Maha A. Al-Mohaya

Successful treatment of ligneous gingivitis with warfarin

Ligneous gingivitis is a rare condition characterized by inflammation and nodular gingival enlargement secondary to fibrin deposits in the gingival that results from plasminogen deficiency. Several therapeutic approaches have been used with limited success. We report a case of a patient with homozygous plasminogen deficiency and ligneous gingivitis that was initially refractory to local care and systemic antibiotics, but later improved with the addition of warfarin.

Oral squamous cell carcinoma among Yemenis: Onset in young age and presentation at advanced stage

Objectives: Oral cancer represents a health burden worldwide. Up to 90% of oral cancer cases are squamous cell carcinomas (SCC). The data on oral SCC in Yemen are lacking. The objective of this study therefore was to describe and analyze the demographic, clinical and histological characteristics of Yemeni patients with oral SCC. Study Design: In this cross-sectional study, two sets of retrospective data for Yemeni cancer patients were obtained officially by two different registries. Patients with oral SCC were included. Their ages were dichotomized using 40 and 45 years alternately as individual cut-points for young and old patients. The patients` demographic, clinical and histological characteristics were statistically analyzed. Results: There were 457 Yemenis with oral SCC; 253 patients (55.4%) were men. The overall mean age was 58.15±14.11 years. The tongue was the most affected oral sub-site accounting for 53% of the reported cases. The well and moderately differentiated oral SCC accounted for 55.5% and 25.6% of the total cases respectively. Noteworthy, 62 patients (14%) were affected by the age of ?40; this increased to 105 patients (23%) aged ?45 years. Additionally, a high proportion of oral SCC patients (62%, 283) were diagnosed at advanced tumor stages (regional extension or metastasized). The distributions of histological grades and tumor stages in young and old patients were significantly different (P=0.006 and 0.026 respectively). Conclusion: The relative frequency of oral SCC among Yemeni young people is high. Unfortunately, most of oral SCC patients in Yemen were diagnosed at advanced stage. Key words:Oral squamous cell carcinoma, Yemen, young patients, advanced stage.

Association of genetic polymorphisms in interferon-γ, interleukin-6 and transforming growth factor-β1 gene with oral lichen planus susceptibility

BackgroundOral lichen planus (OLP) is a premalignant mucocutaneous disease in which genetic factors and immune responses play a major role. Cytokines play an important role in the pathogenesis and disease progression of OLP. The aim of this study was to investigate the impact of gene polymorphisms of T helper cell subtype Th1 and Th2 cytokines, interferon-gamma (IFN-γ), interleukin-6 (IL-6) and transforming growth factor (TGF)-β1 on OLP susceptibility in a Saudi cohort.MethodsForty two unrelated patients with OLP and 195 healthy controls were genotyped for IFN-γ (874A/T), IL-6 (174G/C) and TGF-β1 (509C/T) polymorphisms.ResultsThe frequency of genotype AT of IFN-γ (874A/T) was significantly higher while genotype AA was lower in OLP patients as compared to controls (P < 0.05). The frequency of T containing genotypes (AT + TT) was also higher in OLP patients as compared to that in controls (P = 0.003). The frequencies of allele T was higher while that of allele A lower in patients than the controls however the difference was not statistically significant (P = 0.07). There was no significant difference in the frequencies of alleles and genotypes of IL-6 (174G/C) and TGF-β1 (509C/T) polymorphisms between patient and control groups. These results indicated that genotype AT of IFN-γ (874A/T) polymorphism is associated with OLP risk and genotype AA is protective to OLP. On the other hand the polymorphisms IL-6 (174G/C) and TGF-β1 (509C/T) may not be associated with OLP risk in our population.ConclusionIt is concluded that IFN-γ (874A/T) polymorphism is associated with the susceptibility of OLP, however further studies with large sample size involving different ethnic populations should be conducted to strengthen our results.

Excision of oral pyogenic granuloma in a diabetic patient with 940nm diode laser

Pyogenic granuloma (PG) is a common, acquired, benign vascular reactive proliferation that typically develops as a small erythematous papule on the skin or oral mucosal surface. Oral PG is often caused by constant low-grade infection, minor trauma, poor oral hygiene, and due to hormonal disturbances. It shows a striking predilection for the gingiva. Lesions can be excised surgically with removal of the underlying causes. However, this modality may be associated with unnecessary complications. Recently, different laser wavelengths have been used for removal of oral PG. Herein, we present a case of gingival PG in a 51-year-old uncontrolled diabetic woman. The lesion was excised successfully with a 940nm diode laser as a conservative and non-stressful procedure that resulted in a bloodless surgical and post-surgical course with rapid healing, minimal pain, swelling, and scarring. The 940nm Diode laser offers a new efficient noninvasive tool for excising oral soft tissue lesions, especially in medically compromised patients.

Oral health considerations in cancer survivors

Background and Aim: Little prevalence data relating to molar incisor hypomineralization (MIH) exist for Turkey. The aim of this study was to investigate the prevalence and severity of MIH in two different age groups of Turkish children. Materials and Methods: A total of 4,018 children in Ankara, Turkey participated in the study. A younger group was comprised of children in Grade 2 aged 7-9 years (median age: 8.0), and an older group was comprised of children in Grade 5 aged 10-12 years (median age: 11.1). MIH was diagnosed based on the European Association of Pediatric Dentistry criteria. The data was analyzed using Pearson’s Chi-square, Fisher’s Exact, Spearman’s correlation and McNemar’s tests. Results: MIH was found to be prevalent at a significantly higher rate (p<0.05) among the younger group (8.5%) when compared to the older group (6.5%). Mild defects (whitecream and yellow-brown demarcated opacities) affecting first permanent molars were significantly higher in the younger age group (p<0.05), whereas atypical deep, large cavities, atypical restorations and extracted first permanent molars were significantly higher in the older age group (p<0.05). Conclusion: The present study found that MIH was present in 7.7% of 4,018 children and that severity of lesions increased with age. These results indicate that preventive approaches are very important at an early developmental age.Marginal adaptation is one of most important criteria for long term clinical success of dental restorations [1]. The presence of marginal discrepancies exposes the luting agent to the oral environment. The larger the marginal discrepancy and the subsequent exposure of the dental luting agent to oral fluids, the more rapid the rate of cement dissolution and microleakage [2]. These marginal irregularities facilitate the adherence of oral bacteria along with percolation of food, oral debris and other substances to finally cause plaque retention, which in turn causes changes in the distribution of the subgingival microflora, thereby leading to periodontal disease [3] and secondary caries [4].Over the past decade, advances in cancer treatment have helped in prolonging the survival rate for cancer patients. However, the patients who undergo treatment for cancer are potentially at high-risk for developing a number of oral complications, including oral mucositis, infections, hyposalivation, dental caries, and jaw osteonecrosis. Cancer survivors may remain at life-long risk of developing oral complications, and therefore require long-term dental follow-up, well after completion of cancer therapy. Patients should typically undergo thorough oral examination prior to initiation of therapy, during and after therapy to identify any active infection. In addition, and in order to maintain adequate oral health throughout treatment, patients should continue normal oral hygiene with tooth brushing and interproximal cleaning. The aim of this review is to discuss potential oral complications as a result of cancer therapy, and the certain precautions we should be aware of these patients.

Dental publications at the Saudi Medical Journal. Where do we stand 2009-2016

[No Abstract Available] Saudi Med J 2016; Vol. 37 (4): 345-347 doi: 10.15537/smj.2016.4.14777 How to cite this article: Al-Mohaya MA. Dental publications at the Saudi Medical Journal. Where do we stand 2009-2016. Saudi Med J 2016; 37: 345-347.