Dentistry

Pleomorphic adenoma is a benign mixed tumor, which is composed of myoepithelial and epithelial cells. A fibrous capsule separates these cells from the surrounding tissues. Pleomorphic adenoma has unusual histopathologic features. It is the most common benign tumor affecting both major and minor salivary glands. Parotid salivary gland is affected mostly in the major group, and palate is the most common site affected in minor salivary glands. In this case report, a female patient aged 27 years who reported with a complaint of painless swelling in the right palate is presented.

Menopause is associated with a large number of symptoms ranging from physical to psychological. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to be aware of the symptoms and health care needs of peri-menopausal/menopausal/postmenopausal women. After menopause, women become more susceptible to periodontal disease. Various internets based popular search engines were used to explore related data from literature, which includes PubMed, PubMed Central, Cochrane, Google, Medknow, Ebsco, Science Direct, and IndMed. Upon compilation of relevant data, it was observed that periodontal health is most severely affected (up to 60%) followed by dry mouth (25%) and burning mouth (glossodynia; 15%) which, in turn, may increase the occurrence of oral mucosal and dental diseases, such as candidiasis. We believe the problem is due in large part to estrogen deficiency with resulting bone loss and inflammatory processes. Osteoporosis and periodontal disease are best diagnosed early so that treatment can be started sooner and fractures and tooth loss can be prevented.

To investigate the expression of CDK6 in odontogenic lesions. In this study 77 odontogenic lesions consist of 19 unicystic ameloblastoma (UA), 18 solid ameloblastoma (SA), 20 odontogenic keratocysts (OKC), and 20 dentigerous cysts were reviewed by immunohistochemistry (IHC) for CDK6 staining. Frequency of positive cytoplasmic CDK6 expression in ameloblastoma (solid and unicystic) and DCs, were recorded as, 100% and 15% respectively which show a statistically significant different (p=0.000). Positive nuclear CDK6 in SAs and UAs was 100% and 94.7% respectively which was significantly higher than DCs and OKCs (p=0.000). Mean percentage of both cytoplasmic (72.71 ± 10.0) and nuclear (45.0 ± 10.7) CDK6 staining in SAs was significantly higher than other lesions (p=0.000). Our study demonstrated that overexpression of the nuclear CDK6 and dysregulation of the PRb pathway play a role in the oncogenesis of ameloblastoma but not DCs and OKCs and might be one of the reasons for aggressive behavior of ameloblastoma.

Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology and patients with symptomatic lesions usually require treatment. Topical corticosteroids are widely used as the first choice of treatment. Laser therapy is a new method of treatment for symptomatic, resistant oral lesions. CO2 lasers have been used to treat multi-centric lesions and lesions in difficult areas. The aim of this study was to assess the effects of CO2 laser therapy and compare them with topical corticosteroids in the treatment of symptomatic OLP. In this interventional clinical trial ,thirty-six patients with symptomatic OLP were randomly allocated into two groups. The experimental group consisted of patients treated with a CO2 laser and the control group consisted of patients who used a topical steroid, namely0.1% dexamethasone mouthwash. The laser group was treated withCO2 laser ablative therapy in2 consecutive sessions during one week, in which2-3mm of normal tissue bordering the lesion was ablated. The control group used the steroid mouthwash 3 times daily in affected sites for 4 weeks. The visual analogue scale (VAS) used for pain and discomfort evaluation. Clinical data and treatment responses were graded according to Thongprasom criteria. Patients underwent a follow-up 2 months after the last treatment session to assess for recurrence of lesions. Collected data were analyzed using SPSS software version 15.Chi square tests and repeated measurement tests were used for analysis of appearance score, pain score, and lesion severity modification in this study. The laser group included 4 male and 14 female patients with a mean age of 45.89 years and the corticosteroid group consisted of 6 male and 12 female patients with a mean age of 47.68 years. Total of 112 oral lesion sites in both groups existed. The mean duration of lesion presence in the oral cavity was 5.67 months in the laser group and 5.53 months in the corticosteroid group. At the end of treatment, The mean VAS in the laser group was 4.83 ± 1.098 and in the corticosteroid group was 4.72 ± 1.32. The most common type of lesion according to the Thongprasom criteria had a score of 3 (white steria with atrophic area > 1cm2) in both groups. Chi square tests did not identify any difference between the two groups with respect to mean age and sex distribution (P value >0.05). Appearance scores, pain scores, and lesion severity were reduced in both groups after treatment according to repeated measurement tests, but no significant differences were found between the two groups .However , more accelerated pain reduction was found in the laser group, as indicated by the slope of the repeated measurement graph. No significant differences were observed across groups in terms of the response and relapse rates, according to the Mann-Whitney U test. (P value >.05). This study demonstrated that CO2 laser was as effective as topical corticosteroid therapy and it may be considered as an alternative treatment for symptomatic OLP in the future. Key words: oral lichen planus, CO2 laser, topical corticosteroid

Neurofibromatosis type 1 is an autosomal dominant neurogenic disorder, which is occurring one in every 3000 of population. We present a 37-year-old man with complaint of hard speech and several masses in his tongue. Neurofibromatosis rarely occurs as intraosseous lesion in its primary form that in this case, it has appeared as unilacular and well-defined radiolucency in panoramic view. Cone beam Computed tomography (CBCT) was carried out for better evaluation of the extension of mandibular lesions. The aim of this article is to report a sporadic case of NF1 in a family, with multiple soft and hard tissue lesions, and eliminate the complications and functional impairments.

The aim of the present study was to evaluate the efficacy of application of chlorhexidine mouthwash on Candida colonization in patients with complete dentures. Sixty-eight patients with complete denture were included in this study and divided in two groups. One group of patients were instructed to rinse their mouth with chlorhexidine mouthwash once per day for one week. The second group of patients were instructed to use placebo mouthwash containing normal saline solution. Palatal swabs and smears were taken from each patient before and after chlorhexidine and saline application and specimens were examined mycologically. For each group, Candida colony forming units (CFU) were assessed using Sabouraud agar culture. The difference between Candida colonization before and after treatment and the differences between pre-treatment and post-treatment clinical findings were assessed using paired t test. Application of chlorhexidine mouthwash significantly reduced the CFU and improved the palatal inflammation (p<0.05). This reduction was found in all patients even in smokers and diabetic patients, as well as in the subjects without suitable denture health. We demonstrated the effectiveness of application of a commercial chlorhexidine gluconate mouthwash in the management of candida colonization in patients with complete dentures specially in high-risk candidates.

Temporomandibular disorders (TMD) occur as a result of problems with the jaw, TM joint, and surrounding facial muscles that control chewing and the movement ofthe jaw.Patients affected by TMD’s present an array of symptoms which include jaw or neck pain, headache, and clicking or grating within the joint. The objective of comprehensive TMD management is not only relief of pain, but the rehabilitation or return of the entire masticatory apparatus to optimum physiologic function. The rationale for such an approach is to minimize the likelihood of exacerbations & chronicity, which are common in TMD. As our dental curricula provide nominal training in TMD management, most dentists have limited understanding of these disorders and its management. Similarly therapists also have little understanding of the importance of the dental role in management of these disorders. Hence treatment of TMD requires an interdisciplinary approach of appropriate and effective dental therapy combined with well executed physiotherapy. Physiotherapy includes modalities (e.g., Iontophoresis, Phonophoresis), relaxation techniques, and complementary therapies (e.g., Acupuncture, Hypnosis) which are used for the treatment of temperomandibular joint disorders and have proven to provide good results.