Arash Azizi

The Comparison of Efficacy of Adcortyl Ointment and Topical Tacrolimus in Treatment of Erosive Oral Lichen Planus

Background and aims Oral lichen planus (OLP) is a common chronic mucocutaneous disease. Patients with atrophic and erosive lichen planus often have symptoms of soreness and need proper treatment. The main therapy of OLP has been the administration of topical or systemic corticosteroids. Potent topical corticosteroids have been increasingly prescribed in the treatment of erosive lichen planus. The purpose of this study was to compare the efficacy of adcortyl ointment (triamcinolone in orabase) with topical tacrolimus for the treatment of erosive oral lichen planus. Materials and methods Sixty Patients with histopathologically confirmed oral lichen planus were enrolled in the study. The severity of lesions was scored from 0 to 5 according to the criteria described in a previous study. Patients were randomly given adcortyl (group A) and topical tacrolimus ointment (group B) and asked to apply the medication on dried lesions 4 times a day. The lesions were evaluated after 4 weeks of treatment. Visual analogue scale was used to assess the severity of pain before and after treatment. The severity scores were analyzed using the Kruskal-Wallis k-sample test. Results The average score of lesions improved from 3.4 to 1.5 in patients who received adcortyl ointment and from 3.2 to 1.2 in patients who received topical tacrolimus ointment. The differences between the im-provements in scores were not statistically significant in the two groups. The average pain severity in A and B groups was 8.2 and 7.8 at the beginning of treatment, and 3.5 and 3.2 at the end of treatment, respectively. There was a statistically significant reduction in pain severity in both groups. Conclusion Topical tacrolimus is a safe and effective alternative therapy in the treatment of oral lichen planus.

Comparison of salivary and plasma antioxidant levels in lichen planus patients and healthy subjects

INTRODUCTION Oral lichen planus (OLP) is a chronic, mucocutaneous, inflammatory disease. It has become more evident that the immune system plays a primary role in the development of this disease. The aim of the present study was to evaluate the total antioxidant status (TAS) of saliva and serum in patients with erosive OLP. METHOD AND MATERIALS This study was designed as case-control. In total, 48 patients with erosive OLP (34 women and 14 men) were enrolled as case group, and 44 self-admitted healthy people (34 women and 10 men) were selected as control group. Measurement of total antioxidant status was carried out in saliva and plasma. t-test was used for statistical analysis with significant level set at P < 0.05. RESULTS The mean ± SD of salivary TAS in case group was 0.98 ± 0.12, and in control group was 1.32 ± 0.18 mM, respectively, and there were significant differences between groups (P < 0.02). The mean ± SD of the plasma TAS in the case group and the control group was 1.24 ± 0.17 and 1.84 ± 0.34 mM, respectively. There were significant differences between two groups (P < 0.01). CONCLUSION Our results showed that salivary and plasma levels of total antioxidant status in erosive OLP patients were lower than those in healthy subjects.

Human Pulp Responses to Partial Pulpotomy Treatment with TheraCal as Compared with Biodentine and ProRoot MTA: A Clinical Trial

Introduction Questions exist regarding the efficacy of resin‐containing materials such as TheraCal directly applied on the pulp. This study sought to investigate the clinical efficacy of TheraCal as compared with Biodentine and ProRoot mineral trioxide aggregate (MTA) for partial pulpotomy. Methods In this clinical trial, partial pulpotomy was performed for 27 sound human maxillary and mandibular third molars scheduled for extraction. The teeth were randomly divided into 3 groups (n = 9) and underwent partial pulpotomy with TheraCal, Biodentine, and ProRoot MTA. The teeth were then restored with glass ionomer cement. Clinical and electric pulp tests were performed after 1 and 8 weeks. The teeth were radiographed and extracted at 8 weeks. Histologic sections were prepared and analyzed for pulp inflammation and dentinal bridge formation. Data were analyzed by using one‐way analysis of variance. Results Clinical examination showed no sensitivity to heat, cold, or palpation in ProRoot MTA and Biodentine groups. Two patients in TheraCal group (20%) reported significant pain at 1 week. Periapical radiographs showed no periapical pathology, and electric pulp test revealed a normal pulp response with no hypersensitivity. Inflammation was absent with all materials at 8 weeks. Normal pulp organization was seen in 33.33% of the teeth in ProRoot MTA, 11.11% in TheraCal, and 66.67% in Biodentine group (P = .06). Biodentine group showed complete dentinal bridge formation in all teeth, whereas this rate was 11% and 56% in TheraCal and ProRoot MTA groups, respectively (P = .001). Conclusions Overall, Biodentine and MTA performed better than TheraCal when used as partial pulpotomy agent and presented the best clinical outcomes.

Effect of photodynamic therapy with two photosensitizers on Candida albicans

BACKGROUND AND OBJECTIVES Oral candidiasis (OC) is an opportunistic infection of the oral cavity most commonly caused by Candida albicans (C. albicans). Considering the drawbacks of standard treatments with antifungal agents, this study sought to assess the efficacy of photodynamic therapy (PDT) with methylene blue (MB) and indocyanine green (ICG) photosensitizers against C. albicans. MATERIALS AND METHODS In this in-vitro, experimental study, 130 samples of C. albicans standard suspensions were subjected to various combinations of MB and ICG photosensitizers with and without laser irradiation with different exposure parameters, nystatin and chlorhexidine (CHX) in 13 groups of 10. Samples were cultured in microplates containing Sabouraud dextrose agar medium and colony forming units (CFUs) were counted after 24h of incubation at 37°C. Data were analyzed by SPSS version 19.0, one-way ANOVA and Tamhanes test. RESULTS The maximum number of CFUs was seen in the control group (mean of 214,200CFUs with a log value of 5.32) while the minimum values were noted in the laser (808nm and 100Hz PRR) plus ICG (mean of 13,460CFUs and log value of 4.12) and nystatin (mean of 13,940CFUs and log value of 4.14) groups. CONCLUSION Within the limitations of this in vitro study, the results revealed that laser application (808nm, 100Hz PRR) plus ICG caused a significant reduction in C. albicans CFUs.

Prevalence of Candida species in the oral cavity of patients undergoing head and neck radiotherapy.

Background and aims Candidiasis is a common opportunistic infection in immunocompromised patients. Radiation to the head and neck affects the oral mucous membrane and produces xerostomia. Xerostomia alters the oral mucosa and predisposes them to colonization by Candida species. The aim of this study was evaluation of Candida species before and after radiotherapy. Materials and methods Twenty patients undergoing radiation therapy were selected. None of the patients had taken any antibiotics and antifungals during the 3-month period prior to the study and did not take any during the study; in addition, they did not have any systemic conditions predisposing them to Candida infections. Swabs were collected from all the patients for Candida species culturing procedures 3±1 days before treatment and 2 and 4 weeks after radiotherapy. Swabs were inoculated on 2% Sabouraud’s dextrose agar. Different types of Candida species are specified by colony color. Analysis of variance was used to assess the difference between the periods before and after treatment. Results Mean age of the patients were 59.4 years. Ten patients were Candida-positive before the initiation of radiotherapy. Eighteen and 20 patients were Candida-positive after two and four weeks of radiotherapy, respectively. The most frequent type of Candida in this study was Candida albicans both before and after radiotherapy. Conclusion The present study suggests that patients undergoing head and neck radiotherapy should take antifungal agents, especially sugar-free agents, topical fluoride and salivary substitutes. The most commonly found Candida in this study was Candida albicans, which might be attributed to its high pathogenecity.

In Vitro Effect of Zingiber officinale Extract on Growth of Streptococcus mutans and Streptococcus sanguinis

Background and Objectives. Tooth decay is an infectious disease of microbial origin. Considering the increasing prevalence of antibiotic resistance due to their overuse and also their side effects, medicinal plants are now considered for use against bacterial infections. This study aimed to assess the effects of different concentrations of Zingiber officinale extract on proliferation of Streptococcus mutans and Streptococcus sanguinis in vitro. Materials and Methods. In this experimental study, serial dilutions of the extract were prepared in two sets of 10 test tubes for each bacterium (total of 20). Standard amounts of bacterial suspension were added; 100ƛ of each tube was cultured on prepared solid agar plates and incubated at 37°C for 24 hours. Serial dilutions of the extract were prepared in another 20 tubes and 100ƛ of each tube was added to blood agar culture medium while being prepared. The mixture was transferred to the plates. The bacteria were inoculated on plates and incubated as described. Results. The minimum inhibitory concentration (MIC) was 0.02 mg/mL for S. mutans and 0.3 mg/mL for S. sanguinis. The minimum bactericidal concentration (MBC) was 0.04 mg for S. mutans and 0.6 mg for S. sanguinis. Conclusion. Zingiber officinale extract has significant antibacterial activity against S. mutans and S. sanguinis cariogenic microorganisms.

The Management of Oral Pemphigus Vulgaris with Systemic Corticosteroid and Dapsone

Background and aims Oral pemphigus vulgaris is a chronic autoimmune mucocutaneous intraepi-thelial disease that primarily affects patients over the age of fifty, resulting in mucosal ulceration and is a potentially life-threatening disease. The purpose of this study was to investigate the efficacy of dap-sone in combination with systemic corticosteroids to treat the oral lesions of oral pemphigus. Materials and methods Twenty patients diagnosed with oral pemphigus were selected. Oral mani-festations were graded according to the severity of disease from 1 to 3. All patients were treated initially with systemic corticosteroids. Each was assigned to one of 4 groups according to their response to ther-apy. Patients who responded less than 50% healing of lesions began a trial of dapsone. After 4 weeks, signs and symptoms were recorded, and if a patient was lesion-free, the dapsone dosage was gradually tapered. Results Five patients with mild to moderate disease were treated with systemic corticosteroids alone. 15 patients with moderate to severe disease were treated with systemic corticosteroid and dapsone ther-apy. Of these, 10 patients had significant benefits, while 5 patients did not respond to dapsone adjuvant. Conclusions. The use of dapsone in combination with systemic corticosteroids is a useful method for treatment of oral pemphigus. Conclusions The use of dapsone in combination with systemic corticosteroids is a useful method for treatment of oral pemphigus.

Effects of Low-level Laser in the Treatment of Myofascial Pain Dysfunction Syndrome

Background and aims Muscular pain in the facial region is the most common cause of facial pains. Myofascial pain dysfunction syndrome (MPDS) is one of the most important facial muscle disorders comprising of signs and symptoms including pain during function, tenderness in the muscles of mastication and restricted jaw movement. Due to the lack of an accepted therapeutic approach, the purpose of this paper was to find an effective treatment to decrease the pain of such patients. Considering the analgesic and anti-inflammatory action of laser therapy, the effects of low level laser (Ga-Al-As) in the treatment of MPDS patients referred to Tehran University of Medical Sciences Faculty of Dentistry, were investigated in the present study. Materials and methods This study was a quasi-experimental research. Twenty-two MPDS patients were selected from those referred to Department of Oral Medicine, Tehran University of Medical Sciences Faculty of Dentistry. Clinical examination was performed at six stages in the following order: prior to the treatment, at 2 and 4 weeks after treatment, and monthly thereafter for a 3-months follow-up. All patients underwent low-level laser therapy for 4 weeks (12 sessions). Variables such as pain severity, pain of cheek region, pain frequency, tenderness of masticatory muscles, click, and mouth opening were evaluated at each stage. Numerical variables were investigated using Analysis of Variance test for repeated measures whereas ranking variables were studied by non-parametric Kruskal-Wallis test. Results At the end of treatment period, pain severity, pain of cheek region, pain frequency, tenderness of masseter, temporalis, medial pterygoid, and lateral pterygoid muscles showed significant improvement as compared with the commencement of any treatment which continued during the 3-months post-treatment (p<0.05). Conclusion It was shown that low-level laser (Ga-Al-As) therapy had the efficacy to alleviate pain and decrease the tenderness of masticatory muscles among MPDS patients through a continuous and regular therapeutic program.

Comparison of the bond strength of ceramics to Co-Cr alloys made by casting and selective laser melting

PURPOSE Considering the importance of metal-ceramic bond, the present study aimed to compare the bond strength of ceramics to cobalt-chrome (Co-Cr) alloys made by casting and selective laser melting (SLM). MATERIALS AND METHODS In this in-vitro experimental study, two sample groups were prepared, with one group comprising of 10 Co-Cr metal frameworks fabricated by SLM method and the other of 10 Co-Cr metal frameworks fabricated by lost wax cast method with the dimensions of 0.5 × 3 × 25 mm (following ISO standard 9693). Porcelain with the thickness of 1.1 mm was applied on a 3 × 8-mm central rectangular area of each sample. Afterwards, bond strengths of the samples were assessed with a Universal Testing Machine. Statistical analysis was performed with Kolmogorov-Smirnov test and T-test. RESULTS Bond strength in the conventionally cast group equaled 74.94 ± 16.06 MPa, while in SLM group, it equaled 69.02 ± 5.77 MPa. The difference was not statistically significant (P ≤ .05). CONCLUSION The results indicated that the bond strengths between ceramic and Co-Cr alloys made by casting and SLM methods were not statistically different.

Effect of GLUMA desensitizer on the retention of full metal crowns cemented with Rely X U200 self-adhesive cement

PURPOSE Considering the importance of retention in the success and long-term clinical service of fixed partial dentures (FPDs) as well as the existing controversy regarding the effect of GLUMA desensitizer on the retention of full metal crowns cemented with RelyX U200 self-adhesive cement, this study aimed to assess the effect of GLUMA desensitizer on the retention of full metal crowns cemented using RelyX U200. MATERIALS AND METHODS In this experimental study, 20 sound human premolars were prepared; a 0.5 mm chamfer finish line was prepared above the cementoenamel junction. The teeth were randomly assigned to two groups: a desensitizer group (n = 10, treated with GLUMA desensitizer) and a control (n = 10, no surface treatment). Full metal crowns were fabricated of base metal alloy and had a ring. All crowns were cemented with RelyX U200 and subjected to retention test by using a universal testing machine. The data were analyzed using SPSS version 20 and independent t-test. RESULTS The mean tensile bond strength was significantly higher in the GLUMA desensitizer group (230.63 ± 63.8 N) compared to the control group (164.45 ± 39.3 N) (P≤.012). CONCLUSION GLUMA desensitizer increases the tensile bond strength of RelyX U200 self-adhesive cement to dentin.