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IN THE NAME OF GOD

IN THE NAME OF GOD. EVALUATION AND COMPARISON OF SALIVARY PEROXIDASE IN PATIENTS WITH ORAL LICHEN PLANUS AND NORMAL INDIVIDUALS . DR. HEIDAR KHADEMI Associate PROFESSOR OF ORAL MEDICINE DEPARTMENT SCHOOL OF DENTISTRY OF ISFAHAN MEDICAL SCIENCES UNIVERSITY AND HEALTH SERVICES,IRAN.

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IN THE NAME OF GOD

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  1. IN THE NAME OF GOD

  2. EVALUATION AND COMPARISON OF SALIVARY PEROXIDASE IN PATIENTS WITH ORAL LICHEN PLANUS AND NORMAL INDIVIDUALS.DR. HEIDAR KHADEMI Associate PROFESSOR OF ORAL MEDICINE DEPARTMENT SCHOOL OF DENTISTRY OF ISFAHAN MEDICAL SCIENCES UNIVERSITY AND HEALTH SERVICES,IRAN

  3. Oral lichen planus (OLP ) is a chronic immunologic inflammatory mucocutaneous disorder and may appear in different forms .

  4. ETHILOGY AND DIAGNOSISCELL –MEDIATED IMMUNOLOGICALLY INDUCED DEGENERATION OF THE BASAL CELL LAYER OF THE EPITHELIUM.Although lichen planus may manifest as a particularly well-defined and characteristic lesion, the differential diagnosis for less specific lesions is expensive

  5. CLASSIFICATION RETICULAREROSIVEBULLUOSE ATROPHIC PLAQUE

  6. CLINICAL FEATURES There is no evident genetic bias or uniform etiologic factor.Mean age 50 female predominance 1% of population have cutaneous lesion The prevalence:0.1 -2.2 %

  7. DIFFERETIAL DIAGNOSISlechenoid lesions: drug –induced lesions,contact mercury hypersenstivity,erythema multiform,sle,graft-versus-host reaction,leukoplakia,scc bmmp ,candidiasis,Although it dose not always provide an unequivocal diagnosis, a biopsy should be carried out before treatment of the lesions ,because of the tendency for corticosteroids to confuse the diagnosis.

  8. TREATMENTThere is no known cure for OLP Only management of symptoms1-corticosteroids (topical, systemic)retinoid topical application of cyclosporine

  9. SALIVA • Salivary and its constituents play an important role in the homeostasis of the oral cavity, and alterations • either in its quality or quantity might contribute to various oral diseases and disturbances. Few investigations have been done .

  10. The role of salivary peroxidaes in the pathogenesis and clinical course of oral mucosal diseases have yet not been studied .Human whole saliva contains 2 peroxidase enzymes that are important mucosal defense factors.

  11. This enzyme is synthesize and secreted by acinar cells and catalyzes the oxidation of scn to produce hypothiocyanous acid and the hypothiocyanate anion. This reaction has an important consequence for the host because inhibit the growth and metabolism of many species of pathogens.In addition SP has antimicrobial properties and protect the host cells from h2o2 toxicity.

  12. Major salivary glands secrete salivary peroxidase ,which structurally somewhat different but catalytically quite similar to bovin milk lactoperoxidae .Oral polymophonuclear leukocyte release myeloperoxidase into gingival cervicular fluid and whole saliva in amounts proportional to the degree of gingival inflammation.

  13. The aim of this study was to evaluate SP values in patients with OLP.

  14. REVIEW OF LITRATURES • 1 -Putter j –Becker 19832- Putter j –Becker 1985 • 3-Goecke R,Benecke 1985 • 4-Carlson J1986 • 5-Mansson-Rahemtulla 1986 • 6-Gandara BK 1987 • 7Navazesh M 1992 • 8-Kiristilla V 1996 • 9Vucicevic Boras 2004

  15. Materials and Methods

  16. This was a cross sectional analytical study. Prior to the investigation informed consent accord. Population of study was all of OLP patients who referred to dental clinics of Isfahan Medical Sciences Dental Faculty. This study included 20 patients in each group cases were confirmed pathohistologically OLP and age range 18-58 cases (mean 35.4) 8men 12women,and 20 controls (age 20-48),mean 39.3 ,9 women.11 men. The unstimulated whole saliva obtained by simple method of participants spitting the collected saliva into the calibrated tube(.01ml) for 5 minutes between 8-10 AM. The salivary peroxidase values were determined according to Putter and Becker. Data were analyzed by SPSS software.

  17. RESULTS

  18. Table 1: Frequency of different type of OLP in case groups

  19. Table 2:Mean salivary peroxidase levels in OLP patients and healthy individuals 74

  20. Table 3: Mean salivary peroxidase levels in OLP patients and healthy individuals according to gender 3.57 3.71

  21. DISSCUSSION AND CONCLUSION

  22. Results: Totally 52.5% of participants were male and 47.5% were female. In patients group the ratio of mail and female was 50% but in control group was 45=55% mean age of participants was 37.4% and the range was 17-58%. Mean age of pasionts was 35.4 and control group 39.3. Mean of peroxidase in patients was 0.71 ± 3.59 and in controls 3.69 ± 0.74 tha was not significant by T- Student Test. Mean of peroxidase in male was 3.57± 0.62 and in females were 0.82 +- 3.71 that were not significant by T-Student Test.

  23. Some authors found that patients with OLP had significantly lower levels of total peroxnidase and salivary peroxidase in resting whole saliva as well as other salivary components. These authors suggested that patients with OLP had a lower activity and that the excess oxidative substances attacking keratinoytes might be responsible for modifying surface proteins, which in turn ,could trigger the autoimmune response. Some authors did find these results. Results of our study indicate that SP levels were not significantly increased in patients with OLP .Our data show that SP levels do not have a role in pathogenesis of OLP .We suggest studies are needed in order to evaluate SP in patients with different type of OLP and to examine in particular to the acute phase and remission period of OLP.

  24. Conclusion: However the mean difference of peroxidase was not statistically significant but the mean of it was different in two groups that need more studies on it

  25. .AKNOWLEDGMENTWe would like to appreciate the financial support of VICE CHANCELLOR OF ISFAHAN Medical sciences university and health services (MOI).

  26. Thank you for your attention

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