Periodontal findings in patients with oral submucous fibrosis and comet assay of affected gingival epithelial cells

Elongated Styloid Process Evaluation Using Panoramic Radiography in Patients With Oral Submucous Fibrosis: A Retrospective Study

Background Oral submucous fibrosis (OSMF) is a chronic condition primarily affecting the buccal mucosa, characterized by fibrotic changes, scarring, and precancerous lesions. Pathologically, it involves inflammation, collagen deposition, and muscular degeneration. Objective This study aimed to assess the prevalence and distribution of elongated styloid process (ESP) in patients diagnosed with OSMF, contributing to the understanding of anatomical variations in this population. Methods A retrospective study was conducted at the Department of Oral Medicine and Radiology of Saveetha Dental College. We collected records of OSMF patients from 2021 to 2023, which included panoramic radiographs. We evaluated the presence, type, and grading of ESP alongside OSMF grades using standardized classifications. Results Out of 125 OSMF patients, 67 (53.6%) had ESP. Type I ESP was most prevalent (83.58%). Bilateral occurrences were more common (52.2%) than unilateral (41.79%). On both sides, type I ESP predominated significantly. Among unilateral cases, left-side occurrences were slightly more frequent. Type I ESP remained predominant regardless of laterality. Conclusion The study highlights the high prevalence of ESP, predominantly type I, in OSMF patients, with bilateral occurrences more common. These findings provide valuable insights into the anatomical variations associated with OSMF, contributing to clinical understanding and potential future research directions.

Comet assay as a suitable biomarker for in vivo oral carcinogenesis: a systematic review

BACKGROUND AND OBJECTIVES

In order to detect genetic damage, different methods have been developed, such as micronuclei and comet assay. The comet assay presents some advantages when compared to the other aforementioned methods, including wide versatility, as any eukaryotic cell can be evaluated at an individual cellular level. In this context, the aim of this systematic review was designed to help further elucidate the following question: is the comet assay a suitable biomarker of in vivo oral carcinogenesis?

MATERIAL AND METHODS

The present systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Full manuscripts from 18 studies were carefully selected in this setting.

RESULTS

A total of 15 studies demonstrated positive findings for genotoxicity in peripheral blood or oral cells in patients with pre-malignant lesions or oral cancer. In the quality assessment of studies, 1 was classified as Strong, 5 were considered as Moderate, and 12 were classified as Weak.

CONCLUSION

In summary, the comet assay can be a useful biomarker for oral carcinogenesis. However, further studies with more strict parameters are suggested (with less uncontrolled confounders) in order to increase findings reliability for diagnosis of oral potentially malignant lesions.

Evaluation of DNA damage in tobacco associated human buccal cells using comet assay

Aim and objective

To assess the DNA damage in tobacco associated human buccal cells using comet assay.

Methods

The study included 75 study subjects, which were divided into 3 groups on the basis of tobacco usage. Group I - 25 individuals with no history of tobacco usage, Group II - 25 individuals with tobacco usage but without oral lesions and Group III - 25 individuals with tobacco associated oral lesions. Cytological smears collected from these individuals were used to assess the tobacco associated DNA damage by measuring the tail length in the comet assay method.

Results

The average tail length was found to be 1.46 μm in the normal mucosa, 2.86 μm in tobacco users without oral lesions, 3.86 μm in the lesional sites of tobacco users and 3.67 μm in the non-lesional sites of these individuals. Factors like age, gender, duration and different forms of tobacco habit had their own impact on the oral mucosa.

Conclusion

Comet assay helps assess the subclinical genetic changes of oral mucosa even before the clinical manifestations of the precancerous lesions appeared due to tobacco usage. Thus, comet assay may bloom out as a novel adjuvant tool for the prevention of oral cancer in the near future.

Oral Mucosa as a Potential Site for Diagnosis and Treatment of Allergic and Autoimmune Diseases

Most prevalent food allergies during early childhood are caused by foods with a high allergenic protein content, such as milk, egg, nuts, or fish. In older subjects, some respiratory allergies progressively lead to food-induced allergic reactions, which can be severe, such as urticaria or asthma. Oral mucosa remodeling has been recently proven to be a feature of severe allergic phenotypes and autoimmune diseases. This remodeling process includes epithelial barrier disruption and the release of inflammatory signals. Although little is known about the immune processes taking place in the oral mucosa, there are a few reports describing the oral mucosa-associated immune system. In this review, we will provide an overview of the recent knowledge about the role of the oral mucosa in food-induced allergic reactions, as well as in severe respiratory allergies or food-induced autoimmune diseases, such as celiac disease.

Otorhinolaryngological symptoms among smokeless tobacco (Maras powder) users

OBJECTIVE:

This study aims to investigate the relationship between smokeless tobacco (maras powder) consumption and otorhinolaryngological symptoms.

METHODS:

This descriptive study was carried out on 599 participants. The participants were divided into two groups. Of these, 299 (49.9%) patients aged over 18 years were the first group; they used smokeless tobacco for at least 5 years. The remaining patients comprised the second group, which included 300 (50.1%) healthy volunteers who did not use tobacco or its products and demonstrated some similarities with the first group. For the purpose of data collection, a questionnaire consisting of 45 questions was administered to the participants.

RESULTS:

Cough, sputum, shortness of breath, dysphagia, snoring, and apnea-hypopnea were found to be significantly increased in smokeless tobacco users. The highest odds ratio (OR) found was for sputum at 2.615. Similarly, other oral cavity symptoms such as mouth tickling, dryness of throat, mouth sores, halitosis, taste disorders, and toothache were found to be significantly increased in smokeless tobacco users. It is noteworthy that halitosis was 9.4 times more prevalent among smokeless tobacco users than in the non-tobacco users. Sinonasal symptoms such as sneezing, headache, facial fullness, and anorexia were found to be significantly increased in smokeless tobacco users. However, there were no differences between the groups in terms of ear symptoms.

CONCLUSION:

This study demonstrated that the negative effects of smokeless tobacco consumption were particularly higher in the oral cavity, which in turn gave rise to a number of serious upper respiratory tract complaints.

Profilin-mediated food-induced allergic reactions are associated with oral epithelial remodeling

BACKGROUND

In areas of high exposure to grass pollen, allergic patients are frequently sensitized to profilin, and some experience severe profilin-mediated food-induced reactions. This specific population of patients is ideal to study the relationship between respiratory and food allergies.

OBJECTIVE

We sought to determine the role of oral mucosal epithelial barrier integrity in profilin-mediated allergic reactions.

METHODS

Thirty-eight patients with profilin allergy stratified into mild or severe according to their clinical history and response to a profilin challenge test and 6 nonallergic subjects were recruited. Oral mucosal biopsies were used for measurement of CD11c, CD3, CD4, tryptase, claudin-1, occludin, E-cadherin, and vascular endothelial growth factor A levels; Masson trichrome staining; and POSTN, IL33, TPSAB, TPSB, and CMA gene expression analysis by using quantitative RT-PCR. Blood samples were used for basophil activation tests.

RESULTS

Distinct features of the group with severe allergy included the following: (1) impaired epithelial integrity with reduced expression of claudin-1, occludin, and E-cadherin and decreased numbers of epithelial cells, which is indicative of acanthosis, higher collagen deposition, and angiogenesis; (2) inflammatory immune response in the mucosa, with an increased number of CD11c⁺ and CD4⁺ infiltrates and increased expression of the cytokine genes POSTN and IL33; and (3) a 10-fold increased sensitivity of basophils to profilin.

CONCLUSIONS

Patients with profilin allergy present with significant damage to the oral mucosal epithelial barrier, which might allow profilin penetration into the oral mucosa and induction of local inflammation. Additionally, severely allergic patients presented with increased sensitivity of effector cells.

E-cigarettes and flavorings induce inflammatory and pro-senescence responses in oral epithelial cells and periodontal fibroblasts

Electronic-cigarettes (e-cigs) represent a significant and increasing proportion of tobacco product consumption, which may pose an oral health concern. Oxidative/carbonyl stress via protein carbonylation is an important factor in causing inflammation and DNA damage. This results in stress-induced premature senescence (a state of irreversible growth arrest which re-enforces chronic inflammation) in gingival epithelium, which may contribute to the pathogenesis of oral diseases. We show that e-cigs with flavorings cause increased oxidative/carbonyl stress and inflammatory cytokine release in human periodontal ligament fibroblasts, Human Gingival Epithelium Progenitors pooled (HGEPp), and epigingival 3D epithelium. We further show increased levels of prostaglandin-E2 and cycloxygenase-2 are associated with upregulation of the receptor for advanced glycation end products (RAGE) by e-cig exposure-mediated carbonyl stress in gingival epithelium/tissue. Further, e-cigs cause increased oxidative/carbonyl and inflammatory responses, and DNA damage along with histone deacetylase 2 (HDAC2) reduction via RAGE-dependent mechanisms in gingival epithelium. A greater response is elicited by flavored e-cigs. Increased oxidative stress, pro-inflammatory and pro-senescence responses (DNA damage and HDAC2 reduction) can result in dysregulated repair due to proinflammatory and pro-senescence responses in periodontal cells. These data highlight the pathologic role of e-cig aerosol and its flavoring to cells and tissues of the oral cavity in compromised oral health.

Association between kharra chewing and periodontal health status in oral submucous fibrosis patients of Central India, Nagpur

Purpose:

Kharra is a mixture of areca nut and tobacco. Arecoline, an areca nut extract, disrupts the harmony of the periodontal cells and thus leads to destruction of the periodontium. Oral submucous fibrosis (OSMF) is a premalignant condition that arises due to the consumption of kharra. The aim of this study was to evaluate and compare the effects of kharra chewing on periodontal status in patients with OSMF.

Materials and Methods:

Forty-five patients were divided into Group I: healthy periodontium (n = 15), Group II: chronic periodontitis without OSMF group (n = 15), and Group III: chronic periodontitis with OSMF group (n = 15). The clinical parameters assessed for patients with chronic periodontitis were gingival index (GI), plaque index (PI), probing pocket depth (PPD; overall and regional) ≥3 mm, and clinical attachment level (CAL; overall and regional) ≥3 mm. For patients in Group III, the OSMF diagnosis and staging were based on Khanna's classification. The level of significance was set at P < 0.05.

Results:

The sample with a mean age of 35 years had a frequency of chewing kharra >6 times per day for at least 3 years. PI, PPD and CAL in Group III were 2.1 ± 0.4, 3.2 ± 0.6, and 4.8 ± 0.6 mm, respectively. the results of the clinical parameters in Group III and Group II were higher than Group I. GI was higher in Group II as compared to the other groups.

Conclusion:

The habit of chewing kharra is found to be associated with poor periodontal health in patients with OSMF.

Magnolia officinalis L. Fortified Gum Improves Resistance of Oral Epithelial Cells Against Inflammation

Inflammatory diseases of the periodontal tissues are known health problems worldwide. Therefore, anti-inflammatory active compounds are used in oral care products to reduce long-term inflammation. In addition to inducing inflammation, pathogen attack leads to an increased production of reactive oxygen species (ROS), which may lead to oxidative damage of macromolecules. Magnolia officinalis L. bark extract (MBE) has been shown to possess antioxidant and anti-inflammatory potential in vitro. In the present study, the influence of MBE-fortified chewing gum on the resistance against lipopolysaccharide (LPS)-induced inflammation and oxidative stress of oral epithelial cells was investigated in a four-armed parallel designed human intervention trial with 40 healthy volunteers. Ex vivo stimulation of oral epithelial cells with LPS from Porphyromonas gingivalis for 6[Formula: see text]h increased the mRNA expression and release of the pro-inflammatory cytokines IL-1[Formula: see text], IL-[Formula: see text], IL-8, MIP-1[Formula: see text], and TNF[Formula: see text]. Chewing MBE-fortified gum for 10[Formula: see text]min reduced the ex vivo LPS-induced increase of IL-8 release by 43.8 [Formula: see text] 17.1% at the beginning of the intervention. In addition, after the two-week intervention with MBE-fortified chewing gum, LPS-stimulated TNF[Formula: see text] release was attenuated by 73.4 [Formula: see text] 12.0% compared to chewing regular control gum. This increased resistance against LPS-induced inflammation suggests that MBE possesses anti-inflammatory activity in vivo when added to chewing gum. In contrast, the conditions used to stimulate an immune response of oral epithelial cells failed to induce oxidative stress, measured by catalase activity, or oxidative DNA damage.