Knowledge of Dental Students and General Dentists about Medical Emergencies

Objectives Considering the fact that lack of knowledge about medical emergencies is associated with serious consequences for patients, the present study was conducted to compare the knowledge level of dental students and general dentists about medical emergencies. Methods This descriptive cross-sectional study was performed on senior dental students of Babol University of Medical Sciences in the academic year 2014-2015 and dentists practicing in Babol city. Data were collected by a questionnaire, which included questions regarding the demographic information of participants, their educational experience in this field, and knowledge level. Data were analyzed by t-test, Chi-square test, and Pearson and Spearman’s correlation coefficients. Results Fifty dental students with a mean age of 26.78 years and 50 dentists with a mean age of 37.36 years were evaluated. The mean experience of dentists was 7.46 years. Totally, 11 students (22%) and 39 dentists (48%) had encountered medical emergencies in the past year. Of all, 16 students (32%) and 12 dentists (24%) had received the necessary training in their university. The mean knowledge score was statistically similar in both groups (5.46±1.07 and 5.76±1.30 in students and dentists, respectively; P=0.2). The level of knowledge of 48% of dental students and 44% of dentists was poor; 8% of dentists had very good knowledge level. Conclusion The knowledge of dentists and senior dental students of Babol regarding medical emergencies was similar and generally not satisfactory

Genotoxicity and cytotoxicity effects of X-rays on the oral mucosa epithelium at different fields of view: a cone beam computed tomography technique

Background: Cone beam computed tomography (CBCT) is considered a common examination for dentistry problems. Cellular biology can be affected by exposure to ionizing radiations procedures. In this study, we aimed to assess the genotoxicity and cytotoxicity effects of CBCT dental examinations at two different fields of view (FOVs) in exfoliated buccal epithelial cells. Methods: Sixty healthy adults participated in the current study. They were divided into two identical groups; CBCT with FOV of 6*6 cm2 and 8*11 cm2. Exfoliated oral mucosa cells were prepared immediately before and after 10-12 days of CBCT exposure. The cytological smears were stained with the Papanicolaou technique. The amounts of micronuclei and other cytotoxicity cellular changes (Pyknosis, Karyolysis, and Karyorrhexis) were evaluated. The variables of the parameters before and after CBCT examination in the two investigated FOVs were performed using Wilcoxon test and paired-samples t-test in SPSS software. Results: The micronuclei and other cytotoxic changes parameters before and after CBCT exposure for both FOVs (6*6 and 8*11 cm2) increased significantly (p<0.001). Furthermore, a significant difference (p<0.05) was observed between the investigated parameters at the two FOVs. Notably, the FOV of 8*11 cm2 had more side effects than that of 6*6 cm2. There were no statistically significant among males and females for both FOVs. Conclusion: CBCT examinations of dental disorders would increase the risks of inducing genetic damage. The cytotoxicity and chromosomal damage were considered in males and females in both investigated FOVs (6*6 and 8*11 cm2). In this regard, the use of CBCT must be following the ALARA principle

Histologic evaluation of pulpal response to MTA and capsaicin in cats

Introduction: In direct pup capping, the exposed pulp is directly capped with a capping material to provoke a dentinal bridge formation to seal the exposed area.The aim of this study was to evaluate the pulpal response to MTA and capsaicin in cats. Methods: The sample for this experimental study consisted of 24 canines of cats, weighed approximately 3-4kg. After sedation, the teeth were cut and exposed at 3mm above cementoenamel junction, then divided into two groups: 1) direct pulp capping with MTA 2) direct pulp capping with Capsaicin. The cavities were filled with glass ionomer cement (Fuji IX). The cats were sacrificed in the first, second, and fourth weeks 4 canine teeth were extracted for the purpose of histologic analysis. 6Serial sections were cut parallel to the longitudinal axis of the canines. The sections were stained with hematoxylin & eosin, and were observed and analyzed using a light microscope. Results: In both groups treated with MTA and capsaicin, the inflammation decreased during weeks1, 2, and 4. Less inflammation was seen in MTA group but there was no statistical difference between the two groups (p=0.22). In the group treated with capsaicin, necrosis was observed in every 12 samples, but in the other group treated with MTA, only 1 pulp necrosis was seen in the first week (p=0.000). There was no significant difference in dentinal barrier formation, inflammatory response, and soft tissue changes between the two groups. Conclusions: The results of this study showed that capsaicin can decrease the severity of inflammation, but it is ineffective in dentinal barrier formation

Histopathological evaluation of dental pulp of cat after using of sodium sulfonate in composite restorative treatment

Introduction: Previous researches showed that neutral soaps significantly increased bond strength and decreased microleakage of dentin bonding agents. The aim of this study was histopathological evaluation of the effect of sodium sulfonate application as neutral soap on the cat's dental pulp after an ideal composite restorative treatment. Methods: Ten adult cats with 40 caries-free canine teeth were selected for the study. Class V cavities were prepared in the buccal surfaces of all the teeth. The teeth of the right quadrants were treated with composite, whereas the teeth of the left quadrants were primarily etched, after using of sodium sulfonate solution, they treated with composite. The first five cats were killed after one week and the other five cats after one month. The teeth were fixed, decalcified and after being sliced, paraffined blocks were made and microscopic slides were prepared and histologically evaluated. Results: The results of the histological evaluation showed that there were no statistically significant differences between the intensity of inflammation in the pulp of the teeth in the right and left quadrants after one week (p=1.000) and one month (p=0.773). However, there was significant difference after one week regarding predentin formation (p=0.017) and in the teeth of the left quadrants, the formation of predentin was more that the right quadrants, but no meaningful difference was observed after one month (p=0.203). Conclusions: It seems that the sodium sulfonate in composite restorative treatments without fear of damage to the pulp can be used

A histopathological study of smoking on free gingiva in patients with moderate to severe periodontitis

Introduction Cigarette smoking has been recognized to be a risk factor for progression of periodontal disease. Due to less inflammation and bleeding in the presence of clinical signs of periodontal disease in smokers than in nonsmokers and given the conflicting results of studies on changes in the epithelium and gingival connective tissue by smoking, this study was performed to evaluate the thickness and keratosis on the epithelium of free and sulcular gingival tissue in smokers and nonsmokers patients with moderate to advanced periodontitis. Methods: In this cross sectional study, biopsies were obtained from palatal gingival of 60 patients with moderate to advanced periodontitis (30 smokers and 30 nonsmokers). These biopsies were histologically processed, serially sectioned at 5 microns, stained with H. E. and examined by image analysis software (analysis-SL-starter), which was used to perform the morphometric evaluation of the outer and inner epithelial thickness, keratosis and vascularity in connective tissue. The data were analyzed with SPSS 17, t-test, Mann-Whitney Test, and Pearson correlation. p<0.05 was considered significant. Results: Histopathological examination showed significant association between smoking and CAL (p=0.048), keratosis on outer epithelium (p=0.020) and mean of thickness of outer (p=0.023) and inner (p<0.001) marginal gingival epithelium but gingival vascular density in nonsmokers was more than smokers (p=0.002). Collagenized connective tissue was observed in smokers more than nonsmokers. (p<0.001) Conclusions: It seems that the reduction of the clinical signs of inflammation in the gingival tissue of smokers is due to changes in gingival epithelium and connective tissue from smoking

Histopathological, Histomorphometrical, and Radiographical Evaluation of Injectable Glass-Ceramic-Chitosan Nanocomposite in Bone Reconstruction of Rat

Background. Bone defects following tumor resection and osteolysis due to bone lesions, periodontal tissue disorders, and bone reconstruction are challenges that surgeons face. Gass-ceramic-chitosan nanocomposite contains chitosan, a derivative of crustaceans’ exoskeleton. Methods. Thirty-two 6–8-week-old male Wistar rats were chosen. One hole on each right and left tibia was made. The right tibia holes were filled with injectable glass-ceramic-chitosan nanocomposite, and the left tibia holes were left empty. After 7, 14, 28, and 60 days, histopathological, histomorphometrical, and radiographical assessments were performed. Results. Radiographic density on days 7 and 14 was significantly higher in the right tibias than in the left tibias. Trabecular bone thickness, which was higher in the right tibias, increased from day 7 to day 60 in both right and left tibias, although not significantly. Conclusions. Glass-ceramic-chitosan nanocomposite is suggested for use in bone repair in cases of bone loss. More histopathological, histomorphometrical, and radiographical assessments are also recommended

Plexiform schwannoma of the floor of the mouth: a case report

Plexiform schwannoma is a type of schwannoma that can be occured at any age and any site of the oral cavity. In the gross and histopathological features, it shows plexiform or multinodular growth pattern. This variant of schwannoma is sometimes associated with neurofibromatosis type II or schwannomatosis. Histopathologically, plexiform schwannoma is composed of schwann cells that show Anthony A growth pattern. Mitosis are rare or absent. This study reports a case of a healthy 34 year old female with swelling in floor of her mouth; according to the clinical and histopathological findings, the diagnosis was Plexiform schwannoma

Evaluation of Interleukin- 6 Levels in Saliva of patients with Oral Lichen Planus

Introduction: Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disorder with an unknown etiology. Although a considerable body of evidence suggests that immunologic factors are involved in the etiology of OLP, the involvement of cytokines in the pathogenesis of the disease is not fully understood yet. The aim of the present study was to assess interleukin-6 (IL-6) levels as a proinflammatory cytokine in the saliva of OLP patients compared to healthy controls. Materials & Methods: This case-control study was conducted on 30 OLP patients (12 males and 18 females) and 30 healthy control subjects, selected from individuals who were referred to the Department of Oral and Maxillofacial Diseases in Faculty of Dentistry, Babol University of Medical Sciences. Samples of unstimulated saliva were collected. Salivary IL-6 levels were measured using an ELISA kit and compared between OLP patients and healthy controls. The collected data were analyzed by Chi-square, independent t-test, and receiver operating characteristic (ROC) curve using SPSS 18. Sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) ​​were calculated. A value of p<0.05 was considered significant. Results: Mean salivary IL-6 values in OLP patients and healthy controls were 24.68±9.90 ng/L and 13.76±9.27 ng/L, respectively. The difference was statistically significant (P<0.001). The mean IL-6 values in reticular and erosive forms of OLP clinically were 24.35±9.26 ng/L and 24.91±10.64 ng/L, respectively. This difference was not statistically significant (P=0.87). Conclusions: Higher levels of IL-6 in saliva of OLP patients compared with healthy controls support the role of IL-6 in the pathogenesis of the disease

Comparing Immunohistochemical Expression of Podoplanin between Oral Squamous Cell Carcinoma and Normal Oral Mucosa

Background and purpose: Oral squamous cell carcinoma (OSCC) is the sixth most common cancer in the world. Podoplanin is a mucin-like integral membrane glycoprotein that is expressed in the lymphatic endothelial cells but not in the blood vascular endothelial cells. The aim of the present study was to investigate the immunohistochemical expression of podoplanin and evaluating lymphangiogenesis in OSCC compared with normal oral mucosa. Materials and methods: In this laboratory study, 40 paraffin blocks archived in the Department of Oral and Maxillofacial Pathology in Babol Dental School with previous diagnosis of OSCC were used. Also, 40 samples of normal oral mucosa obtained during impacted wisdom tooth surgery with minimal inflammation from histological and histopathological point of view were included. Immunohistochemical expression of podoplanin in epithelial cells and the number of lymphatic vessels were evaluated in both groups. Chi-square, Mann-Whitney, Wilcoxon, and Oneway ANOVA were applied for data analysis. Results: Findings showed significant difference in the mean number of lymph vessels between the area of tumor invasion in OSCC group (4.43±2.02) and center of the tumor (6.78±2.72) (P<0.001). In the study of podoplanin expression in terms of quality, it was found that in the OSCC group, podoplanin expression was between 51% and 100% in 23 cases (57.5%), while these expression levels in the control group were seen only in four cases (10%). Podoplanin expression in epithelial cells in squamous cell carcinoma was significantly higher than normal oral mucosa (P<0.001). Conclusion: The present study suggests that podoplanin is involved in the pathogenesis of oral squamous cell carcinoma

Osteosarcoma of the Maxilla: A Rare Case with Unusual Clinical Presentation

Osteosarcoma (OS) is a malignant mesenchymal tumor, which rarely occurs in the maxilla. Although variable histologic and radiographic features of OS have been reported previously, in the majority of the cases painful swelling of the jaw is mentioned as the first clinical presentation. Furthermore, early diagnosis and wide surgical resection of the tumor are the most important determinant factors of prognosis. Therefore, the unusual clinical presentations of OS should be considered meticulously to expedite the diagnosis process. We describe a case of OS of the maxilla with extremely unusual presentation in a 42-year-old female, that was initially designated as “epulis fissuratum”. Here, we highlight the importance of combining the clinical, radiographic and histopathologic examination to obtain a definitive diagnosis and also the significance of early effective surgical intervention in evaluation of pathologic lesions