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   Table of Contents - Current issue
March-April 2020
Volume 17 | Issue 2
Page Nos. 85-166

Online since Tuesday, March 17, 2020

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Expression of epidermal growth factor receptor in oral and esophageal squamous-cell carcinoma p. 85
Fatemeh Shahsavari, Rosa Miri, Maedeh Ghorbanpour
Background: Squamous-cell carcinoma (SCC) represents the most common type of malignancies in the oral cavity (O) and esophagus (E). Epidermal growth factor receptor (EGFR) plays a key role in numerous processes that affects tumor growth, progression, differentiation, invasion, metastasis, and inhibition of apoptosis. In this study, we wanted to investigate the EGFR expression in OSCC and ESCC cases. As well, another purpose was to observe if there exists any relation between its expression and clinicopathologic factors. To the best of our knowledge, this is the first study which compares the EGFR protein expression between OSCC and ESCC. Materials and Methods: This cross-sectional study was performed on 46 paraffin blocks (23 OSCC and 23 ESCC). The expression of EGFR was evaluated with immunohistochemical technique. Data analyses were done using SPSS software by Fisher's exact test. Significance was assigned at P < 0.05. Results: Out of 46 patients, 25 cases (54.3%) were male and 21 (45.7%) were female. Seventy-eight percent of OSCCs and 73.9% of ESCCs showed high expression of EGFR. No statistically significant difference was observed between the two groups (P = 0.73). There were no statistically significant correlations between EGFR expression and clinicopathologic factors (age, gender, grade, and stage) of OSCCs (P > 0.05). A statistically significant correlation was found between EGFR expression and stage in ESCCs group (P = 0.006). Conclusion: No significant correlation was found between the expression of EGFR protein in OSCCs and ESCCs. High expression of EGFR was observed in ESCCs with Stages II, III.
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Esthetic outcome of immediately placed and nonfunctionally loaded implants in the anterior maxilla utilizing a definitive abutment: A pilot clinical trial p. 92
Sandra AlTarawneh, Ahmad A. S. Hamdan, Abeer Alhadidi, Susan Hattar, Mohammad Al-Rabab'ah, Zaid Baqain
Background: Immediate dental implants placement and loading utilizing definitive abutments might save time and cost when an esthetic final result is anticipated. The objective of this prospective clinical trial was to evaluate the esthetic outcome of immediate implantation and immediate nonfunctional loading utilizing definitive abutments, with and without bony substitutes filling the peri-implant gap. Materials and Methods: In this clinical trial study a total of 11 implants were placed utilizing a flapless immediate post extraction approach in the maxilla (second premolar to second premolar). Atraumatic extraction was performed and implants were immediately placed. The gap was either left without grafting or filled with particulate bone material. Immediate nonfunctional loading was performed utilizing a definitive abutment. The pink esthetic scores (PESs) were assessed preoperatively, at 1- and 2-year follow-up periods. Dental casts were obtained at respective time intervals; scanned, registered, and closest point distances were measured. For all statistical tests, value of P = 0.05 was set as a statistical significance level. Results: The mean of PES at baseline was 9.4 ± 1.69, at 1 year was 9.5 ± 2.07, at 2 years was 10.2 ± 2.75, for the graft group 10.3 ± 2.8, and for nongrafting group was 10.2 ± 2.59. There were no statistically significant differences in PESs at baseline when compared to 1- and 2-year intervals, and for grafting group versus nongrafting group (P = 0.24). Distances between the two time points for all cases were <1 mm in all reference planes. Conclusion: Immediate placement and nonfunctional loading utilizing a definitive abutment appear to result in a stable result as far as esthetic outcome and alveolar process sufficiency are concerned.
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Evaluation of VEGF expression correlates with COX-2 expression in pleomorphic adenoma, mucoepidermoid carcinoma and adenoid cystic carcinoma p. 100
Nafiseh Shamloo, Nasim Taghavi, Farzad Yazdani, Parnia Azimian, Samane Ahmadi
Background: Pleomorphic adenoma (PA), mucoepidermoid carcinoma (MEC), and adenoid cystic carcinoma (AdCC) are the most common benign and malignant salivary gland tumors. Cyclooxygenase-2 (COX-2) is a key regulatory enzyme that its overexpression in various tumors is correlated with progression, metastasis, and apoptosis inhibition. Vascular endothelial growth factor (VEGF) is a potent angiogenic mediator that has an important role in neoplastic angiogenesis. The aim of this study was to immunohistochemically analyze the expression of COX-2 and VEGF and to compare the expression of benign and two malignant salivary gland tumors with varied structures. Materials and Methods: In this cross-sectional study, 90 specimens including 30 cases of each tumor were retrieved. Immunohistochemical staining of COX-2 and VEGF was performed for all the samples. The percentage of positive tumor cells and staining intensity was evaluated by two pathologists blindly. Data were analyzed by Chi-square and Gamma test and P < 0.05. Results: A statistically significant difference was noted between the expression and intensity of COX-2 and VEGF in PA, MEC, and AdCC (P < 0.05). A significant correlation was observed between COX-2 and VEGF expression in MEC and AdCC (P < 0.05). However, no significant correlation was found between the expression and intensity of COX-2 and VEGF with histologic grade and lymph node metastasis in MEC and AdCC (P < 0.05). Conclusion: High expression of VEGF and COX-2 in malignant tumors compared to PA suggested the role of both markers in malignant transformation. The significant correlation of VEGF expression with COX-2 may represent the role of COX-2 in tumor angiogenesis by modulating VEGF production.
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Proliferation and osteogenic differentiation of bone marrow-derived mesenchymal stem cell after exposure to red flesh dragon fruit extract p. 107
Mardiyanto Riski Hartono, Ketut Suardita, Anita Yuliati
Background: Induction of the proliferation and differentiation of stem cells could represent a viable alternative therapeutic method for treating bone diseases. Stem cells are essential to bone tissue regeneration; although, their availability is limited. One possible method of increasing the number of stem cells and promote osteogenic differentiation is the application of red flesh dragon fruit extract supplement. The present study was performed to identify and analyze proliferation and osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMMSCs) after exposure to red flesh dragon fruit extract.Materials and Methods: This in vitro study was posttest only control group design. Red flesh dragon fruit extract was produced by means of water extraction method and subsequent dilution with different amounts of water to produce a range of concentrations. BMMSCs were obtained from the femurs of three White New Zealand rabbits. BMMSCs were then treated with 50, 100, 200, 300, and 400 μg/ml red flesh dragon fruit extract concentrations. The in vitro proliferation assay was determined by means of an 3-(4.5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Osteogenic differentiation was determined by means of the degree of nodule mineralization. There were two groups as follows: group I with the addition of 50 μg/ml of red flesh dragon fruit extract and Group II without the addition of red flesh dragon fruit. Data were analyzed using analysis of variance and the Student's t-test (P = 0.05).Results: 50, 100, 200, 300, and 400 μg/ml of red flesh dragon fruit extract demonstrated the capacity to significantly increase the proliferation of BMMSCs (P ≤ 0.05). Red flesh dragon fruit extract could significantly increase osteogenic differentiation (P ≤ 0.05).Conclusion: Red flesh dragon fruit extract enhances proliferation and osteogenic differentiation of BMMSCs.
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Evaluation of the effect of hydro alcoholic extract of cinnamon on herpes simplex virus-1 p. 114
Maryam Moshaverinia, Mehrnaz Rastegarfar, Afagh Moattari, Fatemeh Lavaee
Background: Long-term treatments of herpes simplex with drugs such as acyclovir, the side effects to such drugs including limited usage during the lactation period, and concerns for the emergence of drug-resistant strains have given rise to a need for new medications with fewer complications. Nowadays, there is an increasing usage of herbal medicines throughout the world due to their higher effectiveness and safety. The present study aims to assess the effects of hydroalcoholic cinnamon extract on herpes simplex virus type 1 (HSV-1) in culture with vero cells. Materials and Methods: In this in vitro study Hydroalcoholic extract of cinnamon was extracted through percolation. To assess cell survival rates, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was employed, and the tissue culture infective dose 50 assay was used to quantify the virus. Effects of the extract were evaluated in three stages, including before, during, and after viral inoculation into the culture medium. Two-way ANOVA and Post hoc analysis the test was performed in 1, 0.5, and 0.25 mg/ml concentrations of cinnamon extract in every stage (P < 0.05). Results: Over 50% of the cells survived in the 0.25 mg/ml extract concentration. Results of our viral quantification showed a viral load of 105. The cinnamon extract was able to reduce the viral titer in all concentrations under study. Conclusion: Hydroalcoholic extract of cinnamon was effective in reducing the viral titer of HSV-1. This effect could have been caused by prevention of viral attachment to cells; however, further research is required to determine the exact mechanisms at play.
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A comparative study on the antimicrobial activity of irreversible hydrocolloid mixed with silver nanoparticles and chlorhexidine p. 120
Azadeh Farhang Nia, Mahdi Ataei, Habib Zeighami
Background: Impressions taken from patients have the potential of cross-transmission of infection among dentistry personnel. The present study aimed to compare the antimicrobial activity of chlorhexidine (CHX) and silver nanoparticles (AgNPs) combined with irreversible hydrocolloid. Materials and Methods: This experimental study examined the in vitro antimicrobial effects of irreversible hydrocolloid mixed with silver nanoparticles and chlorhexidine using four groups, namely CHX (0.2%) solution and mouthwash mixed with irreversible hydrocolloid Groups 1 and 2), AgNPs (0.1 and 0.2%) (Groups 3 and 4), and specimens mixed with distilled water as a control group (Group 5) on bacterial strains, namely, Staphylococcu saureu s,Enterococcu sfaecali s,Pseudomona saeruginos a,Escherichi acoli, andStaphylococcu sepidermidi s through disc diffusion method. There were three replications per bacterial species. As data were not normally distributed, Kruskal–Wallis test was used at a significance level of 0.05. Results: No antimicrobial activity was observed in the control groups. In S. aureus, CHX mouthwash had the highest antimicrobial activity, and AgNPs 0.1% and 0.2% groups had lower antimicrobial activity, and there was a significant difference between the two concentrations of AgNPs (P < 0.05). InE.faecali s, the effects of CHX compounds and AgNPs 0.2% were similar to each other and were higher than the effect of AgNPs 0.1% (P < 0.05). In E. coli, CHX compounds exhibited the highest efficacy relative to other materials (P < 0.05), and the AgNPs had no effect. In P. aeruginosa, AgNPs showed the highest growth inhibition zone, which had a significant difference compared to other materials (P ≤ 0.01), whereas the CHX compounds were not effective. InS.epidermidi s, the effect of CHX compounds was similar to one another and was higher than the effect of AgNPs (P ≤ 0.01). Conclusion: According to our observations, the antimicrobial activity of AgNPs at 0.1 and 0.2% against five tested bacterial strains was similar to those of pure CHX 0.2% solution and CHX 0.2% mouthwash.
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Effects of five levels of noise reduction applied to indirect digital radiography on diagnostic accuracy of external apical root resorption p. 126
Sanaz Sharifi Shoshtari, Seyed Arman Mohagheghi, Nastaran Farhadi, Negin Kheradmand, Lida Naderi
Background: Radiologic diagnosis of external apical root resorption (EARR) is clinically important. Noise might disrupt this diagnosis. Therefore, we assessed the efficacy of noise reduction on periapical indirect digital radiography. Materials and Methods: This in vitro study as performed on 792 radiographs. A total of 66 single-rooted premolars were inserted in dried hemimandibles of sheep and fixed with modeling wax. Digital images were obtained using the parallel technique. The storage phosphor plates were processed in the DIGORA Optime scanner. The resulting images were sent to a computer using the Scanora software for radiographic analysis. The teeth were removed from the mandible, and artificial EARR defects were simulated. Afterward, the indirect digital radiographs were obtained at the same condition of the baseline. Five levels of noise reduction were applied. All images were saved in Digital Imaging and Communications in Medicine format and monitored by two observers twice over 2 weeks. Data were analyzed statistically using Cochran and McNemar tests (α = 0.05). Results: The highest sensitivity rate was found in the baseline group (0.99), and the lowest sensitivity was related to the “four-time noise reduction” method (0.91). The highest specificity rate was in the “five-times noise reduction” method (0.88) and the lowest specificity was associated with “one-time noise reduction” method (0.71). There was no statistical difference between images with/without noise reduction enhancement with varied gradation levels in terms of diagnostic accuracies of EARR (P > 0.05). Conclusion: Application of noise reduction procedure in Scanora software might have no effect on the accuracy of EARR diagnosis.
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Streptococcus mutans, sugar consumption, and oral hygiene: Which one has more effect on decayed, missing, and filled teeth (DMFT) score in Iranian adults? p. 134
Laleh Babaeekhou, Akram Abouie Mehrizi, Maryam Ghane
Background: Streptococcus mutans as an acid-generator of biofilm, sugar as a caries-conducive environment, and oral hygiene have been implicated as major etiological agents in dental caries. This study was designed to assess the association and impact of S. mutans, sugar consumption, and tooth brushing on decayed, missing, and filled teeth (DMFT) score in Iranian 20–30-year-old individuals and compare the effect of the three mentioned factors to find the most effective one. Materials and Methods: In this cross-sectional study, 459 adults completed a Sugar Frequency Questionnaire and were examined for dental caries using DMFT index, sugar consumption level, and tooth brushing frequency per day. Saliva and plaque samples were collected, and the target population without Streptococcus sobrinus in their microbial oral community was selected using polymerase chain reaction technique. Data were analyzed by one-way analysis of variance and multiple linear regression tests (α = 0.05). Results: Nearly 77.1% of the study population were harboring S. mutans. Mean DMFT of the population was 6.62. Mean comparison analysis showed that there is a strong relationship between S. mutans existence in mouth flora and DMFT scores (P < 0.0001). Multiple linear regression test showed higher percentage of S. mutans contribution (28.2%) in DMFT score changes than sugar consumption (3.6%) and tooth brushing (0.7%). Conclusion: This study provides a recent report from S. mutans frequency and DMFT score in Iranian adult population. It is also the first study that shows significantly higher impact of S. mutans in microbial population of mouth microflora on caries development than sugar consumption and oral hygiene. Accordingly, S. mutans screening program should be more highlighted in preventive strategies.
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Evaluation of the film thickness and antibacterial property of mineral trioxide aggregate mixed with propylene glycol as a root canal sealer p. 142
Amin Salem Milani, Ayda Moeinian, Mohammad Hosein Soroush Barhaghi, Amir Ardalan Abdollahi
Background: The aim of this in vitro study was to compare the film thickness and antibacterial properties of mineral trioxide aggregate-propylene glycol (MTA-PG) as a sealer in comparison with MTA Fillapex and AH26 sealers. Materials and Methods: In these in vitro study the antibacterial property of the sealers was evaluated using direct contact test in fresh and set states. Enterococcus faecalis was incubated in direct contact with fresh and set materials. The growth of exposed bacteria was evaluated by counting colony-forming units (CFUs) after 10 min and 1 h in the culture medium. The film thickness of sealers was measured according to the International Standard Organization 6876/2012. The data were statistically analyzed using an independent t-test and repeated measures of ANOVA. The level of significance was set at 0.05. Results: CFU means in AH26 was significantly more than other groups (P < 0.0001), but there was no difference between MTA-PG and MTA Fillapex. The mean of CFUs in set AH26 after 1 h exposure was significantly >10-min exposure (P = 0.006). The mean film thickness values of MTA Fillapex, MTA-PG, and AH26 were 57.3, 50.9, and 78.3 μm, respectively. Conclusion: MTA-Fillapex and MTA-PG showed distinct antibacterial effect. AH26 showed more antibacterial effect in fresh state in comparison with set state. The film thickness of MTA-PG and MTA-Fillapex was significantly less than AH26.
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Enterococci in the oral cavity of periodontitis patients from different urban socioeconomic groups p. 147
Sonia Bhonchal Bhardwaj, Manjula Mehta, Shaveta Sood
Background: Enterococci are the transient constituents of the oral microbiome and have been now increasingly related to oral and systemic diseases. They have now become the most notable nosocomial pathogens and also been linked to etiology of periodontitis. This study evaluates the prevalence of Enterococci in the chronic periodontitis and healthy Indian cohort in different urban socioeconomic groups. Materials and Methods: In this retrospective study, individuals in the age range of 18–75 years were included. Seventy individuals had mild-to-moderate periodontitis and 30 healthy persons were taken as controls. A questionnaire was administered. Paper point samples of gingival crevicular fluid were obtained, pooled, and sent to microbiology laboratory in a transport media. Forty-six isolates were identified as enterococci for statical analyzes Pearson's Chi-square test used and. P < 0.001 was considered to be significant. Results: The prevalence of enterococci was seen mostly in the individuals from lower socioeconomic class, having poor oral hygiene, and smokers. This was significantly different from those of upper class (P < 0.001). The predominant species isolated was Enterococcus faecalis. Conclusion: Enterococci particularly E. faecalis followed by Enterococcus faecium could play a crucial role in the severity or progression of periodontitis particularly in a favorable oral environment.
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Effect of different coloring techniques and surface treatment methods on the surface roughness of monolithic zirconia p. 152
Rashin Giti, Shekoofeh Haghdoost, Elham Ansarifard
Background: This study aimed to evaluate the effect of different coloring techniques and surface treatment methods on the surface roughness of monolithic zirconia ceramic. Materials and Methods: In this in vitro study seventy-two disk-shaped monolithic zirconia (2 mm × 10 mm) were divided into three coloring techniques groups (white, internal staining, external staining) (n = 24). Each group was subdivided into four surface treatment subgroups (n = 6), as unpolished, polished with Shofu polishing kit, polished with dental direct polishing kit, and glazed. Profilometer was used to measure the Ra (roughness average) and Rz (roughness height) surface roughness values (μm) and scanning electron microscopy (SEM) for visual inspection of the surface morphology. The surface roughness parameters were calculated and analyzed with two-way ANOVA and Tukey's post hoc test (α = 0.05). Results: The coloring technique, surface treatment method, and interaction of these two parameters significantly affected the Ra and Rz parameters (P < 0.05). Concerning the surface treatment, the Rz value was significantly higher in the unpolished subgroup, followed by the glazed and polished subgroups. However, the two polishing systems were not significantly different. The internal staining group had significantly higher Rz value than the other staining method, when the specimens were glazed or polished with Shofu kit. SEM showed multiple scratches in unpolished samples which were smoothened by glazing and specially by polishing. Conclusion: Among all the studied surface treatment methods, the lowest surface roughness was observed in highly polished monolithic zirconia, which was even less than the glazed one. The internal staining method can create a rougher surface for some of the surface treatment methods.
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A sectional complete denture for microstomic patients p. 162
Seyyed Hamid Shams, Seyyed Saeed Shams, Ehsan Ghasemi
Microstomic patients may experience a significant limitation in the mandibular opening. The prosthetic rehabilitation of microstomic patients presents difficulties at all stages, from preliminary impressions to prosthetic fabrication. This clinical report described the method of fabrication of sectional denture for patients with microstomia caused by burns. The denture was fabricated in two pieces, and patients inserted and removed the denture easily.
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