Serum vitamin D and antinuclear antibody level in oral lichen planus patients: a cross-sectional study.

Vitamin D is a secosteroid prohormone that regulates the immune system. Antinuclear antibody (ANA) is a protein antibody made against substances inside the nucleus of cells. Serum vitamin D and ANA levels progress to psoriasis and oral cancer. The present study aimed to measure the serum vitamin D and ANA levels in patients with oral lichen planus (OLP), an autoimmune and precancerous disease. Methods: We conducted this cross-sectional study on patients with OLP (n=50) and healthy individuals (n=50). We used the enzyme-linked immunosorbent assay method to measure serum vitamin D and ANA levels and Mann-Whitney U-test and t-test to analyze data. Results: The present study showed that 14 (28%) patients with OLP had vitamin D deficiency, and 18 (36%) had insufficient vitamin D. Further, 9 (18%) and 15 (30%) of the participants in the control group suffer from vitamin D deficiency and insufficient vitamin D level, respectively. Results showed a significant relationship between levels of serum vitamin D in both groups. The level of ANA positive in patients with OLP was 6 (12%). The results of the t-test showed no significant difference between the mean serum ANA levels in the two nodes with an 80% confidence interval (P=0.34). Conclusion: Researchers of the present study reported low serum vitamin D in many OLP patients. Due to the prevalence of vitamin D deficiency in society, we need to perform comprehensive studies to evaluate the deficiency's effects on pathogenesis.

Effect of cell phone use on salivary components; a review of literature.

Mobile phones have been increasingly used in the past decade and have become a cultural instrument. There is a great concern over the harmful effects of electromagnetic and radiofrequency waves as well as microwaves generated by mobile phones and their telecommunication stations on health. The saliva plays an important role in preserving oral homeostasis as the first defensive line against the microbial invasion which protects oral mucosa mechanically and immunologically. A search was run in PubMed, Goggle Scholar, Medline, and Web of Science databases using the following keywords: cell phone, mobile phone, antioxidant profile, saliva, oxidative stress, interleukin, and inflammation. Sixty-five published articles were identified. Studies on the use of cell phones as educational aids, the use of immune histochemistry on salivary glands, or the evaluation of saliva in individuals with specific conditions, such as the use of orthodontic brackets, were excluded. In addition, duplicate articles are eliminated, and finally, 14 articles were included in the present study. Nowadays mobile phone is very popular, causing concern about the effect it has on people's health. Parotid salivary glands are in close contact with a cell phone while talking with the phone and the possibility of being affected by them; so this study was designed to investigate the effect of cell phone use on salivary components.

Evaluation of the effect of melatonin in patients with Burning mouth syndrome: a double-blind, placebo-controlled randomized clinical trial

Abstract The present study was carried out to evaluate the effect of Melatonin and Placebo in the patient with the Burning mouth (BMs). This double-blind, placebo-controlled randomized clinical trial study was carried out on 30 patients who were suffering from BMS. During this period patients were divided into 2 study and control groups. The study group used four 3 mg Melatonin daily and the control group received a placebo. Then the severity of the burning sensation was measured by the physician Sleep quality was measured using the VAS scale using the Petersburg questionnaire. Data in the application Enter SPSS 20 and then using T test or equivalent Nonparametric was analyzed, mean sleep score and mean severity of oral irritation before and after treatment in two the group was evaluated using T-test Independent. Level significance was considered 0.05. The results of the present study show that the use of melatonin and a placebo in patients with BMS reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study severity of burning was 4.93±2.56 after treatment in the study group and 6.93±2.12 in the control group, which was statistically significant (P =0.036). No significant difference was observed between the two groups in the sleep quality score (P-value = 0.43). Using Melatonin can be a reliable way to treat pain for which there is no standard treatment to date. Although evidence suggests an association between sleep disorders and BMS, melatonin was not superior to a placebo in reducing BMS-induced burning in the present study. Identification of stressors and the ways to struggle with them, further studies with larger samples and higher oral doses, extended follow-up periods and control of psychological factors, and measurement of body mass index that may affect pharmacokinetics are recommended.

Burning mouth syndrome: a review of therapeutic approach.

Burning mouth syndrome (BMS) is described by an intense burning sensation of the tongue or other oral areas without a clear etiopathology. The diagnosis of BMS is challenging due to variations of manifestations. The management of BMS is complicated due to the complex etiology of the disease. Many medications and treatment methods have been recommended for BMS management, but no one confirmed as the standard method. In this study, the therapeutic approaches of BMS were evaluated. The data of the article was obtained from PubMed/MEDLINE, Cochrane Library, and Web of Science. The following terms including "burning mouth syndrome", "therapy", and "treatment" were used for search in the databases. A wide range of articles about the therapeutic approach of BMS was searched and reviewed. Pharmacological and non-pharmacological approaches have been used for BMS management. Pharmacological treatments are including Capsaicin, Clonazepam, Low-dose aripiprazole, Alpha-lipoic acid, Duloxetine, Amitriptyline, Gabapentin, and Pregabalin, and ultra-micronized palmitoylethanolamide. Non-pharmacological therapies for BMS are cognitive therapy, Electroconvulsive therapy, Laser therapy, Acupuncture and auriculotherapy, Transcranial Magnetic Stimulation (rTMS), Salivary Mechanical Stimulation, and Botulinum Toxin. A detailed assessment of the etiology and pathophysiology of BMS, and having information about novel therapeutic interventions are essential for the management of BMS.

Salivary ß2-microglobulin levels in patients with erosive oral lichen planus and squamous cell carcinoma.

OBJECTIVES: ß2 microglobulin, as a biomarker, is used for the diagnosis of oral malignant and pre-malignant lesions. The components of the microglobulin system can directly or indirectly help grow and develop tumors. The present study aims to compare beta-2 microglobulin levels in patients with lichen planus of the esophagus, oral squamous cell carcinoma, and healthy individuals. Further, it evaluated the salivary ß2-microglobulin level in malignant and pre-malignant lesions. Oral lichen planus (OLP) is a chronic skin-mucus disorder. Of the total 75 patients referred to Oral Medicine at Dentistry School of Zahedan University of Medical Sciences, 25 were healthy and 25 had oral lichen planus (OLP) and the rest had squamous cell carcinoma (SCC). To collect the saliva samples, unstimulated spitting was used. They were collected between 9 and 12 a.m. Salivary beta2 microglobulin was recorded based on the factory instructions by ELISA optical density method with 450 nm wavelength for each sample. The data were analyzed using descriptive, Kruskal-Wallis and Mann-Whitney and Pearson's correlation coefficient (SPSS 21). RESULTS: The salivary ß2 microglobulin level in patients with squamous cell carcinoma (SCC) and oral lichen plan (OLP) is significantly higher than that in healthy group. Thus, this index is used for assessing early malignant transformation and oral pre-malignant lesion.

The Complaints, Type, and Severity of Stressful Events in Patients with Burning Mouth Syndrome Referring to Zahedan School of Dentistry, Iran.

INTRODUCTION: Burning mouth syndrome (BMS) is a burning sensation in oral mucosa without visible lesions in clinical examinations. The present study aimed at comparing complaints, frequency, type, and severity of stressful events between patients with BMS and healthy individuals referred to Zahedan School of Dentistry, Zahedan, Iran. MATERIALS AND METHODS: In the present study, 30 patients with BMS were matched with controls by age and gender after enrollment. The Holmes-Rahe questionnaire and the complaint registration form were used to compare the frequency of complaints, and the type and severity of stressful events between the groups. Data were analyzed by descriptive statistics, Chi-squared and t-tests. RESULTS: The mean age of the subjects in the case and control groups was 40.13 ± 2.30 and 40.07 ± 2.31 years, respectively. The obtained results showed no statistically significant difference between the groups in terms of mean age and gender distribution (P>0.05). The results of the Chi-squared test showed a significant difference in the frequency of complaints between the two groups (P<0.001). The t-test results indicated that the average severity of complaints and the average severity of stressful events were significantly different between patients with BMS and controls (P<0.001). The results of Chi-squared test revealed that the mean frequency of complaints (P<0.001) and mean frequency of stressful events (P<0.001) were significantly different between the two groups. CONCLUSIONS: Based on the study results, the frequency of complaints, and the type and severity of stressful events were significantly different between patients with BMS and healthy individuals referred to the clinic of Zahedan School of Dentistry.

Oral Health-Related Quality of Life in Patients with Rheumatoid Arthritis.

INTRODUCTION: The assessment of the quality of life (QOL) in rheumatoid arthritis (RA) patients is of great importance for health researchers, health planners, and clinical specialists. Thus, the present study aimed to evaluate the oral health-related quality of life in patients with RA. MATERIALS AND METHODS: In this case-control study, data were collected by two standard questionnaires filled by 80 patients with rheumatoid arthritis and 80 healthy individuals. They were analyzed using independent t-test, chi-square test, Mann-Whitney test, Pearson's correlation coefficient, and Kruskal-Wallis test in SPSS 21. RESULTS: The mean of Health Assessment Questionnaire (HAQ) score in RA patients and control groups was 1.17± 0.89 and 0.35±0.12, respectively, and the mean of General Oral Health Assessment Index (GOHAI) score in patients and control groups was 37.46±9.53 and 53.21±11.35, respectively; 62.5% of the patients got HAQ score more than or equal to 1 (≥1) and 91.2% got GOHAI score less than or equal to 50 (≤50). CONCLUSION: The results of the present study suggested that most of the patients with RA had a poor oral health quality of life. Deterioration of disease and aging decrease the GOHAI and the oral health quality of life of patients.

The comparison of the effect of curcumin with nystatin on inhibition level of Candida albicans.

BACKGROUND: Curcumin is a kind of medicinal plant, a member of the ginger family, Zingiberaceae. As the herbal medicine has been globally demanded in recent years and due to the anti-viral, anti-inflammatory, and antifungal properties of curcumin, the present study aimed to compare the inhibitory effect of curcumin with that of nystatin on Candida albicans growth. METHODS: In this experimental study, the antifungal effect of curcumin on Candida albicans was evaluated. Candida albicans is cultivated in Agar Sabuard medium containing chlorophenic, 10-series of curcumin extract, and one 10-series of a disc impregnated with nystatin. Inside of each plate, one disc of herbal extract, one disc of nystatin as a positive control, one disc of methanol and one empty disc as negative control were placed, after 24 hrs, the inhibitory zone diameter of the herbal extract was compared with that of positive control using Mann-Whitney. RESULTS: The mean of inhibitory zone diameter in nystatin and curcumin was 1.04±20.46 and 1.36±0.89 mm, respectively. Mann-Whitney test shows a significant difference between the inhibitory zone diameter of these materials (P<0.001). CONCLUSION: The results of this study suggested that curcumin extract did not have any effect on the inhibition of Candida albicans in laboratory environment.

Oral Lichen Planus: an Overview of Potential Risk Factors, Biomarkers and Treatments

Oral lichen planus (OLP) is an immune-related disorder with unknown exact etiology but established prevalence in females. There are six clinical forms of OLP, ranging from asymptomatic white keratotic lesions to painful erosions and ulcerations. The aim of the present report is to overview pathologic and therapeutic aspects. Peroxidation products, antioxidants, cortisol, and immunoglobulins are potential biomarkers to predict OLP occurrence. The risk of OLP development in patients with hepatitis B and C infection is 2-fold greater than in healthy individuals, while there is no significant relation with diabetes mellitus. Corticosteroids are common drugs to treat OLP and their combination with other agents can be most effective. Folic acid and variants of vitamin B are also potential treatments since they target hematological abnormalities.

Comparison of the Effects of Curcumin Mucoadhesive Paste and Local Corticosteroid on the Treatment of Erosive Oral Lichen Planus Lesions.

INTRODUCTION: Lichen planus is a prevalent chronic mucocutaneous condition, whose exact pathogenesis has not been elucidated yet and its standard treatment at present involves the use of local corticosteroids. Curcumin is a colored material extracted from Curcuma longa plant species and is used as an appetizer and for medical purposes. It has anti-inflammatory, antioxidative and anti-cancerous properties. In the present study, the effect of mucoadhesive pastes containing curcumin and local corticosteroids was evaluated for the treatment of erosive lichen planus lesions. MATERIALS AND METHODS: In this case‒control study, 40 patients with oral lichen planus were evaluated. Twenty patients, as the cases, were given mucoadhesive pates containing curcumin and 20 patients, as the controls, were given local corticosteroids. The lesion sizes were recorded in the first session and during the follow-up sessions. Pain severities were measured and recorded using the visual analogue scale (VAS) on the first session and during the follow-up sessions. Data were analyzed with SPSS 19, using Student's t-test and Mann-Whitney test. Data are significant P < 0.05. RESULTS: The lesion sizes, pain severities and changes in classification of the lesions exhibited significant differences at different follow-up sessions (weeks 1, 2, 4, 8 and 12) in the two groups (P < 0.05). However, there were no significant differences between the group treated with curcumin and the group treated with local corticosteroids (P > 0.05). CONCLUSION: Curcumin was effective in the treatment of oral lichen planus lesions and resulted in decreases in lesion sizes, pain and burning sensation severities and changes in classification of the lesions without any complications.

Salivary Chemical Factors in Relation with Oral Cancer in Smokers and Non-Smokers: a Literature Review.

Squamous cell carcinoma of oral cavity is of malignant tumors, which causes cancerous complications. DNA damage, mainly because of products of oxidative stress like reactive oxygen species, is a frequent mutagenic that triggers carcinoma. Smoking increases the probability of cancer incidence. Saliva is the first biological medium to interact with external compounds, especially smoking substances. The present study overviews the salivary level of some remarkable compounds in relation with smoking and squamous cell carcinoma. To collect data, English literature was searched in databases including PubMed, ScienceDirect and Google Scholar. The keywords used for search were as follows: 'Carcinoma, Squamous Cell', 'Smoking', 'Saliva', and 'Biomarkers'. The inclusion criteria were the presence of salivary chemical factors in relation with oral cancer and influence by smoking. Out of 239 found articles, only 56 were selected. Our results demonstrated the potential role of salivary biochemistry to predict and/or treat complications with cancer in both smoker and non-smoker individuals. Changes in concentrations of salivary chemicals including antioxidants, total antioxidant, glutathione and uric acid, epithelial growth factor, cytokine biomarkers, superoxide dismutase activity, and transcriptome were related to squamous cell carcinoma and could be used as potential biomarkers for cancer prognosis; moreover, enhancement of antioxidant level might be a potential treatment.

Salivary MMP-1, MMP-2, MMP-3 and MMP-13 Levels in Patients with Oral Lichen Planus and Squamous Cell Carcinoma

The aim of present study was to evaluate salivary matrix metalloproteinase-1 (MMP-1), MMP-2, MMP-3 and MMP-13 levels in patients with oral lichen planus (OLP) and squamous cell carcinomas (SCC) as well as in healthy controls. Thirty cases of OLP (bilateral lesions, papular and reticular lesions, and Wickham lines) clinically and histopathologically (group A), 30 with oral SCCs (group B), and 30 with no history of oral cancer, other lesions or lichen planus (group C) were enrolled at the Department of Oral Medicine School of Dentistry, Zahedan, Iran. Unstimulated whole saliva was collected and laboratory measurement of salivary concentration of MMP-1, MMP-2, MMP-3 and MMP-13 was conducted by immuno-sorbent enzyme-linked methods. Data analysis was performed with Kruskal-Wallis and Mann-Whitney tests and Pearson's correlation coefficients. In the present study, MMP-2 and MMP-13 levels were higher in oral SCC patients than in OLP and healthy individuals. More research is required to assess MMP links with tumor invasion.

Investigating the level of salivary endothelin-1 in premalignant and malignant lesions.

PURPOSE: This study aimed to investigate the level of salivary endothelin-1 in premalignant and malignant lesions. MATERIALS AND METHODS: In this study, 75 cases were investigated of which 25 cases were healthy, 25 cases had oral lichen planus (OLP), and 25 cases had oral squamous cell carcinoma (OSCC). In order to collect the saliva samples, the unstimulated spitting was used. The samples were collected between 9 and 12 a.m. They were sent to the lab shortly after being collected and salivary endothelin-1 was recorded for each sample according to the instruction of factory by using enzyme-linked immunosorbent assay and optical density at a wavelength of 450 nm. SPSS version 20 and one-way ANOVA and LSD tests were used to analyze the data. RESULTS: The mean of salivary endothelin-1 level in patients with OSCC was 163.98 pg/ml, in patients with OLP was 160.9 pg/ml, and in healthy people was 137.19 pg/ml. The analysis of one-way ANOVA suggested that the level of salivary endothelin-1 in both groups was the same and significantly higher than that in control group (p < 0.05). CONCLUSIONS: The level of salivary endothelin-1 in patients with SCC and OLP was higher than that in healthy group. Thus, it can be used as the latest therapeutic protocol for oral premalignant and malignant lesions.

Comparison of Salivary Cortisol and α-amylase Levels and Psychological Profiles in Patients with Burning Mouth Syndrome.

PURPOSE: The aim of the study was to compare salivary cortisol and α-amylase levels and psychological profiles in patients with burning mouth syndrome (BMS) and healthy subjects. METHODS AND MATERIALS: Spitting method was used to collect unstimulated salivary. Salivary cortisol and α-amylase levels were determined using ELISA and the Caraway starch-iodine technique. SLC-90 questionnaire was used to determine the psychological profiles. RESULTS: The difference between mean of salivary cortisol levels in patients with BMS and in healthy subjects was not significant (4.50 ± 3.68 ng/mL vs. 3.69 ± 3.07 ng/mL, p = 0.377). The difference between mean of α-amylase levels in the BMS patients and healthy subjects was significant (351.68 ± 142.5 and 146.22 ± 130.4, p = 0.001). Note that, 83.4% and 18% of the patients in the case and control groups had psychological problems (p = 0.001). CONCLUSION: The results showed higher salivary levels of cortisol and α-amylase in patients with BMS compared to healthy individuals. Psychological problem was prevalent in patients.

Efficacy of Omega-3 in Treatment of Recurrent Aphthous Stomatitis: A Randomised, Double-blind, Placebo-controlled Study.

OBJECTIVE: To evaluate the potential of omega-3 polyunsaturated fatty acid supplement as an effective, safe and inexpensive medicine for the treatment of recurrent aphthous stomatitis. METHODS: In this double-blind clinical trial, 50 patients with recurrent aphthous stomatitis were randomly divided into the omega-3 group and placebo group. Patients in the omega-3 group received 1000 mg omega-3 group capsules (Daroupakhsh Company, Tehran, Iran) for 6 months; while those in the placebo group received placebo capsules with the same instructions. The pain, size, duration and recurrence rate of ulcers were recorded in each follow-up phase. Follow-up was done weekly in the first month of drug prescriptions and then monthly in the next 5 months. The data were analysed with SPSS-20 through the Mann-Whitney test to compare the groups with respect to each variable and the Wilcoxon and Friedman tests to compare the groups over time. Values were significant at P < 0.05. RESULTS: In the omega-3 group, pain was lessened from 4.96 to 3.04, irritation was reduced from 5.88 to 4.00 (P = 0.0627) and the size of ulcers was decreased from 2.30 to 1.48 mm (P = 0.062). No significant change was observed in the aforementioned variables in the placebo group. Moreover, the number of ulcers indicated a significant reduction in the fourth, fifth and sixth months in comparison with the placebo group (P = 0.00). CONCLUSION: The recurrence of ulcers in the omega-3 group showed a significant decrease in the fifth and sixth months compared with the placebo group (P < 0.05). The current study indicated that omega-3 consumption decreased the symptoms of recurrent aphthous stomatitis.

Comparison of Cotinine Salivary Levels in Hookah Smokers, Passive Smokers, and Non-Smokers.

BACKGROUND: At present smoking is considered a great health-related problem. Smoking cigarettes and use of tobacco are on the rise in the Middle East countries; therefore, the number of people exposed to passive cigarette smoke is increasing, too. The aim of the present study was to determine and compare salivary cotinine levels in hookah smokers, individuals exposed to passive cigarette smoke and non-smoker (passive smokers). METHODS: In the present cross-sectional study, unstimulated salivary samples were collected from 150 subjects, including 50 hookah smokers, 50 passive smokers, and 50 non-smokers. Bioassay Technology Laboratory cotinine kit was used to determine salivary levels of cotinine using the enzyme-linked immunosorbent assay (ELISA) technique at a sensitivity rate of 0.019 pg/ml. Data were analyzed with SPSS software using t-test and Pearson's correlation coefficient. FINDINGS: The highest salivary cotinine levels were recorded in hookah users (20.24 ± 5.62 ng/ml), followed by passive smokers (16.09 ± 3.51 ng/ml), in descending order. No detectable cotinine levels were observed in non-smokers. Pearson's correlation coefficient showed a strong and positive correlation between use of hookah and salivary cotinine levels (r = 0.932, P = 0.001). CONCLUSION: Based on the results of the present study, salivary cotinine levels were higher in hookah smokers compared with passive smokers and non-smokers, in descending order.

Detection of Salivary Human Papilloma Viruses 16 and 18 (HPV) in Smoker Men in an Iranian Population by PCR: A Pilot Study.

BACKGROUND: Human papilloma virus (HPV) infection of the oropharynx is acquired through a variety of sexual and social forms of transmission. Recent epidemiologic evidence has suggested that HPV may be an independent risk factor for oropharyngeal cancers, but risk factors for persistent HPV infection in the oropharynx are unknown. More evidence is needed regarding the prevalence of oral high-risk HPV among healthy smoker and nonsmoker adults. OBJECTIVES: The aim of this study was to compare salivary infection with human papilloma virus types 16 and 18 between smokers and nonsmokers. PATIENTS AND METHODS: A hundred healthy adult subjects were selected from Zahedan dental school for this pilot study. DNA was isolated from saliva samples and screened for high-risk HPV strains of HPV 16 and 18. Then, further processed using Real Time PCR for quantification and confirmation of sensitivity and specificity of the test. Data was analyzed by t-test. RESULTS: There were no high-risk types of virus in patients and no significant differences between the groups (P = 1). CONCLUSIONS: It seems that smoking cannot increase the prevalence of high risk HPV 16, 18 in saliva samples.

Clinical and histopathological analysis of oral squamous cell carcinoma of young patients in Mashhad, Iran: a retrospective study and review of literature.

OBJECTIVES: Oral Squamous cell carcinoma (OSCC) is primarily a disease that mainly occurs in males in their sixth and seventh decades of life and is rare in young adults. STUDY DESIGN: In this retrospective study, records of patients under the age of 40, with the diagnosis of OSCC in the Oral Medicine Department of Mashhad Dental Faculty during the past 13 years were analyzed. Their socioeconomic data, demographic, clinical and histopathological characteristics, risk factors, familial history were assessed and applicable studies and case reports in the literatures were reviewed. PCR (Polymerase chain reaction) analysis was also done for detection of human papilloma virus (HPV). RESULTS: From 158 cases of OSCC diagnosed in our centre, 21 patients were younger than 40 years. Most of them were young men (12 cases). There was no significant risk factor in this group. The most common site of involvement was the tongue. The most common clinical presentation was exophytic lesion with ulcer. No HPV DNA was detected in these patients. CONCLUSION: Characteristics of OSCC in young patients are different from older age group. Major risk factors (smoking and alcohol consumption and HPV) were not etiologic factors for OSCC in young patients in our province.