearance, is reported here