Potential effects of anticoagulants in preclinical mice models of oral cancer: A systematic review.

Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. There is mounting evidence to suggest that several components of the coagulation system directly affect carcinogenesis. Our recent in vitro studies demonstrated, for the first time, that various anticoagulants have anticancer effects on OSCC. They also showed the need for the immediate translation of these experimental conditions from bench to preclinical animal models. Here, we carried out a systematic review to summarise existing evidence on murine models built around the interactions between anticoagulants and oral cancer. Only one preclinical murine study was included in our systematic review, investigating the role of heparins in tumour pathophysiology. The paucity of evidence regarding the interactions between oral squamous cell carcinoma and anticoagulants emphasises the urgency with which further preclinical research should be conducted.

Investigation of Salivary RANKL and OPG Levels in Periodontitis Patients at Hospital Universiti Sains Malaysia.

OBJECTIVE: This study was aimed to determine the levels of salivary receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) and its association with periodontal status among periodontitis patients. MATERIALS AND METHODS: A cross-sectional study was designed and performed at the Dental Clinic, Hospital Universiti Sains Malaysia (HUSM). Random sampling was employed to identify 88 participants into three groups: 30 mild periodontitis, 30 moderate to severe periodontitis, and 28 healthy (nonperiodontitis) patients. Periodontal parameters: periodontal pocket depth (PPD), clinical attachment level (CAL), plaque score (PS), and gingival bleeding index (GBI) were recorded. In total, 4 mL of unstimulated whole saliva was collected to determine the levels of salivary RANKL and OPG proteins by using ELISA technique. Data were analyzed by using SPSS software version 24.0. RESULTS: Mean values for PPD (5.3 ± 0.5) and CAL (5.6 ± 0.5) were observed higher for moderate to severe periodontitis as compared with values (4.4 ± 0.2) (4.5 ± 0.2) in mild periodontitis patients. The mean salivary RANKL and OPG was 0.23 ± 0.07 ng/mL and 1.78 ± 0.70 ng/mL respectively in moderate to severe periodontitis. Only salivary RANKL levels were significantly and positively correlated with all the clinical periodontal parameters. CONCLUSION: The levels of salivary RANKL were higher as opposed to lower OPG levels in periodontitis patients in contrast to healthy (nonperiodontitis) patients. RANKL levels were significantly associated with the periodontal parameters. Therefore, we can conclude that RANKL can potentially aid as an adjunctive diagnostic protein in evaluating periodontal disease.

Oral health of individuals with dementia and Alzheimer's disease: A review.

This paper explores the epidemiological evidence about oral health of individuals with neurodegenerative conditions of Alzheimer's disease (AD) and dementia. PubMed, Web of Science, and Scopus were searched to identify the relevant research papers published during January 2012 to June 2020. All cross-sectional, case-control, and cohort studies reporting oral and dental morbid conditions for status and association with AD and dementia were explored. The explored literature from 22 studies shows that oral health parameters of oral health and levels of oral inflammatory markers were deranged and exaggerated in patients suffering from AD and dementia. Many studies have observed poor oral hygiene as result of lack or irregularity in toothbrushing. Regarding decayed, missing, and filled teeth status in AD/dementia populations, no significant difference is reported. Periodontal diseases have been noted at raised levels in AD and dementia patients and shown progression with aggravation in neurological disorders. Both edentulousness and low chewing efficacies are associated with low cognition. Stomatitis and coated tongue and other oral pathologies are significantly higher in AD patients. AD patients have demonstrated higher bacterial load and inflammation levels than controls, and consequently, inflammatory biomarker levels are also raised. AD patients have reduced salivary secretions and with low buffering capacity. Evidence from the current literature update postulates that individuals suffering from AD and dementia have special oral health-care needs. Appropriate oral health management may thus significantly improve their oral health-related and general quality of life.

Emerging Role of Epigenetics in Explaining Relationship of Periodontitis and Cardiovascular Diseases.

Cardiovascular diseases such as ischemic heart diseases or stroke are among the leading cause of deaths globally, and evidence suggests that these diseases are modulated by a multifactorial and complex interplay of genetic, environmental, and lifestyle factors. Genetic predisposition and chronic exposure to modifiable risk factors have been explored to be involved in the pathophysiology of CVD. Environmental factors contribute to an individual's propensity to develop major cardiovascular risk factors through epigenetic modifications of DNA and histones via miRNA regulation of protein translation that are types of epigenetic mechanisms and participate in disease development. Periodontal disease (PD) is one of the most common oral diseases in humans that is characterized by low-grade inflammation and has been shown to increase the risk of CVDs. Risk factors involved in PD and CVD are determined both genetically and behaviorally. Periodontal diseases such as chronic inflammation promote DNA methylation. Epigenetic modifications involved in the initiation and progression of atherosclerosis play an essential role in plaque development and vulnerability. Epigenetics has opened a new world to understand and manage human diseases, including CVDs and periodontal diseases. Genetic medicine has started a new era of epigenetics to overcome human diseases with various new methodology. Epigenetic profiling may aid in better diagnosis and stratification of patients showing potential predisposed states for disease. A better understanding of the exact regulatory mechanisms of epigenetic pathways driving inflammation is slowly emerging and will aid in developing novel tools for the treatment of disease.

Effect of Sodium Bicarbonate Mouth Wash on Salivary pH and Interleukin-1ß Levels among Smokers.

OBJECTIVE: Smoking induces changes in salivary pH and inflammatory biomarker levels associated with oral diseases. This study examined the effect of alkaline oral rinse to modify this effect of smoking on salivary study parameters. MATERIALS AND METHODS: A double-blind randomized controlled trial (RCT) on systemically healthy smokers was conducted. A total of 78 smokers, aged 18 to 40 years, were enrolled as per exclusion/inclusion criteria. An alkaline mouthwash was provided to the intervention group and a placebo to control group. Salivary pH and inflammatory biomarker interleukin (IL)-1ß levels were evaluated at baseline and at follow-up (14 ± 2 days). STATISTICAL ANALYSIS: Chi-squared test, independaent t-test, and paired t-test were used to observe the changes in parameters among and between groups before and after intervention using SPSS v16 with a significance level of p≤0.050. RESULTS: Sixty eight salivary samples were analyzed. All study parameters of the study sample were statistically insignificant between both intervention and control groups at baseline. pH level was 6.56 ± 0.53 at baseline and 6.62 ± 0.45 at follow-up in the intervention group; respective values for control group were 6.70 ± 0.36 and 6.83 ± 0.44 and the changes were not significant (p≥0.071). IL-1ß level was 9.39 ± 10.23 pg/µL at baseline and 5.40 ± 6.62 pg/µL at a follow-up in the intervention group and the change was significant (p = 0.001); respective values for the control group were 10.63 ± 11.50, and 9.33 ± 11.73 and the difference was nonsignificant (p = 0.076). CONCLUSION: This randomized trial indicated that sodium bicarbonate mouth rinse is effective in decreasing IL-1ß levels and increasing salivary pH favorable for prevention of oral diseases.