The therapeutic effects of chamomilla tincture mouthwash on oral aphthae: a randomized clinical trial

Introduction: Recurrent aphthous stomatitis (RAS) is a common clinical condition producing painful ulcerations in the oral cavity. However, there has been no optimal therapeutic approach. Topical and systemic steroids commonly prescribed for the condition have local and systemic side-effects. Recently, there is growing tendency toward herbal medication in the modern society. The objective of this study was to assess the efficacy of a chamomilla mouth rinse on reducing the signs and symptoms of aphthous lesions in comparison with a placebo mouth rinse. Material and Methods: A randomized, triple-blind, placebo-controlled trial was performed on 36 patients, from cases diagnosed with RAS, attending the Department of Oral Medicine, Mashhad University of Medical Sciences. They were randomly divided into two groups: the intervention group(A), receiving chamomilla mouth rinse, and the control group (B) receiving a placebo rinse. The ability of the solution to control the pain and burning sensation and the number and size of the ulcers were evaluated. Results: The number of ulcers in the 3 rd visit (four days after treatment) showed a significant difference between the groups ( P <0.001). The pain and burning sensation (VAS) was reduced significantly in the test group in the 2 nd ( p =0.001),3 rd and 4 th visit ( P <0.001). Conclusions: Chamomilla mouth rinse was effective in the treatment of RAS, controlling the pain and burning sensation without producing any adverse side effects and can be advised as an alternative RAS treatment

Evaluation of desmoglein 1 and 3 autoantibodies in pemphigus vulgaris : correlation with disease severity

Pemphigus is an autoimmune blistering disease of the skin and mucous membranes caused by autoantibodies against desmoglein 1 (Dsg1) and desmoglein 3 (Dsg3). Pemphigus vulgaris (PV) is the most common form of pemphigus. The aim of this study was to assess the correlation between the levels of anti-desmoglein 1 and 3 autoantibodies and the severity of PV disease. Nineteen newly diagnosed patients with pemphigus vulgaris were enrolled in this study. The titers of Dsg in subjects by using enzyme-linked immunosorbent assay (ELISA) were done at diagnosis time-point, 4th and 8th weeks after the initiation of treatment, and the correlation of antibodies with the oral and skin disease severity was evaluated. The severity of cutaneous lesions was significantly correlated with anti-Dsg1 titer in all visits and the severity of mucosal lesions was correlated with the titer of Dsg3 in the third visit (<0.001, 0.001, 0.016 and 0.015 P value, respectively). Anti-Dsg-1 autoantibodies titers seem to be more useful in showing the extent of the disease and activity in pemphigus with mucocutaneous lesions

Evaluation of the diagnostic value of a Modified Liquid-Based Cytology using OralCDx Brush in early detection of oral potentially malignant lesions and oral cancer

Objectives: To determine diagnostic value of modified Liquid Based Brush Biopsy technique. Study design: 26 oral premalignant and malignant lesions in 25 patients (12 females; 54.23±19.77 years and 13 males; 53.77±15.43 years) underwent Modified (Liquid Based) Brush Biopsy and scalpel biopsy simultaneously from the same area. Results: There were 16 positive and 10 negative brush biopsy results, with no inadequate readings. Histological findings were compatible with oral leukoplakia(n=5)with dysplasia, Oral lichen planus and lichenoid reaction(n=7) (with or without dysplasia)oral squamous cell carcinoma(n=11),verrucous carcinoma(n=1) and granular cell tumors( n=2). Sensitivity, specificity, positive predictive value, negative predictive value, positive diagnostic likelihood ratio(LR+) and negative diagnostic likelihood ratio(LR-) were 88.8%,100%,100% , 80%, infinity and 0.11 respectively(no false positive results). Conclusion: It is the first attempt to do LBC (liquid based cytology) with a specialized oral brush. Our results show that modified technique is a useful tool for screening of oral premalignant and malignant lesions

Clinical and histopathological analysis of oral squamous cell carcinoma of young patients in Mashhad, Iran : a retrospective study and review of literatures

Objectives: Oral Squamous cell carcinoma (OSCC) is primarily a disease that mainly occurs in males in their sixth and seventh decades of life and is rare in young adults. Study Design: In this retrospective study, records of patients under the age of 40, with the diagnosis of OSCC in the Oral Medicine Department of Mashhad Dental Faculty during the past 13 years were analyzed. Their socioeconomic data, demographic, clinical and histopathological characteristics, risk factors, familial history were assessed and applicable studies and case reports in the literatures were reviewed. PCR (Polymerase chain reaction) analysis was also done for detection of human papilloma virus (HPV). Results: From 158 cases of OSCC diagnosed in our centre, 21 patients were younger than 40 years. Most of them were young men (12 cases). There was no significant risk factor in this group. The most common site of involvement was the tongue. The most common clinical presentation was exophytic lesion with ulcer. No HPV DNA was detected in these patients. Conclusion: Characteristics of OSCC in young patients are different from older age group. Major risk factors (smoking and alcohol consumption and HPV) were not etiologic factors for OSCC in young patients in our province. © Medicina Oral S. L

Evaluation of Risk Factors in Patients with Head and Neck Cancer: A Case Control Study

Background: Head and neck squamous cell carcinoma (HNSCC) is one of the most common types of cancer worldwide. Since there are many factors that influence the development of cancer, identifying risk factors plays an important role in cancer prevention. The aim of this study was therefore to identify the risk factors for HNSCC in Mashhad, Iran. Methods: In this case-control study, 76 patients with HNSCC were included as the case and 91 healthy people as the control group. A checklist of risk factors was completed for each participant and the two groups were compared for the presence of risk factors. Chi-square, t test, and Mann-Whitney tests were used to compare the data. Odds ratios (ORs) for several factors have also been determined. Findings: The educational level and body mass index (BMI) of the patients in the case group were significantly lower than in the control group (P<0.001). Moreover, there were significant differences between the two groups in terms of risk factors such as tobacco smoking, the number of cigarettes smoked per day, and its duration (P=0.001, P<0.001, P=0.05), as well as the duration of hookah smoking, opium consumed per day and use of alcohol (P=0.023, P<0.001, P=0.015). Conclusion: There was a direct relationship between HNSCC and risk factors such as cigarette smoking, number of cigarettes smoked per day, duration of cigarette consumption and hookah, opium consumed per day, and alcohol use. However, extensive studies with larger sample sizes are needed to better assess the impact of these factors and generalize the results

Evaluation of Antioxidant Capacity and Cotinine Levels of Saliva in Male Smokers and Non-smokers

Background: The cigarette compounds are associated with the increase in the incidence of oral cancer andprecancerous lesions. Salivary antioxidant system plays an important role in anti-carcinogenic capacity ofsaliva. Cotinine, a nicotine metabolite, has a longer half-life in comparison with nicotine and is a suitablemarker for exposure to cigarette smoke. This study aims to measure total antioxidant capacity (TAC) andcotinine level in saliva of smokers and non-smokers and compare salivary cotinine level and TAC in each grou.Methods: In this cross-sectional study, 32 smokers and 34 non-smokers were recruited by consecutivesampling from Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences,Mashhad, Iran. Salivary cotinine and TAC concentrations were determined using the enzyme-linkedimmunosorbent assay (ELISA) technique. For data analysis, correlation tests of Spearman, Mann-WhitneyU, and independent samples t-test were used.Findings: A significant difference was observed between the two groups in the mean cotinine level and in themean TAC (P = 0.015, P = 0.027, respectively). TAC showed a weak negative correlation with the cotininelevel, but the difference was not significant (P = 0.651).Conclusion: Antioxidants are of great importance to smokers because antioxidants are able to scavenge freeradicals found in cigarette smoke. According to the results of present study, the salivary TAC in smokers waslower than that of non-smokers, and the salivary cotinine level in smokers was higher than non-smokers.Therefore, smoking endangers the oral cavity health by reducing the salivary TAC. Further studies with ahigher sample size and other factors affecting the salivary TAC are needed for definitive comment

Oral Cancer Awareness of People Attending the Oral Medicine Center of Zahedan Dental School

Abstract: Despite persistent attention to early detection and treatment, cancer remains important public health problem and cause of death. Squamous cell carcinoma(SCC) is the most common malignant neoplasm of the oral cavity. Oral SCC is a important public health threat over the world. W e studied to access awareness about oral cancer among patients attending for dental treatment at dental school. W e studied in a cross sectional -descriptive survey 200 persons attending to oral medicine center of Zahedan dental school. The questionnaire consisted of 14 questions about demographic information and signs and symptoms, risk factors of oral cancer. Finally, the achieved information analyzed by SPSS 13 software and statistic test of chi square. Patient&apos;s knowledge level about oral cancer were as follow: Among the people, %37 of patients had poor knowledge, %57.5 moderate knowledge and %5.5 good knowledge about oral cancer. The relation between the studied patient&apos;s knowledge with educational level was significant (P&lt;0.05). Gender, age, occupation and source of information did not have significant relation with patient&apos;s oral cancer knowledge (P&gt;0.05). Majority of the respondents had moderate level of knowledge about oral cancer. There was a significant relationship between educational level and oral cancer knowledge

Oral lichen planus: retrospective study of 420 Iranian patients

Objective: In terms of the demographic and clinical characteristics, this is the one of the largest studies on Iranian patients with Oral Lichen Planus (OLP).Study design: Data was taken from the medical records of 420 consecutive patients referred to the Oral Medicine Department, and who were subsequently found to have clinical and usual histopathology consistent with features of OLP.Results: Seventy percent of the patients had been referred to the Oral Medicine Department by general dental practitioners. 52.6% were referred due to oral mucosal and/or gingival pain or burning sensation. Reticular OLP was the most common presentation (76.9%); about 18% of patients reported symptoms or signs, or had a known history of OLP, or possible Lichen Planus affecting non-oral epithelia. A malignant transformation rate of 0.07% was observed

Numbness in the jaw, the first symptom of multiple myeloma: a case report

Background: Jawbone involvement and destructive bone lesions in the mandible and maxilla are reported in 30% of patients with multiple myeloma. In general, plasma cell neoplasia rarely occurs in the maxillofacial area, and an incidence of 2.6-3.3 per 100,000 people is reported for solitary plasmacytoma in jawbones. This study aims to present and evaluate a patient with multiple myeloma and the first symptoms in the maxillofacial area. Case Presentation: The patient was a 52 years old woman complaining of painful swelling in the left area of the face that had enlarged during the last month. She was referred to the maxillofacial disease department of the Dental School of Mashhad, Iran in Feb 2022. The patient has had paresthesia in the left area of the face since 6 months ago. In the extra-oral examination, a 4×10 cm mass was observed in the left mandibular angle extending anteriorly toward the sublingual area. The oral mucosa was normal. According to the clinical profile, malignancy was considered a differential diagnosis. Incisional biopsy of the lesion revealed the proliferation of neoplastic plasma cells. The positive result of immunohistochemistry (IHC) staining for CD138, performed on the specimen to confirm plasmacytoma and detection of small primary lytic lesions in the skull and spine confirmed multiple myeloma. The usual symptoms of multiple myeloma, including low back pain, were not observed. The patient underwent chemotherapy under the supervision of a hematologist. Conclusion: Jawbone involvement is often less mentioned as the first symptom of multiple myeloma; however, compared to the vertebral column or skull lesions, these areas are easily biopsied, providing the possibility of early detection and treatment of multiple myeloma, hence a promising disease prognosis. The concurrence of destructive bone lesions and sensory changes in the maxillofacial area is a red flag. Precise radiographic evaluation and blood tests can help early detect multiple myeloma. Awareness of general dentists about the possibility of blood dyscrasia such as multiple myeloma with such early symptoms in patients can lead to early diagnosis of patients. This report reminds inexperienced clinicians of the special importance of sensory changes in the head and neck