A systematic review of medicinal plants and herbal products' effectiveness in oral health and dental cure with health promotion approach.

Medicinal plants and herbal drugs are being used increasingly as part of primary health care in most parts of the world. As important adjunctive and alternative treatments for oral health care, herbal products' use may continue to increase and become more widespread. The objective of this study is to present a comprehensive systematic review of the current published literature on the effectiveness of medicinal plants and herbal products employed to improve oral health in adolescents with a health promotion approach. The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The keywords "herbal medicine," "herbal extract," "herbal supplements," "plant extract," "natural drug," "pulpitis," "dental caries," "oral viral diseases," and "abscess" were used in combination with the Boolean operators OR and AND. PubMed, Embase, Scopus, and Web of Science were searched. Quality assessment of the included studies was performed using the Cochrane Handbook for Systematic Reviews of Interventions. The search yielded 49 original research studies. A total of 22 studies had low or unclear risk bias. The geographical distribution of included studies was primarily concentrated on western countries. Overall, studies reported herbal product users' age, ranging from young adults aged 18 years to elderly people aged 75 years or older. Most studies reported multiple compounds, including herbal drugs and herbal extracts. Chamomile and Aloe vera were the most frequently reported herbal compounds. The most commonly described herbal products to treat oral diseases were gels, mouth rinses, and pastes. The studies included a range of people with oral diseases, including periodontal and gingival diseases, recurrent aphthous stomatitis, oral lichen planus, and oral candidiasis. Herbal product interventions were found to be effective and safe alternatives for oral health care. One of the most important goals of the World Health Organization (until 2015) is the oral health index, so it is important that dental services be followed up more seriously. Considering the problems in reaching this goal of the World Health Organization in our country, herbal products have the ability to improve clinical oral health outcomes in adolescents. Limited adverse side effects indicate the overall safety of these treatments for a wide range of oral diseases. Therefore, the use of medicinal plants as well as alternative medicine is one of the useful methods in achieving this important goal of public health.

Oral Health-Related Quality of Life among Children Aged 11-14 Years Old with and without Parental Care in South-East of Iran

ABSTRACT Objective: To measure the Oral Health-Related Quality of Life (OHRQoL) and compare children with and without parental care. Material and Methods: This cross-sectional study was conducted on 160 schoolchildren with parental care and 100 orphans in Kerman, Iran. After fulfilling the questionnaire voluntarily, a clinical examination was performed, and indices such as decayed, missing, and filled teeth (DMFT), molar-incisor hypoplasia (MIH), modified gingival index (MGI), traumatic dental injury (TDI), and malocclusion were recorded. Data were statistically analyzed using SPSS version 25 via the ANOVA, Pearson's correlation coefficient test, Chi-Square test, and descriptive statistics. Results: Children without parents scored poorly for OHQRoL items compared to those with parents (p<0.001). DMFT was not significantly related to OHRQoL; however, missing teeth were correlated with the CPQ11-14 overall. Also, the TDI index had a significant relationship with CPQ mean score (p=0.02). Moreover, the difference in the mean CPQ11-14 score in children with TDI in the two groups was significant regarding the quality of life (0.031). Conclusion: OHRQoL differed significantly between children in the two groups, which can be influenced by gender and habits. Due to the vulnerability of welfare-supported children without parental care, these findings emphasize the value of preventive and health-promoting measures for this group of children.

Clinical, radiological, and histological correlation in diagnosis of pulpitis.

Background: To establish an endodontic diagnosis, a clinician should consider a variety of factors. Various studies have failed to demonstrate a strong correlation between histological findings with clinical and radiographic assessments. This study sought to evaluate the histopathological features of reversible and irreversible pulpitis diseases and their correlation with clinical diagnosis in extracted human molar teeth. Materials and Methods: In this experimental ex vivo study, 75 molars with caries and three intact molars were used. According to the radiographic findings and clinical criteria and the need for root canal therapy, samples were categorized as having normal/reversible pulpitis and irreversible pulpitis. Immediately after extraction, an exposure was made at 2 mm below the cementoenamel junction. Formalin-fixed specimens were decalcified, sectioned and stained with hematoxylin and eosin for histological examinations using light microscopy. Variables including the type and severity of the inflammation, hyperemia, necrosis, fibrosis and the existence of an odontoblastic layer and dentin bridge were evaluated. The Fisher's exact test and the Chi-squared test were used for statistical analysis. P <0.05 was considered as significant. Results: Acute inflammation, hyperemia and pulp exposure were significantly more common among subjects with irreversible pulpitis (P < 0/005). However, fibrosis was significantly higher in the reversible group (P < 0/005). There were no statistically significant differences between the groups regarding the other variables. Conclusion: Some discrepancies between clinical, radiographic and histological findings were observed in our experimental study. Indeed, effective clinical practice requires consideration of all discrepancies found.

The effects of neonatal maternal deprivation and chronic unpredictable stresses on migraine-like behaviors in adult rats.

BACKGROUND: Stress is known to cause migraine. This study investigates the effects of neonatal maternal deprivation (MD) and chronic unpredictable stress (CUS) on migraine in rats. METHODS: Seventy rats were randomly divided into ten groups (five groups of each sex, and seven rats/group). The groups included: untreated intact, nitroglycerin (NTG) only, NTG + MD, NTG + CUS (10 weeks after birth), and NTG + MD + CUS. For the induction of MD, pups were separated from their mothers from postnatal day 2 to day 14. The CUS was conducted by daily exposure to different stressors for 2 weeks. For the induction of migraine after stress, NTG (5 mg/kg/IP) was administered every second day for 9 days. Afterward, NTG-related symptoms, including climbing behavior, facial rubbing, body grooming, freezing behavior, and head-scratching, were recorded for 90 min. Statistical differences between the groups were analyzed by one-way and two-way ANOVA followed by the Newman-Keuls test. RESULTS: Migraine symptoms, including increased head-scratching, facial rubbing, and decreased climbing behavior, were more significant in females than in males. Head scratching and facial rubbing increased in stressed females, but not in males as compared to NTG-treated rats. Body grooming was significantly decreased in MD males compared to the NTG group. The effects of NTG in MD + CUS on the rats did not differ from those in the MD or CUS groups. CONCLUSIONS: MD and CUS had a sex-related aggravating effect on the development of migraine, while the combination of MD and CUS had no additive migraine-aggravating effect.

Antimicrobial Activity of Methanolic Extracts of Myrtus Communis L. and Eucalyptus Galbie and their Combination with Calcium Hydroxide Powder against Enterococcus Faecalis.

STATEMENT OF THE PROBLEM: The goal of endodontic therapy is the reduction or elimination of microorganisms from the root canal system. The use of intracanal medicament between treatment appointments is recommended in order to eliminate any remainang microorganisms in the pulp space. PURPOSE: The aim of the present study was to investigate the antimicrobial activity of methanolic extracts of Myrtus communis L. and Eucalyptus galbie, their combination with calcium hydroxide powder; combination of calcium hydroxide powder with water, and ready-to-use calcium hydroxide paste with iodoform; against Enterococcus faecalis. MATERIALS AND METHOD: In this experimental study, after gathering the plants, their methanolic extracts were obtained by masceration method. The diameters of inhibition zone of all mentioned materials were determined by agar diffusion test. Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC); and anti biofilm effect of the materials that showed antibacterial effect in agar diffusion test, were then evaluated by tube dilution test, and microtiter plate assay followed by colorimetric crystal violet methods, respectively. RESULTS: After 48 hours, both herbal extracts showed antimicrobial effect. However, combination of calcium hydroxide with extracts produced no zone of inhibition. The mean inhibition zone of Eucalyptus extract was more than that of Myrtus. However, the results of ANOVA test, showed that there was no significant difference between the antibacterial effect of Eucalyptus galbie, Myrtus communis L. and positive control (Cefoxitin) (p Value= 0.987). The MIC for both extracts were 12.5 mg/ml. MBC evaluation of the two methanolic extracts showed no bactericidal effect on Enterococcus faecalis. Based on ELISA analysis, biofilm formation in response to different sub-MIC concentrations of both extracts was scored as weak to moderate. CONCLUSION: The methanolic extracts of Eucalyptus galbie and Myrtus communis L. in combination with calcium hydroxide powder were not able to eliminate Enterococcus faecalis within 48 hours.

Shear Bond Strength of a Multi-Mode Adhesive to Bur-Cut and Er,Cr:YSGG Lased Dentin in Different Output Powers.

STATEMENT OF THE PROBLEM: Universal or multi-mode adhesives are new adhesive systems that can be used in both etch-and-rinse (ER) and self-etch (SE) modes. Lesser technical sensitivity and dual use of these adhesives have made them popular among dentists. Studies are being conducted to analyze the advantages and disadvantages these adhesives in different conditions. PURPOSE: The aim of this study was to compare shear bond strength (SBS) of a multi-mode adhesive in different etching modes to Er,Cr:YSGG laser ablated and bur-cut dentin. MATERIALS AND METHOD: Buccal and lingual surfaces of 30 sound human molars, randomly divided to three groups, were prepared by bur and Er,Cr:YSGG (4 Watt and 5 Watt, 20 Hz, 96% water, 60% air, and 600-µm spot size) to reach a flat surface in superficial dentin. Each group was randomly divided into 2 subgroups (ER and SE), and then Scotchbond Universal adhesive was applied. Composite cylinders were attached to the surfaces and cured. Specimens were stored in 37 °C water for 24 hours and thermocycled (500 cycles) and were tested for SBS and failure modes were determined by stereomicroscope. Data was analyzed using SPSS19 and one- way ANOVA and Tukey's post hoc tests and p< 0.05 was considered as significance level. RESULTS: Bur-cut dentin with ER method had the highest mean SBS value (33.80 MPa). SBS in bur-cut and 4Watt laser in ER mode were significantly higher than SE mode (p= 0.002 and p= 0.000 respectively). Highest mean SBS value in lased dentin was achieve in 4 Watt ER mode. CONCLUSION: SBS of Scotchbond universal adhesive to dentine is highest in bur-cut and ER mode and in 4-Watt lased-dentin is higher than 5-Watt lased-dentin. Moreover, in 4-Watt lased-dentin, SBS of ER mode is more than SE mode.

Effect of chronic stress on capsaicin-induced dental nociception in a model of pulpitis in rats.

OBJECTIVE: Chronic stress can alter nociceptive sensitivity. However, the effect of stress exposure on dental nociception has been less addressed. Therefore, the present study investigated the effects of chronic exposures to some social and psychological stresses on pulpal nociceptive responses. DESIGN: The stress groups were constructed as follows: forced swimming (n=6), restraint (n=6), and mild (n=10) and severe (n=15) crowding stresses. Rats were subjected to stress for 1h per day for a week. At the end of the stress session, pulp irritation was induced by intradental application of capsaicin (100µg). There were another capsaicin or capsaicin plus stress training groups that received articaine 5min before the administration of capsaicin. Nociceptive responses were recorded for 40min. The time (ins) of continuous shaking of the lower jaw and excessive grooming and rubbing of the mouth near the procedure site was measured as nociceptive behaviors. Data was analyzed using one-way analysis of variance (ANOVA) followed by post hoc Tukey's test. RESULTS: Significant nociceptive responses were evoked by the administration of capsaicin. Exposures to forced swimming (p<0.01), restraint (p<0.001), and both mild and severe crowding stresses (p<0.05) exaggerated capsaicin-induced nociceptive reaction. There was, however, no significant difference in nociceptive reaction time between the different stress groups. Articaine buccal infiltration attenuated nociceptive time in capsaicin and capsaicin plus stress training groups (p<0.001). CONCLUSIONS: The current data support the association between chronic stress exposures and nociceptive behavior following intradental capsaicin administration.

The effects of regular exercise on capsaicin-induced pulpal pain and pain-induced changes in passive avoidance learning and memory in rats.

BACKGROUND: Pulpal pain is one of the most common and severe orofacial pain conditions with considerable adverse effects on physiological processes including learning and memory. Regular exercise is known to be effective on cognitive function as well as pain processing in the central nervous system. Here, the possible effects of regular exercise on pulpal pain response as well as pain-induced changes in learning and memory efficiency in rats were investigated. METHODS: Twenty-four male Wistar rats were randomly assigned to the control, capsaicin, exercise, and exercise plus capsaicin groups. Rats in exercise groups were forced to run on a treadmill with a moderate exercise protocol for 4 weeks. Capsaicin was used to induce dental pulp pain. Passive avoidance learning and memory performance was assessed by using a shuttle box apparatus. RESULTS: According to the results, regular exercise could decrease the time course of capsaicin-induced pulpal pain (P < 0.001). Moreover, in capsaicin-treated rats, passive avoidance acquisition was impaired as compared to the control (P < 0.05) and exercise (P < 0.001) groups. Additionally, regular exercise before capsaicin injection could attenuate capsaicin-induced memory impairments (P < 0.05). CONCLUSIONS: Taken together, the present data showed that regular exercise has inhibitory effects on capsaicin-induced pulpal pain as well as pain-induced cognitive dysfunction in rats.

Oral manifestations of asthmatic patients.

The effect of asthma on oral health is the subject of debate among dental practitioners. The current study was planned to investigate the oral manifestations of asthmatics compared to healthy subjects. The study group composed of 100 asthmatics and 100 age-matched healthy controls. The caries status based on Decayed/Missing/Filled Teeth (DMFT) criteria and oral lesion were evaluated in all subjects. The mean age of the asthmatics group was 47.5±3.5 years and in the control group it was 43.5±3.0 years. Asthmatics included 45(45%) males and 55(55%) females. There was no statistical difference between caries prevalence in both groups. The most prevalent oral lesions in asthmatics group were geographic tongue 10(10%), fissured tongue 13(13%), chronic atrophic candidiasis13(13%), and in the control group were fissured tongue(11%) and lichenoid reaction(2%). The dental professional must be familiar with all signs and symptoms of this disease in order to offer effective and safe treatment.

Elastofibroma of the Face: A Case Report.

Elastofibroma is a rare neoplasm that characteristically occurs in subscapular area in response to microtrauma. There are some reports of this tumor in other sites of the body but, up till now, there has been no report of elastofibroma in the face. A 20-year-old man presented with a slow growing painless mass in the face without any history of trauma. Histopathologic examination revealed a soft tissue mass composed of eosinophilic fibers admixed with aggregation of fat cells, capillary blood vessels, and fibroblasts. Elastic stain and Masson's trichrome stain confirmed the nature of elastic and collagen fibers. It was a case of elastofibroma in the face.

Evaluation of Minichromosome Maintenance-3 (MCM3) in Oral Squamous Cell Carcinoma.

STATEMENT OF THE PROBLEM: The expression of minichromosome maintenance-3 (MCM3) proteins and their diagnostic value in oral mucosal dysplasia and squamous cell carcinoma (SCC) is not well known. PURPOSE: This study was conducted to evaluate the usefulness of minichromosome maintenance 3 (MCM3) as a biomarker for diagnosis of oral premalignant lesions and SCC. MATERIALS AND METHOD: In this study, 31 oral SCC, 20 dysplastic epithelium and 20 controls were selected and immunohistochemical staining was done for MCM3. ANOVA, Tukey HSD, Mann-Whitney and Kruskal-Wallis tests were used to compare the groups and the correlation between different grades. RESULTS: There was increasing trend of MCM3 from control to dysplastic epithelium and from dysplastic epithelium to SCC both in suprabasal layers and in total epithelial layers. MCM3 expression was elevated with increasing the grade of dysplasia, but there was no statistically significant difference (p= 0.93). The expression was also increased in high grades of SCC compared to lower grades. CONCLUSION: MCM3 can be used as a useful biomarker in the diagnosis of premalignant lesions and oral SCC.

Ctla-4 gene polymorphism in +49 a/g position: a case control study on patients with oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a premalignant mucocutaneous disease in which genetic factors and immune responses play a major role. Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) is a co-inhibitory molecule that down-regulates immune responses to prevent autoimmunity. This study aimed to investigate the relationship between polymorphism of the CTLA-4 gene in +49 A/G position and OLP. MATERIALS AND METHODS: Thirty-five patients with OLP (16 males, 19 females, with a mean age of [± standard deviation (SD)] 55.92 [± 12.83]) and 105 sex- and aged-matched healthy subjects (48 males, 57 females, with a mean age of [± SD] 56.82 [± 14.71]) were recruited in this study. Genomic DNA of both groups was extracted from white blood cells and then CTLA-4 genotypes and allele frequencies were investigated using polymerase chain reaction-restriction fragment length polymorphism methods. The data were collected and examined using Pearson's Chi square test (SPSS version 11.5). RESULTS: In the patient group, AA, AG, and GG genotypes occurred in position 49 A/G in the CTLA-4 gene with the frequency of 19 (55.9%), 11 (31.4%), and 3 (8.8%), respectively. With respect to the control group, they occurred with the frequency of 58 (55.2%), 39 (37.1%), and 8 (7.6%), respectively. As far as the frequency of A and G alleles in this position was concerned, we had, respectively, 49 (74.24%) and 17 (25.75%) for patients and, respectively, 155 (73.80%) and 55 (26.19%) for the control group. The calculated values were not significantly different between these groups (P > 0.05). CONCLUSION: Polymorphisms of CTLA-4 genes in position +49 A/G did not show any significant relationship with each other in OLP patients in Shiraz, Iran.

Ultrasonographic findings of mesenchymal chondrosarcoma of the mandible: report of a case.

Today, ultrasound imaging is being widely used to assess soft tissue lesions in the maxillofacial region. However, ultrasound investigations of intra-osseous lesions are rare, especially for tumors of the jaws. This report emphasized the capability of this useful imaging modality in identification of the characteristics of malignant conditions involving the bone. Mesenchymal chondrosarcoama, one of the unusual malignant conditions of the jaw, was presented in a young male with significant facial swelling. Different imaging modalities parallel with the histopathologic investigation confirmed the diagnosis. Interestingly, destruction of the bony cortex and new bone formation with a characteristic "sun ray appearance", highly suggestive of sarcomas, was manifested on the ultrasonograph. Thus, this report presented the ultrasonographic features of chondrosarcoma of mandible and considered the ultrasonography to be a useful imaging modality to evaluate intra-osseous jaw lesions.

Oral mucocutaneous diseases: clinicopathologic analysis and malignant transformation.

Oral mucocutaneous diseases (MCDs) are a heterogeneous group of disorders that could involve oral mucous membrane frequently. The purpose of this study was analysis of clinicopathologic features and relative frequency of MCDs with emphasize on malignant transformation of oral lichen planus (OLP). In this retrospective study, clinical data regarding to site of involvement, patient's age and sex, and accompanied symptoms were noted, and pathologic slides of OLP were reviewed for the detection of dysplastic changes. Among 309 patients, OLP and pemphigus vulgaris were the first and second most common MCDs. Buccal mucosa was the most frequent affected site. Female predominance (70.23%) and mean age of 45.3 years were seen. Approximately 12.4% of OLPs showed dysplastic and neoplastic changes. In conclusion, MCD with oral manifestation is most probably to be OLP and pemphigus vulgaris rather than other rare disorders. Malignant transformation may occur in all forms of OLP, and hence, regular, exact follow-up of the patient is necessary for enhancing quality of life.