Preventing and therapeutic effect of propolis in radiotherapy induced mucositis of head and neck cancers: a triple-blind, randomized, placebo-controlled trial

Background: Mucositis is one of the acute complications of radiotherapy which can ulcerate oral mucosa and cause severe pain and discomfort which can affect oral normal function. Propolis is a natural source of flavenoid which has antiulcer, antibacterial, antifungal, healing and anti-inflammatory effects. Using such an affordable compound without any bad smell or taste that has reasonable price can help the radiotherapy undergoing patients

Objectives: Our goal is assessing the preventing and therapeutic effect of propolis in radiotherapy induced mucositis in patients with head and neck cancer

Patients and Methods: In a randomized triple blind clinical trial, 20 patient were selected randomly to swish and swallow 15 ml of water based extract of propolis mouth wash 3 times a day in the case group [n = 10] and 15 ml placebo mouth wash in control group [n = 10]. We use NIC-CTC scale for determining mucositis grading

Results: We use T-test, Man-Whitney, Chi-square, and Friedman as analyzing tests. Case group had significantly [P < 0.05] lower grade of mucositis in all of the follow-ups, but xerostomia is not significantly different in two groups [P > 0.05]

Conclusions: This is a pilot study which shows water based extract of propolis efficiently prevents and heals radiotherapy induced mucositis

[Evaluation of awareness of general dentists and dental specialists about dental management of pregnant and diabetic patients]

With advances in medicine, more systemic patients seek dental treatment. On the other hand, oral health care is an essential part of pregnancy and diabetes mellitus health care. The aim of this study was to assess dentist's awareness about dental management of pregnant and diabetic patients. This study was conducted on 106 out of 204 dentists attending in oral medicine congresses and continuous education programs from June 2009 to June 2010. A self-established questionnaire with approved validity and reliability was used. Along with demographic data, some multiple choice questions about dental management of diabetic and pregnant patients were asked. Totally 20 points were assigned to questions and awareness was classified to excellent [18-20 points], good [14-<18 points], moderate [10-<14 points] and poor [<10 points]. Statistical analysis was done by Mann- Whitney and Kruskal-Wallis tests. P-value less than 0.05 were considered significant. The mean awareness score [MAS] was moderate [10.5 +/- 2.5]. The MAS for pregnancy was [3.5 +/- 1.78] of 10 and for diabetes mellitus were [7 +/- 1.32] of 10. MAS were higher in women especially about diabetes mellitus but it was not significantly different. The University of Graduation and years of career were not significantly related to awareness status. Education and treatment attitude for pregnant patients were not related to awareness but women had a higher attitude in treatment of pregnant patients [P<0.05]. The lowest awareness was about indications of consultation in diabetic patients and the highest awareness was about administration of suitable antibiotic and analgesic during pregnancy. The awareness level of dentists studied here was moderate and low about dental management in pregnancy and diabetes mellitus which should be improved via continuous education programs

Pyostomatitis vegetans

Pyostomatitis vegetans [PV] is a rare chronic inflammatory disease of unknown etiology. Oral appearance are the first symptoms. One of the less common clinical features is erosions which tend of form granulation tissue, and finally develop a vegetative looking, especially in the skin folds and heal and face. In clinical examination diffuse vegetation and snail tract was found

[Knowledge and diagnostic skill of general dentist in khorasan razavi province common [Iran] toward oral diseases 2009-10]

Proper and prompt diagnosis of oral mucosal diseases improves their prognosis level and therapy, but unfortunately these lesions are often misdiagnosed because of their clinical features resemblance. General dentists are important in early diagnosis and treatment of common oral diseases, therefore assessing their knowledge and practice is crucial. The aim of this study was to assess knowledge and skill of general dentists toward common oral lesions in Khorasan Razavi Province. A cross-sectional survey was conducted on 260 dentists using an illustrated questionnaire. Knowledge and diagnostic skill of oral diseases were assessed and the responses were analyzed by SPSS software. Of the 260 dentists surveyed, 257 responded. The mean knowledge score of the dentists working in the city of Mashhad and other cities was 3.03 and 2.94; and the average of diagnostic skill was 2.024 and 1.97, respectively. There was no significant difference between two groups regarding knowledge score but the difference was significant in diagnostic skill. General dentists working in the city of Mashhad had better results in diagnostic skill significantly. Considering the overall low diagnostic skill score, it is recommended to schedule more workshops toward common oral diseases for general dentists.

[Non-Hodgkin's lymphoma in the mandible: case report]

Malignant lymphoma of the oral region is uncommon and accounts for approximately 3.5% of all oral malignancies. Non-Hodgkin's lymphoma occurs primarily in adults, although children may also be affected, particularly by the more aggressive intermediate and high-grade forms. The condition most commonly develops in the lymph nodes, but so-called extra nodal lymphoma is also found. In children, extanodal lymphoma is more common. The presentation can be as a non tender mass mostly in cervical, auxiliary, or inguinal regions that has been enlarging for months. In the oral cavity, lymphoma appears usually as extra nodal disease. The malignancy may develop in the oral soft tissues or centrally within the jaws. Soft tissue lesions appear as non-tender, diffuse swelling; they most commonly affect the buccal vestibule, posterior hard palate, or gingiva. The patient may complain of paresthesia, particularly with a mandibular lesion [numb chin syndrome]. An 8-year-old boy was visited in the Oral Medicine Department of Mashhad Dental School with the chief complaint of permanent tooth mobility in the oral cavity for 15 days. The patient also had a history of bone pain mainly in lower lip for the last month and Bell's palsy [left side] was observed which had been occurred since 7 days before. Simultaneously, the patient had malaise, anorexia, bone pain, illness, lymphadenopathy [head and neck], and flu like signs and symptoms, fatigue and leukocytosis. Under clinical diagnosis of lymphoma, the patient was referred to pediatric hematologist-oncologist. Our diagnosis, none Hodgkin's lymphoma [NHL], was confirmed by the report of lymph node biopsy. Dentists can play an important role in the early detection of the malignant lymphoma of the oral cavity. NHL primarily appears in the head and neck. It is typically characterized by a swollen, non-painful lymph node although other presentations may pose significant diagnostic problems and frequently lead to misdiagnosis and mistreatment

[Chondrosarcoma of the mandibular symphysis: report of a case]

Chondrosarcoma is a malignant tumor of cartilaginous origin. The most common type in the jaw is mesenchymal. Chondrosarcoma in maxillofacial region is an uncommon tumor and maxilla is more commonly affected than mandible. The aim of this paper is cases report of a rare chondrosarcoma of the mandible. A 65-year-old woman was referred to Oral Medicine Department of Mashhad dental school with swelling over the buccal and lingual aspect of the anterior mandible. Swelling had been present for 1 year and had increased gradually in six over time. The patient did not have any systemic disase and was not currently taking any medications. Extraoral examination did not reveal any obvious facial swelling, asymmetry or cervical lymphadenopathy. Intraoral examination revealed an exophitic nodular and tendered lesion with smooth and purple surface. IT was firm to rubbery in buccal aspect and bony in lingual surface with 3x3.5 diameters. Occlusal and panoramic radiographs revealed the multibular well defined and mixed radiolucent-redioopague lesion from right mandibular first premolar to left mandibular first premolar. Subperiosteal ossification is revealed in the occlusal cross sectional radiography. Histopathological examination revealed chondrosarcoma [grade I]. The patient was advised to undergo surgery, and the tumor was respected by segmental mandibulectomy. Clinical and radiographic feature at chondrosarcoma are varied, the incidence of this lesion in unusual location like anterior of jaw with a well-defined feature and ossification could lead to clinician error and delaying treatment. Considering age, course and invasion could be helpful in diagnosis

[Psychiatric evaluation of patients with recurrent aphthous ulceration referred to oral disease department of Mashhad dental school-Iran [2006-2007]]

Recurrent aphthous ulcers [RAS] are one of the most common painful diseases affecting the oral mucosa. The psychological-emotional factors should be considered as predisposing factors. However, the association between psychiatric disorders and RAS has not been fully investigated in Iranian population. The purpose of this study was to determine the type and frequency of psychological disorders in patients with aphthous ulceration. Thirty five subjects of 50 patients suffering from RAS referred to oral medicine department of Mashhad dental school, were enrolled for this study. Demographic data and medical history as well as the number and type of the recurrent ulcers were obtained. The records of SCL9O questionnaire and interviews were analyzed by psychiatrist. Data obtained by personality evaluation and also the frequency of psychopathologic disease according to age, sex and duration of ulcers were described in tables and charts. 65.7% of 35 subjects were female; the average age range was 21-30 years. 74.3% of patients had psychiatric disorders and the others were normal. The most common psychiatric disorder was concurrent minor depression and anxiety. Psychiatric disorders were most common among women. The current study revealed that majority of patients with aphthous ulcers have some kinds of psychiatric disorders especially anxiety, depression and obsession compulsion. The results of this study proposed that all the medical staff should consider psychological disorders as etiologic factors for aphthous ulcers during their work up and treatment

Gorlin-Goltz syndrome

We report a case of Gorlin-Goltz syndrome in a 21-year-old man. Gorlin-Goltz syndrome [basal cell nevus syndrome] is an infrequent hereditary disease with its prevalence varying from 1 / 57,000 to 1/250,000. It is principally characterized by a wide range of developmental abnormalities. Main clinical manifestations include multiple odontogenic keratocysts of the jaws, facial basal cell carcinomas and skeletal anomalies. The prevalence varies from 1/57,000 to 1/250,000