Evaluation and comparison of antifungal effect of voriconazole with nystatin on candida species derived from neoplastic patients undergoing maxillofacial radiotherapy.

Background: Radiotherapy is a common treatment for head-and-neck malignancies and causes complications such as oral candidiasis and the change of oral Candida species from albicans to nonalbicans. Voriconazole has acceptable antifungal effect. The aim of this study was to determine and compare the antifungal effect of nystatin with voriconazole on these species. Materials and Methods: The samples used in this in vitro study were identified by polymerase chain reaction-restriction fragment length polymorphism from patients before and 2 weeks after head-and-neck radiotherapy in Seyed Al-Shohada Hospital. The antifungal effect of nystatin and voriconazole was determined by microdilution method and measurement of the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration, and the results were analyzed by Mann-Whitney analysis. Results: The results showed that all species before and after radiotherapy showed 100% sensitivity to nystatin. Prior to radiotherapy, 57.1% of albicans species isolated were in the sensitive range (MIC ≤1) and 42.9% were in the dose-dependent range (MIC = 2) to voriconazole. After radiotherapy, 58.3% of albicans species were in the sensitive range and 41.7% of these species were in the dose-dependent range to voriconazole. Conclusion: The results of the present study showed that before radiotherapy, all species were sensitive to nystatin, while a percentage of albicans and nonalbicans were resistant to voriconazole. In the 2nd week of radiotherapy similar to prior to radiotherapy, all species isolated from patients were sensitive to nystatin, while a percentage of albicans and nonalbicans were resistant to voriconazole.

Evaluation and relation of oral health-related quality of life and oral health status in Thalassemia Major patients, a cross-sectional study.

BACKGROUND: Beta-Thalassemia is the most common human inherited disease, directly impacting patients' physical and psychosocial aspects. The present study evaluated oral health status, oral health-related quality of life (OHRQoL), and their correlation in Thalassemia Major patients. METHODS: Two hundred Thalassemia Major patients aged 12-49 participated in this cross-sectional study. Subjects were selected among the patients referred to the Faculty of Dentistry of Isfahan University of Medical Sciences using simple sampling. Oral Health Impact Profile 14 (OHIP 14) was used to assess OHRQoL. The decayed, Missing, and Filled Teeth (DMFT) index was used as an oral health index. SPSS 22 was used for analysis, using T and Pearson Correlation tests. RESULTS: 53% of participants were female, and 47% were male. The mean OHIP-14 score (± SD) was 13.20 (± 7.01). The mean DMFT score was 9.54 (± 5.72). DMFT and total OHIP 14 scores correlated significantly (p < 0.001, r = 0.78). All domains of the OHIP-14 score were also significantly correlated with DMFT (p < 0.05). CONCLUSIONS: Poor oral health conditions might adversely affect OHRQoL in TM patients. It seems necessary to provide oral treatment needs in order to improve OHRQoL in patients suffering from this particular disease.

Comparison of oral candidiasis characteristics in head-and-neck cancer patients before and during radiotherapy.

Background: Patients undergoing head-and-neck radiotherapy are susceptible to Candida colonization and infection. This study aimed to identify oral Candida species type (ST), colony count (CC), and oropharyngeal candidiasis (OPC) in head-and-neck cancer patients, undergoing radiotherapy, before and 2 weeks after radiation. Materials and Methods: In this quasi-experimental study, head-and-neck cancer patients undergoing radiotherapy (up to 6000 cGy) were recruited. Samples were taken before and 2 weeks after radiation therapy (RT). CC was assigned using Sabouraud dextrose agar culture medium and morphological studies were performed to confirm OPC. For identification, polymerase chain reaction-restriction fragment length polymorphism was performed. Data were analyzed using Chi-square-test and kappa coefficient. P < 0.05 was considered statistically significant. Results: Twenty-one of 33 patients were Candida positive. The detected fungal species included Candida albicans (60%), Candida tropicalis (22%), Candida glabrata (9%), and other species (9%). Following RT, OPC and CC changed significantly (P = 0.003 and P = 0.001, respectively), whereas ST did not significantly change (P = 0.081). Two new species (Candida krusei and Candida parapsilosis) were detected after the intervention. The OPC, CC, and ST changes after RT were not significantly related to malignancy site or radiation dose (P > 0.05). Conclusion: The present study showed that OPC, CC, and ST were not related to the malignancy site. Following RT, OPC and CC changed significantly, while ST showed no significant change. The radiation dose and malignancy site had no effects on the OPC, CC, or ST alterations following RT.

Oral health-related quality of life and xerostomia in type 2 diabetic patients.

BACKGROUND: Diabetes mellitus (DM) is a known risk factor for xerostomia. Oral health-related quality of life (OHRQoL) is a multi-dimensional issue reflecting several effects of the oral condition on the quality of life. OBJECTIVES: The present study aimed to assess OHRQoL and its relationship with xerostomia severity in type 2 diabetic patients. MATERIAL AND METHODS: A total of 200 patients participated in this cross-sectional study. The Xerostomia Inventory (XI) assessed xerostomia severity and the Oral Health Impact Profile-14 (OHIP-14) questionnaire evaluated OHRQoL. In addition, the fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) tests were conducted, and the results were recorded, as well as the disease duration and denture wearing. Data analysis employed the t test and Pearson's correlation coefficient. RESULTS: The mean XI score was 22.27 ±6.92 and the mean OHIP-14 score was 13.76 ±8.41. The mean FBS, HbA1c and disease duration values were 161.23 ±49.14 mg/dL, 7.90 ±1.12% and 11.02 ±7.78 years, respectively. The OHIP-14 score correlated significantly with the XI score, age, FBS, HbA1c, the disease duration, and denture wearing (p < 0.05). CONCLUSIONS: There was a significant correlation between OHRQoL and xerostomia severity in patients with type 2 DM. Age, denture wearing, the disease duration, and the medical management of DM also correlated significantly with OHRQoL. Treating both the underlying disease and oral health comorbidities, such as xerostomia, seems to be essential for achieving a better OHRQoL in type 2 diabetic patients.

Oral health-related quality of life in chronic kidney disease patients.

Background: Chronic kidney disease (CKD) is a systemic disease with a major burden on several life aspects, including oral health. As life expectancy has improved in CKD patients, oral health status has become important regarding their quality of life. The aim of this study was to investigate oral health and oral health-related quality of life (OHRQoL) in CKD patients. Materials and Methods: This was a cross-sectional study. Patients' age, gender, and estimated glomerular filtration rate (eGFR) stage were recorded. Oral Health Impact Profile-14 (OHIP-14) was used to evaluate OHRQoL. Decayed, missing, and filled teeth (DMFT) index was utilized to record oral health status. SPSS software was used to analyze data. One-way ANOVA, t-test and Pearson/Spearman correlations were used. P < 0.05 was considered statistically significant. Results: One hundred and four patients participated; 60.6% male versus 39.4% female. Mean age was 52.1 ± 18.1 years. The most frequent eGFR stage was 5 (41.2%). Mean DMFT score was 18.7 ± 8.5. Mean OHIP-14 score was 14.82 ± 5.86. DMFT score was significantly correlated with OHIP-14 total score as well as its physical domains (P < 0.05). The correlation between eGFR stage and OHIP-14/DMFT score was both statistically significant (P = 0.03/P = 0.02, respectively). Conclusion: DMFT score was significantly correlated with OHRQoL in CKD patients, especially regarding its physical domains. Paying attention to fulfill dental treatment needs seems mandatory to improve OHRQoL and overall quality of life in these patients.

Oral health-related quality of life and orthodontic treatment need in thalassemia major patients.

Background: Thalassemia major (TM) is a severe life-threatening hemoglobinopathy. It causes a typical chipmunk face due to increased hematopoiesis. Severe malocclusion often accompanies facial deformity, which may affect Oral Health-related Quality of Life (OHRQoL). The aim of this study was to assess the relationship between orthodontic treatment needs and OHRQoL in TM patients. Materials and Methods: One hundred and five adult patients with TM participated in this cross-sectional study. Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure OHRQoL and the patient's need for orthodontic treatment was evaluated using the Index of Orthodontic Treatment Need (IOTN). The comparison of OHIP-14 scores between groups regarding orthodontic treatment need was carried out using t-test (SPSS software); P < 0.05 was considered statistically significant. Results: The mean age of participants was 24.92 (±9.33) years, with 52% female versus 48% male. Orthodontic treatment need was 27.6%. The mean score of OHIP-14 was 12.95 (±7.02). A statistically significant relationship was found between OHIP-14 score and age, gender, and orthodontic treatment need (P < 0.05). All domains of OHIP-14 were significantly related to orthodontic treatment need (P < 0.05), except for "physical disability" (P = 0.282). Conclusion: OHRQoL was lower in TM patients with orthodontic treatment needs. Planning to treat malocclusion seems necessary to improve the quality of life in these patients.

Oral health-related quality of life in erosive/ulcerative oral lichen planus patients.

Background: Oral lichen planus (OLP) is a chronic oral mucosal disease. It can manifest as severe erosive/ulcerative oral lesions, causing pain and discomfort. Oral health-related quality of life (OHRQoL) may be deteriorated due to the patient's symptoms. The aim of this study was to evaluate OHRQoL and its relation to oral pain in erosive/ulcerative OLP patients. Materials and Methods: In this cross-sectional study, patients with erosive/ulcerative OLP filled out Chronic oral mucosal disease questionnaire (COMDQ). Meanwhile, they recorded their oral pain through Visual analog scale (VAS). The Pearson's correlation coefficient was used to analyze the relationship between COMDQ score and VAS (IBM SPSS Statistics). P < 0.05 was considered statistically significant. Results: Sixty patients participated in the present study; 51 (85%) were women and 9 (15%) were men. The mean age of participants was 50 ± 14.5 years. The mean score of COMDQ was 47.44 (±18.21). The mean VAS score was 4.5 (±2.4). COMDQ total and all domain scores were significantly correlated with VAS (P < 0.05), except for the "Patient support" domain (P = 0.63). Conclusion: In patients with erosive/ulcerative OLP, there was a significant correlation between oral pain and COMDQ total score, as well as its physical, social, and emotional domains. It seems that COMDQ can be a complementary tool for assessing treatment outcomes in OLP patients.

Intraoral mass presenting as maxillary sinus carcinoma: a case report.

Sinonasal undifferentiated carcinoma is an extremely rare malignancy of the paranasal sinuses and nasal cavity. It is of unknown etiology, and occurs more commonly in the elderly men, with a routinely shown aggressive behavior and poor prognosis for survival. Radiographically, it looks like severe osteomyelitis. Histopathologic study is essential to confirm diagnosis, and the undifferentiated histologic appearance often necessitates immunohistochemical studies for differentiation from other high-grade neoplasms. We present an 83-year-old man complaining of pain and unilateral swelling on the left side of the face due to a rare malignant tumor of maxillary sinus origin, a sinonasal undifferentiated carcinoma. He underwent hemimaxillectomy and radiotherapy, but refused chemotherapy. Maxillary sinus malignancy may be presented with unspecific symptoms mimicking sinusitis or dental pain. Coming across such symptoms, the physician or dentist must consider malignancies as well, and carry out medical and dental workups.