Tunable theranostics: innovative strategies in combating oral cancer

Objective

This study aims to assess and compare the potential of advanced nano/micro delivery systems, including quantum dots, carbon nanotubes, magnetic nanoparticles, dendrimers, and microneedles, as theranostic platforms for oral cancer. Furthermore, we seek to evaluate their respective advantages and disadvantages over the past decade.

Materials and Methods

A comprehensive literature search was performed using Google Scholar and PubMed, with a focus on articles published between 2013 and 2023. Search queries included the specific advanced delivery system as the primary term, followed by oral cancer as the secondary term (e.g., "quantum dots AND oral cancer," etc.).

Results

The advanced delivery platforms exhibited notable diagnostic and therapeutic advantages when compared to conventional techniques or control groups. These benefits encompassed improved tumor detection and visualization, enhanced precision in targeting tumors with reduced harm to neighboring tissues, and improved drug solubility and distribution, leading to enhanced drug absorption and tumor uptake.

Conclusion

The findings suggest that advanced nano/micro delivery platforms hold promise for addressing numerous challenges associated with chemotherapy. By enabling precise targeting of cancerous cells, these platforms have the potential to mitigate adverse effects on surrounding healthy tissues, thus encouraging the development of innovative diagnostic and therapeutic strategies for oral cancer.

Prediction of Lymphovascular and Perineural Invasion of Oral Squamous Cell Carcinoma by Combined Expression of p63 and Cyclin D1

OBJECTIVES

 The aim of this study was to determine the value of immune expression of p63 and cyclin D1 in the prediction of lymphovascular invasion (LVI) and perineural invasion (PNI) in oral squamous cell carcinoma (OSCC).

MATERIALS AND METHODS

 Clinical and histopathologic features of 65 subjects with histologically confirmed OSCC were collected. Tissue microarray blocks representing all subjects were prepared for the immunohistochemical quantification of the nuclear expression of p63 and cyclin D1 using immune ratio plugin of image J software. Image analysis was performed by two independent pathologists. Independent samples t-test, analysis of variance, and receiver operating characteristic curve tests were used for statistical analysis. The level of significance was set at p≤ 0.05.

RESULTS

 The optimum cutoff value for the prediction of LVI for p63 and cyclin D1 was found to be 100 and 93.2, respectively, while the optimum cutoff value for the prediction of PNI for p63 and cyclin D1 was found to be 95.9 and 94, respectively. p63 and cyclin D1 expression correlated with several clinicopathologic features of the studied population. p63 expression was a significant predictor of moderate/poorly differentiated OSCC compared with well-differentiated OSCC. A parallel combination of positive p63 and cyclin D1 increased the specificity of predicting LVI from 89.1% and 67.4% for either p63 or cyclin D1, respectively, to 93.5% with a positive predictive value of 92.5%. Similarly, the parallel combination of the two markers raised the specificity of predicting PNI from 70% and 77.5% for either p63 or cyclin D1, respectively, to 90% with a positive predictive value of 86.3%.

CONCLUSION

 Combined overexpression of nuclear markers p63 and cyclin D1 can be considered as a valuable independent predictor of LVI and PNI, and hence tumor progression, in OSCC.

Mechanisms underlying sex bias in oral immune-mediated conditions, an insight

The predilection for women in systemic autoimmune diseases is well established. However, this sex bias in oral autoimmune diseases has been classically reported from an epidemiological perspective without any elaborate attempts to unveil the underlying mechanisms. The unique nature of the oral environment is likely to impose a combination of systemic and local factors that ultimately result in the sex bias in autoimmune diseases of the oral cavity. Variations of immune responses, target organ vulnerability, endocrine and genetic factors, sex chromosomes and modes of parental inheritance are potential systemic factors, while the oral microbiome, oral tolerance, saliva, and oral epithelial stem cells may account for local contributing factors. This review will discuss the preponderance of women in oral immune-mediated diseases, the potential systemic and local mechanisms underlying this predominance and highlight the crucial need for further research in this area.

Morphometric analysis of odontoid process among Arab population: a retrospective cone beam CT study

Objective

This study aims to evaluate the feasibility of using cone beam computed tomography (CBCT) scans to assess the odontoid process diameter in the Arab population and to determine whether one or two cortical screws can be used for treating odontoid fractures.

Methods

The odontoid process of 142 individuals aged 12-75 years, including 72 males (mean age: 35.5) and 70 females (mean age: 36.2), were analyzed using CBCT scans. The sagittal and coronal CBCT views were used to evaluate the antero-posterior (AP) and transverse diameters of the odontoid process.

Results

Males had substantially bigger transverse and AP diameters of the odontoid process than females (p < 0.05 & P < 0.01 respectively). Among the sample, 97 individuals (67.4%) had external transverse diameter (METD) of less than 9 mm which is slightly bigger than that of Indians and 48 individuals (31.83%) had enough room for two 3.5 mm or two 2.7 mm screws as their METD was more than 9 mm like that of Greek and Turkish. Age had no significant impact on the morphometric measurements of the odontoid process.

Conclusion

More than sixty percent of the sample had METDs of less than 9 millimeters, indicating that a single 4.5-mm Herbert screw may be suggested for fixing fractured odontoid processes in the Arab population.

Anatomical landscape of oral squamous cell carcinoma: A single cancer center study in UAE

Objectives

This study aimed to present demographic and clinicopathological aspects of OSCC identified in Pathology service in the UAE over a 13-year period and compare these findings to a cohort of 523 cases of Head and neck squamous cell carcinoma using the Cancer Genome Atlas's cBioPortal database (http://cbioportal.org).

Material and methods

Histological examination of all hematoxylin and eosin-stained slides and assessment of all demographic and clinical information from laboratory records were performed on all OSCC diagnosed between 2005 and 2018.

Results

Males made up 71.4% of the sample of 231 OSCCs that were evaluated. The patients' average age was 55.38 years. The two most prevalent afflicted sites were the anterior two-thirds of the tongue (57.6%) and the cheek (28.1%). The most prevalent site among smokers were the floor of mouth, cheek, and jaw bones. There was a link between tumor size and numerous anatomical subsites that was shown to be highly significant. OSCC in the FOM was associated with a 25% mortality rate. Patients with OSCC of the anterior tongue and cheek had the best prognosis, with only 15.7% and 15.3% of patients dying during follow-up.

Conclusion

The present investigation found a correlation between the diverse clinicopathological characteristics of the various anatomical subsites in OSCC. Different anatomical subsites also displayed varying degrees of gene mutation.

The impact of reflex-based recreational activities and preclinical training on psychomotor skills in an educational dental environment

BACKGROUND

Participating in recreational activities from a young age may have the potential enhance psychomotor skills early on, and conversely, low levels of participation in these activities may predict slower development of preclinical hand skills.

PURPOSE

This study aims to evaluate the eye-hand coordination benefits of leisure and reflex-based activities to those of typical instructional techniques among dental students.

DATA SOURCES

The databases used were PubMed, EBSCOhost, and Scopus.

STUDY SELECTION

Ten articles were selected from a total of 1135 articles found across three databases.

DATA EXTRACTION

The articles were screened by four investigators through a series of steps in accordance to inclusion and exclusion criteria and rid of any duplicates.

DATA SYNTHESIS

The majority of the 10 featured articles were conducted in the United States. All of the research included was cohort observational studies. This systematic review includes a total of 1975 participants from the publications selected for this purpose.

RESULTS

Manual dexterity may be taught and improved by practice, and tests designed to measure it should be used primarily to pinpoint which students would benefit most from individualized, close supervision during their education.

CONCLUSION

Researchers found that reflex-based activities helped students develop better hand-eye coordination in a classroom setting. However, more precise dental-related tests and questionnaires can always be developed through further study; doing so would yield a wealth of information that would be immensely useful to the dental sector.

MicroRNA expression in apical periodontitis and pulpal inflammation: a systematic review

Background

The aim of this systematic review is to determine microRNAs (miRs) that are differently expressed between diseased pulpal and periapical tissues.

Design

This systematic review used PubMed, Scopus, EBSCO, ProQuest, Cochrane database as well as manual searching to extract studies from January 2012 up to February 2022.

Results

A total of 12 studies met the eligibility criteria were included. All selected studies were of case-control type. Twenty-four miRNAs associated with apical periodontitis, 11 were found to be upregulatedand 13 were downregulated. Four out of the 44 miRs associated with pulpal inflammation were upregulated, whereas forty were downregulated. Six miRs, namely hsa-miR-181b, hsa-miR-181c,hsa-miR-455-3p,hsa-miR-128-3p, hsa-miR199a-5p, and hsa-miR-95, exhibited considerable downregulation in both periapical and pulp tissues.

Conclusion

MiRs have been investigated for their role in pulpal and periapical biology and may be utilised in diagnostic and therapeutic purposes. Further investigations are required to determine why certain irreversible pulpitis situations progress to apical periodontitis and others do not, based on the various miR expressions. Moreover, clinical and laboratory trials are needed to support this theory.

Analysis of inferior nasal turbinate volume in subjects with nasal septum deviation: a retrospective cone beam tomography study

Background

The association of the linear dimensions of the inferior turbinate hypertrophy with nasal septal deviation has been studied recently. However, the volumetric dimensions provide a more accurate status of the turbinate hypertrophy compared to linear measurements. The aim of this study was to analyze the association of inferior nasal turbinate volume with the degree of nasal septal deviation (NSD).

Methods

A retrospective evaluation of the cone beam computed tomography (CBCT) scans of 412 patients was carried out to obtain 150 scans which were included in the study. The scans were categorized into three groups. Group 1 comprised of 50 scans of patients with no inferior turbinate hypertrophy (ITH) and no nasal septal deviation. Group 2 comprised of 50 scans of patients with ITH and no NSD; whereas Group 3 included 50 scans of patients with ITH and NSD. The total turbinate volume of inferior turbinates (bilateral) were determined by using Vesalius 3D software (PS-Medtech, Amsterdam, Netherlands).

Results

The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologists was 0.82. There were no significant age and gender related changes in the total turbinate volume. Patients in Group 3 had significantly higher (p = 0.001) total turbinate volume compared to Group 2 and Group 1. There was a positive and significant correlation (r = 0.52, p = 0.002) between the degree of septal deviation and total turbinate volume. When the total turbinate volume of the patients with different types of septal deviation was compared in Group 3, a statistically significant difference (p = 0.001) was observed. Regression analysis revealed that the septal deviation angle (SDA) (p = 0.001) had a relationship with total turbinate volume. From the results of the study we can conclude that the total turbinate volume is higher in patients with nasal septal deviation. It can also be concluded that the septal deviation angle has a positive correlation with total turbinate volume. The data obtained from the study can be useful in post-surgical follow up and evaluation of patients with nasal septal deviation and hypertrophied inferior nasal turbinate.

Depression, Anxiety and Stress Among Dentists During COVID-19 Lockdown

Introduction:

The objective of this study was to investigate the levels of depression, anxiety, and stress among dentists during covid-19 lockdown and to investigate the relationship between stress and each mental health state.

Methods:

A cross-sectional survey on 269 dentists was conducted using DASS-21 and PHQ-9 questionnaires. Bivariate and multivariate models were constructed and the odds ratio (OR) was calculated to assess the strength of the association between an independent categorical variable and the outcome.

Results and Discussion:

Being unsatisfied with the job was associated with a statistically significant increase in DASS-21 score by an average of 5.9 points after adjusting for the possible confounding effect of the other independent variables included in the model. For each extra 10 years of clinical experience, there is a statistically significant reduction in DASS-21 score by an average of 1.3 points compared after adjusting for the possible confounding effect of the other independent variables included in the model.

Conclusion:

Stress, depression, and anxiety were prevalent during the pandemic among dentists. These psychological domains were modulated by several factors including marital status, gender, years of clinical experience, and degree of job satisfaction.

Titanium dioxide dental implants surfaces related oxidative stress in bone remodeling: a systematic review

Background

Titanium dioxide dental implants have a controversial effect on reactive oxygen species (ROS) production. ROS is necessary for cellular signal transmission and proper metabolism, but also has the ability to cause cell death as well as DNA, RNA, and proteins damage by excessive oxidative stress. This study aimed to systematically review the effect of titanium dioxide dental implant-induced oxidative stress and its role on the osteogenesis-angiogenesis coupling in bone remodeling.

Methods

This systematic review was performed conforming to preferred reporting items for systematic review and meta-analysis (PRISMA) model. Four different databases (PubMed, Science Direct, Scopus and Medline databases) as well as manual searching were adopted. Relevant studies from January 2000 till September 2021 were retrieved. Critical Appraisal Skills Programme (CASP) was used to assess the quality of the selected studies.

Results

Out of 755 articles, only 14 which met the eligibility criteria were included. Six studies found that titanium dioxide nanotube (TNT) reduced oxidative stress and promoted osteoblastic activity through its effect on Wnt, mitogen-activated protein kinase (MAPK) and forkhead box protein O1 (FoxO1) signaling pathways. On the other hand, three studies confirmed that titanium dioxide nanoparticles (TiO₂NPs) induce oxidative stress, reduce ostegenesis and impair antioxidant defense system as a significant negative correlation was found between decreased SIR3 protein level and increased superoxide (O₂ ^•-). Moreover, five studies proved that titanium implant alloy enhances the generation of ROS and induces cytotoxicity of osteoblast cells via its effect on NOX pathway.

Conclusion

TiO₂NPs stimulate a wide array of oxidative stress related pathways. Scientific evidence are in favor to support the use of TiO₂ nanotube-coated titanium implants to reduce oxidative stress and promote osteogenesis in bone remodeling. To validate the cellular and molecular cross talk in bone remodeling of the present review, well-controlled clinical trials with a large sample size are required.

Postoperative care in ICU versus non-ICU after head and neck free-flap surgery: a systematic review and meta-analysis

OBJECTIVE

Admission to the intensive care unit (ICU) has long been considered as routine by most head and neck surgeons after microvascular free-flap transfer. This study aimed to answer the question 'Is there a difference in the flap survival and postoperative complications rates between admission to intensive care unit (ICU) versus Non-ICU following microvascular head and neck reconstructive surgery?'.

DESIGN

Systematic review, and meta-analysis.

METHODS

The PubMed, Embase, Scopus and Cochrane Library electronic databases were systematically searched (till April 2021) to identify the relevant studies. Studies that compared postoperative nursing of patients who underwent microvascular head and neck reconstructive surgery in ICU and non-ICU were included. The outcome variables were flap failure and length of hospital stay (LOS) and other complications. Weighted OR or mean differences with 95% CIs were calculated.

RESULTS

Eight studies involving a total of 2349 patients were included. No statistically significant differences were observed between ICU and non-ICU admitted patients regarding flap survival reported (fixed, risk ratio, 1.46; 95% CI 0.80 to 2.69, p=0.231, I²=0%), reoperation, readmission, respiratory failure, delirium and mortality (p>0.05). A significant increase in the postoperative pneumonia (p=0.018) and sepsis (p=0.033) was observed in patients admitted to ICU compared with non-ICU setting.

CONCLUSION

This meta-analysis showed that an immediate postoperative nursing in the ICU after head and neck microvascular reconstructive surgery did not reduce the incidence of flap failure or complications rate. Limiting the routine ICU admission to the carefully selected patients may result in a reduction in the incidence of postoperative pneumonia, sepsis, LOS and total hospital charge.

Prevalence of Anosmia or Ageusia in Patients With COVID-19 Among United Arab Emirates Population

Objective

The aim of this research was to determine the relationship and prevalence of taste and smell dysfunction in patients with COVID-19 in the United Arab Emirates (UAE) population.

Methods

Enrolled participants were interviewed online via a phone call after obtaining their informed consent. Quantification of smell, taste, and other sensations before, during, and after COVID-19 infection was correlated with the severity of COVID-19 symptoms.

Results

A total of 500 patients with (mild–severe) COVID-19 completed the survey. A total of 26.4% were asymptomatic, and 21.4% were classified as paucisymptomatic with less severe symptoms. Almost equal proportions of the studied population experienced extreme taste sensation reductions (43%) and loss of smell sensation (44%). Statistically significant drastic decreases in smell and taste senses were seen among younger individuals. The magnitude of reduction in both sense changes increased steeply from the asymptomatic group to the paucisymptomatic group to the symptomatic group.

Conclusions

Sudden anosmia or ageusia need to be recognised for early detection of COVID-19 infection to identify otherwise hidden carriers, thus favoring an early isolation strategy that will restrict the spread of the disease.

Prevalence of Burnout among Dental Students during COVID-19 Lockdown in UAE

AIM

To estimate the prevalence of burnout among dental students in two major universities in the United Arab Emirates during the coronavirus disease-2019 (COVID-19) lockdown.

MATERIALS AND METHODS

In this cross-sectional observational study, the burnout clinical subtype questionnaire (BCSQ-12-SS) (English version) was used. It consists of 12 questions covering domains of overload (4 questions), lack of development (4 questions), and neglect (4 questions). The questionnaire was sent to 500 dental students from the University of Sharjah (UOS) and Ajman University of Science and Technology (AUST). The association between burnout and sociodemographic variables was also investigated.

RESULTS

The majority of responders were females (74%). Socio-demographic and study characteristics of dental students from both universities were not remarkably different. However, the responses to the BCSQ-12-SS questions were not very different. In this study, there was no significant association between burnout and demographic variables, such as age, gender, relationships, distance from family, residency, year of study, studying hours, and number of failed subjects. However, there was a significant association between burnout and receiving a scholarship and family support.

CONCLUSION

Identifying individuals at risk for burnout may provide a potential intervention strategy and counseling to assist in dental student development, as it has good psychometric properties.

CLINICAL SIGNIFICANCE

Burnout among dental students could develop into anxiety and depressive disorders. Early identification and prevention will protect the psychological well-being of dentists. How to cite this article: Al-Rawi NH, Yacoub A, Zaouali A, et al. Prevalence of Burnout among Dental Students during COVID-19 Lockdown in UAE. J Contemp Dent Pract 2021;22(5):538-544.

Oral health awareness, attitude towards dental treatment, fear of infection and economic impact during COVID-19 pandemic in the Middle East

Objectives

To assess the impact of COVID‐19 on oral hygiene (OH) awareness, attitude towards dental treatment, fear of infection and economic impact in the Middle East.

Methods

This survey was performed by online distribution of questionnaires in three countries in the Middle East (Jordan, Iraq and Egypt). The questionnaire consisted of five sections: the first section was aimed at collecting demographic data and the rest sections used to assess OH awareness, attitude towards dental treatment, degree of fear and economic impact of COVID‐19. The answers were either multiple choice, closed‐end (Yes or No) or 5‐point Likert scale for the last four sections.

Results

A total of 3782 respondents completed the questionnaire. Overall, OH awareness was low (mean ±SD; 1.84 ± 1.03), while attitude towards dental treatment (5.04 ± 1.68) and economic impact (11.29 ± 4.37) were moderately affected. In addition, fear of infection showed moderately high level (14.04 ± 4.11). All subgroups of the demographic variables showed significant differences among them in relation to OH awareness and attitude towards dental treatment. The regression model suggested country, gender, age, education level, income level and fear as predictors for OH awareness (R² 0.036) and attitude towards dental care (R² 0.141).

Conclusions

The pandemic negatively impacted the level of OH awareness. However, the attitude towards dental treatment was moderately affected. Increasing public fear and compromised economy influenced OH awareness and the attitude towards dental treatment.

Salivary microRNA 155, 146a/b and 203: A pilot study for potentially non-invasive diagnostic biomarkers of periodontitis and diabetes mellitus

Dysregulated expression of MicroRNAs (miRNAs) plays substantial role in the initiation and progression of both diabetes and periodontitis. The aim of the present study was to validate four miRNAs in saliva as potential predictive biomarkers of periodontal disease among patients with and without diabetes mellitus (DM). MiRNAs were extracted from the saliva of 24 adult subjects with DM and 29 healthy controls. Each group was subdivided into periodontally healthy or having periodontitis. In silico analysis identified 4 miRNAs (miRNA 155, 146 a/b and 203) as immune modulators. The expression of miRNAs-146a/b, 155, and 203 was tested using quantitative PCR. The expression levels in the study groups were compared to explore the effect of diabetes on periodontal status and vice versa. In our cohort, the four miRNAs expression were higher in patients with periodontitis and/or diabetes. miRNA-155 was the most reliable predictors of periodontitis among non-diabetics with an optimum cut-off value of < 8.97 with accuracy = 82.6%. MiRNA 146a, on the other hand, was the only reliable predictor of periodontitis among subjects with diabetes with optimum cut-off value of ≥11.04 with accuracy = 86.1%. The results of the present study concluded that MiRNA-146a and miRNA155 in saliva provide reliable, non-invasive, diagnostic and prognostic biomarkers that can be used to monitor periodontal health status among diabetic and non-diabetic patients.

Epithelial tissue thickness improves optical coherence tomography's ability in detecting oral cancer

BACKGROUND

OCT is a non-invasive imaging technique that enables the measurement of epithelial thickness and architectural changes, which can help in the diagnosis of pre-cancerous and cancerous lesions. The purpose of the study was to assess whether epithelial tissue thickness improves optical coherence tomography's ability in detecting oral cancer.

PATIENTS AND METHODS

Surgically resected oral margins from 60 patients diagnosed with oral squamous cell carcinoma were subjected to OCT. Three OCT measurements (immediate, 1 h and 24 h post-resection) were conducted per resected tissue specimen to look at the effect of saline and formalin on the specimen and its effect on the reproducibility of the OCT. OCT was, then, used to measure the epithelial tissue thickness in cancer-free and cancer-involved margins in eight oral anatomical locations. This data was, then, combined with architectural changes data to calculate the sensitivity and specificity.

RESULTS

An overall of 189 cancer-free margins and 51 cancer-involved margins had their epithelial thickness measured using OCT and compared to histopathology. With regards to the validity of the OCT and histopathological measurements, epithelial thickness showed good correlation between different readings at all oral sites. With regards to the reproducibility of the OCT measurements, the mean epithelial thickness for all measurements at first (immediate) and second (1 h post-resection - saline preserved) measurements was not significantly different. Underestimation of the epithelial depth in cancer-free margins was 20 μm, while in the cancer-involved margins was 10 μm. Combining data from architectural changes and epithelial thickness, a sensitivity of 92% and a specificity of 94% was achieved.

CONCLUSION

Oral epithelium measurements using OCT were valid compared to those made with gold standard pathology. Measurements made using OCT was also reproducible with minor underestimation. Epithelial thickness, combined with architectural changes, led to high accuracy in differentiating between cancer-free and cancer-involved margins.

Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: A cone-beam computed tomography study

Purpose

To determine the prevalence of concha bullosa (CB) and nasal septal deviation (NSD) and their impact on maxillary sinus volume (MSV).

Materials and Methods

Cone-beam computed tomographic (CBCT) images of 106 Emirati people were used in this study. The direction and angle of septal deviation were calculated. The presence of CB, which could be unilateral, contralateral, or bilateral in relation to the direction of NSD, was also recorded. MSV was measured using reconstructed Digital Imaging and Communication in Medicine images on Dolphin 3D imaging software version 11.8 premium (Dolphin Imaging, Chatsworth, CA, USA). P values <0.05 were considered to indicate statistical significance.

Results

CB was detected in 37.7% of the sample; 20.7% of the sample showed single unilateral CB and 16.6% had single bilateral CB. NSD was seen in 74.5% of the sample. In the participants with CB, 45.5% showed mild deviation, 34.4% showed moderate deviation, and only 12.5% showed severe septal deviation. CB, but not NSD, was associated with significantly higher MSV on the affected side (P=0.001).

Conclusion

Although NSD was observed in more than two-thirds of the sample and CB was present in more than one-third of the sample, only CB had a significant impact on MSV.

Occupational noise-induced hearing loss among dental professionals

OBJECTIVE

The purpose of this study was to determine whether the persistent high-frequency noise produced by dental equipment could cause hearing impairment among the dental professionals in the United Arab Emirates (UAE).

METHOD AND MATERIALS

This cross-sectional study was conducted to evaluate the hearing capacity of 90 randomly selected dental practitioners from different specialties working in the UAE. The participants were approached in their workplace and their hearing capacity was evaluated using the pure tone audiometer.

RESULTS

Twenty dental practitioners suffered from hearing impairment, which constitutes 22.2% of the studied sample. At high frequencies, left ears were more affected than right ears, but this was not statistically significant. There was a direct relationship between working hours per week and the hearing capacity, but this did not reach a statistically significant level. The lowest hearing capacity was detected in males at a significantly lower value compared to females.

CONCLUSIONS

Positive correlation was found between years of experience and reduced hearing capacity among dental practitioners. In addition, males had a significantly higher median count of severely affected hearing frequencies compared to females. Online pure tone audiometric testing is an easy, cost-effective tool that can be used to self-assess the hearing capacity of dental professionals, and it is recommended to perform this test annually.

Vertebral Malalignment among Male Dentists with Work-related Musculoskeletal Pain in the United Arab Emirates

AIM

Musculoskeletal pain (MSP) is a highly prevalent and debilitating disorder among dentists, often leading to early retirement. Poor ergonomics in the dental practice not only causes MSP, but can also lead to postural deviations as a result of an imbalance in muscle function. The aim of this study was to observe the relationship between MSP and vertebral deviations among male dentists in the United Arab Emirates (UAE).

MATERIALS AND METHODS

A total of 60 male dentists participated in this cross-sectional study. Standardized Nordic questionnaire (SNQ) was used to record MSP and PostureScreen Mobile® (PSM) application was used to observe postural deviations in the vertebral regions, including the neck, shoulders, upper back, lower back, and hips.

RESULTS

About 83% of participants were suffering from MSP, with the lower back as the most commonly reported region (29%). The pain characteristics reported were chronicity (63%) and dullness (72%). As for postural deviations, the most common site recorded was the neck region (72%). The correlation between the regions of deviation and the regions of pain showed that the shoulder region was more significant than other regions.

CONCLUSION

Musculoskeletal pain and vertebral malalignment are common among practicing dentists, probably because of bad postural habits and lack of awareness. Preventive strategies to minimize the risk of developing these health problems are highly recommended.

CLINICAL SIGNIFICANCE

Work-related MSP (WRMSP) is a significant health problem among dentists and may be linked to the later development of vertebral deviations. Posture screen analysis is a quick, yet objective postural and movement screening tool in which findings can quickly be rendered to prospective dentists, so that custom postural and functional exercises may be correctly practiced.

Comparison of osteoclastogenesis and local invasiveness of ameloblastoma and keratocystic odontogenic tumor

Objectives:

The aim of this study was to compare the expression of receptor-activated nuclear factor kappa B (RANK) with its ligand (RANKL) and matrix metalloproteinase-2 (MMP2) in solid/multicystic ameloblastomas (ABs) and keratocystic odontogenic tumors (KOTs).

Materials and Methods:

The expression of MMP2, RANK, and RANKL molecules was evaluated in 13 ABs and 14 KOTs by immunohistochemistry. The expressions were calculated in the odontogenic epithelial cells as well as the stromal cells.

Results:

Odontogenic epithelia of AB expressed MMP2, RANK, and RANKL significantly higher than that of KOTs (P < 0.05). The expression of MMP2, RANK, and RANKL was highest in plexiform subtype (79.9%, 81.08%, and 65.1%, respectively). KOTs without daughter epithelia nests expressed both MMP2 and RANK the least (56.06% and 47.5%, respectively). Stromal cells, on the other hand, expressed similar MMP2 pattern in odontogenic epithelia of both AB and KOT. RANKL was expressed weaker in the stromal cells of both lesions.

Conclusion:

Invasive biological and osteolytic behaviors of both lesions were evaluated in this study. It was found to be more in AB than keratocystic odontogenic. A significant expression of MMP2, RANK, and RANKL in both KOTs associated with microcyst and plexiform type AB as well.

Shisha Smoking Habit among Dental School Students in the United Arab Emirates: Enabling Factors and Barriers

OBJECTIVES

The objective of the present study was to assess shisha smoking among dental school students in Sharjah, United Arab Emirates (UAE). In addition, the role of suggested barriers and enabling factors in shisha smoking was also evaluated.

METHODS

A cross-sectional questionnaire-based survey was conducted at the College of Dental Medicine, University of Sharjah, between February and May 2016. The questions were adapted from previously published water pipe smoking studies. The collected data were analyzed to identify the relationship between shisha smoking and sociodemographic characteristics. Relevant questions were further categorized as enabling factors and barriers for shisha smoking.

RESULTS

Three enabling questionnaire items related to social environment were significantly associated with an increased risk of being a current smoker. The most powerful is peer pressure ("friends smoke shisha"), which increased the odds ratio of shisha smoking 11.3 times, followed by smoker sibling with increase in odd ratio by 4.52 times, then the belief of social acceptance with increase in odd ratio by 4.31 times.

CONCLUSION

Shisha smoking is a serious problem among university students. Any intervention program in the university curricula should consider teaching students that shisha is no less risky than cigarettes and is addictive.

Oxidative stress, antioxidants, and lipid profile in the serum and saliva of individuals with coronary heart disease: is there a link with periodontal health?

BACKGROUND

Oxidative stresses and dyslipidemia are an important risk factor in the development of coronary atherosclerotic complications like angina pectoris and myocardial infarction. The aim of this study was to find the relationship between the salivary lipid profile, lipid peroxidation and antioxidants and the periodontal health status of patients with acute coronary heart disease (CHD).

METHODS

Forty patients who had experienced a recent attack of angina pectoris or myocardial infarction and another 40 noncardiac patients matched for age, sex and residence (control) were recruited. The lipid profile level, lipid peroxidation and antioxidant status were measured in the serum and saliva of all participants together with lactate dehydrogenase (LDH) and C-reactive protein. The studied parameters were then correlated with the periodontal status of the participant using the Clinical Periodontal Sum Score (CPSS). A multiple linear regression was used to assess the net effect of each set of independent variables on the outcome variable using SPSS-21. A P value ≤0.05 was considered statistically significant.

RESULTS

Salivary total cholesterol, triglycerides, low density lipoprotein-cholesterol, very low density lipoprotein-cholesterol, malondialdehyde, uric acid, superoxide dismutase and LDH levels increased with the upper tertile of the CPSS, while salivary high-density lipoprotein-cholesterol decreased with the upper tertile of the CPSS.

CONCLUSIONS

Periodontal health status could be considered as an independent risk factor for acute CHD.

Work-related Musculoskeletal Pain among Different Dental Specialists in United Arab Emirates

INTRODUCTION

Dentists are at a very high risk of developing work-related musculoskeletal pain. The present study aimed at studying the prevalence of musculoskeletal pain among different dental specialists in the United Arab Emirates (UAE), and correlating the region of pain with the type of clinical work done by the specialists.

MATERIALS AND METHODS

A sample of more than 100 dentists was chosen randomly from different emirates in UAE. An interview questionnaire was administered regarding the number of years of experience and the presence, region, duration, and type of musculoskeletal pain they experienced.

RESULTS

Musculoskeletal pain is experienced by 83.3% of periodontists, 80% of conservative dentists, 77.8% of endodon-tists, 72.7% of orthodontists, 70% of oral surgeons, 63.6% of prosthodontists, 63% of general dental practitioners, and 50% of pedodontists. The results have also indicated that the region of experienced musculoskeletal pain does vary according to the specialty. From those dentists who experience work-related musculoskeletal pain, 80% of conservative dentists experience pain in neck and shoulders, 66.7% of periodontists, and 54.5% of orthodontists experience pain in the lower back region. More than 50% of endodontists experience pain in the neck and shoulders regions, and 39% of general dental practitioners who experience pain in the neck region.

CONCLUSION

Preventive measures need to be taken to decrease the risk of dentists and dental specialists developing work-related musculoskeletal pain.

CLINICAL SIGNIFICANCE

The prevalence and distribution of musculoskeletal disorders (MSDs) among registered general dental practitioners and dental specialists in UAE was not clearly documented. The study results indicated that the region that experienced musculoskeletal pain does vary according to the specialty.

Histological evaluation of bone healing using organic bovine bone in combination with platelet-rich plasma (an experimental study on rabbits)

OBJECTIVES

This study was carried out to histologically assess the effect of bone grafting materials extracted from bovine origin on the bone healing process either alone or when mixed with autologous platelet-rich plasma which could be used in many procedures of oral and maxillofacial bone and implant reconstructive surgery.

MATERIALS AND METHODS

Sixteen rabbits were used; three intrabony defects in the femur bone of each rabbit were created, one left unfilled for normal healing process and served as control, the second filled with xenogenic graft (Gen-Ox-lyophilized bovine bone organic matrix), and the third filled with (Gen-Ox-lyophilized bovine bone organic matrix) mixed with autologous platelet-rich plasma. Histological examination of the sections was performed after staining with H&E and Van Geison stains. The histomorphometric analysis including counting of bone cells (osteoblasts, osteocytes, and osteoclasts) with performance of osteon diameter and lamellar thickness at the end of the fourth week postoperatively was obtained.

RESULTS

It has been shown that with the use of autologous platelet-rich plasma in combination with the xenogenic bone graft prepared from bovine origin, new bone formation and neovascularization were enhanced significantly when compared with xenogenic graft alone.

CONCLUSION

The addition of PRP to xenogenic bone substitute in small bone defects of the rabbit femur showed a histomorphometric increase in bone formation (at the fourth week of healing).

CLINICAL RELEVANCE

Platelet concentrate might be used to accelerate the osseointegration of enosseous dental implants.

Evaluation of foramen magnum in gender determination using helical CT scanning

OBJECTIVE

The present research was undertaken to study the accuracy and reliability of the foramen magnum (FM) and some cranial measurements in gender classification through the use of reconstructed helical CT images.

METHODS

88 patients (43 males and 45 females; age range, 20-49 years) were selected for this study. FM sagittal diameter, transverse diameter, area and circumference were measured and data were subjected to discriminant analysis for gender using multiple regression analysis.

RESULTS

FM circumference and area were the best discriminant parameters that could be used to study sexual dimorphism with an overall accuracy of 67% and 69.3%, respectively. By using multivariate analysis, 90.7% of FM dimensions of males and 73.3% of FM dimensions of females were sexed correctly.

CONCLUSION

It can be concluded that the reconstructed CT image can provide valuable measurements for the FM and could be used for sexing when other methods are inconclusive.

Evaluation of maxillary sinus dimensions in gender determination using helical CT scanning

Gender determination is an important step in identification in forensic medicine. CT measurements of maxillary sinuses may be useful to support gender identification. This study was undertaken to study the accuracy and reliability of maxillary sinus dimensions measurement in gender classification through the use of reconstructed helical CT images. Eighty-eight patients (43 men and 45 women) with age range from 20 to 49 years were selected in this study. The width, length, and height of the maxillary sinuses in addition to the total distance across both sinuses were measured. Data were subjected to discriminant analysis for gender using multiple regression analysis. Maxillary sinus height was the best discriminant parameter that could be used to study sexual dimorphism with an overall accuracy of 71.6%. Using multivariate analysis, 74.4% of male sinuses and 73.3% of female sinuses were sexed correctly. The overall percentage for sexing maxillary sinuses correctly was 73.9%. It can be concluded that reconstructed CT image can provide valuable measurements for maxillary sinuses and could be used for sexing when other methods of sexing are not conclusive.

Oxidative stress, antioxidant status and lipid profile in the saliva of type 2 diabetics

BACKGROUND

The aim of this study was to assess the salivary content of lipid peroxidation and antioxidants in patients with type 2 diabetes.

METHOD

We studied 25 patients with type 2 diabetes and other 25 age- and sex-matched health control. To evaluate the oxidative status we measured the levels of malondialdehyde (MDA) in the saliva and serum of all participants. Lipid profile was also estimated through measuring total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels. Antioxidant levels were also assessed through measuring the salivary and serum concentration of uric acid, superoxide dismutase and reduced glutathione (GSH).

RESULTS

The high concentration of lipid fractions in saliva usually follows that recorded in serum. Salivary MDA levels, a product of lipid peroxidation, were significantly increased among diabetics together with uric acid. However, GSH levels were similar to those of the control group.

CONCLUSION

Lipid peroxidation and antioxidant parameters assessed in saliva of diabetic patients may be of great importance in evaluating the disease activity and severity. The increase in lipid peroxidation and the tendency of antioxidants to rise in diabetes is probably due to an adaptive response to the pro-oxidant status of diabetes.

Salivary neuron specific enolase: an indicator for neuronal damage in patients with ischemic stroke and stroke-prone patients

BACKGROUND

The blood-brain barrier is compromised in patients with stroke. The release of neuro-biochemical protein markers, such as neuron specific enolase (NSE) into the circulation may allow the pathophysiology and prognosis of patients with cerebrovascular diseases to be evaluated further. The present study was designed to measure the marker of neuronal damage, NSE, in saliva and serum of patients with acute ischemic stroke and patients with stroke related diseases as a diagnostic and/or monitoring tool for early prediction of ischemic stroke.

METHODS

Salivary and serum NSE concentrations were measured in 150 individuals. Fifty were patients recently diagnosed as having ischemic stroke, 75 were gender and age-matched risk-group patients (patients with hypertension, type 2 diabetes and ischemic heart disease). Another 25 were gender and age-matched healthy controls.

RESULTS

Salivary and serum NSE concentrations were significantly higher than that of healthy controls. The cut-off threshold for salivary NSE of 3.7 microg/L was optimum, showing 80% accuracy for differentiation of ischemic stroke from normal individuals.

CONCLUSIONS

Salivary NSE (alone or in combination with serum) can be used as a valuable diagnostic and possibly prognostic tool for measurement of neuronal damage in patients with stroke and stroke-related diseases.

Evaluation of frontal sinus and skull measurements using spiral CT scanning: an aid in unknown person identification

The present study was undertaken to test a simple system for the identification of unknown bodies using spiral CT images of frontal sinus and other skull measurements among selected Iraqi sample. Ninety patients (45 males and 45 females) with age range from 20 to 49 years were selected in this study. Three features and two groups of measurements of frontal sinus and three skull dimensions were obtained from the CT images. Three basic features were F (presence or absence of frontal sinus), S (septum) and S (scalloping). Measurements selected for the study were frontal sinus width, height and anteroposterior length. In addition to measurements of total width, the distance between the highest points of the two sinuses, the distance between the highest points of each sinus to its maximum lateral limit. Skull measurements included; maximum skull length, prostio-bregmatic height and maximum skull width. All data were subjected to a descriptive and discriminative analysis using the SPSS (Version 17.0). The pre-post comparison (number of discordant items) resulted in 95% accurately predicted perfect match for intra-examiner calibration and 90% accurately predicted perfect match for inter-examiners calibration and the result for one discordant item was 5% for intra-examiner calibration and 10% for inter-examiners calibration. The discriminative analysis showed that the ability of the frontal sinus to identify gender was 76.9%, adding the skull measurements to the frontal sinus measurements gave a higher overall classification accuracy for gender (85.9%). Frontal sinus measurements are valuable method in differentiating gender. Adding skull measurements to the frontal sinus measurements can significantly improve accuracy of gender determination using discriminant analysis. CT based films can provide valuable and precise measurements not only for frontal sinus but even for the whole skull that cannot be approached by other means.

Squamous cell carcinoma of the oral cavity: a case series analysis of clinical presentation and histological grading of 1,425 cases from Iraq

Peoples in Iraq face a mixture of health hazards associated with poverty. Oral cancer is a major public health issue worldwide; it remains a highly lethal and disfiguring disease. It is primarily a disease of epithelial origin. A total of 1,425 cases of histologically diagnosed squamous cell carcinoma collected from the main centers of pathology in Iraq were analyzed according to age, sex, site, patient complaints at the time of presentation, and histological grading. Patients at their fifth decade of life were the most commonly affected with a male-to-female ratio of 2:1. The lower lip was the most commonly affected site followed by the tongue. The most common clinical complain was ulceration and swelling. More than 70% of the cases were well-differentiated squamous cell carcinoma. Oral cancer is increasingly seen as a major health problem-In line with general trend in the region, the need for interprofessional health care delivery approaches for reducing oral cancer mortality and improving patient's quality of life.