SOX2 promotes a cancer stem cell-like phenotype and local spreading in oral squamous cell carcinoma

Emerging evidence shows that oral squamous cell carcinoma (OSCC) invasiveness can be attributed to a small subpopulation of cancer stem cells (CSCs) in the bulk of the tumor. However, the presence of CSCs in the OSCC close resection margins is still poorly unexplored. Here, we found that BMI1, CD44, SOX2, OCT4, UBE2C, CXCR4 CSCs marker genes are significantly upregulated, while IGF1-R, KLF4, ALDH1A1, CD133, FAM3C are downregulated in the tumor core vs healthy mucosa of 24 patients with OSCC. Among these, SOX2 appears also upregulated in the tumor close margin vs healthy mucosa and this significantly correlates with tumor size and lymph node compromise. In vitro analyses in CAL27 and SCC15 tongue squamous cell carcinoma cell lines, show that SOX2 transient knockdown i) promotes the mesenchymal-to-epithelial transition, ii) smooths the invasiveness, iii) attenuates the 3D tumor sphere-forming capacity, and iv) partially increases the sensitivity to cisplatin treatment. Overall, our study highlights that the OSCC close margins can retain CSC-specific markers. Notably, SOX2 may represent a useful CSCs marker to predict a more aggressive phenotype and a suitable target to prevent local invasiveness.

Removal of dental implants displaced into the maxillary sinus: a retrospective single-center study

Background

The use of dental implants in the prosthetic rehabilitation of the posterior atrophic maxilla might be a challenge procedure because of low bone quantity and quality. This study aimed to report cases of implant displacement or migration into the maxillary sinus treated from 2008 to 2021.

Materials and methods

All patients with unintentional insertion and/or displacement of dental implants into the maxillary sinus cavity that underwent surgical removal were included. Variables assessed included the patients’ characteristics, past medical history, clinical and radiological findings at presentation, surgical approach (transoral, transnasal, combined), and outcome.

Results

A total of forty patients (23 male, 17 female) underwent surgical removal of dental implant displaced in the maxillary sinus. The mean age was 52,3 + 11,3 years. Seven patients presented with oro-antral fistula (OAF). In 15 cases, an ostium obstruction was diagnosed. Twenty-five patients underwent transoral surgery under local anesthesia. Eleven patients were treated solely via transnasal endoscopic approach, and four patients who had an associated OAF underwent surgery through a combined transnasal and transoral approach. All patients healed uneventfully without complications.

Conclusion

These results and recent literature validate that transoral and transnasal approach, or a combination of these procedures, can be used safely to treat complications following displacement/migration of dental implants in the maxillary sinus. Early surgical removal minimizes sinus inflammation and prevents more invasive procedures. Each procedure presents specific indications that must be carefully evaluated prior to treatment choice to optimize intervention outcomes.

Efficacy of platelet-rich fibrin compared with triamcinolone acetonide as injective therapy in the treatment of symptomatic oral lichen planus: a pilot study

OBJECTIVES

Oral lichen planus (OLP) is a chronic immune-mediated disease that affects the oral cavity. Topical steroids are considered the treatment of choice for painful lesions of OLP. The aim of this split-mouth study was to compare the efficacy of platelet-rich fibrin (PRF) and triamcinolone acetonide (TA) injective therapies in patients with symptomatic OLP.

MATERIALS AND METHODS

Participants with symptomatic OLP were recruited in the Academic Hospital of Magna Graecia University of Catanzaro, Italy. Once a week for a month, patients randomly received a 0.5-mL TA injection in one buccal mucosa and 1-mL PRF injection in the opposite side. The measured outcomes were reduction of the lesions area and symptomatology modifications using visual analogue scale (VAS) score RESULTS: Four weeks after the last injections, an average reduction of 59.8% in the lesion extension and an average reduction of 47.6% in the VAS score for PRF-treated sites were observed; the same variation for TA-treated sites was respectively of 59.2% and 40%. There were no statistically significant differences between the two groups.

CONCLUSIONS

PRF was effective in reducing OLP lesions extension and symptomatology, and it seems to be as effective as TA. Additional data should be collected with a larger sample size, at a longer follow-up and on the PRF lowest effective dose.

CLINICAL RELEVANCE

Current treatment options for OLP are limited. The study proved benefits of PRF injections in management of painful lesions of OLP comparable with TA.

Are Dental Students Aware of and Knowledgeable about COVID-19? A Questionnaire-based Investigation

Background:

Coronavirus disease 2019 (COVID-19) is a major global concern.

Objective:

This study aims to evaluate the knowledge of dental students toward COVID-19 in a context of a health emergency.

Methods:

A questionnaire-based survey was drawn up in an online form, to investigate knowledge and awareness level about COVID-19 among dental students at Magna Graecia University of Catanzaro, Italy. The questionnaire contained socio-demographic questions and 12 questions about definition, contagiousness, symptoms, incubation, source of infection, routes of transmission, treatment and infection control practices related to COVID-19.

Results:

72 dental students responded to the questionnaire-based survey. The participants had 87.6% of the essential knowledge about COVID-19 and 56.9% of the participants had also already heard about similar respiratory diseases. However, only 50% of the responders perceived a greater risk of contagion for dentists than other health professionals.

Conclusion:

Italian dental students had a good level of awareness of COVID-19. The most positive attitude of participants was toward the period of incubation, route of transmission and treatment. The COVID-19 outbreak reminded us the importance of knowledge on cross-infection control. It is essential to further sensitize future dentists to not underestimate the risk of exposure to the virus in dentistry.

COVID-19 is a challenge for dental education-A commentary

The COVID-19, which appeared to originate in China in December 2019, has spread worldwide pandemically. In this commentary, authors described this new challenge for dental education using the recent literature and experience gained in the Italian University of Catanzaro.

Successful Non-surgical Management of a Mandible Fracture Secondary to Medication-related Osteonecrosis of the Jaw: A Unique Case Report

Background:

Medication-related osteonecrosis of the jaw (MRONJ) may be a severe side effect of bone-modifying agents.

Objective:

Pathologic fractures treatment in patients with MRONJ remains challenging. The authors reported a unique case of successful non-surgical management of a mandible fracture secondary to MRONJ.

Methods:

A 78-year-old osteoporotic woman with a 4-year history of oral bisphosphonate therapy and a compromised dental condition developed an MRONJ-related right mandibular body fracture. Treatment consisted of systemic antibiotic administration (amoxiclav and metronidazole) and chlorhexidine mouthwash.

Results:

Follow-up visits revealed progressive healing of the mandibular fracture with bone callus formation and complete recovery of the ipsilateral lip and chin sensitivity after one year.

Conclusion:

Non-surgical management of pathological fractures related to MRONJ might be of interest in patients that refuse any type of surgery, but preventive measures, such as careful dental examination, should be taken before start antiresorptive therapy and during the treatment. The authors reported the first case in the literature of successful management of a mandibular fracture secondary to MRONJ with only antibiotics and mouthwashes.

Gene expression analysis of autofluorescence margins in leukoplakia and oral carcinoma: A pilot study

OBJECTIVES

Autofluorescence is considered a useful technique in the early detection of oral mucosal alterations. However, its efficacy to discriminate tumor margins is still under debate. The purpose of this pilot study was to confirm the existence of molecular divergence from the center of a lesion compared to white light and autofluorescence (VELscope^TM ) visualized margins in leukoplakia and oral carcinoma.

MATERIALS AND METHODS

Molecular divergence from the center of the lesion to white light and VELscope^TM defined margins was compared in patients with leukoplakia (n = 3) and oral carcinoma (n = 4). Expression profiling of 45 selected genes was performed through custom-made TaqMan arrays. Gene Ontology was used for biological pathway analysis.

RESULTS

Irrespective of pathology, the greatest molecular divergence existed between the center of the lesion and both white light and VELscope^TM margins. VELscope^TM and white light margins were also molecularly distinct in oral carcinoma samples. Indeed, the white light margin retained molecular abnormalities observed in the center of the lesion thus suggesting the existence of a "partially transformed" cell population.

CONCLUSION

Despite the limited low number of patients, our data confirm the benefit of combining autofluorescence with conventional oral examination in identifying surgical margins during biopsy procedures for leukoplakia and oral carcinoma.

Is the application of platelet concentrates effective in the prevention and treatment of medication-related osteonecrosis of the jaw? A systematic review

The aim of this systematic review was to answer the question: Is the application of autologous platelet concentrates (APCs) effective in the prevention and treatment of medication-related osteonecrosis of the jaw (MRONJ)? A literature search of PubMed, Scopus, and Web of Science databases (articles published until June 30, 2019) was conducted, in accordance with the PRISMA statement, using search terms related to "platelet concentrate" and "osteonecrosis". The Jadad scale was used to assess the quality of the articles. Fisher's exact test was used to evaluate eventual differences between groups. Of 594 articles, 43 were included in the review (8 for MRONJ prevention and 35 for MRONJ treatment). Out of a total of 1219 dental extractions recorded (786 with APCs), only 12 cases of MRONJ have been reported (1%), all in patients with a history of high-dose antiresorptive treatment, and regardless of the use of APCs (p = 0.7634). Regarding MRONJ treatment, there were no statistically significant differences in terms of improvement between APC application and surgical treatment alone (p = 0.0788). Results are not sufficient to establish the effectiveness of APCs in the prevention and treatment of MRONJ. Randomized controlled trials with large sample size are needed.

Formation, stability and hydrothermal waves in evaporating liquid lenses

We present a fascinating experimental investigation of the formation, stability and thermal patterns of evaporating liquid lenses deposited on an evaporating or non-evaporating liquid pool. The use of infra-red allowed measuring the key parameters of the lens and the pool surface temperature. We unveil the significant interaction of the lens with the underlying liquid in the pool. In particular, the contact line of the lens is deformed very significantly and we ascribe this to the combined buoyancy-thermocapillary convection cells on the surface of the liquid pool, generated by a self-induced evaporative cooling effect. We also demonstrate that the evaporative cooling is ultimately responsible for the formation of the lens, which otherwise would have not formed at ambient temperature. The depth of the pool is shown to be very influential on the stability of the volatile lens and its dynamics.

Marangoni-driven instabilities of an evaporating liquid-vapor interface

Marangoni-driven instabilities of a liquid-vapor interface of ethanol formed in a horizontally oriented capillary tube of 600 microm diameter are described. Instabilities of the interface are reported as well as instabilities of the liquid flow underneath the meniscus. The experimental results consist of visual observation of the interface, microscale particle image velocimetry measurements of the liquid flow and ir temperature measurements of the interface. The instabilities are found in both the flow structure and the interfacial temperature which present a periodic oscillatory pattern with a characteristic frequency of about 5 Hz. The interface also oscillates periodically, having a characteristic frequency of about 1.4 Hz. The differential evaporative cooling along the extended meniscus in the triple-line region produces a temperature difference which sustains the liquid-thermocapillary Marangoni-driven convection. A linear stability analysis based on a one-sided model, modified to take into account evaporation, is used to show that the self-induced temperature difference at the triple-line region is responsible for the observed interfacial instabilities. The instabilities in the flow pattern are due to competition between the surface tension driving force and gravity and are also found to be influenced by the meniscus instabilities.