آتوسا امین زاده

Oral lichen planus (OLP) and oral lichenoid lesion (OLL) have similar clinical andhistopathological features but are with different etiology and treatment. Therefore, their differentiatingis of interest. The role of human papillomavirus (HPV) in OLP development has been reported in previousstudies, but its role in development of OLLs has not been investigated. Therefore, the present study aimsto investigate the presence of HPV16 in OLL and OLP.

This retrospective study was performed on 21 paraffin blocks of OLP and 15paraffin blocks of OLL collected from the archive section of the Department of Pathology, Faculty ofDentistry, Islamic Azad University, Khorasgan branch in Isfahan, Iran in 2017. For the confirmation of DNAextraction from formalin-fixed paraffin-embedded tissue blocks, β-globin gene expression was examinedusing The samples were tested for the presence of HPV16 genome by PCR. Data were analyzed using chisquare,Fisher’s exact test, and independent t-test.

The prevalence of HPV16 was 0% in the OLP group and 6.7% (1 out of 15) in the OLL group.Fisher’s exact test did not show a significant difference between the two groups (P>0.05).

There is no significant association between HPV16 infection and having OLL and OLP. Furtherstudies with more samples are recommended.

Jawbones can be affected by many lesions such as genetic, metabolic, inflammatory, cysts, and tumors. For proper diagnosis and treatment, t is necessary for dentists to be aware of the most prevalent lesions, demographic and clinical features, and their distribution patterns in every population. The present study aimed to evaluate the distribution pattern of jaw bone lesions in 7 years in Isfahan, Iran.

This retrospective analytic descriptive study was performed on 370 reports available from the department of oral pathology at Isfahan Azad university. demographic data, clinical features, and histopathology diagnosis were gathered and analyzed statistically by ANOVA and Chi-square (α = 0.05).

Intraosseous lesions consisted 28.6% of all lesions.41.5% in females and 58.4% in males (p < 0.05. (Mean age of male patients was 35.96 and 33.70 for females (p value > 0.05). Lesions were mostly in the right lower jaw (p value < 0.05). The swelling was the only clinical feature reported in only 15% of 106 intraosseous lesions, 73 cases were odontogenic cysts,19 inflammatory,9 odontogenic tumors,2 benign non-odontogenic tumors, and 3 non-odontogenic cysts. The periapical and dentigerous cyst was the most prevalent lesions reported.

Results of the present study showed jaw bone lesions mostly occurred in the right lower jaw in male patients. it is understood that the distribution of intraosseous lesions of the oral cavity is related to genetic, environmental, and geographic factors. Further studies are required.

Comprehending the pathogenesis of chronic periodontitis is helpful in the prevention of this disease. Since there are conflicting results regarding the role of mast cells in periodontitis, the aim of this study was to compare mast cell counts and morphology in periodontitis with clinically healthy gingiva.Materials &

This cross sectional case-control study was performed on 36 gingival samples (obtained from 14 patients with chronic periodontitis and 22 cases with clinically healthy gingiva among those referred to a specialized medical center in 2013. Toluidine blue and hematoxylin -eosin staining was used to identify mast cells. The total number of mast cells (intact and degranulated) was counted under the light microscope in 5 consecutive high power fields (10×40) with no overlap. Data were recorded and analyzed statistically by SPSS 22 and Independent T-test. All of the data with a statistical significance (p value < 0.05) were analyzed.

According to Independent t-test, mean number of degranulated mast cells in periodontitis group was 17.78 and in healthy gingiva group was 29.72 which was not statistically significant(p value = 0.071). Mean number of mast cells in periodontitis group was 20.57 and in healthy gingiva was 36.54 and was statistically significant (p value = 0.042). Mast cell degranulation proportion in periodontitis group was 0.857 and in healthy gingiva group was 0.866, not statistically significant (p value = 0.891).

According to results of present study it can be concluded that total number of mast cells and proportion of degranulated mast cell to the total number showed no significant relationship but the total number of mast cell was significantly increased in healthy group.

Candida Albicans, has been suggested as a possible etiologic factor in the development of leukoplakia and oral squamous cell carcinoma. The aim of this study was to evaluate and compare the presence of Candida Albicans in samples with histopathological diagnosis of squamous cell carcinoma and dysplasia with healthy oral mucosa.

 Materials & Methods:

This retrospective descriptive-analytical study was carried out on 30 samples in three groups (10 samples per group) with histopathological diagnosis of squamous cell carcinoma, epithelial dysplasia, and healthy mucosa. To identify Candida, used special PAS staining and a 400X optical microscope. The results of study analyzed with Fisher exact testwith the 0.05 level of significance.

In the group diagnose with squamous cell carcinoma, Candida Albicans was present in 90% of the samples. In the other two groups with epithelial dysplasia and normal epithelium, positive PAS staining of candida was observed in 50% and 60 % samples respectively. A significant statistical difference between the group of squamous cell carcinoma and the other two groups was observed in terms of amount of Candida Albicans present in the samples. (p value < 0.05), however there was no such significant between the group with epithelial dysplasia samples and the one with normal epithelium samples (p value > 0.05).

According to the results of present study and the results of previous studies, it can be concluded that Candida Albicansprobably plays a role not as an etiological factor but as a factor leading to epithelial malignancies. We recommend more studies to be carried out on this topic.

Odontogenic keratocyst (OKC) or keratocystic odontogenic tumor (KCOT) is a developmental odontogenic cyst which requires special attention due to its unique clinical and histopathological features. CK19 is expressed in non-keratinized normal epithelium and its expression increases during inflammation. Recently the use of this tumor marker has been suggested for identification of odontogenic cysts and tumors. Thus the aim of the present study was to evaluate the expression of CK19 in inflammatory and non-inflammatory keratocyst epithelial cells. This retrospective cross-sectional study was performed immunohistochemically on 25 inflamed and non-inflamed OKC paraffin blocks retrieved from the Archives of the Oral Pathology Laboratories of Isfahan Azad University and Isfahan University of Medical Sciences Medical Faculties. After selecting the samples, sections measuring 3‒5 µm in thickness were prepared. The intensity of cytoplasmic stainability was studied immunohistochemically in three different layers of cyst epithelium: basal, suprabasal and superficial under a light microscope at ×10 and ×40. Data were analyzed with Mann-Whitney test using SPSS 20 (α = 0.05). Expression of CK19 was seen in 100% of inflammatory OKCs and 84% of non-inflammatory OKCs. In inflamed OKCs expression of CK19 was seen in all the three layers of epithelium; however, in non-inflamed OKCs expression of CK19 was seen in the middle layer in only one sample (p value < 0.001). According to the results of the present study, CK19 was expressed in both inflammatory and non-inflammatory OKCs; however, the intensity of staining was different between the groups. In contrast to oral mucosal lesions CK19 was expressed in keratinized odontogenic epithelium. In odontogenic keratocyst, expression of CK19 was seen in response to inflammation as seen in oral lesions.

  Suturing is a common procedure during surgeries to fix surgical flaps to improve tissue integration during healing phase. The aim of this study was to make a histological comparison of gingival tissue reaction in the vicinity of silk and vicryl suture materials during the initial healing phase in crown lengthening surgeries. The present double-blind, randomized clinical trial had a paired design method. This study was performed on 24 sites in 12 patients with an age range of 20-40 years, needing crown lengthening surgery of maxillary premolars and molars. The subjects had no systemic problems or gingival inflammation at the surgical sites. The sutures were placed in the surgical sites 7 days before the crown lengthening procedure. Vicryl and silk sutures were placed on the mesial or distal gingival papilla of each tooth randomly. All the suture materials used in this study were identical in term of physical dimensions (4-0). After 7 days, during crown lengthening surgery, gingival tissues along with suture materials were harvested for histological examination. Then the severity of inflammation and infiltration of inflammatory cells were evaluated in tissue specimens using Wilcoxon test (α = 0.05). The study indicated that vicryl suture material resulted in less infiltration of the inflammatory cells in the gingival tissues compared to silk sutures (p value = 0.001). Considering the lower infiltration of inflammatory cells in the vicinity of vicryl suture material, it seems in procedures such as oral surgeries, vicryl suture could be an appropriate alternative for silk material

Rete ridges are epithelial extensions toward the underlying connective tissue in skin and mucous membranes. Given the advances in tissue engineering in recent years, rete ridges have become the center of attention. Therefore, the aim of the present study was to evaluate the shape of rete ridges (RR) in different oral mucosal lesions for possible histological differential diagnosis and their possible relation with inflammation for better understanding of their histogenesis.
This retrospective, descriptive, analytical study was performed on 154 oral lesions classified as epithelial (E), connective tissue (Ct) and mucocutaneous (Mc) lesions. RRs were evaluated under a light microscope at ×100 as flat or hyperplastic. Inflammation at epithelium‒connective tissue interface was evaluated in 5 consecutive high-power fields (×400). Data were analyzed with chi-squared test (α = 0.05).
In 87%, 80% and 58% of Ct, E and Mc lesions, hyperplastic RRs were seen, respectively (p value The results of the present study showed that rete ridges in oral mucosal lesions were hyperplastic predominantly, indicating that inflammation is not the reason for the hyperplastic nature of rete ridges. Further studies are recommended.

Recently efforts have increased to diagnose premalignant lesions. One of these techniques is brush cytology. The aim of this study was to compare changes in the cytology samples taken from passive smokers and nonsmoking healthy patients using staining Papanicolaou technique.
In this descriptive/analytical cross-sectional study, in two groups with 23 subjects (case and control), brush cytology samples were taken from the buccal mucosa and lateral border of the tongue from passive smokers with records of the duration of exposure to cigarette smoke (hours/day), using a sterilized brush. Then samples which were already fixed by a specific spray were stained with Papanicolaou technique in the laboratory. Then the samples were evaluated for the frequency of granular cells, binuclear cells, clear nucleolus, rough chromatin, nuclear vacuoles, apoptotic cells, and nuclear and cytoplasmic polymorphism. Data were analyzed with chi-squared test and t-test (α = 0.05).
There were no meaningful differences in the buccal mucosa and lateral border of the tongue between the passive smokers (p value = 0.31) and healthy control nonsmokers (p value = 0.26) in the frequency of micronucleus, clear nucleus, polymorphism, inflammation, and keratin overproduction. The mean years of cigarette consumption in the two groups of passive smokers with and without binuclear cells were significantly different (p value = 0.004).
The risk of cytologic changes might increase in passive smokers with an increase in exposure to cigarette smoke. However, cigarette was not a potential risk for mucosal changes in passive smokers.

Oral manifestations of endocrine disorders may lead to early diagnosis and proper treatment of these disorders. In addition, many of these patients need special care in dental office; therefore, it is mandatory for dentists to be familiar with oral manifestations of these disorders regarding diagnosis and observing the special care they require. To date no study has been performed on the knowledge of dentists about oral manifestations of endocrine disorders. The aim of this study was to evaluate the knowledge of dentists in Esfahan about oral manifestations of endocrine disorders.
This descriptive‒analytical study was performed on 94 general dental practitioners in Esfahan in 2015‒2016. A 20-score self-made questioner with a Cronbach's alpha value of 2 was used. Data were analyzed with t-test using SPSS (α = 0.05).
The mean knowledge score of the subjects was 11.138 ± 3.23, which was significantly less than the maximum score (p value The knowledge of dentists about the oral manifestations of endocrine disorders was significantly less than what was expected. It seems it is necessary to include oral manifestations of endocrine disorders in the syllabus of dental schools and in continuous dental education programs.

OLP is a relatively common chronic inflammatory skin disease with an immunologic background that often affects the oral mucosa. OLR is a mucosal lesion, clinically and histologically similar to OLP, and can occur in the oral cavity in response to some drugs or synthetic materials. The risk of dysplastic changes have been considered in both lesions. On the other hand, OSCC is one of the most common malignancies of the oral cavity. The aim of this study was to evaluate and compare expression of cytokeratin-19 (CK19) in OLP, OLR, OSCC and normal oral mucosa in terms of their staining intensity and patterns.
This descriptive-retrospective analysis was performed on 70 samples obtained from paraffin blocks of 20 cases of OLP, 20 cases of OLR, 20 cases of OSCC and 10 samples of normal oral mucosa. CK19 expression pattern and intensity of immunohistochemical staining were evaluated using Envision method. Data were analyzed with SPSS 20 using two-tailed regression test.
There seemed to be a significant relationship between suprabasal expression of CK19 and type of lesion (p value Increased expression of CK19 was dramatically consistent with region (basal and suprabasal) and type of lesion. In addition, the pattern of expression of CK19 in OLR and OSCC was very similar. Therefore, perhaps this protein marker might be used as both a diagnostic tool to distinguish lichen planus from lichenoid lesions and as a detector in possible malignant transformation of lichenoid lesions.

Diabetes mellitus and chronic periodontitis are common worldwide disorders and since periodontal diseases are more common and more severe in diabetic patients, the aim of present study was to investigate the relationship between HbA1C serum levels and chronic periodontitis.
In this case‒control, descriptive/analytical study, the HbA1C levels were evaluated in 55 subjects, 35‒45 years of age, in two groups with and without periodontitis, who were healthy otherwise. Thirty subjects had chronic periodontitis (PPD > 2 mm) and 25 subjects had healthy gingiva. HbA1C levels were determined by means of Ichroma equipment. Data were analyzed with independent t-test using SPSS 18 (α = 0.05).
Independent t-test showed significantly higher serum levels of HBA1C in patients with periodontitis compared to healthy subjects (p value = 0.021).
Based on the results of the present study, inflammation in chronic periodontitis disturbs the metabolism of glucose, possibly resulting in periodontitis in the long term. Therefore, a definitive diagnosis and treatment of chronic periodontitis along with proper oral health is emphasized.

Host modulatory therapy (HMT) is a new method that has been used as adjunctive therapy for periodontal diseases. Licorice tablet contains an extract with anti-inflammatory effects. Considering that most patients prefer to take herbal medications. we found it necessary to compare the effects of licorice tablet and doxycycline on chronic periodontitis. In this interventional clinical trial study, 45 patients with mild to moderate chronic periodontitis were selected. Plaque Index (PI), Pocket Depth (PD), Clinical Attachment Loss (CAL) and Bleeding on Probing (BOP) were recorded for all periodontal patients. Then scaling and root planning was done and patients were divided into three groups.In the first group, a 20mg doxycycline capsule was given to each patient daily, the second group was given a 490mg licorice tablet per day and the third group was given a placebo capsule per day. After 6 weeks, all the above-mentioned parameters were recorded again for all patients. Chi-square, paired sample T and one-way ANOVA tests were used for data analysis. The mean of PD, CAL and BOP after treatment reduced significantly within the three groups (P <0.05). The mean difference of PD, CAL and BOP between the two groups of doxycycline and licorice was not significant (P =0.54, 0.74 and 0.64, respectively). licorice decreases clinical periodontal indices of similar to doxycycline in chronic periodontitis.

Peripheral giant cell granuloma or giant cell epulis is a relatively common reactive lesion of the oral mucosa in response to local irritation and trauma. It is mostly seen in women during the 4th to 6th decades of life. Since recurrence is relatively common surgery with extraction of the involved tooth or teeth and curettage of the alveolar bony socket is the preferable treatment. In children this lesion can occur after deciduous tooth root resorption and might have a more aggressive clinical course in this age group. Case report: Reported here is occurrence of a relatively common lesion in an uncommon age and sex group. A soft tissue lump in an asymptomatic, otherwise healthy, 10-year-old boy with no evidence of bone destruction was surgically excised and submitted for microscopic evaluation. Microscopically a diagnosis of peripheral giant cell granuloma was established. At 6-month follow-up the site of surgery had healed completely with no post-surgical complications. Discussion and Although peripheral giant cell granuloma is more common during the 4th to 6th decades of life, this lesion might occur in children, with alveolar bone resorption, abnormal patterns of eruption of permanent teeth and loose and displaced teeth. Therefore, the aim of this report was to draw attention to the possibility of the occurrence of these lesions at a young age to pave the way for early diagnosis and treatment.

Prevalence of malignancies is different in different communities and different at different times and locations in a community. Epidemiological studies can help recognize high-risk groups. The aim of this study was to evaluate the frequency of oral and paraoral malignancies based on patient age and gender and the area involved and the type of malignancy in one cancer referral center in Isfahan in a 5-year period from 2005 to 2010. In this retrospective descriptive/analytical study، data of 236 oral and paraoral malignancies was collected in a 5-year period from 2005 to 2010، along with data on age، gender and the area involved. The malignancies were divided into epithelial، salivary، hematologic، soft tissue and hard tissue groups based on their origin. Data was analyzed descriptively using SPSS. Oral cavity malignancies comprised 1. 8% of all the malignancies of the period in question. Mean age of patients with oral cavity malignancies was 54 years (56. 5 years in men and 52 in women). Male-to-female affliction ratio was 2. 2. The majority of the lesions were epithelial in origin (72%)، followed by salivary (15%)، hematologic (5. 5%)، soft tissue (2. 9%) and osseous lesions (2. 9%). A total of 20% of lesions had occurred in the larynx، with 17% in the tongue. The most common malignancy was squamous cell carcinoma (SCC) with a prevalence rate of 90% of epithelial lesions. SCC was the most common malignancy، with the highest prevalence rate in 56. 6-year-old males in the larynx and tongue.

Radicular and Residual cysts are by far the most common cystic lesions in the jaws which consist 50-75% of all oral cystic lesions. Radicular cysts have been considered rare in the primary dentition. It has been suggested that pathogenesis of radicular cysts in primary and permanent dentition could be different; although caries and pulp infection still are the most important of all. After extracting or shedding of the causative tooth, the cyst remains in jaws and from now on is considered a residual cyst.Case Report: A 12 year old female patient came to our clinic because of a painless swelling in the lower back region of her left jaw. According to surgical and microscopic findings, the lesion was diagnosed a radicular cyst associated with her 2nd deciduous molar which has had a pulp treatment. The cyst was enucleated. Although radicular cysts in deciduous dentition is considered to be rare, but it has been seen in primary molars treated endodontically which could be due to remaining of infection in inaccessible parts of root apex or periapical irritation with formocresol containing materials used in root canal filling. Assuming that the pathogenesis of radicular cysts is identical in primary and permanent dentition, the low frequency in the former is yet to be clarified.

Histiocytosis of lagerhans cell is a spectrum of disorders characterized by proliferation of Histiocyte like cells and includes following: Eosinophilic granuloma, Hand - Schuller Christian disease and Letterer- Siwe disease. The incidence is 0/5 in 100/000 person per year in individuals younger than 15 year of age.Case Report: The patient was a 57 day old male infant that was referred with papulovesicular cutaneous and exophitic oral lesions without bone and visceral involvement. Diagnostic procedures until final diagnosis of Langerhance cell Histiocytosis and treatment of this case have been reported. oral lesions could be the first manifestation of disease and dentists should be aware of that. According to different investigations, the disease may have a genetic basis.