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Background: Chronic kidney disease is a gradual loss of kidney function with diabetes and hypertension as the leading cause. Chronic kidney disease is one of these systemic diseases that can affect salivary contents. Aims: This study aimed to assess salivary immunoglobulin A, interleukin-6 and C- reactive protein in chronic kidney disease patients on hemodialysis and those on conservative treatment in comparison with control subjects. Materials and methods: Ninety subjects were included in this study divided into three groups: 30 patients with chronic kidney disease on hemodialysis for at least 6 months ago; 30 patients with chronic kidney disease on conservative treatment and 30 healthy control subjects. Secretory immunoglobulin A, interleukin-6 and C- reactive protein in saliva samples were measured by enzyme-linked immunosorbent assay ELISA. Results: No significant difference in salivary immunoglobulin A level among study groups was seen. A significant increase in salivary interleukin-6 and C- reactive protein in both chronic kidney disease patients on hemodialysis and those on conservative treatment compared to the control group. While, no significant salivary IL-6 and CRP differences were seen between both patient groups, on hemodialysis and conservative treatment. Conclusions: There was no significant difference among chronic kidney disease patients on hemodialysis, on conservative treatment and control healthy subjects regarding to salivary IgA while Salivary interleukin -6 and C- reactive protein was significantly higher in chronic kidney disease patients on hemodialysis and those on conservative treatment compared to healthy subjects.

Background: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress. Material and method: 60 individuals were included in this study, divided into two groups; the first group composed of 30 hypertensive patients on Amlodipine antihypertensive agent. The second group, the control group, composed of 30 healthy subjects without any systemic disease and with almost healthy oral hygiene. Intraoral examination was done for each individual and salivary samples were collected with the salivary flow rate (F/R) which was calculated in ml per minute and pH was measured by pH meter. Salivary MDA and SOD were analyzed by using ELISA kit based on the principle of competitive enzyme immunoassay technique; the concentrations of markers were measured by spectrophotometer at 450nm in a microplate reader. Results: Salivary MDA was significantly higher in hypertensive patients compared to control, while salivary SOD was significantly lower in patients than control group. Salivary flow rate and pH was significantly lower in patients as compared to the control group. Conclusions: There is a relation between oxidative stress and hypertension. Salivary MDA and SOD can be used as potential marker for monitoring patients with Hypertension. Keywords: hypertension, Oxidative stress, Amlodipine, MDA and SOD

Background: Oral Lichen planus (OLP) is a T-cell mediated chronic inflammatory oral mucosal disease of unknown etiology. Recent studies have reported an increased oxidative stress and lipid peroxidation in such patients. This suggests that reactive oxygen species may have a role in the pathogenesis of lichen planus. Oxidative stress in OLP release molecules consisting of granzymes resulting in local tissue damage in the effectors. Antioxidants that can defend against oxidative stress in the body cells include enzymes, as well as non- enzymatic antioxidants, such as melatonin, uric acid, vitamin A and E. Purpose: To study the level of salivary vitamin E and uric acid as antioxidant agents in patients with OLP and compared with healthy control. Methods: Twenty five patients with OLP were enrolled in this study. Age, gender, occupation, smoking status (smokers or non-smokers), lesion types, duration, location and size were recorded for each patient. After an oral examination, salivary samples were collected and flow rates (ml/min) were recorded. The collected samples were centrifuged at 3000 rpm for 10 minutes; the clear supernatants were separated and stored frozen at (-20 c) until analysis. Then salivary vitamin E was investigated using ELISA kit based on bioten double antibody sandwich technology. Uric acid was analyzed using a proprietary enzymatic reaction mixture that enables the detection of uric acid by the production of a red chromogen, which is quantitatively measured at a wavelength of 515 or 520 nm. Results: The mean age of OLP patients was 48.3 years with a range of 30-60 years. Control group consisted of 35 healthy subjects who were age matched with OLP patients. Fourteen (56%) patients were with reticular and 11 (44%) were with erosive form, with the buccal mucosa was the most commonly affected site (88%), followed by tongue (8%) then gingiva (4%). A significantly lower salivary flow-rate, lower salivary vitamin E and uric acid level in OLP patients compared to control; while, no significant difference was seen between reticular and erosive type of OLP for both vitamin E and uric acid level. Regarding gender, no differences were found between males and females in salivary vitamin E. No significant correlation was found between vitamin E /uric acid and age. Similarly, no difference was found between males and females in uric acid. Conclusion: Salivary anti-oxidant markers represented by vitamin E and uric acid decreased in OLP patients due to increase oxidative stress which may have an important role in the pathogenesis. Thus, it is recommended to give OLP patients anti-oxidant agents that may either help in healing process or decreased the severity.

Background: Saliva is a specific bio-fluid with important biomarkers. Analyzing any alternation in these markers could give valuable information, in relation to oral health status parameters. The aim of this study was to investigate the level of α -amylase in unstimulated whole saliva of healthy, primary school children in relation to some oral health parameters. Materials and Methods: A questionnaires consisted of demography and medical histories of participants were filled by children families. Saliva samples were collected for 5- minutes between 9:00 -11:00 AM from 114 healthy students aged 6-13 years, divided into four age groups. Flow- rate, Plaque and Gingival Index were assessed and dentition status was investigated by DMFT/dmft using WHO criteria. Salivary amylase was analyzed in unite per litter, using quantitative colorimetric amylase determination at 585nm. Results: A significant positive correlation was found between age and salivary flow-rate, (r=0.362, P < 0.001). Salivary α-amylase concentration increased significantly with age (P< 0.001). For each one year there is an increase in age, amylase level is expected to increase by 5.2 U/L. A male gender is expected to reduce salivary α -amylase level by 10.6 U/L compared to female, however the effect was not significant. Gingival index was positively, although non-significantly associated with salivary α -amylase concentration. DMFT showed a significant weak positive linear correlation with salivary amylase level (r=0.309, P

Background: Oral squamous cell carcinoma (OSCC) remains a lethal and deforming disease, with a significant mortality and a rising incidence in younger and female patients. It is thus imperative to identify potential risk factors for OSCC and oral PMDs and to design an accurate data collection tool to try to identify patients at high risk of OSCC development. 14 factors consistently found to be associated with the pathogenesis of OSCC and oral PMDs. Eight of themwere identified as high risk (including tobacco, alcohol, betel quid, marijuana, genetic factors, age, diet and immunodeficiency) and 6 low risk (such as oral health, socioeconomic status, HPV, candida infection, alcoholic mouth wash and diabetes) were stratified according to severity of risk, associated carcinogenicity and clinicopathological effects, using evidence obtained from the International Agency for Research on Cancer (IARC). This review provides understanding of the significance of various risk factors in oral carcinogenesis to help to stratify patients, especially those with potentially malignant disorders, into high and low risk groups. Key words: Oral cancer, oral potentially malignant disorders and risk factor.

Background: Saliva plays an important role in oral health. Several salivary proteins are involved in the antimicrobial defence mechanism and are able to eliminate or inhibit bacterial growth in the oral cavity. Secretory IgA (SIgA) is one of the principal antibodies present in saliva, could help oral immunity by preventing microbial adherence, neutralizing enzymes and toxins. The aim of this study was to investigate the relationship between salivary Streptococcus Mutans (SM) count and S IgA in stimulated whole saliva in children with primary dentition compared to those with permanent teeth in relation to some oral hygiene parameters. Material and methods: Stimulated whole saliva was collected from 50 children (25 with primary dentation and 25 with permanent teeth). Salivary flow rate and pH was measured. Oral hygiene index (OHI) and gingival inflammation was assessed using classical method. S IgA level was measured using an immunoassay kit and SM count was determined by culture media. Results: Mean salivary flow rate, pH and S IgA were significantly higher among children with permanent teeth compared to those with primary dentition. Compared to primary dentition, permanent dentition was associated with a significantly reduced mean plaque index, increased mean gingival index and reduced mean salivary SM count. Although plaque index showed a statistically significant positive correlation with SM count, gingival index showed a weak negative correlation with bacterial count. S IgA, PH and flow rate showed a statistically significant moderately strong negative correlation with bacterial count. Conclusion: This study showed a clear correlation between count of SM in stimulated whole saliva and both SIgA and plaque index.

Background: The incidence of oral cancers is increasing all over the world. Early detection ofthis important public health matter makes them more amenable to treatment and allows the greatest chance of cure.The aim of this study was to investigate the awareness and knowledge on oral cancer among final -year dental students in Iraq. Materials and methods: Questionnaires were delivered to 160 finalyear dental students in the College of Dentistry in Baghdad. The questionnaire focused on the awareness/knowledge of oral cancer, earlyand common clinical signs and symptoms andassociated risk factors. Results: It was found that 87% of students were aware of oral cancer. The followings were recognized as signs and symptoms of oral cancer: persistent ulcer and lymphadenopathy (71 %, 70%), followed by presence of white patch (63%). A satisfactory knowledge was observed on; smoking (86%), family history (84%), old age (63%), sun light exposure (59%), smokeless tobacco (57%), alcohol consumption (55%) and Immunosuppression (54%).Considering dilatory risk-factors, a satisfactory knowledge was identified on hot and spicy food (57%), but not on the other factors. Although satisfactory knowledge of dental risk-factors including premalignant disorders (84%) and previous history of oral cancer (70%) was observed, inadequate knowledge about other factors was observed.91% of future dentists indicated that oral cancer can be cured when detected early. Conclusion: This study highlighted the need for more education in dental schools to enhance dental professionals awareness and knowledge of oral cancer, aiding in early diagnosis and treatment of patients.

Oral potentially malignant disorders (PMDs) are at risk of transforming to invasive squamous cell carcinoma (SCC), but controversy exists over their management and the precise role of interventional treatment. In this study, a cohort of 100 patients presenting with new, single oral dysplastic PMD lesions were followed for up to 10 years following laser excision. PMDs presented primarily as homogeneous leukoplakias on floor of mouth and ventrolateral tongue sites and showed mainly high-grade dysplasia following analysis of excision specimens. Sixty-two patients were disease-free at the time of the most recent followup, whilst 17 experienced same site PMD recurrence, 14 developed further PMDs at new sites, 5 underwent same site malignant transformation, and 2 developed SCC at new oral sites. Whilst laser excision is an effective therapeutic tool in PMD management, prolonged patient followup and active mucosal surveillance together with clear definitions of clinical outcomes are all essential prerequisites for successful interventional management. Multicentre, prospective, and randomised trials of PMD treatment intervention are urgently required to determine optimal management strategies.