Assessing the reliability of CBCT-based AI-generated STL files in diagnosing osseous changes of the mandibular condyle: a comparative study with ground truth diagnosis.

OBJECTIVES: This study aims to evaluate the reliability of AI-generated STL files in diagnosing osseous changes of the mandibular condyle and compare them to a ground truth (GT) diagnosis made by six radiologists. METHODS: A total of 432 retrospective CBCT images from four universities were evaluated by six dentomaxillofacial radiologists who identified osseous changes such as flattening, erosion, osteophyte formation, bifid condyle formation, and osteosclerosis. All images were evaluated by each radiologist blindly and recorded on a spreadsheet. All evaluations were compared and for the disagreements, a consensus meeting was held online to create a uniform GT diagnosis spreadsheet. A web-based dental AI software was used to generate STL files of the CBCT images, which were then evaluated by two dentomaxillofacial radiologists. The new observer, GT, was compared to this new STL file evaluation, and the interclass correlation (ICC) value was calculated for each pathology. RESULTS: Out of the 864 condyles assessed, the ground truth diagnosis identified 372 cases of flattening, 185 cases of erosion, 70 cases of osteophyte formation, 117 cases of osteosclerosis, and 15 cases of bifid condyle formation. The ICC values for flattening, erosion, osteophyte formation, osteosclerosis, and bifid condyle formation were 1.000, 0.782, 1.000, 0.000, and 1.000, respectively, when comparing diagnoses made using STL files with the ground truth. CONCLUSIONS: AI-generated STL files are reliable in diagnosing bifid condyle formation, osteophyte formation, and flattening of the condyle. However, the diagnosis of osteosclerosis using AI-generated STL files is not reliable, and the accuracy of diagnosis is affected by the erosion grade.

Evaluation of the relationship between the degenerative changes and bone quality of mandibular condyle and articular eminence in temporomandibular disorders by cone beam computed tomography.

OBJECTIVE: To evaluate whether there was a relationship between the degenerative bone changes and bone quality of the mandibular condyle and articular eminence in patients with temporomandibular disorder (TMD). METHODS: The study group consisted of 100 patients with TMD. "Diagnostic Criteria/TMD" was used to identify the pathologies. Degenerative bone changes and bone qualities were detected by cone beam computed tomography; the bone qualities were classified using the Bone Quality Index (BQI) scale. RESULTS: No statistically significant difference was found between degenerative bone changes and bone quality of the temporomandibular joint (TMJ) according to gender (p > 0.05). However, degenerative bone changes were more frequent than articular eminence in the mandibular condyle. BQI Type III was the most common bone quality among all types of degenerative bone changes. DISCUSSION: Although no causality relationship was found between the bone quality and degenerative bone changes, low bone quality was found in TMD patients.

A deep learning algorithm for classification of oral lichen planus lesions from photographic images: A retrospective study.

INTRODUCTION: Deep learning methods have recently been applied for the processing of medical images, and they have shown promise in a variety of applications. This study aimed to develop a deep learning approach for identifying oral lichen planus lesions using photographic images. MATERIAL AND METHODS: Anonymous retrospective photographic images of buccal mucosa with 65 healthy and 72 oral lichen planus lesions were identified using the CranioCatch program (CranioCatch, Eskisehir, Turkey). All images were re-checked and verified by Oral Medicine and Maxillofacial Radiology experts. This data set was divided into training (n = 51; n = 58), verification (n = 7; n = 7), and test (n = 7; n = 7) sets for healthy mucosa and mucosa with the oral lichen planus lesion, respectively. In the study, an artificial intelligence model was developed using Google Inception V3 architecture implemented with Tensorflow, which is a deep learning approach. RESULTS: AI deep learning model provided the classification of all test images for both healthy and diseased mucosa with a 100% success rate. CONCLUSION: In the healthcare business, AI offers a wide range of uses and applications. The increased effort increased complexity of the job, and probable doctor fatigue may jeopardize diagnostic abilities and results. Artificial intelligence (AI) components in imaging equipment would lessen this effort and increase efficiency. They can also detect oral lesions and have access to more data than their human counterparts. Our preliminary findings show that deep learning has the potential to handle this significant challenge.

A Deep Learning Approach for Masseter Muscle Segmentation on Ultrasonography.

Aim: Deep learning algorithms have lately been used for medical image processing, and they have showed promise in a range of applications. The purpose of this study was to develop and test computer-based diagnostic tools for evaluating masseter muscle segmentation on ultrasonography images. Materials and methods: A total of 388 anonymous adult masseter muscle retrospective ultrasonographic images were evaluated. The masseter muscle was labeled on ultrasonography images using the polygonal type labeling method with the CranioCatch labeling program (CranioCatch, Eskisehir, Turkey). All images were re-checked and verified by Oral and Maxillofacial Radiology experts. This data set was divided into training (n = 312), verification (n = 38) and test (n = 38) sets. In the study, an artificial intelligence model was developed using PyTorch U-Net architecture, which is a deep learning approach. Results: In our study, the artificial intelligence deep learning model known as U-net provided the detection and segmentation of all test images, and when the success rate in the estimation of the images was evaluated, the F1, sensitivity and precision results of the model were 1.0, 1.0 and 1.0, respectively. Conclusion: Artificial intelligence shows promise in automatic segmentation of masseter muscle on ultrasonography images. This strategy can aid surgeons, radiologists, and other medical practitioners in reducing diagnostic time.

A systematic review and meta-analysis on serum and salivary levels of total antioxidant capacity and C-reactive protein in oral lichen planus patients.

OBJECTIVE: Oral lichen planus (OLP) is an inflammatory disease that total antioxidant capacity (TAC) and C-reactive protein (CRP) play an important role in its pathogenesis. In this meta-analysis, we compared the salivary and serum levels of TAC and CRP between OLP patients and controls. DESIGN: A comprehensive search was performed in four databases (PubMed, Scopus, Web of Science, and Cochrane Library). Standardized mean difference (SMD) and 95% confidence intervals (CI) were computed by the RevMan 5.3. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were analyzed by the CMA 2.0. RESULTS: Nineteen articles were included in the meta-analysis. The pooled SMDs were -1.80 µmol/L (95%CI: -2.75, -0.85; p = 0.0002) and -2.56 µmol/L (95%CI: -4.40, -0.72; p = 0.006) for the salivary and serum levels of TAC, respectively. The SMDs for salivary and serum levels of CRP were 0.64 µg/L (95%CI: 0.35, 0.94; p < 0.0001) and 0.97 mg/L (95%CI: 0.56, 1.338; p < 0.00001), respectively. Geographical area based on the country was a significant factor in the subgroup analysis for salivary TAC level. There was adequate evidence supporting the occurrence of less salivary and serum TAC levels in OLP patients than controls, but the amount of information was inadequate to make valid conclusions for salivary CRP level. CONCLUSIONS: In OLP patients, salivary and serum levels of TAC is significantly lower while the salivary and serum levels of CRP is significantly higher than controls.

Assessment of Knowledge Level and Awareness About Human Papillomavirus Among Dental Students.

Epidemiological studies have shown that the worldwide trend of human papillomavirus (HPV)-induced oral cancer has increased. Dentistry students need comprehensive information about HPV to provide accurate advice to their patients. The aim of this study is to evaluate 3rd, 4th, and 5th grade students' knowledge and awareness about HPV. A questionnaire consisting of 16 questions was applied to 318 students (100 3rd grade, 119 4th grade, and 99 5th grades), who were studying at XXX. In this survey, students' knowledge level and awareness were examined. In our study, 99 (31.0%) of the participants were male and 219 (68.9%) were female. There was a statistically significant difference between the classes in terms of participation rates in the statement "Some types of HPV cause oral cancer (p, 0.000; p < 0.05). The rate of participation of third grade (72%) students in this proposition was significantly lower than 4th grade (89.9%) and 5th grade (84.8%) students (p1, 0.000; p2, 0.000; p < 0.05). There was no statistically significant difference between 4th and 5th grade students (p > 0.05). Overall, advanced students showed better knowledge, attitudes, and perceptions regarding human papillomavirus-related oral cancer. Comprehensive training and motivation for improving dentistry students' awareness against HPV-induced oral cancer will also improve knowledge and attitudes of the dental students.

Prevalence of pneumatization of the articular eminence and glenoid fossa viewed on cone-beam computed tomography examinations in a Turkish sample.

OBJECTIVE: The aim of this study is to evaluate the prevalence of the pneumatization of the articular eminence and glenoid fossa (PAT and PGF, respectively) using cone-beam computed tomography (CBCT). METHODS: CBCT images of 1000 patients (511 females and 489 males) representing 2000 regions of interest (the glenoid fossa and articular eminence of each patient) were examined retrospectively with regard to age, gender, laterality, and type of pneumatization. The mean age of the female patients was 39.66 and that of males was 39.79. Suitable images from patients aged 16 years and over found in the archives of CBCT images were included in the study. The data were assessed using IBM SPSS 20 and statistical comparisons between two categorical variables were conducted using Chi square tests. RESULTS: It was observed that 14.7% of the patients had PAT and 47.1% had PGF. There was no significant difference in PAT and PGF prevalence between ages, age ranges, and gender in our study (p > 0.5). CONCLUSIONS: It is important to evaluate the pneumatic cells in the articular eminence and glenoid fossa regions before surgery. It was also found that CBCT is more helpful in detecting pneumatization than plain film.

Comparative Evaluation of Conventional and OnyxCeph™ Dental Software Measurements on Cephalometric Radiography.

OBJECTIVE: Cephalometry can be measured with traditionally conventional analysing methods (hand tracing), as well as using computers. Many dental softwares have been developed for this purpose. The reliability of these programs are often compared with the conventional method. The aim of the present study was to compare the conventional method of manual cephalometric analysis with a computerized one, OnyxCeph ™ (Image Instruments, Chemnitz, Germany) dental software. METHODS: Lateral cephalometric radiographs of 150 patients (75 males and 75 females) age range 12-34 were traced by two methods. Conventional method and computerized (OnyxCeph) cephalometric analysis method. 2 maxillar, 3 mandibular, 2 maxillo-mandibular, 3 vertical, 7 dental and 1 soft tissue parameters; 10 angular, 8 linear totally 18 cephalometric parameters were measured. Intra-class correlation coefficients were performed for both methods to assess the reliability of the measurements. RESULTS: The results 9 of 18 parameters were found statistically significant. They were Cd-A distance, Cd-Gn distance, Go-Me distance, GoGnSN angle, ANS-Me distance, upper incisor-NA distance, lower incisor-NB distance, lower incisor-NB angle, overbite distance. CONCLUSION: Despite some discrepancies in measured values between hand-tracing cephalometric analysis method and the OnyxCeph cephalometric analysis method, statistical differences were minimal and only Cd-A, Cd-Gn, Go-Me, ANS-Me, GoGnSN° were clinically important for cephalometric analysis OnyxCeph was evaluated as an efficient method to replace conventional method.

Assessing Oral Cancer Awareness Among Dental Students.

The aim of this study was to assess oral cancer awareness among undergraduate dental students in Marmara University Faculty of Dentistry. A validated questionnaire which tested oral cancer awareness was given to third- and fifth-year students of the dental faculty of Marmara University. A total of 198 students participated in this survey. Knowledge of oral cancer risk factors and diagnosis procedures, dentistry student's attitude towards oral cancers, management practice regarding oral cancer, and oral cancer information sources were assessed using 25 questions. The data were analyzed with IBM SPSS Statistics 22.0 program. Among 198 participant dentistry students, there were 99 (50%) third-grade and 99 (50%) fifth-grade students. The largest number of the third- and last-grade students identified tobacco (98%) and alcohol usage (87.4%), prior oral cancer lesions (94.9%), viral infections (91.9%), UV exposure (94.4%), betel quid chewing (84.8%), older age (62.1%), and low consumption of fruit and vegetables (85.4%). Both groups showed higher scores in indicating squamous cell carcinoma as the most common form of oral cancer (p < 0.05); yet, third-grade students performed significantly higher scores in indicating erythroplakia and leukoplakia for most likely to be precancerous (p = 0.001; p < 0.05). This study highlighted the importance of improved educational methods for dentistry on oral cancer detection and prevention.

Assessment of Masseter Muscle Appearance and Thickness in Edentulous and Dentate Patients by Ultrasonography.

OBJECTIVES: The purpose of the present study was to examine ultrasonographic appearances of Masseter Muscle (MM) in dentate and edentulous patients without Temporomandibular Disorder (TMD). MATERIALS AND METHODS: The thickness of the MM in 25 dentate (mean age: 30,68 ± 10,49) and 24 edentulous (mean age: 61,46 ± 9,71) patients, who visited routine dental examination, was measured at rest and at maximum contraction bilaterally. Examinations were performed using an Aloka Prosound α6 (Hitachi Aloka Medical Systems, Tokyo, Japan) equipped with an 8 MHz-wide bandwidth linear active matrix transducer (ranging from 1 to 15 MHz). The visibility and width of the internal echogenic bands of the MM were also assessed and the muscle appearance was classified as I of III types. Type I, characterized by the clear visibility of the fine bands; Type II, thickening echogenicity of the bands; Type III, disappearance or reduction in a number of the bands. RESULTS: MM thickness at rest and contraction in the dentate group were significantly higher than the edentulous group (p <0.05). Type I was the most common echogenic type in both dentate (right:16 (64%), left; 15 (60%)) and edentulous patients (right; 22 (91.7%), left; 18 (75%)). In a dentate group, type II was significantly higher than the edentulous group in both the right and left sides (p <0.05; p <0.01, respectively). Age and gender seemed to have no significant effect on the echogenic type (p ˃0.05). CONCLUSION: There were significant differences in the thickness at rest and contraction between the dentate and edentulous groups. It was clarified that ultrasonographic features of the MM in dentate and edentulous patients were different.

Assessing Oral Cancer Awareness Among Dentists.

The aim of this study was to assess oral cancer awareness among dentists who attended 101st FDI World Dental Congress, Istanbul, Turkey. Among 170 dentists who agreed to participate, there were 13 oral surgeons, 6 restorative dentists, 4 endodontists, 4 orthodontists, 6 periodontists, 5 pedodontists, and 14 prosthodontists. Knowledge of oral cancer risk factors and diagnosis procedures, dentists' attitude towards oral cancers, management practice regarding oral cancer, and oral cancer information sources were assessed using 25 questions. The data were analyzed with IBM SPSS Statistics 22.0 program. Among 170 participant dentists, there were 69 (40.6%) male dentists and 101 (59.4%) female dentists. Largest number of them identified tobacco (98.8%) and alcohol usage (91.2%), prior oral cancer lesions (95.3%), viral infections (90.0%), UV exposure (86.5%), and betel quid chewing (80.6%), and lower numbers reported older age (56.5%) and low consumption of fruit and vegetables (52.4%). Oral medicine specialists scored marginally higher in indicating erythroplakia and leukoplakia most likely to be precancerous and squamous cell carcinoma as the most common form of oral cancer (p < 0.01). This study highlighted the importance of improved educational methods for dentists on oral cancer detection and prevention.

Evaluation of Distolingual Canal/Roots in Mandibular Molars and Mesiobuccal Canals in Maxillary Molars by CBCT.

BACKGROUND/PURPOSE: The objectives of this study were to identify the bilateral distolingual (DL) canals / roots of the mandibular first molars and second mesiobuccal (MB2) canals of the maxillary first molars in the same Turkish individuals using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A total of 150 CBCT images including all mandibular and maxillary first molars were retrospectively investigated in a Turkish subpopulation. The patient age, sex and presence of roots and root canals were assessed. The frequency, of bilateral DL canals, DL roots, and MB2 canals were reviewed. Data were analyzed using Fisher'sexact test and Chi-square test. RESULTS: The prevalences of right DL canals, DL roots and MB2 canals were 31.3, 14.0 and 34.7%, respectively. The prevalences of left DL canals, DL roots and MB2 canals were 31.3, 4 and 27.3%, respectively. There was no statistically difference in the frequency of right and left DL canals, DL roots of mandibular first molars and MB2 canals of maxillary first molars according to gender. CONCLUSION: CBCT is a competent tool for the detection of additional distolingual canals/roots and second mesio buccal canals, and it is a valuable aid for dentists providing root canal treatment.

Ultrasonographic Appearances of Cervical Lymph Nodes in Healthy Turkish Adults Subpopulation: Preliminary Study.

OBJECTIVES: The aim of the study was to assess whether there was any relation between age, gender and body mass index (BMI) and nodal forms and vascular type in healthy Turkish adults. STUDY DESIGN: Three neck areas in 25 wholesome patients who were aged from 21 to 58 years, were assessed by gray-scale and color doppler ultrasonography. Ultrasonographic examinations were performed using an ALOKA Prosound Alpha 6 (Hitachi Aloka Medical Systems, Tokyo, Japan) and the images were obtained with a 7.2 MHz linear array transducer. Hajek's categorization of cervical lymph nodes for sonographic analysis was used. The ultrasonographic characteristics like size, shape, short axis/long axis ratio (S/L), hilum were evaluated. Ultrasonographic examinations of upper cervical, submandibular and submental lymph nodes were carried out and recorded. RESULTS: The mean age of patients was 31.84±12.80 years. The ratios of lymph nodes with avascular pattern were 96% for the upper cervical lymph area, 92% for the submandibular area and 96% for the submental area. The lowest and highest ratios of short to long axis diameter (S/L) were calculated as 0.18 and 0.66 in all areas. Most normal nodes in the study were oval with an S/L ratio of less than 0.5. CONCLUSION: Normal cervical lymph nodes are oval, with an unsharp border and an echogenic hilum but no relation between the age, gender and BMI. Also ultrasonography is an applicable imaging modality for the examination of cervical lymph nodes. However, the deficiency in the number of patients might not allow to generalise our findings to the general populations.

Cone beam computed tomographic evaluation of styloid process: A retrospective study of 1000 patients.

OBJECTIVE: The styloid process (SP) is a bony projection, located just anterior to the stylomastoid foramen, the normal length of which is approximately 20-30 mm. The length of SP when exceeds 30 mm it is said to "elongated." The purpose of this retrospective study was to assess the prevalence of elongated SP (ESP) by cone beam computed tomography (CBCT) examination in Turkish subpopulation and its relation to gender and age. MATERIALS AND METHODS: This study analyzed CBCT of 1000 patients who were randomly selected to participate and were aged from 14 to 78 years. Any radiograph with questionable SP was excluded from the study. The apparent length and thickness of the SP were measured by two dental and maxillofacial radiologists. The ESP was classified with radiographic appearance-based morphology of elongation. The data were analyzed with the IBM SPSS Statistics 20.0. RESULTS: The mean age of patients was 42.49 ± 14.83 years. The length of SP was measured over 30 mm in 151 patients (15.1%). A total of 151 CBCT showed ESP, of which 87 (57.6%) were noticed in males and 64 (42.4%) in female patients. The length of right-sided SP ranged from 30.05 to 85.49 mm and left-sided SP from 30.14 to 83.72 mm. CONCLUSION: CBCT is a valuable diagnostic imaging tool which makes accurate length measurements. It is important for the clinicians to be aware of natural variations of the SP whose clinical importance is not well understood.

An evaluation of the efficacy of a topical gel with Triester Glycerol Oxide (TGO) in the treatment of minor recurrent aphthous stomatitis in a Turkish cohort: A randomized, double-blind, placebo-controlled clinical trial

BACKGROUND: Triester glycerol oxide gel (Protefix(R) Queisser Pharma, Germany) is a new topical agent that has the property of adherence to the oral mucosa by forming a lipid film which protects against mechanical trauma and may help to reduce oral tissue moisture loss and inflammation. The aim of this clinical trial was to determine the efficacy of a topical TGO gel and to also compare it with triamcinolone acetonide pomade in the treatment of minor recurrent aphthous stomatitis. MATERIAL AND METHODS: This study was a randomized, double-blind, placebo-controlled clinical trial and 180 patients with the complaint of minor aphthous ulcers were enrolled in this study. The sociodemographic data and clinical characteristics of the ulcer were collected by questionnaire. Ulcer size and pain level measurements were performed and the efficacy indices for ulcer pain and size were calculated at day 0,2,4,6 by the same investigator. RESULTS: Significant differences were not detected among the demographics and ulcer histories including age, gender, onset of ulcer, mean healing time, family RAS history and ulcer localization between three groups. The pain score in TGO group was found statistically lower at day 2,4, and 6. Efficacy index and improvement rate of TGO group, regarding pain score, was higher than the other two groups at day 2 and 4. The reduction in ulcer size was statistically higher in TGO group than the other two groups at day 4 and 6. CONCLUSIONS: Topical application of TGO gel could decrease pain intensity, accelerate ulcer healing without any side effects, utilizing an easy appliable and accessible procedure. Therefore TGO gel could be a well-tolerated, safe, topical therapeutic agent in the clinical practice of RAS treatment

Comparison of ultrasound-guided and conventional arthrocentesis of the temporomandibular joint.

Arthrocentesis of the temporomandibular joint (TMJ) can be done either conventionally or under ultrasonographic guidance, and we have compared the effectiveness of the two techniques. Twenty patients who required arthrocentesis of the TMJ were randomly assigned to ultrasonographically guided (US-guided) and conservative arthrocentesis (n=10 in each group). The number of relocations of the first and second punctures, pain experienced during each procedure measured using a visual analogue scale (VAS), and the duration of the procedure were the main outcome variables. The pain score compared with the maximal interincisal mouth opening measured preoperatively, immediately after operation, at 1 week, and 1 and 3 months, were secondary outcome variables. No patient in either group developed a complication, and there was no significant difference between the two groups, except that US-guided arthrocentesis took significantly longer than the conventional technique (p=0.000). US-guided arthrocentesis of the TMJ was no more successful than the conventional technique, and took longer. Further studies with more patients are required to validate these findings.

Effect of Septal Deviation, Concha Bullosa and Haller's Cell on Maxillary Sinus's Inferior Pneumatization; a Retrospective Study.

PURPOSE: Maxillary sinus's inferior pneumatization is a physiological process, which increase with time and accelerates following extraction. The aim of this study was to determine the prevalence of nasal septal deviation (NSD), concha bullosa (CB), and Haller's cells (HC) and to examine the correlation of maxillary sinus inferior pneumatization (MSIP) with these anatomical variations. Material and Methods : 300 (150 m, 150 f) CBCT scans taken at the Marmara University School of Dentistry from 2011 to 2014 were retrospectively reviewed for the presence of CB, NSD, HC and MSIP. The correlation between pneumatization to the anatomic variants was then compared. Data were analyzed with a Chi-square test. Results : Of the 300 CBCT scans, 44.3% have CB, 37.3% NSD, 19.3% HC and 27.7% MSIP. There was no statistical significancewhen comparing the relationship of patients with CB, NSD, HC and pneumatization. Conclusion : NSD, CB and HC do not have a definite role on sinus's inferior pneumatization. Further studies should be conducted including potential factors related pneumatization with more sample size for further correlation with NSD, CB,HC.

Awareness assessment in Turkish subpopulation with chronic oral mucosal diseases.

OBJECTIVES: The aim of this study was to evaluate the awareness of group Turkish patients with chronic oral mucosal diseases by chronic oral mucosal diseases questionnaires (COMDQ). MATERIALS AND METHODS: Eighty patients with chronic oral mucosal diseases were participated in the study. A detailed medical history of each patient was taken, and all the COMDQ questions, which were translated from English version, were filled out. The data were analyzed with the IBM Statistical Package for Social Sciences Statistics 22.0. RESULTS: The mean ages of patients were 48.91 ± 13.36 years. Of the total 80 cases of chronic oral mucosal diseases identified 52 (65%) were female and 28 (35%) male. The standardized mean scores for COMDQ were 1.72 ± 1.11 for "pain and functional limitation," 1.09 ± 0.94 for "medication and treatment," 2.31 ± 1.06 for "social and emotional," and 2.27 ± 0.83 for "patient support," respectively. CONCLUSIONS: The results of this study indicate that the Turkish version of the COMDQ has the profitable psychometric peculiarity and comfortable to patients with chronic oral mucosal diseases in Turkey.

HLA-A, B (Class I) and HLA-DR, DQ (Class II) antigens in Turkish patients with recurrent aphthous ulceration and Behçet's disease.

OBJECTIVE: The aims of the present study were to typify the human leukocyte antigen system (HLA)-A, B (class I) and HLA-DR, DQ (class II) antigens and to assess the frequency of the presence of these antigens in the Turkish population with recurrent aphthous ulceration (RAU) and Behçet's disease (BD) compared to healthy subjects. SUBJECTS AND METHODS: Thirty patients with RAU, 30 with BD, and 15 healthy subjects were included in the study. HLA typing was performed by serology with commercial kits for HLA class I and II (One Lambda, Canoga Park, Calif., USA). RESULTS: The HLA-A23 frequency was 26.7% in the RAU patients, which was significantly higher than the 3.3% frequency in the patients with BD (p < 0.05). The HLA-A24 frequency was 33.3% in the RAU patient group, which was significantly higher (p < 0.05) than the frequency in the healthy subjects (6.7%). Significantly higher frequencies (46.7%) of HLA-A30 were found in the healthy subjects compared to the BD (13.3%) and RAU (3.3%) patients (p < 0.05 and p < 0.01, respectively). A higher frequency of HLA-B13 was observed in the RAU (23.3%) patients compared to the BD (0%) patients (p < 0.01). A decrease was observed in HLA-DR10 and HLA-DR17 in the RAU patients (p < 0.05), while a higher frequency of HLA-DR10 was observed in the BD patients compared to the RAU patients (p < 0.01). CONCLUSIONS: These results showed that RAU and BD were not in the same spectrum and the involvement of other genetic and/or environmental factors might be responsible for the development of these diseases and/or disease progression.

Cytokine profiles in serum of patients with oral lichen planus.

OBJECTIVE: Oral lichen planus (OLP) is a chronic inflammatory disorder of oral mucosa, which represents T-cell-mediated autoimmune diseases. The inflammatory response in OLP is characterized by the accumulation and expansion of T-helper 1 (Th1) lymphocytes. Several lines of evidence have suggested that a complex cytokine network plays an important role in the exacerbation and perpetuation of OLP. The aim of this study was to evaluate Th1 and T-helper 2 (Th2) cytokine profile in serum of patients with OLP in comparison to healthy controls. METHODS: Thirty patients with OLP, and 30 healthy controls participated in the study. Tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-2, IL-4, IL-5 and IL-10 levels have been measured in flow cytometry by bead based cytokine measurement. RESULTS: Although no statistical differences were observed in the serum levels of TNF-α, IFN-γ, IL-5 and IL-4 between OLP patients and controls (p>0.05), there were statistically significant differences in the serum levels of IL-2 and IL-10 (p<0.05 and p<0.01, respectively). A significantly decreased tendency towards the levels of IL-2 were observed in OLP patients when compared to controls (p<0.05), and the mean level of IL-10 in serum increased remarkably in the OLP patients than those in the controls (p<0.01). CONCLUSIONS: The finding of higher serum levels of IL-10 in patients in presence of low serum IL-2 levels, shows us that there is a dominance of Th2 response. This makes us think that there is a change in Th1/Th2 balance. Dominance of the Th2 response may indicate that OLP could be a result of a delayed type hypersensitivity.