Assessment of the anti-oxidant reduced glutathione in oral squamous cell carcinoma - Systematic review and meta-analysis

Background

The excess reactive oxygen species or free radicals reaction leads to oxidative injury to the biological components such as cells and tissues, which would result in the initiation and progression of carcinogenesis. The magnitude of oxidative damage depends primarily on the balance between free radicals (pro-oxidants) and antioxidant system activity.

Aim

To assess antioxidant status by evaluating the reduced glutathione (GSH) levels in various biological samples of patients with oral squamous cell carcinoma (OSCC) using available literature.

Materials and Methods

An electronic literature search was carried out in PubMed (MeSH), Science Direct, Scopus and Cross Reference by using specific keywords.

Results

The systematic electronic search identified 704 articles. After studying the articles' titles and abstracts, 657 articles were excluded for the following reasons; duplicated articles, animal studies, studies of low quality and not relevant to the research question. The remaining 47 articles were selected for full-text assessment. After eliminating the articles that did not match the objectives, the present qualitative synthesis finally included 27 articles for evaluation. The ten studies, which showed coherent data, were included in quantitative analysis. The GSH levels in OSCC groups are significantly decreased (P < 0.001) in plasma and erythrocyte samples compared to healthy controls.

Conclusion

The selected studies showed significantly lower levels of GSH in various biological samples of OSCC. Hence, future studies are required to validate the expression of GSH as a prognostic biomarker in oral cancer.

A Meta-analysis of Oral Squamous Cell Carcinoma in Young Adults with a Comparison to the Older Group Patients (2014-2019)

Background:

The oral squamous cell carcinoma (OSCC) often affects elderly aged adults, who had long-term tobacco exposure. In the recent past decade, there is an increasing incidence of OSCC in younger individuals, who had less tobacco association.

Aim:

The aim of this study is to examine the risk factors and to assess and compare the clinicopathological features and prognosis of OSCC in young patients with the older group patients.

Materials and Methods:

We included studies that addressed the OSCC involving young patients during the period between 2014 and 2019. Initially, we found 679 articles; after refined evaluation, 92 works had their titles matching to the present work. After extraction of case reports, reviews, and studies with un-matched objectives or inadequate data, we have chosen only 24 presentations matching to the abstract. The statistical analysis performed by Chi-square tests using SPSS 20.0 version for windows.

Results:

Of the total OSCC, 10% of patients belonged to the younger age group, and 90% were the older aged group. Both the groups showed male gender predominance and tongue as the predominant site of involvement. The younger patients tend to have significantly reduced tobacco exposure. The highly reported tumors were advanced staged and moderately differentiated tumors in both groups. There was a statistically evident high recurrence reported in the younger group. The overall survival seems to be similar for both groups.

Conclusion:

The identification of the potential risk factors, along with unique molecular mechanisms, and biological behavior of the disease is mandatory to control the incidence of OSCC in young adults.

A Meta-Analysis in Assessing Oxidative Stress Using Malondialdehyde in Oral Submucous Fibrosis

Objective This study aimed to evaluate the oxidative stress (OS) marker Malondialdehyde (MDA) in oral submucous fibrosis with available literature.

Materials and Methods We conducted a literature search electronically in PubMed (MeSH), Science Direct, Scopus, and Google Scholar using specific keywords.

Results A systematic search in PubMed, Science Direct, and Google Scholar identified 334 articles. Of these, four were duplicate reports, and three were animal studies. After reading the abstracts of the collected articles, 288 articles were excluded for the following reasons: low quality, not relevant to the research question, or did not meet the inclusion criteria. The remaining 46 articles were chosen for full-text assessment. Finally, the present qualitative synthesis included 23 articles for evaluation. The selected studies in MDA analysis in a random-effects model showed higher heterogeneity (Q = 477.636, p < 0.001, I ² = 95.394%). The standard difference in mean MDA concentration between oral submucous fibrosis (OSMF) and healthy subjects was estimated as 2.73 nmol/mL (95% confidence interval: 2.08–3.38).

Conclusion The selected studies showed significantly higher MDA levels in various biological samples of patients with OSMF. Therefore, further studies are needed to estimate oxidative stress levels by using different biomarkers in OSMF to direct future therapy.

Oncogenic Viruses and Mechanisms in Oral Squamous Cell Carcinoma: A Mini Review

Oral squamous cell carcinoma (OSCC) is a common epithelial malignancy with varied etiology. The traditional risk factors are the usage of tobacco and tobacco products. About 15-20% of the population exists with oral squamous cell carcinoma without being exposed to these carcinogenic products. The other factors which may influence the disease process are environmental factors, genetic alterations and viruses. Some oncogenic DNA viruses are strongly associated with OSCC while other viruses are little expressed. While diagnosing OSCC one should always consider the possible role of viruses in their etiopathogenesis as it is crucial for diagnosis and successful treatment. Screening of the oncogenic viruses at an early stage may also aid in the prognosis of oral squamous cell carcinoma. The current review focuses on the possible mechanisms of the oncogenic viruses in the etiopathogenesis of OSCC.  

A rare case of palatal schwannoma with literature review

Schwannoma or neurilemmoma is a benign, slow-growing nerve sheath tumor arising from Schwann cells of the cranial, peripheral or autonomic nerves. Approximately 25%–40% of schwannomas occur in the head and neck region. Occurrences of intraoral schwannomas are rare with reported prevalence being 1%. Intraorally, schwannomas occur in the tongue, palate, buccal mucosa, lips and gingiva. This article provides an insight into a rare case of palatal schwannoma with literature review.

Meta-analysis on risk factors of squamous cell carcinoma of the tongue in young adults

Tongue squamous cell carcinoma (TSCC) generally affects the older age group exposed to tobacco for an extended period. However, recent research points out that there is an increased incidence of TSCC in the younger age group without any traditional risk factors making TSCC as a distinct biological entity in this group. This study aims to assess the prevalence and risk factors of tongue carcinoma in the younger group of patients. This article included studies that addressed the TSCC involving young patients and that which are PubMed indexed. Initially, 390 articles were considered; but after refined evaluation, 123 articles had their titles and abstracts matching to this present work. After the extraction of the case reports, review articles and the articles without the assessment of the parameter of harmful habits, we have included only 23 articles in the sample matching the title. The statistical analysis was formed by using chi-square tests using IBM SPSS ver. 20.0. The cohort of the younger population in these studies was mostly in the 35- to the 45-year age group. The majority of reports (64%) classified the patients below 40 years of age as a young group. Though male predominance is reported to be 55%, female patients are also more affected (40%) in the younger age group compared with, the more typical and usual group of head and neck carcinoma patients. TSCC in older adults predominantly reported in tobacco users (70%) whereas in young adults, TSCC was associated with a higher incidence in nonsmokers (53%); the causes of these cancers in young adults remain unclear. The identification of the potential risk factors aside from traditional factors is vital to control the incidence of TSCC in young patients.

Herpes Zoster with Post Herpetic Neuralgia Involving the Right Maxillary Branch of Trigeminal Nerve: A Case Report and Review of Literature

Herpes Zoster (HZ) is an acute, self-limiting, neuro cutaneous viral infection caused by the reactivation of the Varicella Zoster Virus (VZV) that remains latent in the dorsal root ganglion. About 50% of occurrence is seen in older age groups and immunocompromised patients. Less than 5% occur in children. HZ is characterized by the unilateral pain, burning and tingling sensation followed by the vesicular eruptions limited to the single dermatome that are innervated by the single cranial ganglion, sometimes it leads to Post Herpetic Neuralgia (PHN). We report a case of a HZ in a 22-year-old young female patient involving the right maxillary branch of the trigeminal nerve along with PHN.

Effect of Transcutaneous Electrical Nerve Stimulation on Parotid Saliva Flow in Patients with Hyposalivation

Context:

In recent days, we have come across an increase incidence of dry mouth as a side effects of drugs and in order to bring an awareness about a simple non- invasive method to increase the salivary flow, we have used TENS which in many way is beneficial to patients with metabolic disorders.

Aims and Objectives:

The aim is to assess the effectiveness of transcutaneous electrical nerve stimulation on salivary gland function in patients with hyposalivation.

Subjects and Methods:

The present study included total of 25 subjects with complaint of hyposalivation. Written informed consent was obtained from all the participants. Subjects with pacemakers, autoimmune diseases, pregnancy, and history of salivary gland pathology were excluded from the study. Subjects were asked to refrain from eating, drinking, chewing gum, smoking, and oral hygiene procedures for at least 1 h before the appointment. Unstimulated saliva was collected using modified Carlson Crittenden cup placed over the Stenson's duct bilaterally for 5 min and measured. TENS pads were placed over the parotid region and were activated. The intensity control switch was adjusted for patient's comfort. The intensity was turned up 1 increment at a time at 5 s intervals until the optimal intensity level was reached and stimulated saliva was then collected for 5 min using the modified Carlson Crittenden cup and measured. Any increase in parotid salivary flow (SF) with electrostimulation was considered a positive finding.

Statistical Analysis Used:

A paired t-test, evaluating mean changes in stimulated versus unstimulated SF rates, was applied to look for statistically significant differences using PASW 18.0 for Windows. An independent sample t-test was performed to note difference between genders.

Results:

There was significant increase in parotid SF in 19 of 25 patients after transcutaneous electrical nerve stimulation. Males showed more salivary secretion when compared to females.

Conclusions:

From the results of the study and within limitations of the study, it can be concluded that TENS was effective in increasing the SF rate in hyposalivatory patients with residual saliva. TENS was less effective in patients who are under xerogenic drugs. Thus, TENS may be an ever-growing armamentarium in the management of salivary gland hypofunction when other therapies have failed or are contraindicated.

Imprint cytology

A valuable information on morphological details of the cell can be obtained through imprint cytology. Though it has some pitfalls, it is still considered to be one of the best methods as it provides an excellent cytological clarity in fresh surgical specimens. This article shares knowledge about the procedure, uses, advantages and disadvantages of imprint cytology.

Fibrous dysplasia-recent concepts

Fibrous dysplasia (FD) is a benign intramedullary fibro-osseous lesion. FD is a bone developmental anomaly characterized by replacement of normal bone and marrow bone by fibrous tissue. It involves any of the bones as single lesion (monostotic) or in multiple bone lesions (polyostotic) or all of the skeletal system (panostotic). Long bones are most commonly involved, which mostly identified incidentally and clinically appears asymptomatic. Clinical, radiographical and histopathological findings will help in confirming the lesion. There are many treatment option available, but still management of FD remains challenging.

Candida in potentially malignant oral disorders

Oro-pharyngeal cancer is a significant component in the global burden of cancer. A considerable proportion of oral squamous carcinomas develop from preexsiting potentially malignant disorder of the oral cavity. The term potentially malignant oral disorders (PMD) were proposed for the precancerous lesions and conditions by World Health Organization in 2007. PMD are considered an in-between clinical state, which showed increased risk for cancer development. Etiology of PMD is multifactorial. Tobacco and alcohol are the major risk factors. In recent years, role of candidal infection is recognized as a significant factor in the development of PMD. There is an enduring discussion whether Candida infection can be a cause of PMD or a superimposed infection in a preexisting lesion. This article highlights the association between Candida and PMD.

Oral lichen planus: An overview

Lichen planus is an immunologically mediated mucocutaneous disease that is triggered by varied etiological agents. The oral lichenoid reaction is considered a variant of the disease that needs to be clearly diagnosed as a separate entity from oral lichen planus and treated. They follow a strict cause-effector relationship, protocols that suggest the differentiation. Lichen planus has varied clinical forms in the oral mucosa and cutaneously that has different prognosis. This condition also arises in association with various other systemic conditions such as hypertension, diabetes mellitus. There have been cases reported in the esophagus, larynx, scalp, nail, cutaneous areas, especially arms and wrists, trunk. There is reported malignant transformation that essentiates careful examination, treatment protocol and regular follow-up sessions. This article throws light on the disease condition of oral lichen planus and oral lichenoid reaction that is essential for the differentiation and treatment.

Apoptosis in immune-mediated diseases

Apoptosis plays a significant role in both the physiological and pathological process. A dysfunctional apoptotic system can lead to either excessive removal or prolonged survival of cells. Therefore, dysregulation is involved in the pathogenesis of a variety of immunological diseases. The present review aims to provide an overview regarding role of apoptosis in immune-mediated disease.

Leukoplakia: A short review on malignant potential

Oral leukoplakia is one of the most common potentially malignant disorders. Right diagnosis of potentially malignant disorders may help to prevent these lesions from malignant transformation. Proper understanding, recognizing, identification and differentiating these lesions from normal mucosa are necessary for proper treatment.

Aggressive granular cell ameloblastoma: Report of a rare case

Granular cell ameloblastoma is a slow growing odontogenic ectodermal tumor. The tumor shows typical ameloblastoma with the cells showing eosinophilic granularity. This variant of ameloblastoma is aggressive with high recurrence rates. We report a case of aggressive ameloblastoma of granular cell variant.

Flavonoids - Clinical effects and applications in dentistry: A review

Flavonoids include a huge group of naturally occurring organic compounds. It is found in a large variety of plants including fruits, seeds, grains, tea vegetables, nuts, and wine. Many studies have shown that there is a strong association between flavonoid intake and the long-term effects on mortality. It is widely used in dentistry and it has many clinical effects. This article summarizes the effects of flavonoids to humankind and its clinical applications in dentistry.

Mystery inside the tooth: the dental pulp stem cells

Stem cells are distinguished by their ability to differentiate into different types of cells in the body and to self-replicate. During the recent years, stem cells have been used extensively in the field of medicine for the repair and regeneration of defective tissues and organs. However, the knowledge on the stem cell technology is increasing quickly in all medical disciplines and it dictates the need for new protective approaches in all fields, which include reparative dentistry. Stem cell therapy constitutes a common challenge for dentists as well as for biotechnologists. The aim of this study was to review the knowledge which was related to stem cells and to consider the possibility of use of stem cell populations and their technology in the future clinical applications, to cure diseases like Parkinsonism, Juvenile diabetes, certain forms of cancer, spinal injuries and heart problems.

How to help the oral pathologist in making an accurate diagnosis

A biopsy is a valuable diagnostic tool in clinics. In this procedure, the sample tissue is obtained in order to study its structure both macro and microscopically, thus making it possible to establish a final diagnosis. Some clinicians are surprised and disappointed when the report from the oral pathologist comes as "not from the representative area and "inadequate specimen size", instead of a final diagnosis. To avoid such disappointments and to make the best utilization of the skills of the oral pathologist, certain ideas have been suggested. Right from the history taking to the clinical examination to the operative findings, the clinician can pave the way to a conclusive histopathological diagnosis.