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Background: Oral lichen planus (OLP) is a chronic inflammatory disease of oral mucosal surfaces. Objective: The aim of this study was to determine if salivary IL-8 levels changed after autologous platelet-rich plasma (PRP) therapy and to assess its therapeutic effects on OLP. Materials and Methods: For each patient, demography, social, medical, and medication history was recorded. Before receiving 0.5 mL of PRP for each square centimeter of lesion, each patient was examined for phenotype, color, size, and site of OLP lesions. Patient’s salivary samples were taken between 8 and 11 AM. Three to four milliliters of saliva was obtained from each patient. ELISA kit for IL-8 using a sandwich-ELISA technique, to measure salivary IL-8 before and after PRP injections. Each patient had signed a consent form to participate in this study. Results: Thirteen OLP patients took part in this study, six males (46.2%) and seven females (53.8%). Patients were between 32 and 79 years of age, with a mean age of 60.2 ± 13.9 years. Mean salivary IL-8 was (459.94 ± 233.74 pg/mL) before PRP injections and (465.68 ± 158.30 pg/mL) after PRP injections with no significant difference; however, IL-8 was higher after PRP injections. No association was found in salivary IL-8 level in relation to color changes, signs, and symptoms; pain and burning sensation, lesion phenotype, size, and location. Conclusion: Majority of OLP lesions showed an increased salivary IL-8 level after PRP treatment. PRP injections relieved OLP lesions’ signs and symptoms, and turned hyperemic lesions into normal mucosal color, but lesions’ dimensions were resistant to change.

Background: Interleukin-6 (IL-6) is a cytokine that has several functions, including stimulating growth and inhibiting cell death. It has the potential to operate as a biomarker for the accurate prediction of disease severity and activity, platelets-rich plasma was used in the treatment of oral lichen planus and can change the salivary IL-6 level. Objectives: To study the clinical outcome of intralesional platelets-rich plasma in patients with oral lichen planus and to measure salivary IL-6 levels before and after the treatment with platelets-rich plasma were the aims of this study. Subjects and Methods: In this clinical trial, for each patient a standardized case sheet was filled including demography, social, medical, and medication history. Before receiving, each patient was examined for phenotype, color, size, and site of oral lichen planus lesions. Patient's salivary samples were taken between 8 and 11 a.m. Three to four milliliters of saliva was obtained from each patient. The ELISA kit for IL-6 using sandwich-ELISA technique, to measure salivary IL-6 before and after PRP injections. Results: Thirteen oral lichen planus patients were took part in this study, six males (46.2%) and seven females (53.8%). The patients were between 32 and 91 years of age, with a mean age of 60.2(±13.9) years. All symptomatic and most of the hyperemic ones showed improvement after PRP injections, while the size of the lesions was resistant to change. Mean salivary IL-6 was 44.27 pg/mL (±43.24) before PRP injections and (69.74±59.86 pg/mL) after PRP injections. No significant difference was found, however IL-6 was higher after PRP injections. In relation to color changes after PRP, there was a significant changes in IL-6 level compared with that before PRP injections. Similarly, a significant relation was found between IL-6 level and signs and symptoms; pain and burning sensation. No association was found in salivary IL-6 level in relation to lesion phenotype, size, and location. Conclusion: All symptomatic OLP lesions that were treated with intralesional PRP responded very well, similarly almost all hyperemic lesions turned into normal mucosal color after completing the course of treatment. The majority of OLP lesions showed an increased salivary IL-6 levels after PRP treatment.

Aims and Objectives: Temporomandibular disorder is a broad term for the joint musculoskeletal problems. This study was aimed to assess the therapeutic effect of hyaluronic acid (HA) and platelet-rich plasma (PRP) on salivary matrix metalloproteinases (MMPs) 2 and 9 expression in patients with internal derrangment. Materials and Methods: Fifty-two patients with tempromandibular joint internal derrangment were participated in this study. Patients were separated into two groups: HA and PRP groups. Saliva was obtained before treatment and 6 months after treatment. The expression of MMP-2 and 9 was identified using enzyme-linked immunosorbent assay kit. Results: The expression of both salivary MMP-2 and 9 was significantly decreased after treatment (p = 0.000). A positive correlation was established between MMP-2 and 9 with the mean pain scale and joint click score. However, a negative correlation was found between MMP-2 and 9 with the maximum mouth opening (MMO). Conclusion: Both HA and PRP showed a beneficial therapeutic effect revealed through the reduction of salivary MMP-2 and 9 as an inflammatory biomarkers. [ABSTRACT FROM AUTHOR]

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.

Diabetes mellitus (DM) is a chronic, metabolic condition marked by defects in insulin production, action, or both. Environmental and genetic factors can contribute to the onset of diabetes mellitus. Adiponectin, a hormone affecting pancreatic beta cell proliferation, has emerged as a potential indicator of diabetes risk. This cross-sectional study aimed to evaluate serum and salivary adiponectin levels as predictors of diabetes mellitus in children with/without a family history of diabetes mellitus. The study was conducted at Al-Zahra Hospital in Najaf city and included 125 children aged 5 to 16. Data on demographics, including name, age, and gender, were collected, and body mass index (BMI) was assessed. Serum and salivary adiponectin levels were measured and analyzed in relation to family history and BMI. Children with a family history of DM had high serum adiponectin (ADP) levels. Serum adiponectin levels were significantly higher in children with first-degree relatives having a history of diabetes mellitus, except for cases involving mothers and other relatives with diabetes mellitus history (p<0.05). Furthermore, serum adiponectin levels were higher in obese children. Salivary adiponectin levels were significantly elevated in children with a maternal family history of diabetes (p=0.01), while no significant correlation was found with BMI. A significant negative correlation (r=-0.180, p=0.05) between salivary and serum adiponectin concentrations was observed. Compared to children with a normal, healthy weight, children with obesity had decreased salivary adiponectin levels and increased serum adiponectin levels. [ABSTRACT FROM AUTHOR]

Cemento-ossifying fibroma (COF) and juvenile ossifying fibroma (JOF) have been considered distinct entities within the category of fibro-osseous lesions. This study aimed to assess osteoblast and osteoclast activity in COF and JOF by investigating bone resorption markers, specifically receptor activator of nuclear factor-kB (RANK), RANK ligand (RANKL), and its inhibitor osteoprotegerin (OPG). A comparative analysis of these markers was performed on all lesions. Immunohistochemistry was employed to evaluate and quantify the expression of these biomarkers in a sample of 20 cases of cemento-ossifying fibroma (COF), 15 cases of psammomatoid juvenile ossifying fibroma (PsJOF), and 10 cases of trabecular juvenile ossifying fibroma (TrJOF). The expression of osteoprotegerin was significantly higher in cemento-ossifying fibroma (33.9±13.0) compared to trabecular juvenile ossifying fibroma (27.3±9.2) and psammatoid ossifying fibroma (25.2±14.9), with the COF showing the highest expression followed by the latter two (p=0.037). There was a higher percentage (80%) of stromal fibroblast cells that showed positive expression of RANKL in cemento-ossifying fibroma (COF) compared to psammomatoid juvenile ossifying fibroma (PsJOF) (33.3%) and trabecular juvenile ossifying fibroma (TrJOF) (30.0%) when considering a positive expression score of 3 (p=0.024). Cemento-ossifying fibroma demonstrated the highest expression of osteoprotegerin and RANKL-positive stromal fibroblast cells, followed by psammomatoid juvenile ossifying fibroma and trabecular juvenile ossifying fibroma. These findings provide valuable insights into the pathogenesis of these lesions. [ABSTRACT FROM AUTHOR]

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.

Objective: The aim of this study was to evaluate the epigenetic effect in the process of oral carcinogenesis by screening the methylation of repair gene in chronic tobacco smokers. Material and Method: Study design: One hundred male volunteers, divided into two groups: the 1st group consisted of 58 smokers, each consumed 20 cigarettes/day for at least 10 years; and the 2nd group consisted of 48non-smokers who were consider as a control group. The samples were taking from lateral border of the tongue by exfoliative cytology, and the extracted DNA was treated with phenol-chloroform gDNA, Screening of methylation was done by Methyl Specific PCR (MSP). Results: The results of this studyshowed significant effect of tobacco smoking in methylation of MLH1 gene in site 1in comparison to non-smoker group, (P > 0.05), with Odds ratio = 4.957 CI (). [ABSTRACT FROM AUTHOR]

Background: Saliva is the 1st defense fluid with sialic acid is a significant salivary biomarker. It is an acidic sugar with a nine-carbon backbone, able to mediate a wide variety of patho-physiological processes. the study aims at estimate salivary sialic acid in Iraqi children sample and also find out their association with oral health status. Method: Unstimulated salivary samples were collected from 100 healthy child, aged 6-13 years for 5-minutes, between 9:00 - 11:00 A.M. gingival index(GI) and Plaque index were measured. According to WHO criteria, the dentition status was examined by dmfs, dmft, DMFS and DMFT. Also, flow rate and the level of salivary sialic acid were estimated. Results: In the present study, a positive correlation coefficient is recorded between the salivary flow rate and age and statistically reach the level of significance. Sialic acid concentration increased with age, but did not reach the level of significant. A male gender showed increase salivary sialic acid level by 0.2 U/L compared to female, but fail to reach the significance GI and DMFs showed a positive association with sialic acid level (R=0.036, R= 0.0053), but it's not reach the significant. While sialic acid level observed that a significant weak inverse liner correlation with other variables like DMFS and PI, (R= -0.082, R= -0.066) The outcomes were exposed to t-test and Pearson's correlation coefficient, Plaque index, GI, flow rate and the dental caries status were significantly positive correlated with the sialic acid levels in saliva. Conclusion: The salivary factors evaluated in this study may prove to be useful measures for gingival inflammation in children and allow pediatric dentists to target preventive measures appropriately. [ABSTRACT FROM AUTHOR]

Background : Visual inspection by conventional oral examination (COE) has been the backbone of oral cancer and precancer detection. More recently, several commercially available diagnostic adjuncts have been developed to aid clinicians in the early detection of oral epithelial dysplasia (OED) and squamous cell carcinoma (SCC), such as OralCDx, Toluidine coloring, ViziLite machine, Identafi machine, and VELscope. VELscope is a technology based on the principles of autofluorescence mechanism imaging. This device offers in-vivo, real-time, direct visualization of tissue autofluorescence, termed direct visual fluorescent examination (DVFE). It is currently marketed as an oral cancer screening tool to be used with all new and recall dental patients and as an aid for surgeons in tumor margin delineation. Aim of the study :was to obtain auto fluorescent data on variety of histopathologically distinct oral lesions and assessment of direct auto fluorescent examination validity in identifying dysplastic (premalignant) and malignant oral mucosal lesions using VELscope and judgment with histopathological examination. Materials and methods: Routine oral examination of fifty patients having suspicious oral lesions followed by direct autofluorescent examination by VElscope and then histopathological examination. Conclusion : VELscope can be considered as an adjunctive device to enhance the visualization of oral mucosal abnormalities, but not as a tool for risk stratification. [ABSTRACT FROM AUTHOR]

Background: Sebaceous glands are normal structures of the skin, but may be ectopically found in the mouth, as oral Fordyce granules. They are located just beneath the overlying epithelium and are visible through the epithelium producing local elevations. It has been suggested that there is a relation between elevated lipid profile and the presence of these granules. Method: A total of 130 individuals were included in this cross-sectional study, who were subjected to the oral examination for the presence & scoring of oral Fordyce granules, then blood samples were taken. Case sheet involved, demographic information and medical history. Using specialized kits, lipids profile analysis was done on a fully automated spectrophotometric analyzer. Results: Fordyce granules were recorded in 25% of cases, with males formed the majority of them. In both gender, lip was the most commonly affected sites. Fordyce granules were observed in one-third of patients with systemic diseases. The majority of cases with Fordyce granules, recoded normal triglyceride, HDL, LDL and VLDL levels, but one-fourth of patients with hyper cholesterol were seen with Fordyce granules. Chi-Square test showed no association between lipid profile & these granules. A negative correlation was found between Fordyce granules number and cholesterol, HDL and LDL levels, although statistically non- significant. Conclusion: Oral Fordyce granules were most frequently observed in the lips, with male gender and older age predilections. The current study did not support the association between oral Fordyce granules and serum lipid profile changes. [ABSTRACT FROM AUTHOR]