A Clinical Decision Tree for Preserving versus Extracting a Compromised Tooth with Extensive Subgingival Caries or Crown Fractures

One of the most challenging issues in the field of dentistry is to decide whether to preserve or extract a compromised tooth with subgingival caries/crown fractures. Several patient-related factors (i.e. biological, behavioral, or financial factors), tooth-related factors (i.e. periodontal, endodontic, or restorative factors), and the role of the tooth in the overall treatment plan should be considered to make the most accurate decision. This article has focused on the decision-making process related to the management of compromised teeth with subgingival caries/crown fractures. Based on the current scientific evidence and clinical experience of the authors, an algorithm has been suggested to simplify this process of decision. In the first step, compromised teeth were classified as single-root or multi-root groups. “Crown-to-root ratio” (C/R ratio), and “apical extension of caries to the crestal bone” were considered the main clinical parameters in the decision-making process for single-root and multi-root teeth, respectively. We do not recommend restoring the compromised teeth if the C/R ratio is more than 1 (for single-root teeth) or if the extension of caries has reached the alveolar bone crest (for multi-root teeth). For maintainable single-root teeth, there are three treatment options to provide space for the re-establishment of supracrestal soft tissue attachment (previously named as biologic width) between the future restorative margin and underlying crestal bone. These approaches include: surgical crown lengthening (SCL), orthodontic forced eruption (OFE), and deep marginal elevation (DME). For multi-root teeth, SCL and DME are usually the procedures of choice. Multi-root teeth are not amenable to OFE due to the heavy orthodontic forces needed for extrusion. We also discussed the indications and limitations related to each treatment option. Further studies should be conducted to evaluate the external validity of this decision tree. Keywords: Decision trees; Decision making; Tooth fractures; Dental caries; Tooth extraction

Expression Rate and PAX5 Gene Methylation in the Blood of People Suffering from Gastric Cancer

BACKGROUND: Gastric cancer is one of the most important health issues in the world. Considering the lack of plenty of pre-awarenesses, the survival of gastric cancer is still quite disappointing. Methylation of PAX5 gene promoter is observed in most cancer cells of a human. A study has shown that PAX5 is a new tumoral suppressor in gastric cancer and methylation of the PAX5 promoter is associated with the survival rate of gastric cancer. AIM: The present research seeks to study the expression rate and methylation of the PAX5 gene in the blood of patients who have gastric cancer to be used as a biomarker in this type of cancer. MATERIAL AND METHODS: Real-time PCR technique was used to assess expression of PAX5 gene, while the methylation status of PAX5 gene promoter in the blood samples of people who have gastric cancer versus blood samples obtained from normal Iranian population was studied using MS PCR technique. RESULTS: The final results pointed to the fact that expression of PAX5 in blood samples obtained from those who have gastric cancer is much less than what is observed in normal blood samples. A significant correlation was also observed between expression of this gene and age and promoter methylation rate. The results of methylation also indicated that 28% of PAX5 gene promoters among patients were methylated, while all normal samples were non-methylated. CONCLUSION: Studying the decrease observed in PAX5 gene expression and the rise in promoter methylation can be utilised as a biomarker to enhance pre-awareness of gastric cancer

STUDY OF SINGLE NUCLEOTIDE POLYMORPHISM (SNP) AND GENE EXPRESSION OF PTEN IN IRANIAN GASTRIC CANCER PATIENTS

Gastric cancer is recognized as the fourth most common cancer in the world, and is the second leading cause of cancer death. PTEN is a tumor inhibitor gene. PTEN mutation is observed in most of the cancerous malignancies. In this study, the expression and common PTEN gene polymorphism in blood samples of patients with gastric cancer were studied using REAL TIME PCR and RFLP PCR techniques in Iranian population. 45 blood samples (36 patients and 9 controls) were studied in this study. After extracting the RNA and confirming its quality, cDNA synthesis was performed and the expression of the gene was evaluated by qPCR. In order to investigate the single-nucleotide change in rs10490920, the DNA was extracted from the specimens and then PCR was performed. After obtaining ct, the samples RQ was analyzed and analysis of samples RQ showed that the PTEN Gene expression was reduced in patients compared with controls. In patients with rs10490920 polymorphisms in the PTEN gene, the risk of the disease increased. The results of the study indicate a reduction in gene expression in cancer patients. Thus, it may be possible to use Pten gene expretion assesment as a possible biomarker in early diagnosis or in the treatment process. Keywords: Gastric cancer, PTEN, gene expression, polymorphism, Real time PC

Comparison of Insulin Expression Levels in White Blood Cells of infants with and without Family History of Type II Diabetes

Background: Type II diabetes is known as one of the most important, prevalent, and expensive diseases of mankind. Late diagnosis and subsequent delayed initiation of treatment or surveillance of patients create a variety of problems for affected individuals. This has raised increasing concerns for public health authorities throughout the world. In the current study, we aimed to find a new approach for early identification of high-risk individuals at initial months of their life. This allows us to take preventive measures as early as possible.Materials and Methods: In our study, 102 infants - from one to six months - were selected and placed in two case and control groups. The case group contained 52 babies with at least one of their parents identified as a type II diabetic patient. The control group comprised 50 babies with no family history of type II diabetes in paternal and maternal first-degree relatives. Afterwards, the expression level of insulin gene was analyzed in white blood cells of both groups. Information related to infants - referred to outpatient and inpatient wards of three main pediatric hospitals placed in Tehran - and their parents were collected through questionnaires within a two-year period. The study inclusion criteria for infants were confirmed type II diabetes in at least one of their parents, the absence of any metabolic disorder, and the absence of any disturbing vital signs. After drawing 2 ml of babies’ peripheral blood, total RNA of white blood cells (WBC) was extracted, and used for cDNA synthesis. Real-Time PCR was then applied to quantitatively evaluate the expression levels of insulin gene. The results of Real-Time PCR were statistically analyzed by non-parametric tests of Mann-Whitney and Kruskal-Wallis.Results: The expression of insulin gene was observed in white blood cells of all samples. However, there was a significant difference in expression levels between case and control groups (p<0.05). There was a statistically significant difference in mean levels of gene expression among babies with diabetic mother, and healthy groups (RQ=0.5, P-value=0.002), but this value wasn’t significant for babies with diabetic father (RQ=0.78, P>0.05).Conclusion: Numerous genes contribute to the development of diabetes and novel disease-causing genes are increasingly being discovered. Identification of disease-prone individuals through examining merely one underlying gene is complicated and challenging. Interestingly, all of these abnormally functioning genes finally manifest themselves in the altered expression levels of insulin gene. The expression status of insulin gene in WBCs could be suggested as a useful approach for identification of individuals at high risk for developing diabetes. This paves the way for taking appropriate measures at infancy period in order to prevent the disease as well as inhibit its various side effects in the following years of patient’s life

Determining the P-wave Velocity Structure in the Near-Surface of NW Miami, Florida, Using Quarry Blasts

The fact that Florida is an earthquake-free region has caused seismologists to pay less attention to it. Few earthquakes in this state mean it is not a usual practice to study the propagation of seismic waves. However, utilizing data from quarry blasts, we studied wave propagation in this region. The primary objective of the project is to investigate the near-surface P-wave velocity structure and factors that may affect it. We also analyzed the amplitude of signals versus distance and blast size. A network of up to 10 Raspberry Shake instruments around the NW Miami-Lakes mining area was deployed where four main quarry mines are recognized. More than 1600 blast waveforms were recorded from July 2019 to December 2022, and a catalog was created for measuring parameters. Later, we received detailed information about 447 blasts from the Miami-Dade Pilot Program of the Florida State Fire Marshal office and chose a subset of 165 high-quality events. We located these events in SEISAN and applied a grid search to reduce the misfit for the events\u27 locations. Average P-wave velocity measured from travel time versus distance plots ranges from 4.6 to 5.4 km/s. In addition, first and second polynomials were fit to the data, and the average and root mean square errors were used to evaluate the goodness of fit. The result showed smaller error differences for the quadratic fit that suggests velocity changes with depth. Furthermore, peak-to-peak amplitudes of four distinct waves are compared with the changes in distance and explosive amounts of blasts. A decrease in amplitude versus distance with a combination of 1/r and 1/√r is observed

UBD role of gene expression in patients with breast cancer

Background: Breast cancer is the most common non- skin cancer among women and it’s the second leading cause of cancer related death in women. Ubiquitin and ubiquitin like proteins are member of signal transduction pathways which have several cellular functions. It has shown that Ubiquitin like protein D (UBD) has accelerated the cancer progress. The aims of this study is evaluation of UBD gene expression in women suffering from breast cancer and its correlation with disease progression. Methods: In this study 30 FFPE (Formalin-fixed, paraffin-embedded) samples 20 cases from breast cancer and 10 cases from mammoplasty were collected from Parsian and Kasra Hospitals in Tehran after confirmation by pathologist. For each sample collection characters included ER-positive, lymph node negative, tumor size less than 5 cm in diameter were considered. Samples belonged to May 2010 up to April 2012. At first paraffin was removed by adding xylene then xylene removed with replacing ethanol 98%. After removing ethanol, RNA was extracted from samples by using RNX plus solution and cDNA synthesis were performed by using Moloney murine leukemia virus (M-MuLV) enzyme. UBD gene expression were examined in all samples cDNA by relative Real Time PCR. In this study GAPDH gene expression was also used as internal control. Results: UBD gene expression was obtained by calculating ΔΔCT and RQ. The average incensement of UBD gene expression in comparison of normal samples was 11 times. The results have shown that the level of UBD expression was related to the development and extend of the disease. In patients with stage 1 of disease, UBD gene expression had 2.73 times increase (P=0.001) compared to the control samples. However in stage 4 of disease, this number has increased up to 19.4 times (P=0.0005) more than normal. Conclusion: Considering the results of this study, it could be said that UBD gene expression as useful biomarker has an important role in detection of breast cancer. In addition as UBD gene expression levels increased; stages of disease increased too. So that evaluation of UBD gene expression can be useful in early detection of disease

Central Ossifying Fibroma, Periapical Cemento-Osseous Dysplasia and Complex Odontoma Cccurring in the Same Jaw

Central ossifying fibroma is a rare, benign fibro-osseous lesion that arises from the periodontal ligament. Periapical cemento-osseous dysplasia is another variant of fibro-osseous lesion which occurs in the anterior region of the mandible of females. Odontoma is a benign odontogenic tumor that contains enamel, dentine cement and pulp tissue. A 46-year-old woman was referred to the Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, with two nonpainful swellings on both sides of the mandible, which had been slowly growing over a period of one year. Our differential diagnosis was florid cemento-osseous dysplasia, focal cemento-osseous dysplasia for the right side, complex odontoma for the left side and periapical cement-osseous dysplasia for the anterior side. The historical feature revealed ossifying fibroma, complex odontoma and periapical cemento-osseous dysplasia. The occurrence of these three lesions in the same jaw has been rarely reported in the literature. The relationship between the occurrence of these three lesions is not obvious it could be coincidental. It seems that more case reports are needed to establish the relationship between them

Effectiveness of plaque control on improving gingival manifestation of oral Lichen planus: A review of literature

Background and Aims: Lichen planus is a chronic inflammatory mucocutaneous disease with unknown etiology. One of the most common manifestations of patients with oral lichen planus is gingival involvement in the form of generalized erythematous areas. The aim of this study was to review the articles evaluating the role of plaque control on the gingival manifestations of oral lichen planus. Materials and Methods: Motor searches of Ovid Medline and EM base databases, PubMed, Google Scholar, and Science Direct were searched for article published between January 1990 and December 2017 using of relevant key words. After reviewing the abstracts of articles, 20 full articles were selected and among them, 7 relevant articles were reviewed in this study. Conclusion: From the literature, it was concluded that effective plaque control is the main part of lesions treatment and improvement of symptoms and gingival manifestations of oral Lichen planus

Effect of Lycopene Supplementation on Infertility in Men: A Systematic Review on Clinical Trial Studies

Background and Objectives: Infertility is a reproductive disorder that a person has no reproductive ability, despite having a regular and unprotected sex for at least one year. Studies have shown that antioxidants can play an important role in improving infertility. The aim of this study was to summarize the data from clinical trial articles on the effects of lycopene supplementation on different parameters of sperm in infertile men.   Methods: In the present systematic review study on the researches carried out on the relationship between lycopene and infertility, the studies on the effect of lycopene supplementation on male infertility, were investigated through PubMed, Scopus, ISI, and Google Scholar databases between 1990 and 2018 using keywords of lycopene, antioxidant, sperm parameters, male infertility, and semen parameters.   Results: In most clinical trials, lycopene has a significant effect on the number, motility, and morphology of sperm, and also significant changes were seen with changes in antioxidant capacity and oxidative factors that have a significant role in changing sperm parameters. Changes in the surface of the receptors as well as oxidative enzymes, such as glutathione peroxidase, superoxide dismutase, and catalase were among other results observed in the studies. However, in some studies, no significant effect was found in sperm parameters.   Conclusion: The results of this study indicated that lycopene supplementation can have a positive effect on sperm parameters, antioxidant capacity, and antioxidant enzymes, but due to the low number of studies, especially in the human community, more trials are needed in this field

The Role of TIMP-2 Gene in Skin Cancer

Background and purpose: Skin cancer is one of the most common types of cancer. Several studies suggest a high incidence of skin cancer in most countries. TIMP-2 is the tissue inhibitor of matrix metalloproteinase and exist in both cancer and normal cells. The aim of this study was to investigate the expression of TIMP-2 gene in patients with skin cancer and evaluating the association between the expression of this gene and the disease progression. Materials and methods: In this study 60 FFPE samples of skin cancer (n=30) and noncarcinoma cases (n=30) were collected from Tehran Milad Hospital. The cancer patients aged 30 to 80 years old. RNA was extracted using RNX solution, and then cDNA synthesis was carried out by Oligo dT and Random Hexamer primers and MMulV enzyme. The gene expression was evaluated by Real-time PCR. Results: The TIMP-2 gene expression in carcinoma samples increased 1.13 folds compared to normal tissue samples. Also a direct correlation was seen between tumor size and TIMP-2 gene expression. In fact the gene expression in tumors= 2 cm was more than 6.72 compared with normal samples (P<0.0005). The mean expression levels of TIMP-2 gene in tumors<1 cm and 1-2 cm were 0.57 and 1.003, respectively (P< 0.001). Moreover, the TIMP-2 gene expression was found to be higher in male. Conclusion: According to current findings, expression of TIMP-2 gene has a considerable role in skin cancer development. In other words, the gene expression increases by increase in tumor size and patients age. So, it seems that TIMP-2 gene expression could be a reliable biomarker for evaluation of skin cancer in early stages