Department Of Oral Medicine Research Articles

Dentist Involvement in the Treatment of Radiation-Induced Oral Mucositis-A Pilot Cross-Sectional Study.

Objectives: Oral mucositis (OM) occurs in more than 95% of patients irradiated in the head and neck area. This paper aims to determine the occurrence and characteristics of OM in patients with head and neck cancer (HNC), as well as the involvement of dentists/oral medicine specialists in treating such patients. Methods: This study was conducted at the Department of Otorhinolaryngology and Department of Oral Medicine, University Hospital Center Zagreb, from April to August 2022, on patients irradiated in the head and neck area. A unique OM questionnaire was created on the incidence, characteristics, oral care, and involvement of dentists in the overall care. Results: Thirty patients filled out the questionnaire. Of the 22 patients who had developed OM, 14 had grade-three OM. Ten patients were treated for OM in line with the instructions of an oral medicine specialist, eight based on the instructions of a specialist responsible for monitoring of the underlying disease, and four were not treated at all. Sixteen patients had not been referred to a dentist before the start of RT. Conclusions: These results showed insufficient care and treatment of OM, as well as insufficient involvement of dentists in the oncology team.

Epidemiology of Bruxism and Temporomandibular Joint Disorders (TMD) in Iranian Adults: A Cross-Sectional Study

Objective: The prevalence of bruxism in the literature has been reported differently. The aim of this study was to assess the prevalence of bruxism in patients aged 25–40 who were referred to Kerman Dental School. Methods: This analytical descriptive cross-sectional study was performed on 320 patients referred to the Department of Oral Medicine of Kerman Dentistry Faculty in the age range of 25 to 40 years old. The prevalence of bruxism as well as TMJ disorders were evaluated. Data were collected in a questionnaire and entered into SPSS version 24. Analyzing was done by a chi-square test at a significant level of 0.05. Results: The prevalence of bruxism was 23.8%, with superiority in women. Although clenching was observed in 95.5% of the patients, 84.4% showed premature contacts on teeth, most of them related to the non-working side, and 82.9% presented premature contacts on restorations, especially on the non-working side. Regarding TMD symptoms, pain was the most common (83.4%), and clicking and crepitus were seen in 42% and 6% of the patients, respectively. Also, in 63.7% of the subjects with bruxism, jaw deviation was observed, and 18.7% showed restricted jaw movement. Conclusion: The prevalence of bruxism in the studied population is in the range of similar studies. Regarding TMD, troublesome symptoms such as pain, jaw deviation, and limited mouth opening were the only ones significantly related to bruxism.

Effectiveness of Oral Health Education and Interventions in Improving Oral Health Outcomes in Type II Diabetes Mellitus Patients: A Prospective Study.

Introduction Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The study aimed to evaluate the effectiveness of oral health education and intervention in improving oral health outcomes in type 2 DM (T2DM) patients. Methods The present study was conducted in the Department of Oral Medicine and Radiology between February 2023 and August 2023 at Saveetha Dental College and Hospitals in Chennai, India. All of the patients in the study had T2DM with oral manifestations. This study enrolled 105 participants, of whom 63 were female and 42 were male. A standard pro forma was given to all the participants, and the findings were recorded. The pro forma comprises different oral manifestations, blood glucose levels, the Decayed, Missing, and Filled Teeth (DMFT) index, and Russell's periodontal index. The results were then statistically analyzed. Results This study of 105 individuals with T2DM (60% females and 40% males) revealed significant oral health challenges: 33% had periodontitis, 20% had gingivitis, 5% had lichenoid reactions, 23% had xerostomia, 11% had halitosis, and 8% had candidiasis, illustrating diabetes' impact on dental health. Following appropriate, tailor-made treatment for individual patients, such as scaling, root planning, oral hygiene education, pharmacotherapy, and post-intervention, the prevalence of complications notably decreased by 61%. A total of 7% of patients had gingivitis, 11% had periodontitis, 12% had xerostomia, 4% had halitosis, 2% had candidiasis, and 1% had lichenoid reactions, respectively. This highlights the importance of regular oral care positively impacting diabetes patients, with 61% experiencing improved oral health and 39% experiencing no improvement. Conclusion This study provides compelling evidence for the effectiveness of oral health education and interventions in improving oral health outcomes in T2DM patients. This approach offers a promising strategy for managing the oral health complications associated with diabetes and improving this population's overall health and well-being.

Serum albumin is a potential predictor of delayed healing after minor dental surgery among older patients aged over 65 years: A retrospective study

AbstractAimWith the increasing number of older people worldwide, dentists have more opportunities to manage patients whose oral health requires attention. Such patients often need to undergo minor dental surgery to restore their oral function; however, they usually experience post‐treatment complications that directly reduce their quality of life. This study aimed to comprehensively evaluate the frequency of complications occurring after minor dental surgery and identify predictors of delayed healing (one of the most frequent complications) among patients aged over 65 years.MethodsPatients who visited the Department of Oral Diagnosis and Medicine at Hokkaido University Hospital from 2015 to 2022 were selected and classified into the non‐delayed (n = 87) and delayed (n = 19) healing groups. The clinical backgrounds of these patients were compared between the two groups.ResultsAmong 106 patients aged over 65 years, delayed healing (17.9%) was the most frequent complication after minor dental surgery. Serum albumin levels (odds ratio: 10.0; 95% confidence interval: 2.15–46.6) significantly differed between the delayed and non‐delayed healing groups. Multivariate logistic regression analysis revealed that a serum albumin level of <3.5 g/dl (odds ratio: 10.1; 95% confidence interval: 1.83–56.2) was significantly associated with delayed healing.ConclusionThis study proposed that serum albumin level is a potential predictor of delayed healing in patients aged over 65 years who undergo minor dental surgery. In clinical practice, dentists are required to evaluate and improve nutritional status of older patients even before minor dental surgery.

Diagnostic Dilemma of Radicular Cyst Mimicking a Dentigerous Cyst

Abstract Radicular cyst is the most common odontogenic cyst of the jaw; however, its association with overretained deciduous teeth involving impacted permanent teeth is a rare entity and hence may pose a diagnostic dilemma. The aim of this report is to present a case of radicular cyst that mimicked the dentigerous cyst. A 31-year-old female reported to the department of oral medicine with the chief complaint of swelling on the lower left side of the face. Intraoral examination revealed over-retained carious 75. Based on the clinical features, differential diagnosis was given as a radicular cyst and a dentigerous cyst on radiographic examination; intraoral periapical revealed a cystic lesion involving the crown of the deciduous tooth. Cone-beam computed tomography further confirmed that the cystic lesion was not involving the crown of the impacted premolar. Hence, the three-dimensional radiographic evaluation of the lesion helps to rule out the differential diagnosis.

Dental Attrition and its Association With the Signs and Symptoms of TMJ Dysfunction and Radiographic Condylar Changes – An Observational Study

ABSTRACT To determine the level of dental attrition and its relation to signs of TMJ dysfunction adding to condylar alterations analyzed by conventional TMJ Tomography and to propose the correlation between dental attrition and signs of TMJ dysfunction and condylar changes. Patients for the study were selected from the regular outpatient Department of Oral Medicine, Diagnosis and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, with performed criteria. The radiographic examination of TMJ is performed by the PLANMECA OPG machine using the tomographic program. Statistical analysis was performed using a Chi-square test to determine the relation between attrition and temporomandidular disorders [TMD] signs and symptoms. The study group comprises 60 subjects who are having dental attrition, and they are divided into three groups according to their age: Group I, 20-40 age; Group II, 41-60 age; Group III, more than 60 age 80% of the samples had one or more tooth with significant attrition with grades of two or more on a 0-4 scale The prevalence of changes in condylar morphology was more in individuals above 40 yrs (33.33%) as compared to those below the age of 40 with a total prevalence of 41.67%. The most common symptom reported is tooth sensitivity, joint sounds, and muscle tenderness. The last reported are scalloped tongue, buccal mucosa ridging, referred pain, and limitation of mouth opening. Out of the 25 subjects who showed condylar changes, 10 subjects had symptoms of TMD. The symptoms reported are strain in the mouth opening, tenderness in jaw movements, and TMJ clicking sounds. Attrition is not a predictable sign of TMJ dysfunction, yet a finite association was defined between attrition and signs and symptoms of TMJ dysfunction. Studies involving larger samples compared with additional radiographic modalities are recommended.

Artificial intelligence enabled smart phone app for real-time caries detection on bitewing radiographs.

Diagnosis of proximal caries is a difficult task. Artificial intelligence (AI) enabled diagnosis is gaining momentum. Therefore, it is of interest to evaluate the effectiveness of an artificial intelligence (AI) smart phone application for bitewing radiography towards real-time caries lesion detection. The Efficient Det-Lite1 artificial neural network was used after training 100 radiographic images obtained from the department of Oral Medicine. Trained model was then installed in a Google Pixel 6 (GP6) smartphone as artificial intelligence app. The back-facing mobile phone video camera of GP6 was utilised to detect caries lesions on 100 bitewing radiographs (BWR) with 80 carious lesion in real-time. Two different techniques such as scanning the static BWR on laptop with a moving mobile and scanning the moving radiograph on the laptop with stationery mobile were used. The average value of sensitivity/precision/F1 scores for both the techniques was 0.75/0.846 and 0.795 respectively. AI programme using the rear-facing mobile phone video camera was found to detect 75% of caries lesions in real time on 100 BWR with a precision of 84.6%. Thus, the use of AI with smart phone app is useful for caries diagnosis which is readily accessible, easy to use and fast.

Cleidocranial dysplasia associated with dentigerous cyst-review of literature and case report of two siblings.

Cleidocranial dysplasia (CCD) is a developmental anomaly of the skeleton and teeth which may be inherited, be transmitted as dominant characteristics in either male or female or even appear spontaneously. A case was reported in the department of oral medicine and radiology of two sisters age 17 and 19 years old with a chief complaint of milk teeth not falling since childhood. They presented specific physical and oral findings in common which suggested the idea of an undiagnosed syndrome. The sisters showed CCD characteristics including short stature (4 feet) and frontal bone resorption indicating delayed closure of fontanels. The stature is moderately shortened with the neck appearing long and narrow and the shoulders markedly dropped. Dental abnormalities such as retention of primary dentition, multiple supernumerary teeth, and delayed eruption of permanent dentition. OPG showed the presence of multiple impacted permanent and supernumerary teeth with radiolucency involving the crowns of impacted teeth revealing a cystic lesion. Lateral cephalogram also revealed the presence of multiple impacted teeth. The provisional diagnosis of CCD with dentigerous cyst was given. The enucleation of cyst was done and submitted for histopathological examination. Histopathologically, the soft tissue section suggested the features of dentigerous cyst. The final diagnosis of CCD associated with dentigerous cyst was confirmed.

Pulpotomy for teeth with irreversible pulpitis in immature permanent teeth: a retrospective case series study

To evaluate the success of pulpotomy in treating immature permanent teeth with irreversible pulpitis. This case series included patients with irreversible pulpitis admitted to the Department of Oral Medicine at the author’s Hospital between 2015 and 2020. The pulpotomies were carried out by clinicians with > 5 years of working experience. The follow-up findings and radiographic images were reviewed by two attending dentists. This study included 49 teeth from 48 children (25 boys and 23 girls). The follow-up was 23.3 ± 6.8 months (from 12 to 40 months). The success rate of pulpotomy was 85.7% (42/49). Pulpotomy failed in seven teeth (14.3%). The treatment success rate for traumatic crown fracture was lower than for dental caries and dens evaginatus (P < 0.001). There were no significant differences in the success rate of the pulp-capping agent, tooth root developmental phase, and pulpotomy method (all P > 0.05). Pulpotomy might be successfully used to treat immature permanent teeth with irreversible pulpitis in young patients mainly caused by caries and a fractured tubercle of dens evaginatus.

Clinical Characteristics of Patients with Oral Submucous Fibrosis: A Single Institute Study

Abstract: Background: Oral Submucous Fibrosis (OSMF) is a well-established oral potentially malignant disorder (OPMD) affecting people of Pakistan, India, Bangladesh and Sri Lanka because these nations have a long-standing history of chewing areca nut. Objective: The primary objective of the current study was to assess the clinical features of OSMF in patients presented to the Department of Oral Medicine, Ziauddin University, Karachi, Pakistan. Materials and Methods: This study was done on OSMF patients who came to the Oral Medicine department of Ziauddin University, Karachi, Pakistan from June 2020 to July 2021. Clinicopathological parameters of OSMF like age, gender, habits and its frequency and duration, clinical signs and symptoms and stages were recorded. Result: There were a total of 60 patients of which 35 were males and 25 were females. The mean age of study subjects was calculated to be 36.46±11.96 years. More than 50% of the participants were using a combination of various tobacco products. Most of the patients in our study were of stage III followed by stages II, I and IV. 70% of patients had buccal fibrous bands bilaterally, 36.66% of patients had tongue restriction and 60% of patients complained of burning sensation in the mouth. Conclusion: OSMF becomes a disease of the young generation with a slight male predilection. The majority of individuals suffered from a severe and advanced form of the disease. The development of diagnostic aids is necessary to stop the disease in its early stages.

Assessment of the Anterior Loop and Pattern of Entry of Mental Nerve Into the Mental Foramen: A Radiographic Study of Panoramic Images.

The precise location of the mental foramina is an essential landmark in planning the position of dental implants in the anterior mandible. Injury to inferior alveolar nerve during anterior mandibular implant surgery causes altered sensation which greatly affects patient satisfaction. In this study, we assessed the prevalence of anterior loop of mental nerve and the pattern of entry of mental nerve into the mental foramen. Three hundred panoramic radiographs (600 hemimandibles) obtained from records maintained in the Department of Oral Medicine and Radiology were randomly selected for the study. The radiographs were evaluated by two independent observers for the pattern of entry of mental nerve into the mental foramen on either side of the mandible and for the presence or absence of anterior loop of mental nerve. The most prevalent pattern of mental nerve observed was Straight pattern which totals to 67.5% followed by Anterior loop pattern (18.8%) and then the Perpendicular pattern (13.7%). There was no significant association between the gender and subtypes of looping pattern on the left and right side and a highly significant association between the side of the mandible and loop pattern was observed by Chi square test. The Anterior loop pattern of mental nerve has been found in 18.8% of the population suggesting to accurate planning with three-dimensional imaging techniques to avoid injury to mental nerve during dental implant placement and other surgical procedure involving the interforaminal region of the mandible.

Comparing the efficacy of Leishman–Giemsa Cocktail Stain, Giemsa Stain, and Papanicolaou Stain in Potentially Malignant Disorders: A Comparative Study.

Objective: To estimate the efficacy of the Leishman Giemsa cocktail stain, Giemsa stain, and Papanicolaou for the screening of potentially malignant lesions by exfoliative cytology. Study Design: Comparative study. Setting: Department of Oral Medicine and Oral Pathology, Isra Dental College, Faculty of Dentistry and Allied Sciences Hyderabad, Pakistan. Period: 1st February 2022 to 31st January 2023. Material &amp; Methods: A total of 90 participants were enrolled in the study, 30 subjects of normal healthy individuals were categorized in Group-I and 60 patients with diagnosed potentially malignant lesions (Oral submucous Fibrosis, Oral Lichen Planus, and Leukoplakia) were categorized in Group II. Participants were advised to rinse their mouth with water and the sample was taken by moving a brush clockwise and anti-clockwise over mucosa and the surface of the lesion. Three smears were prepared from each sample, one was fixed with biofix spray and stained with Papanicolaou stain, and other two smears were air-dried and stained with Leishman Giemsa and Giemsa stain. Stained slides were observed under a microscope and the slides were interpreted. Results: In Group-I Leishman Giemsa cocktail stain was highly significant compared to Papanicolaou and Giemsa stain, the mean value of the Leishman Giemsa cytoplasmic stain was 1.16, Papanicolaou was 1.0 and Giemsa was 0.52. Whereas in group II, the mean score of cytoplasmic staining of the Leishman Giemsa cocktail was 1.16, Papanicolaou was 1.10 and Giemsa was 0.67. There was no significant difference found in the mean score of cytoplasmic staining of Group-I and Group II respectively. Conclusion: According to current research study results, the Leishman Giemsa cocktail stain is a better staining technique for the screening of potentially malignant lesions along with the Papanicolaou stain.

Misdiagnosed Geographic Tongue - a Case Report

Aim: This case report presents unnecessary diagnostic procedures performed on a patient with a morphological variation of the tongue called geographic tongue. Case report: In this case, patient presented with discomfort on the left side of the tongue, dry mouth and lesions on the dorsal side of the tongue that lasted 3-4 months. After clinical examination by specialists in otorhinolaryngology and dermatology department, the patient was referred to the Department of Oral Medicine, where he was given a final diagnosis of geographic tongue. Conclusion: Geographic tongue is a benign condition that does not require any special treatment, only follow-ups.

ELSABAGH SCORING SYSTEM FOR ASSESSING SEVERITY AND TREATMENT IMPROVEMENT IN MULTIPLE ORAL LICHEN PLANUS

Introduction: Lichen planus (LP) is a mucocutaneous, chronic, autoimmune disease, with various clinical manifestations, often involving the oral mucosa, and commonly occurs in adults 30-60 years old. Among the various scoring systems for oral lichen planus, the Elsabagh scoring system is valid, accurate, relatively easier to teach, relatively faster to master, and does not require complex calculations.Objective: This paper aimed to report and evaluate the successful therapy given based on using the Elsabagh scoring system in oral lichen planus. Case: A 53-years-old woman came to the Department of Oral Medicine with a main complaint of pain in the upper gums and lower right left a year ago. The pain got worse when eating highly spiced and spicy foods. She felt pain when brushing her teeth. Extra oral examination revealed multiple white plaques on the vermilion border. Intra-oral examination revealed erosive, erythema, accompanied by white plaques mesh-like shaped, irregular, and painful, on the upper labial, right and left buccal mucosa, posterior teeth of the mandible that extend into the mucobuccal fold, and gingiva, palate, and posterior gingiva of the right and left maxillae. Amalgam fillings were found on teeth 37 and 46 with plaque and calculus. Based on clinical features, the patient was diagnosed with Multiple Oral Lichen Planus of Erosive and Reticular type. Case management: The patient received topical and systemic corticosteroids, mouthwashes, and supplements. She was advised to stop eating highly spiced and spicy foods, replace amalgam filling with tooth-colored filling, scaling, and replace removable dentures with permanent dentures. The evaluation result using the Elsabagh scoring system showed an improvement from the value of 8 on the initial visit to 3 on the last visit. There was an improvement in the patient's condition after treatment based on evaluation using the Elsabagh scoring system in this case. The Elsabagh scoring system can correlate disease severity with subjective symptoms, allowing comparisons between the initial evaluation of lesions and treatment efficacy or disease progression in oral lichen planus. Keywords: Autoimmune, Elsabagh Scoring System, Oral Lichen Planus

Special Case Report of Geographic Tongue on the Dorsum of the Tongue of a 2.5-Year-Old Boy

Background: Geographic tongue is a condition that involves the dorsal surface of the tongue. This condition is usually painless, but in some cases, it may be accompanied by pain. The cause is unknown, but it is thought to be related to heredity, hormonal imbalance, and nutritional deficiencies. Case: A 2.5-year-old boy and his parents reported to the Department of Oral Medicine, Dental and Oral Hospital, Jember University with the chief complaints of red islands appearing on his tongue, and worse when he eats and drinks. The patient's mother admitted that her child's complaint had appeared 1 week ago and he had a fever when this condition appeared. The patient's mother also admitted that a similar condition often appeared, almost once a month, but the location was different. The patient's mother never took any action regarding her complaint. Management: Supportive therapy, which was 60 ml of Caviplex syrup 3 times a day and 1 teaspoon after eating. Discussion: Malnutrition in toddlers can lead to disruption of physical growth and health. Indirectly, malnutrition can cause children under the age of 5 years to experience nutritional deficiencies which affect children's health, children's growth, infectious diseases, and children's intelligence, as well as attacks by certain diseases. Nutrient deficiencies inhibit epithelial cell growth. As a result, the differentiation process into stratum corneum epithelium does not occur and the oral mucosa becomes thinner due to loss of normal keratinization. Apart from causing papillary atrophy, substance deficiency can also cause inflammation, pain, and a burning sensation on the geographic tongue. Conclusion: Nutritional deficiencies can trigger geographic tongue due to decreased body resistance. Multivitamins are given as supportive therapy to increase endurance and increase appetite. Keywords: geographic tongue, nutritional deficiencies

Periodontal Lesions among Maxillary Sinus Mucosal Thickening Visiting the Department of Oral Medicine and Radiology of a Tertiary Care Centre.

Maxillary sinus due to its proximity to posterior maxillary teeth could be affected by their pathology. Since cone beam computed tomography is the go-to for 3-D imaging in dental set-up. This study aimed to find out the prevalence of periodontal lesions among maxillary sinus mucosal thickening visiting the Department of Oral Medicine and Radiology of a tertiary care centre. This descriptive cross-sectional study was conducted in the Department of Oral Medicine and Radiology of a tertiary care centre from 01 February 2021 to 30 June 2021 after obtaining ethical approval from the Institutional Review Committee. The medical records from 01 January 2019 to 31 December 2019 were retrieved. The identification of maxillary sinus mucosal thickening of more than 3 mm, in cone beam computed tomography images, was registered separately for the right and left sinuses of each patient. The presence of periodontal lesions of posterior teeth was recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 195 maxillary sinus mucosal thickening, periodontal lesions were found in 74 (37.95%) (31.14-44.76, 95% Confidence Interval) maxillary sinuses of 46 patients. The mean age was 53.67±12.72 years and 30 (65.21%) were males. The prevalence of periodontal lesions among maxillary sinus mucosal thickening in CBCT images was similar to other studies done in similar settings. cone beam computed tomography; maxillary sinus; periodontal disease; prevalence.

Structural and functional abnormalities of the tongue: An epidemiological study from a tertiary care center in India.

The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. Many notable structural and functional alterations can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 to February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed on the tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend their tongue out. Medical history, drug history, and social history were recorded. The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were mostly in the anterior two-thirds (4.2%) of the tongue. Functional abnormalities of the tongue were noted in 8.7% of the study participants. The results of the present study showed that structural and functional abnormalities of the tongue were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkups. This shall help in the prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.

Management of Patients with Oral Lesions Associated Systemic Lupus Erythematous (SLE) Nephritis: A Case Report

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease involving multi-organ such as mucocutaneous, musculoskeletal, and blood vessels with varied extraoral and intraoral clinical manifestations that require treatment from many medical specialists including dentists. The purpose of writing a case report is to describe how to manage oral lesions in patients with SLE Nephritis.&#x0D; Case report: A female 17 years old patient was referred to the oral medicine department of Dr. Hasan Sadikin General Hospital from the pediatrics department and was diagnosed with SLE nephritis due to complaints of ulcers on almost the entire oral mucosa. Extraoral examination revealed a moon face, malar rash, and erythematous rash on the palms of the hands. Intraoral examination revealed multiple ulcers, on labial mucosa, buccal mucosa, lateral right of the tongue, palate, and white plaque on the dorsum of the tongue. The therapy provided was non-pharmacological and pharmacological. Non-pharmacological therapies include oral hygiene instruction and communication, information, education. Pharmacological therapy is a solution containing sucralfate and prednisone which is gargled for one minute, then followed by nystatin oral suspension drug that discards after one minute, then followed by chlorhexidine digluconate 0,12% mouthwash, gargle for one minute, as an antiseptic (each drug is applied in 0,5 – 1 hours). The patient has received a systemic corticosteroid drug (methylprednisolone), but the treatment of oral lesions requires additional topical corticosteroids to accelerate the healing process because of its direct effect on the mucosa.&#x0D; Conclusion: The management of oral lesions using topical corticosteroids in patients with SLE nephritis can help accelerate the healing process.&#x0D; Keywords: Management, Oral Lesions, SLE nephritis

Pollen food syndrome: learning from a case series

Pollen food syndrome (PFS) is an IgE-mediated food hypersensitivity reaction that typically results in immediate-onset oral and oropharyngeal symptoms in individuals who are sensitized to pollen. Symptoms are often mild, but systemic allergic reactions, including anaphylaxis, occur rarely. Using a cases series of six patients who were referred to our oral medicine department and for whom a diagnosis of PFS was made, we illustrate the clinical features of PFS and discuss the possibility that oral mucosal lesions may be a feature. Patients with PFS (or indeed other food hypersensitivities) may present to dental professionals in the first instance, therefore, it is important to be able to recognize key signs/symptoms, to give advice and to investigate/refer appropriately. CPD/Clinical Relevance: Awareness of the clinical features of PFS, including oral mucosal lesions, is of value to dental clinicians

Squamous cell carcinoma in young adult with no predisposing factors: A case report

&#x0D; &#x0D; &#x0D; A 39-year-old male was referred to the Oral and Maxillofacial Medicine department of Alborz University of Medical Sciences Dental School with a lesion that he had noticed for 3 weeks. The patient had no signs or symptoms and no cigarette and alcohol consumption. Because the lesion was placed at the lateral posterior portion of the tongue which is a common place for oral malig- nancies a biopsy was done. The pathology result was Squamous cell carcinoma grade 2. The patient was referred to Imam Khomeini Cancer Institute for further treatment.&#x0D; &#x0D; &#x0D;