Journal of Dentistry, Shiraz University of Medical Sciences
Volume:21 Issue: 2, Jun 2020

Liver cirrhosis is the end stage of liver failure. It is mentioned as one of the main etiologies of morbidity and mortality in the world. The human salivary bacteria may induce oral disorders and interact with other body microbiota.

The aim of the present study is to identify the pathogenic bacteria of non-oral origin from the saliva samples of patients with end stage liver failure.

In this cross-sectional study, the saliva samples of 88 end stage liver disease cases and 84 age- and sex-matched healthy subjects were collected. The samples were cultured using gram staining and API20E Kit.

According to the statistical analysis, the total amount of the non-commensal bacteria was significantly higher in chronic liver failure (CLF) group than controls (p= 0.001). There was no significant difference between both groups for the presence of other bacteria (p= 0.001) except for Escherichia coli (E. coli). E. coli was isolated from the saliva of 15 cases and only 2 controls.

Oral cavity may act as a reservoir for enteric bacteria such as E. coli in liver failure patients. Adequate oral and general hygiene might reduce the risk of systemic infection especially in immunocompromised cases.

Bulk fill composites have been introduced over the recent years in order to accelerate the process of tooth restoration by inserting composite in bulk up to 4mm thickness.

This in vitro study aims to evaluate the effect of occlusal loading on the gingival microleakage of bulk fill composites compared with a conventional composite.

In this experimental study, box only class II cavities with gingival margins placed 1mm below the cemento-enamel junction were prepared on the mesial and distal surfaces of 36 maxillary premolars (72 cavities). The samples were divided into three groups and restored as follows: Group 1 (Tetric N-Ceram, incremental filling), Group 2 (X-tra fill, bulk filling), Group 3 (Tetric N-Ceram Bulk Fill, bulk filling). All restorations were thermocycled for 2000 cycles (5-50̊C), and then half of the samples were subjected to 200,000 cycles of loading. All the specimens were immersed in 0.5% basic fuchsin for 48 hours, and then, sectioned and evaluated for microleakage with a stereomicroscope. Data were analyzed using Kruskal-Wallis, and Mann-Whitney U-tests. P

There were no significant differences among the gingival microleakage of three composites in both unloaded and loaded groups. Also, no statistically significant difference was found between the microleakage of unloaded and loaded groups in all materials.

Occlusal loading did not affect the gingival microleakage of bulk fill composites, and the microleakage of class II cavities restored with the bulk filling technique was similar to that of restored with the incremental technique.

 The tumor suppressor role of myoepithelial cells and related mechanisms in breast tumors are well understood. However, the role of these cells in salivary glands tumors is debatable.

The present study was designed to determine the expression of p63, Maspin and Matrix metalloproteinase 2 (MMP-2) in mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ADCC) of salivary glands due to various cellular differentiation and structure. The association between the expression of these markers and clinicopathologic features and myoepithelial differentiation were also evaluated.

P63, Maspin and MMP-2 expression were immunohistochemically studied in 67 cases including35 cases of MEC and 32 cases of ADCC. The smooth muscle actin (SMA) staining was also applied to confirm the presence of myoepithelial differentiation. Data was analyzed using Chi-square test, Mann-Whitney U test and t-test.

The expression of p63 (p= 0.009) and Maspin (p= 0.012) significantly differed between the study groups.P63 positive cells in MEC were negative for SMA staining in contrast to ADCC. Furthermore, the expression of P63 (p= 0.045) and Maspin (p= 0.019) significantly and inversely correlated with histologic grade in ADCC. Likewise, positive significant correlation was detected between histologic grade and expression of P63 (p= 0.018) and MMP-2 (p= 0.003) in MEC samples.

Ourfindings showed thatMEC is devoid of myoepithelial cells. The difference in expression of P63 and Maspin in ADCC and MEC highlighted the role and presence of myoepithelial cells in ADCC. Indeed, the high expression of P63 and Maspin in well differentiated ADCCs suggests the tumor suppressor effect of myoepithelial cells. Considering the association between the evaluated markers and histological grade, p63 in both tumors, Maspin in ADCC and MMP-2 in MEC may be efficient predictors of clinical behavior.

Preoperative anxiety is the subject of major concern for many patients.

The current study aimed at determining the effect of anesthesia consultation on decreasing anxiety in patients undergoing oral and maxillofacial surgery.

This randomized clinical trial was conducted on 250 patients undergoing different maxillofacial surgeries. The data collection instruments included a questionnaire containing the Spielberger state-trait anxiety inventory (STAI) and a researcher-made questionnaire with queries on the demographic characteristics and surgery-related information. Analysis of the data was performed in SPSS, using descriptive and inferential statistics.

The findings showed that the majority of patients (38.4%) had moderate anxiety; there was no significant difference between the consultation and control groups in terms of age and gender. Also, the scores of state and trait anxiety were significantly lower in the consultation group, compared with the control group.

The present results showed that preoperative anesthetic consultation reduced preoperative anxiety, compared with the control group. Our findings suggest that anesthetic counselling services should be provided for individuals experiencing high levels of stress.

Oral health care for children with visual impairment is challenging for health service providers. Gaining information about parental awareness in this regard can be a basis for health planning and use of preventive services.

The aim of this study was to evaluate parental awareness about the importance of preventive care and its relationship with DMFT index in visually impaired children.

This cross-sectional and descriptive- analytical study was carried out on 50 parents of children with visual impairment referring to schools of the blind children aged 8-14 years in Isfahan in 2017 – 2018. Parental awareness was measured by knowledge questionnaire. DMFT index of first permanent molar was recorded by examination. Data were analyzed using Spearman correlation coefficient, Pearson correlation and T-test in SPSS 22 software. The level of significance was considered less than 0.05.

The mean score of parental awareness about significance of preventive care was 68.4±15.5. Mean DMFT in the studied children was 2.40±1.32 and highest score was related to decayed tooth, followed by filled tooth. There was no significant relation between parental knowledge and mean DMFT (p= 0.30), while there was revers relation with number of extracted teeth (p= 0.02) and direct relation with number of filled tooth (p= 0.04).

Parental awareness generally did not show significant relationship with DMFT, while by increasing their knowledge the number of missed teeth was decreased and the number of filled teeth was increased in visually impaired children.

 Etching process on dentin can activate matrix metalloproteinase (MMP) which hydrolyze organic matrix of demineralized dentin. Gluma and chlorhexidine could inhibit the activation of MMP.

 The aim of the study was to evaluate the effect of a new desensitizing material consisting of Gluma and chlorhexidine together on the shear bond strength and bond durability of composite restorations.

One hundred and twenty caries-free extracted premolars were sectioned horizontally from one third of the coronal crown to expose flat dentin surface and randomly divided into 4 groups. In the control group no surface treatment was used. In the first group chlorhexidine (CHX) 2%, in the second group, new material (NM) and in third group Gluma Desensitizer (GD) was applied after etching and before bonding(total-etch bonding system). After the bonding process, the composite was placed on the surface of the samples using a cylindrical mold. Then, the shear bond strength of half of the specimens was measured after 24 hours and the other half after 6 months of storage in distilled water and thermocycling. The failure type of specimens was evaluated with a stereomicroscope. Data were analyzed using one way Anova and Tukey's Post Hoc tests in SPSS software.

  After 6 months, the bond strength decreased in all groups and differences were statistically significant (p= 0.002).The highest SBS was observed after 6 months in the NM group and the GD group (with no significant difference). Mix failure had the highest rate in all groups. 

 It can be concluded that the effect of combination of chlorhexidine and gluma on maintaining the integrity and strength of bond over time is similar to Gluma compound alone and they have better effect than chlorhexidine.

 Non-syndromic cleft lip and palate are the most frequent craniofacial abnormalities in humans. The genetic, environmental and behavioral factors involved in this malformation must be clarified in different parts of the globe in the view of implementing preventive measures.

To analyze the influence of parental exposure to risk factors on the occurrence of oral clefts.

A case-control study was conducted with 150 mothers of oral cleft children paired by the children’s gender to 300 mothers of children without congenital anomalies from Mato Grosso, Brazil, for the study of the variables: gender and race/color of the children; parental educational level; age; number of pregnancies; prenatal care; obesity; stress; diabetes; hypertension; use of medications, alcohol and illicit drugs; smoking and exposure to ionizing radiation during the first trimester of pregnancy. The results were analyzed in relation to the chances possibility of each variable for the occurrence of oral cleft through the bivariate and multivariate analysis by applying the model of logistic regression.

Passive smoking, obesity, exposure to ionizing radiation and use of antibiotics were associated with the presence of clefts. The use of folic acid and analgesics were identified as preventive factors. The father's low educational level was found as a risk factor, while the black race/color was a preventive factor; nevertheless these variables were not associated in the multivariate analysis.

The results reinforce the need to follow the pregnant women, especially in the first trimester of pregnancy, in order to control the identified risk factors. Clinical Relevance: Knowing the factors associated with the occurrence of oral clefts and those associated with its prevention, it is possible to apply specific health promotion measures during pregnancy, which can result in the reduction of oral clefts’ occurrence.

Smoking affects not only smokers themselves, but also the people around them. 700 million children are exposed to second hand tobacco worldwide. One of the adverse effects of being a passive smoker is oral pigmentation.

Evaluating association between being a passive smoker and oral pigmentation.

This is a historical cohort. 140 healthy children aged from 4 to 10 with the mean age of 6.68±1.60 years old (70 with a smoker parent and 70 without smoker parents) were examined for oral pigmentation. Environmental factors were evaluated by asking the parents to fill a questionnaire. Data were analyzed using Chi-square test, Fisher's exact test, Logistic regression and Spearman scale.

There was a meaningful relationship between having a smoker parent and oral pigmentation (P-value=0.0001). spearman correlation showed parents' duration of cigarette smoking and the number of cigarettes per day meaningfully affect the severity of oral pigmentation (R=0.329). The study did not find a statistical relationship between oral pigmentation in passive smoking and sex or house area.

Children exposed to secondhand tobacco are at more risk for oral pigmentation. Its severity depends on duration of cigarette smoking and the number of cigarettes per day.

 The clinical success of glass ionomer cement (GIC) restorations depends on the strength of its bonding to dentin, yet the bond strength of nanohydroxyapatite (nHAp) added GIC to dentin needs to be investigated.

This study aimed to assess if the type of GIC containing nHAp and dentin depth can affect the shear bond strength (SBS).

In this experimental study, 60 freshly extract intact third molars were randomly divided into two main groups of flat occlusal dentin with different cuts as superficial (S): just below the dentinoenamel junction (DEJ) and deep (D): 2mm below DEJ. After conditioning with 20% polyacrylic acid, each group randomly assigned to the tested GIC (n=10) subgroups as 1: Fuji IX Extra+nHAp, 2: Fuji II LC+nHAp and 3: Zirconomer+nHAp. Plastic tubes were placed on the pre-treated surfaces and filled with one of the GIC, then stored in an incubator at 37oC under 100% humidity for 24hr. The specimens were thermocycled at5/55 oC for 500 cycles and subjected to shear bond strength (SBS) test using a universal testing machine (1 mm/min). The data analyzed by Mann-Whitney and Kruskal-Wallis test (p< 0.05).

The means of SBS of Fuji II LC+nHAp was significantly higher than Fuji IX+nHAp and Zirconomer+nHAp both in superficial and deep dentin (p< 0.05). The means of SBS of Fuji IX Extra+nHAp and Zirconomer+nHAp subgroups in superficial dentin were higher than deep dentin, this differences was statistically significant (p= 0.0001 and p= 0.009, respectively).

It can conclude that SBS was influenced by type of GIC, and depth of dentin.

Oral squamous cell carcinoma (OSCC) is a malignant neoplasm that affect the structures or tissues of the mouth. Early diagnosis of these tumors is important to improve the outcome of treatment. Therefore, using pathological techniques based on molecular markers may be useful for optimal diagnosis and treatment. Glypican-3(GPC3) is involved in regulation of cell proliferation and morphogenesis and is abundant during embryogenesis and organogenesis but is limited in most of adult tissues. GPC3 overexpression has a role in carcinogenesis.

The aim of the present study was to investigate GPC3 expression in the non-neoplastic oral epithelium and oral squamous cell carcinoma.

In this cross-sectional study, 45 patients with OSCC (30 males and 15 females) with a mean age 52.3 of selected from Oral Pathology Department of Shiraz Dental School were enrolled. The control group was consisted of 15 cases of normal oral epithelium. Glypican-3 expression was assessed by using immunohistochemical methods.

Non neoplastic tissues were GPC3 negative. Frequency of GPC3 positivity in tumoral tissues was recorded as 73.3% (33 cases) which was significantly higher than non-neoplastic tissues (p< 0.001). The clinicopathologic features of GPC3 expression demonstrated no association with clinicopathologic parameters except tumor size.

GPC3 was over expressed at protein level in oral squamous cell carcinoma, but its potential use for diagnostic and therapeutic purposes required further investigation.

Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm which is exclusively epithelial in its tissue of origin. Many cases of CEOTs are associated with impacted tooth and simulate dentigerous cyst, radiographically. The histologic features of CEOT are unique, however, among its various histologic subtypes, the cystic variant is a rare and less well understood entity. Our report elucidates a cystic variant of CEOT in the maxilla of a 16-year-old male that presents clinical and radiologic findings conscientious to dentigerous cyst; but histopathological diagnosis came out to be a gold standard in identifying this rare tumor. Herein, the authors describe the clinicopathologic features of this rare entity, highlighting histomorphologic findings along with reviewing of other reported cases.

Calcifying odontogenic cyst (COC) is an uncommon odontogenic lesion that represents less than 2% of all odontogenic cysts and tumors. It usually occurs in incisor and canine areas during the second to fourth decades of life. It can be associated with other lesions like odontoma, Ameloblastic Fibroma, Ameloblastoma, Adenomatoid odontogenic tumors, Odontoameloblastoma, and Odontogenic Myxoma. Ameloblastic fibroma is a truly mixed tumor usually diagnosed within the posterior mandible during the first two decades of life. In the present article, a hybrid odontogenic tumor composed of COC and Ameloblastic Fibroma in a 14-year-old white Persian female is described.