Search

Background & Aims: Blistering disorders are acute or chronic autoimmune diseases affecting the skin and the mucous membranes. In mouth or any non-specific lesions like lichen planus, chronic herpesvirus infection, etc., differential diagnosis needs confirmation by biopsies, direct- and indirect- immunofluorescence. This case study is about Gingival Bullae as a rare sign of Mucous Membrane Pemphigoid (MMP), that is a blistering disease. Case Presentation: A 55-year-old woman without any past medical or family history was referred to the Oral Medicine Department of Semnan University of Medical Sciences by an internist with complaints of oral bullae and burning sensation. Intraoral examinations showed gingival erythema and bullae. The histopathology result after biopsy reported that this Gingival Bullae is related to MMP. An oral corticosteroid was administered and no recurrence was observed at 2-year follow-up. Conclusion: Dentists could be the first healthcare professionals to identify this rare mucocutaneous lesion, ensuring early diagnosis and treatment. This, in turn, determines the prognosis and course of the disease. Multidisciplinary cooperation is recommended.

Multifocal epithelial hyperplasia (MEH) or Heck’s disease is a rare, benign, non-common, self-limiting viral infection of the oral mucosa that is caused by human papillomavirus (HPV), especially subtype 13 or 32. The onset of the disease varies widely between different geographic regions and different races. A 45-year-old male patient was admitted to Department of Oral Medicine of Yazd Dental School for dental examination. Routine extra oral examination revealed numerous papules in the lips. The lesions were multiple, scattered papules that were interconnected in some areas and resembled an exophytic mass. Subsequently, the family history was positive and the clinical features conducted us to the diagnosis of the Focal Epithelial Hyperplasia. Since this disease is rare in the Iranian population and this case is the 19th case in Iran, timely diagnosis and prevention of its transmission had the great importance. Therefore, promotion of dentists' awareness towards diagnosis and appropriate referral to oral medicines specialists were recommended.

Backround: In this study, we aimed to investigate the effect of dentin matrix proteins on the differentiation of guinea pig dental pulp stem cells to regenerate Dentin Bridge. Materials and Methods: This experimental study was performed on six adult male guinea pigs. Pig incisor teeth were divided into two groups: the first group was induced by calcium hydroxide as a control group and the second group was induced by matrix protein induction as a case group. After 1 and 3 days, the samples of both groups were stained by hematoxylin and eosin to examine the presence of odontoblast-like cells, the severity of inflammation, and the type and amount of dentin which was made, microscopically and for counting stem cells in the dentin site. Immunohistochemistry staining method was done. Results: In the case group, the amount of reconstituted dentin, the presence of stem cells and odontoblastic differentiation were higher than in the control group (P < 0.05) and the type of regenerated dentin potentially was of higher quality, although it was not statistically significant (P = 0.924). However, the amount of regenerated dentin (P = 0.001), the presence of pulp stem cells (P = 0.001) and the increased quality of regenerated dentin (P = 0.001) in both groups on the 1st and 3rd days were significantly different. Conclusion: The results showed that dentin matrix proteins were more effective on stem cell migration, odontoblastic differentiation, amount and quality of restorative dentin than the control group, but did not significantly; probably because low sample size.

Medication-related osteonecrosis of the jaw (MRONJ) is a side effect of anti-bone resorption medications. Nowadays antiresorptive medications like bisphosphonate and monoclonal antibodies like denosumab that have been prescribed for bone disorders and metastatic cancer are becoming increasingly common. Although these medications are quite efficient at reducing bone resorption, they can develop osteomyelitis and jaw necrosis as a side effect. A 65-year-old woman was referred to the Oral Medicine Department of Semnan University of Medical Sciences with diffuse bilateral mandibular osteonecrosis, with a history of osteopetrosis and under-treatment of bisphosphonate. This complication started after tooth extraction and without any healing 5 years ago. After 3 sessions of plasma therapy, obvious improvement was seen. A proper medical history and a routine oral examination before treating with any invasive dental treatment are necessary to avoid any medication-related osteonecrosis of the jaw or mucosal abnormalities.

Background: Oral papilloma is benign lesion while there is concern about high-risk types of Human Papilloma Virus (HPV) for cancer. Case Presentation: The patient was a 30-year-old woman who presented to the School of Dentistry, Semnan University of Medical Sciences for orthodontic treatment. Intraoral examinations revealed a prominent white papule on the tip of the tongue. Histopathologic exanimation revealed the proliferation of hyper keratinized stratified squamous epithelium arranged in projections with fibrovascular connective tissue cores, cell irregularity with hyperchromatic nucleus and koilocytes within the epithelium which confirmed the diagnosis of squamous papilloma (SP) with mild to moderate dysplasia. The patient was instructed to take care of the sexual behaviors and the injection of Gardasil vaccine was recommended. A month later, there was no evidence of a lesion. Conclusion: Though SPs are common lesions in the oral cavity, occurrence of dysplasia on SPs on the anterior part of the mouth is rare. Surgical removal supplemented by administration of Gardasil vaccine can be the treatment of choice in these cases. The significance of close attention to the oral lesions and consultation with an Oral and Maxillofacial Medicine Specialist is highly recommended in order to accurate diagnosis and timely treatment.

Background and purpose: Determining the prevalence of various diseases in different communities is one of the first measures to improve the level of education, prevention and treatment of diseases. Occasionally, first symptoms of some diseases appear in mouth, so, timely diagnosis made by dentists is of particular importance. The aim of this study was to determine the frequency of oral mucosal lesions and some related factors in patients over 12 years of age in Oral Medicine Department affiliated with Semnan Dental School in 2017-2019. Materials and methods: In this descriptive study, all individuals aged 12 years and older (n=1001) were investigated. Data, including gender, age, oral lesions, smoking, and wearing dentures were recorded in a checklist and analyzed in Chi-square test in SPSS V26. Results: In this study, 1001 people including 420 men and 581 women were studied. Frequency of oral lesions was 78.5%. The most common lesions were coated tongue (36.5%), gingivitis (34%), and periodontitis (28.4%). There was a significant relationship between age and oral lesions (P< 0.001). Total frequency of lesions was significantly higher in smokers (P= 0.016). Among the patients, 98.8% were unconscious about their oral lesions. Conclusion: Relatively high frequency of oral lesions and lack of awareness of their presence in people studied indicate the necessity for periodic oral mucosal examinations and dental examinations.

Background and purpose: Psoriasis is a chronic inflammatory genodermatosis, and periodontitis is an inflammatory disease of the protective tissue of the tooth. There is increasing prevalence of psoriasis and periodontitis and some studies indicated a relationship between psoriasis and periodontitis. The purpose of this investigation was to study the frequency and severity of periodontitis in patients with psoriasis. Materials and methods: In this study, the severity of psoriasis and mouth and teeth examination results of 40 patients were recorded. Tooth looseness, number of missing teeth, bleeding on probing, and clinical attachment loss were measured using periodontal probe. Data analysis was carried out applying t test, Chi square, and correlation coefficient. Results: The overall prevalence of periodontal diseases was 80%, including loose teeth (10%), missing teeth (47.5%), gingival bleeding (60%), and gingival resorption (62.5%). Periodontal diseases were found to be significantly associated with duration and severity of psoriasis (P = 0.032 and P

Oral squamous cell carcinoma is increasing worldwide, especially in developing countries. The etiology of Oral cancer is multifactorial, and most of the cancer deaths can be prevented through lifestyle modifications, early detection and effective treatment. A 27-year-old man who referred to the Oral Medicine Department of Semnan Dental School complaining of redness on his tongue which has been emerged for eight months. Clinical and histopathological examinations have confirmed the diagnosis of oral squamous cell carcinoma (OSCC). Since, the patient didn’t have any lymph node involvement, the Clinical stage of OSCC was considered as Stage I. He was treated by an Otorhinolaryngologist and on follow up session the patient declared a chief complaint of a swelling in the sublingual fold which was diagnosed as Ranula. Surgery despite improvements, several functional and aesthetic structures of the oral cavity still sacrifice during the surgical procedures of OSCC. Since the Oral cavity has essential anatomical landmarks and OSCC will bring some morbidity for the patients; therefore, surgical treatment should be carefully considered in the risky anatomical areas of the oral cavity, and it is recommended to be performed by maxillofacial surgeons who are more proficient in oral anatomical landmarks to do not impose any complicate for the patient.

Objective: Diabetes Mellitus (DM) is one of the most common endocrine diseases with many systemic complications such as oral manifestations. The present study aimed to compare the oral manifestations frequency in diabetic patients and healthy subjects. Materials and Methods: This cross sectional study was conducted during 2016-17 on subjects came to Yazd Diabetic Research Center. In this study, 181 type 2 diabetic patients (T2DM) and 181 healthy individuals, based on convenient sample method, were included. Two groups were compared for basic information and oral manifestations including candidiasis, oral lichen planus (OLP), periodontitis, xerostomia, delayed oral wound healing, geographic tongue, gingival hyperplasia, fissured tongue, burning mouth and finally at least one of these lesions. Results: The frequency of candidiasis, OLP, periodontitis, delay oral wound healing, geographic tongue, xerostomia and at least one of lesions in diabetics were significantly higher than control group (P-value< 0.001). After regression analysis and adjusting for confounding factors, candidiasis, periodontitis and xerostomia in diabetics were significantly more prevalent than non-DM patients with odds ratio of 15.16 (1.80-127.57), 9.58 (4.68-19.63) and 78.639 (10.05-615.231) respectively. Conclusion: Xerostomia, candidiasis and periodontitis were significantly more prevalent in T2DM than Non-T2DM persons. Therefore, increasing awareness on oral manifestations in this group is recommended for timely diagnosis and referring to an oral medicine.

Giant Cell Fibroma (GCF) is a benign rare fibrous lesion that predominantly occurs on the mandibular gingiva. Clinically, it is presented as a sessile or pedunculated mass that frequently occurs in the third decade with a slight female predilection. The lesion is usually characterized by stellate and multinucleated fibroblasts located in the lamina propria near the overlying epithelium and radiographically treated as a benign lesion. A 20-year-old female was referred to the Oral and Maxillofacial Medicine Department of Semnan Dental School, with the chief complaint of tooth displacement and gingivitis. Clinical examination revealed maxillary protrusion, mouth breathing, localized gingivitis in the interdental areas of the papilla of the lateral and canine teeth; also alveolar bone with pus discharge in the right mandibular premolar area. Radiographically, the lesion leads to the bone resorption and linguistic movement of the teeth in the right side of Mandible. There were no root resorption and no bone expansion. Gentle scaling and root planning, biopsy, and second premolar extraction were performed. The presence of the giant fibroblasts in superficial connective tissue confirmed the diagnosis of Giant Cell Fibroma. At the follow-up session, tissue repair was accomplished, and the first premolar was immobile and was no longer loose. Nevertheless, further studies are required to investigate the precise nature of the mono or multinucleated cells, i.e., atypical fibroblasts that illustrate degenerative and functional changes. Moreover, a high index of suspicion and appropriate analytical examination is required for distinct lesions to achieve a proper diagnosis and suggest an appropriate treatment.

Introduction: Previous studies have shown that Vitamin D has an effect on calcium absorption, mineralization, and dentin formation and also on the maturation and formation of developing teeth, but the aim of this study was to evaluate the relationship between serum level of Vitamin D and Decayed, Missing, and Filled Teeth (DMFT) in adult patients with developed teeth. Materials and Methods: In this descriptive, cross-sectional study, 200 women with the age range of 15–40 years who referred to the Semnan Dental School in 2018–2019 and satisfied the inclusion and exclusion criteria were selected randomly. Then, DMFT, Plaque Index (PI) and SI index, age, the history and recent Vitamin D deficiency, and the history of xerostomia in patients were studied and statistically analyzed. Results: Only 4 (2%) of the women had a DMFT index score of 10 and 78 (39%) had a score of 3 and 4, respectively. Most patients were aged 30 years and younger (64.5%) and most of them (90.5%) had no previous history of Vitamin D deficiency and only eight patients (4%) had xerostomia. More than half of the individuals (54%) had some degree of recent Vitamin D deficiency. More than half of the women had PI grade 3 (54%) and 82 individuals (41%) had high blood sugar levels. According to Spearman's results, there was a moderate and negative correlation between DMFT and Vitamin D levels. Conclusion: Therefore, the lower the level of Vitamin D, the higher the DMFT index by excluding other caries-causing factors. Consequently, it is recommended that this is considered in high-risk groups in order to prevent oral health problems.

Background: Diagnosis of prediabetic stage is very important for prevention of diabetes and complications. This stage may be associated with some oral lesions. Only a few studies are available on the oral status of prediabetic patients and incidence of oral lesions in this population. This study aimed to compare some oral complications between prediabetic and healthy control groups. Methods: The present two-group cross-sectional study was carried out on 302 prediabetic and non-diabetic (healthy) 20- to 60-year-old subjects. In this study, data on age, gender, educational level, medications use, smoking, and some other variables were extracted through history taking. In addition, orodental examination was carried out by an oral medicine specialist to diagnose oral lesions including candidiasis, lichen planus, periodontitis, gingivitis, xerostomia, delayed wound healing, geographic tongue, fissured tongue, and burning mouth sensation. Data entry and analysis was performed by SPSS version 22 software, and P value and odds ratio (OR) were calculated to show statistical relationship between variables. Results: The most common oral lesion in prediabetic subjects was periodontitis (27.2%), followed by gingivitis (14.7%) and xerostomia (11.3%). In the control group, gingivitis (20.5%) followed by periodontitis (11.3%) are common oral lesions. Candidiasis (P = 0.036), periodontitis (P < 0.001), and xerostomia (P < 0.001) in prediabetic subjects were higher than control group that is statistically significant. Regression analysis showed that in the prediabetic group, periodontitis [OR = 2.91, confidence interval (CI): 1.54–5.49] and xerostomia (OR = 18.51, CI = 2.42–141.45) were significantly more prevalent than healthy subjects. Conclusion: Based on the results, glucose intolerance stage exhibited a significantly higher oral problems such as periodontitis and xerostomia than healthy euglycemic stage.