Malignant transformation of calcifying cystic odontogenic tumour - a review of literature.

Calcifying cystic odontogenic tumour (CCOT) has been classified as an odontogenic tumour. Ghost cell odontogenic carcinoma (GCOC) is the malignant counterpart of CCOT. This paper aims to review the literature regarding malignant transformation of CCOT. A literature search was done via the National Library of Medicine PubMed interface, searching for articles relating to malignant transformation of CCOT. From these articles, references were obtained, and from their references lists, pertinent secondary references were also identified and acquired. After reviewing the literature, we found 26 cases of GCOC which developed from CCOT. Malignant transformation of CCOT was seen more commonly in the maxilla. Histologically, changes such as increased nuclear/cytoplasmic ratio, atypical mitotic figures have been reported after malignant transformation. Immunohistochemical analysis has shown an increased expression of ki-67 and p53 in tumour cells. Malignant transformation of CCOT, although rare, mostly takes place in recurrent and long standing cases.

Clinical and radiographic evaluation of periodontal intrabony defects by open flap surgery alone or in combination with Biocollagen(®) membrane: A randomized clinical trial.

BACKGROUND: Guided tissue regeneration (GTR) is often incorporated in regenerative periodontal surgical procedures. However, the actual benefits of adding GTR to such a procedure remain undocumented. The purpose of this randomized controlled trial was to investigate the contribution of GTR to the outcomes of open flap debridement (OFD) in the treatment of intrabony defects. MATERIALS AND METHODS: A total of 16 patients of both sexes satisfying the criteria of chronic periodontitis and each of whom displayed one intrabony defect were randomly assigned to two groups, i.e. either treated with open flap surgery and GTR (group 1) or with open flap surgery alone (group 2), in this parallel-arm study. The soft tissue and hard tissue measurements, including probing pocket depth (PD), clinical attachment level (CAL), and bone mineral density were recorded at baseline and 3,6 and 12 months after surgery. The differences with a P < 0.05 were considered significant. RESULTS: Results showed that the membrane group showed significant difference when compared with open flap surgery alone, in relation to the degree of periodontal pocket, clinical attachment loss, and bone density. CONCLUSION: The findings of this study suggest that biocollagen membrane could be considered as an option in the treatment of intrabony defects. Biocollagen membrane alone gives favorable clinical results in the treatment of intrabony defects. Open flap debridement resulted in acceptable clinical results in the treatment of intrabony defects.

P27 expression in pleomorphic salivary gland adenoma.

AIM OF THE STUDY: This study aims to characterise alterations in the immunohistochemical expression of p27 in normal tissue of the salivary gland surrounding pleomorphic adenoma and in the tumour cells of pleomorphic adenoma. MATERIAL AND METHODS: A retrospective study of data including 120 cases of pleomorphic adenomas (66 female, 54 male) retrieved from the files of the Oral Pathology Departments of Aleppo University, Syria and Al-Farabi Dental and Nursing College. Immunohistochemical expression against p27 was examined in the selected cases. The percentage of p27-positive nuclei was semi-quantitatively assessed by two independent observers and scores were given. The statistical analysis included the use of descriptive statistics and proportional frequencies. RESULTS: The results showed that P27 nuclear staining with high staining (moderate to strong positive staining in more than 50% of nuclei, depending on the percentage of nuclei for the cells) was noted in tumour duct cells of pleomorphic adenoma in 90 (75%) cases out of 120, while 30 (25%) cases showed low staining (positive staining in less than 5% of nuclei, depending on the percentage of nuclei for the cells). CONCLUSIONS: Our data suggests that p27 might have a minor role in the development of pleomorphic adenoma.

Clinical and Radiographic Evaluation of Median Lingualized Occlusion in Implant Retained Mandibular Complete Overdenture.

BACKGROUND: The purpose of this study was to evaluate clinically and radiographically median lingualized occlusion in implant-retained mandibular complete overdenture. MATERIALS AND METHODS: Ten completely edentulous male patients were participated in this study. Each patient received two implants in the intraforaminal area of the edentulous mandible that were left unloaded for 4 months. Patients were received conventional maxillary complete denture and implant mandibular overdenture with ball and socket attachment. The posterior teeth were set according to median lingualized occlusion scheme. All patients were evaluated clinically and radiographically immediately after denture insertion, 6 and 12 months of overdenture insertion. RESULTS: The results revealed significant differences in probing depth, gingival index, plaque index, and marginal bone height between the different follow-up periods. With the limitation of this study, and according to the results of the mean marginal bone loss and the other peri-implant parameters after 1 year of loading. CONCLUSION: The implant retained overdenture with the median lingualized occlusal scheme may be recognized as being acceptable according to the general implant success rates and criteria.

Guideline for the diagnosis and treatment of recurrent aphthous stomatitis for dental practitioners.

Recurrent aphthous stomatitis (RAS) is a well-known oral disease with unclear etiopathogenesis for which symptomatic therapy is only available. This kind of study aimed to highlight the main points that the general practitioners should be taken in their consideration. We have collected our data from PubMed line from 1972 to 2011. Our criteria included the papers that refer to the general predisposing factors, and the general treatment of RAS. Some papers which indicated to the specific details related to RAS that needed a consultant or specialist in Oral Medicine have not included. There is no clear guideline of the etiology, diagnosis, and management of RAS; therefore, the majority of the general practitioners refer most of the cases to appropriate specialist.

Systemic review of dry socket: aetiology, treatment, and prevention.

Our systemic review is to make a comprehensive review about the aetiology, treatment and the prevention of dry socket, the inclusion criteria were all the studies that discuss the dry socket and its etiology, treatment and prevention and exclusion criteria were all the studies that discuss the other complications of tooth extraction, the materials and methods used for this systemic review was to search in the Pub Medline database between 2008 to 2013, using specific words "dry socket, aetiology, treatment and prevention" and published in the English language, the articles were screened by abstract for relevance to aetiology, treatment and prevention of dry socket, 82 papers were identified in pub med but a total of 36 out of Publications were included in the final systemic review according to the specific keywords and materials mentioned above. The occurrence of dry socket in an everyday oral surgery or dental practice is unavoidable. The risk factors are smoking, surgical trauma, single extractions, age, sex, medical history, systemic disorder, extraction site, amount of anaesthesia, operator experience, antibiotics use prior to surgery, difficulty of the surgery and the previous surgical site infection in addition to oral Contraceptives, menstrual cycle and immediate postextraction socket irrigation with normal saline. The traditional options of treatment are directed toward palliative care, such as the irrigation of the surgical site, avoiding curetting the extraction socket, Packing with a zinc oxide- eugenol paste on iodoform gauze can be considered to relieve acute pain episodes, there is also new agents in the market can accelerate the healing of the socket such as PRGF and GECB. The prevention methods include avoiding smoking before and after surgery and a traumatic surgery, the use of antibiotics, such as, azithromycin, can be considered, the other preventive measures such as chlorhecidine rinse or gel can be effective in the reduction of dry socket incidence.

Oral manifestations of Parry-Romberg syndrome: A review of literature.

Parry-Romberg syndrome (PRS) or progressive facial hemiatrophy is a developmental craniofacial disorder of unknown etiology characterized by a slowly progressive unilateral facial atrophy. It is associated with different systemic manifestations particularly, maxillofacial, neurologic and ophthalmologic abnormalities. Dentists must be aware of PRS to identify this invalidating disorder. In this article, we review the etiology, clinical features (especially craniofacial and dental manifestations) and treatment of PRS. We searched in PubMed line using specific words such as PRS from 2008 to 2014 (August). We identify 14 papers have described oral manifestations of this syndrome. We excluded all the article papers that did not indicate to oral manifestations of PRS.

Immunohistochemical comparison of p53, Ki-67, CD68, vimentin, α-smooth muscle actin and alpha-1-antichymotry-psin in oral peripheral and central giant cell granuloma.

INTRODUCTION: Giant cell lesions are characterised histologically by multinucleated giant cells in a background of ovoid to spindle-shaped mesenchymal cells. There is a major debate whether these lesions are separate entities or variants of the same disease. Our aim was to study the nature of multinucleated and mononuclear cells from peripheral giant cell granuloma (PGCG), and central giant cell granuloma (CGCG) and giant cell tumor (GCT) of long bones using immunohistochemistry evaluation and to determine whether there is a correlation between recurrence and the markers used. MATERIALS AND METHODS: Ki-67, p53, Vimentin, smooth muscle specific actin, CD68 and alpha-1-antichymotrypsin were used to study 60 giant cell lesions. These included 26 CGCG, 28 PGCG, and 6 GCT cases using an avidin-biotin-complex immunohistochemistry standard method. RESULTS: All studied cases showed the same results except the percentage of Ki-67 positive mononuclear cells in PGCG was significantly higher than that of both CGCG and GCT (p<0.05). Interestingly, no statistical correlation between recurrence and the markers used was found. CONCLUSION: Our results may suggest that these lesions have the same histogenesis. The mononuclear stromal cells, both histiocytic and myofibroblastic, are thought to be responsible for the behavior of these lesions whereas the multinucleated cells are considered as reactive. This might support the argument that PGCG, CGCG and GCT are different variants for the same disease. Further studies using molecular techniques are required to elucidate why some of these lesions behave aggressively than others.

Effect of yogurt and pH equivalent lemon juice on salivary flow rate in healthy volunteers - An experimental crossover study.

BACKGROUND: Xerostomia is a common clinical problem, and different medications have been tried in its management. In the present study, routine dietary products are used to assess their effect on salivary flow. AIM: To assess the efficacy of yogurt and lemon juice on increase in salivation and its comparison with that of unstimulated saliva. MATERIALS AND METHODS: A total of 40 volunteers (aged 19-48) were selected. The pH of yogurt was calculated, and equivalent pH lemon juice was prepared. First, normal resting saliva was collected as baseline followed by every 1 min for 5 min. Patients were given lemon juice or yogurt and then crossed over to the other group to assess the impact of the stimulants on salivary flow from 1 to 5 min. RESULTS: The results were analyzed statistically. Comparisons between baseline saliva secretion and that by yogurt and lemon juice (using the ANOVA test) showed that there was a significant increase after treatment at the end of the experiment for both yogurt and lemon juice. However, yogurt showed a significant increase in saliva secretion compared to baseline than lemon juice. CONCLUSIONS: Our findings suggest that yogurt is a potential candidate for the treatment of dry mouth.

An In vitro Study on Post Bleaching Pigmentation Susceptibility of Teeth and Scanning Electron Microscopy Analysis.

BACKGROUND: To determine the susceptibility of teeth for repigmentation after bleaching. MATERIALS AND METHODS: Forty premolars were assigned to three groups (n = 12). Group 1 was bleached using 30% w/v hydrogen peroxide 15 min 3 times a day every other day for 4 days. In Group 2 was bleached using 16% carbamide peroxide (Polanight), 90 min a day for 15 days. 2 days later, the shades of the bleached teeth were recorded. Remaining 4 teeth were bleached according to Group 1 and 2 and were subjected to atomic force microscopy, scanning electron microscopy analysis. RESULTS: Specimens of athome bleaching were lighter than the specimens of inoffice bleaching. CONCLUSION: The susceptibility of enamel to pigmentation can be increased after bleaching, and pigmentation is greater if bleaching is performed with H2O2. The percentage change (lighter) was more for athome bleaching specimens as compared to inoffice bleaching specimens.

Palatal rugae patterns in orthodontically treated cases, are they a reliable forensic marker?

BACKGROUND: The specialization of forensic odontology is fast emerging as a branch that helps in personal identification of both living as well as dead individuals and also in crime scene investigations. Establishing a person's identity can be a challenging task in cases of road accidents or acts of terrorism or mass disaster scenario. It is an established fact that palatal rugae are unique for each individual and can be reliably used in the forensic field for personal identification. The present study was undertaken to evaluate the post-treatment stability of palatal rugae pattern in individuals subjected to orthodontic treatment with and without extractions and palatal expansion. MATERIALS AND METHODS: A total of 137 pre- and post-orthodontically treated casts of patients were obtained from our institute, which were divided into 50 cases each of extraction and non-extraction, 37 cases of palatal expansion involving both extraction and non-extraction. Palatal rugae patterns of all the cases were compared pre- and post-treatment. RESULTS: Chi-square test was applied for comparison of changes with respect to shape of rugae patterns. Maximum changes were seen in palatal expansion and extraction group and minimum changes in non-extraction group both on right and left sides. All three groups were compared involving all three parameters by Chi square test. About 89.19% and 84% of the study group showed changes in palatal expansion and extraction cases respectively. Although, a 62% of study subjects showed changes in non-extraction group with a P = 0.00041. CONCLUSION: Orthodontic treatment has an impact on the stability of palatal rugae so investigator should be aware of this fact when analyzing for identification reasons.

Using an existing crown to repair a damaged cast post and core restoration.

A fractured coronal tooth structure beneath an intact crown is a common clinical occurrence. If the underlying root is healthy, the tooth is restored with a post and core followed by refabrication of the crown. This paper describes a technique of using the existing intact crown for the above-mentioned situation. A 34-year-old female was referred with a fractured right canine with an intact crown. A post was found fractured in the canal which was subsequently retrieved. A new fiber post was cemented in the post space followed by adaptation of 50 µm polytetrafluoroethylene (teflon) tape on the tissue surface of the crown. Dual-cured core build-up composite resin was injected into the crown and adapted to the fractured tooth. On curing and removal of the crown, a new composite resin core was found bonded to the tooth structure. The Teflon tape was removed from the crown, and the crown cemented to the core using glass ionomer cement. This technique of building up the core of the tooth using teflon tape adapted to the tissue surface of the crown was found to be successful even after 1 year of follow-up.

Prevalence and severity of plaque-induced gingivitis in a Saudi adult population.

OBJECTIVES: To evaluate the prevalence and severity of plaque-induced gingivitis among a Saudi adult population in Riyadh region. METHODS: Three hundred and eighty-five eligible participants in this cross-sectional study were recruited from routine dental patients attending the oral diagnosis clinic at Al-Farabi College in Riyadh, Saudi Arabia from June 2013 to December 2013. A clinical examination was performed by 2 dentists to measure the gingival and plaque indices of Löe and Silness for each participant. RESULTS: The prevalence of gingivitis was 100% among adult subjects aged between 18-40 years old. Moreover, the mean gingival index was 1.68±0.31, which indicates a moderate gingival inflammation. In fact, males showed more severe signs of gingival inflammation compared with females (p=0.001). In addition, the mean plaque index was 0.875±0.49, which indicates a good plaque status of the participants. Interestingly, the age was not related either to the gingival inflammation (p=0.13), or to the amount of plaque accumulation (p=0.17). However, males were more affected than females (p=0.005). CONCLUSION: The results of this study show that plaque accumulation is strongly associated with high prevalence of moderate to severe gingivitis among Saudi subjects. 

Expression of cyclooxygenase-2 (COX-2) in colorectal adenocarcinoma: an immunohistochemical and histopathological study.

BACKGROUND: The aim of this study was to evaluate cyclooxygenase-2 (COX-2) immunoreactivity in colorectal adenocarcinomas and to find correlations with different pathological features. MATERIALS AND METHODS: This study included 35 cases of colorectal carcinoma for which surgical colectomy specimens were collected. Immunohistochemical staining of COX-2 (cyclooxygenase-2) is done by using the Streptavidin-biotin technique. RESULTS: This work reveals that COX-2 is positive in most cases of colorectal carcinoma and negative in normal colon tissue with statistically non significant relations between COX-2 immunostaining and different pathological features. CONCLUSIONS: Our data suggest overexpression of COX-2 protein in colorectal carcinoma in contrast to normal mucosa, with a possible role in cell proliferation in carcinogenesis.

Knowledge and attitudes of Saudi dental undergraduates on oral cancer.

Oral cancer awareness among future dental practitioners may have an impact on the early detection and prevention of oral cancer. A cross-sectional survey was undertaken to assess the current knowledge of future Saudi dentists on oral cancer and their opinions on oral cancer prevention. A pretested questionnaire was sent to 550 undergraduate dental students in the fourth, fifth, and sixth year of the Al-Farabi College for Dentistry and Nursing, Riyadh, Saudi Arabia. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Four hundred seventy-nine students returned the questionnaire (87.1 %). Eighty-one percent of respondents correctly answered questions relating to oral cancer awareness. Eighty-seven percent of respondents felt confident in performing a systematic oral examination to detect changes consistent with oral malignancy. Interestingly, 57 % of respondents had seen the use of oral cancer diagnostics aids. Thirty-seven percent of respondents felt inadequately trained to provide tobacco and alcohol cessation advice. There is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Incorporating the use of oral cancer diagnostic aids should be made mandatory.

Vitamin D and its relationship with breast cancer: an evidence based practice paper.

BACKGROUND: In oncology research fields, vitamin D has emerged as the most fruitful issue. The previous decade witnessed intensive efforts in connecting vitamin D with risk reduction and progression of various epithelial cancers, especially, breast cancer. PURPOSE: To evaluate the relationship between vitamin D levels and breast cancer. METHOD: A comprehensive search of several electronic databases was conducted in Pub Med, MEDLINE, CINAHL, in addition to, web search engine "Google" for abstracts, in order to determine the relationship between vitamin D and breast cancer. RESULTS: It was found that an increased serum level of vitamin D is associated with decreased risk of breast cancer. CONCLUSION: It was concluded that vitamin D plays a significant role in protection of breast cancer.

Maspin as a tumour suppressor in salivary gland tumour.

Maspin is a protein that belongs to serin protease inhibitor (serpin) superfamily. The purpose of this study was to review the literature concerning the expression of maspin in salivary gland tumours. A literature search was done using MEDLINE, accessed via the National Library of Medicine PubMed interface. Statistical analysis was not done because only seven studies were available in literature, the collected data were different and the results could not be compared. Expression of maspin was down regulated in more aggressive salivary gland tumours. Maspin may function as a tumour suppressor in salivary gland tumours.

An unusual side effect of Ibuprofen post dental therapy: increased erectile and libido activity.

Nonsteroidal anti-inflammatory drugs are the most commonly used medications for pain control in dentistry. The reported adverse effects include gastrointestinal and cardiovascular events, alterations in renal function, and effects on blood pressure, hepatic injury, and platelet inhibition which can lead to increased bleeding. This case report describes an unusual rare adverse event of the use of ibuprofen for pain control post restorative treatment. A 26-year-old, otherwise healthy Saudi male reported an unusual side effect of increased libido and erectile function post use of ibuprofen. The medical and laboratory tests have failed to identify a link between this rare adverse event and either underlying conditions or possibly related etiology. This case represented a puzzling challenge with no clear explanation.

Cryosurgery of the oral and peri-oral region: a literature review of the mechanism, tissue response, and clinical applications.

Cryosurgery is a method of achieving lesion destruction by rapid freezing in situ. Application of cryosurgery in medicine widespread and its use within dentistry is also well documented, using both open and closed liquid nitrogen and carbon dioxide. The major advantages of oral cryosurgery include bloodless treatment, very low incidence of secondary infection, and a relative lack of scarring and pain. This review outlines knowledge on the mechanisms, tissue response, and current practices of cryosurgery in the oral and peri-oral region. More experimental studies are needed to better understand this important modality at cellular and molecular levels. Inconsistency in the current protocols used for the treatment of the oral lesions is evident. Additional studies are needed to define the treatment protocols for different types of oral lesions. Information on the cryogen type and dose and the delivery technique required would help to produce reproducible outcomes for the treatment of targeted lesions.

Possible recurrence of keratocyst in nevoid basal cell carcinoma syndrome: A review of literature.

This review will highlight some current areas of difficulty or controversy in diagnosis and treatment of nevoid basal cell carcinoma syndrome (NBCCS). The odontogenic keratocyst (OKC) has significant growth capacity and recurrence potential and is occasionally indicative of the NBCCS. The objective of this study is to clarify the causes of the recurrence of OKC in NBCCS. A literature search was conducted using Medline, accessed via the National Library of Medicine PubMed interface, searching for articles relating to the cause of recurrence of keratocyst in NBCCS written in English. This study has described the previous and the current outcomes of the treatment of OKC (recurrent cause). A protocol was then agreed to search for the possible causes of keratocyst recurrence in NBCCS. The general treatment of other manifestation of NBCCS has excluded from this study. Studies describing cohort, case series and miscellaneous clinical reports were retrieved and evaluated from 2010 to 2012.