Anti-cancer effects of green synthesized gold nanoparticles using leaf extract of Annona muricata. L against squamous cell carcinoma cell line 15 through apoptotic pathway.

Background: Oral cancer remains one of the most dreadful diseases in developing nations. Currently, there has been a rise in the prevalence of tongue squamous cell carcinoma (SCC), with a poor prognosis. The use of standard treatment approaches against oral cancer patients brings about several side effects. In recent years, nanomedicine has provided a versatile platform for developing new targeted therapeutic modalities. However, safety remains a concern in the synthesis of nanoparticles (NPs). Therefore, the present study aims to synthesize safer phytoconstituent-mediated gold NPs (AuNPs) utilizing leaf extracts of Annona muricata, where the biochemical components of the plant leaf act as the reducing and capping agents in the synthesis of NPs, and to evaluate its anti-cancer activity against SCC. Materials and Methods: In this in vitro experimental study, AuNPs were synthesized through an effective, simple, and ecologically sound green synthesis method. After characterization of these synthesized AuNPs, in vitro assays such as 3-(4, 5-dimethylthiazole2-yl)-2, 5-biphenyl tetrazolium bromide, wound healing, and clonogenic assays were carried out to investigate the anti-cancer potential of green synthesized AuNPs in the human tongue SCC cell line (SCC-15), and the possible mechanism of action was evaluated through gene and protein expression analysis of Bax, Bcl-2, and p53 genes. The results were expressed as mean ± standard deviation using Statistical Package for Social Sciences (SPSS) 20.0 software and Student's t-test was performed for experimental data. P ≤0.05 were considered statistically significant. Results: The in vitro assays demonstrated that the synthesized AuNPs are exhibiting anti-cancer activity by apoptosis of SCC-15 cells in a dose-dependent manner. Further, it also revealed a highly significant decrease in anti-apoptotic Bcl-2 gene expression, whereas pro-apoptotic genes p53 and Bax revealed a highly significant increase, which is statistically significant compared to the control (P < 0.05). Conclusion: Our findings demonstrated that the AuNPs synthesized from A. muricata leaf extract could act as a novel anticancer agent, particularly against SCC, after further scrutiny.

Emerging role of photodynamic therapy as an adjunct to nonsurgical periodontal therapy on periodontal status and glycemic control in patients with type 2 diabetes: A clinical study.

Background: Periodontal disease is considered to be the sixth most common complication of diabetes mellitus (DM). Antibiotics (systemic and local) enhance the outcome of conventional mechanical debridement but frequent use of antimicrobials may develop resistance to microorganisms. To overcome this complicacy, the current study assessed the effectiveness of photodynamic therapy (PDT) in chronic periodontitis patients with type 2 diabetes when used as a combination therapy to standard periodontal therapy by assessing the various clinical and glycemic parameters. Materials and Methods: A total of 16 known cases of chronic Periodontitis patients who were suffering from type 2 DM were allocated into two groups. The test group (n = 8) was treated with standard scaling and root planing (SRP) along with PDT while the control group was treated with SRP alone. Various clinical parameters assessed were plaque index, gingival index, pocket probing depth, clinical attachment level, and Glycated hemoglobin level at baseline and 90 days after therapy. Results: At the end of the study, both the groups showed improvements with regard to all clinical and glycemic parameters compared to baseline. However, the test group presented statistically significant favorable results (all P < 0.05). Conclusion: Conventional periodontal treatment aided with PDT proved to be a beneficial therapeutic measure and effective alternative in patients with chronic periodontitis with diabetes when compared with standard periodontal therapy alone.

Spindle cell carcinoma in the trail of radiotherapy for oral squamous cell carcinoma: A quest for rationale.

Spindle cell carcinoma (SpCC) is a rare variant of oral squamous cell carcinoma (SCC) with unique clinicopathological characteristics, a high recurrence rate, and metastatic potential. It will be truly devastating when it occurs as a second wave in a cancer survivor. Despite the multidisciplinary approach in the management of oral SCC, the incidence of second malignancies or multiple carcinomas has been constantly reporting in the literature. Although radiotherapy has saved the lives of countless cancer patients, its several serious late effects are well-documented in the literature, making it a double-edged sword. Radiation epidemiology studies revealed an increased risk of developing radiogenic second cancers after 5 or more years. The purpose of this article is to document a case of SpCC arising in a patient after a span of 5 years who was previously diagnosed and treated with radiotherapy for well-differentiated SCC.

Evaluation of the cytotoxic, anti-proliferative, anti-metastatic and pro-apoptotic effect of aqueous leaf extract of Annona muricata on oral tongue squamous cell carcinoma cell line (SCC-15): An in vitro study.

Background: Oral cancer still represents the leading cause of mortality in India. Due to the drawbacks of current treatment options, a safe, low-cost therapy is the need of the hour. Recently, novel plant extracts with anti-cancer properties have gained greater attention. One among them is Annona muricata and its leaf extract, which has been studied for its anti-cancer effect against various cancers. However, studies on oral cancer cells are very much limited and hence the study. Aims: To evaluate the cytotoxic, anti-proliferative, anti-metastatic and pro-apoptotic effect of aqueous leaf extract of Annona muricata (ALEAM) against SCC-15 cell lines through in vitro assays. Materials and Methods: In vitro assays such as MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide], colony formation and wound healing assays were performed. Furthermore, to evaluate the underlying mechanism, gene and protein expression analysis of apoptotic/anti-apoptotic marker genes Bax, P53 and Bcl2, were done using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. Student's t-test has been performed for analysis of experimental data. Results: The results showed that ALEAM exhibited significant cytotoxic activity in a dose-dependent manner as well as inhibited colony formation and cell migration. The pro-apoptotic properties were affirmed by a highly significant drop in Bcl-2 gene expression and a highly significant rise in P53 and Bax genes in the study group compared to the control (P < 0.05). Conclusion: The current study provides evidence that ALEAM has the potential to be developed as a novel anti-cancer drug for the treatment of SCC after further clinical studies.

Aggressive oral carcinoma cuniculatum: A rare entity.

Oral carcinoma cuniculatum (OCC) is a rare and distinct clinicopathological variant of oral squamous cell carcinoma (OSCC). The term cuniculatum was derived from a Latin word "cuniculus" meaning burrow, because of the "rabbit burrow" appearance. As it invades the underlying tissue, it forms crypts filled with keratin that are essential in distinguishing this neoplasm from other variants of squamous cell carcinoma (SCC). It is a common lesion of the plantar region of the foot but rare in the oral cavity. The first case of OCC was reported in 1977 by Flieger and Owenski in the jaw, with fewer than 50 cases reported in the English literature till date. Tumor cell cannibalism has been reported in various carcinomas such as lung, gallbladder, hepatobiliary, pancreatic, and SCC. Cell cannibalism when it refers to a cancer cell, either within a tumor mass or cell culture, is "a cell that is contained within another bigger cell with a crescent-shaped nucleus." This report aims to present a rare case of aggressive OCC of the maxillary gingiva with cellular cannibalism and its diverse immunohistochemical expression of E-cadherin, Ki-67, and p53.

An atypical case report of extensive mucormycotic osteomyelitis of maxilla as a consequence of post-COVID complication.

Saprophytic molds such as Mucor, Rhizopus, and Absidia cause mucormycosis, a fungal infection. These saprophytic fungi are common in the environment and have a strong proclivity for invading major blood arteries, causing tissue ischemia, necrosis, and infarction. They have been linked to immunocompromised individuals with a history of diabetic ketoacidosis, corticosteroid medication, HIV infection, malignant lymphomas, and patients currently receiving and recovering from COVID-19 treatment. The foregoing is the case of a 78-year-old COVID-19 recovered male who presented with a primary complaint of upper tooth movement for 1 month and maxillary segmental mobility. The maxillary alveolar process was resected, and histopathological reports revealed mucormycosis, which was treated with antifungal medication and nasolabial flap surgery. For the past 6 months, he has been disease-free. Early detection and treatment may offer a higher chance of successfully minimizing this debilitating condition.

Immunohistochemical expression of putative cancer stem cell markers aldehyde dehydrogenase 1, SOX2, CD44 and OCT4 in different grades of oral epithelial dysplasia.

Objectives: The hypothesized existence of cancer stem cells (CSC) and its markers aldehyde dehydrogenase 1 (ALDH1), CD44, SOX2 and OCT4 in oral dysplastic tissues provides the potential for a more reliable assessment of malignant transformation of oral epithelial dysplasia (OED). Thus, the present study is intended to evaluate the immunohistochemical expression of four different CSC markers ALDH1, CD44, SOX2 and OCT4 in different grades of OED and to investigate the co-expression of these putative stem cell markers in OED. Subjects and Methods: A total of 35 samples of varying grades of OED which included 7 mild, 11 moderate and 17 severe dysplasia samples and 10 samples of normal oral mucosa without dysplasia were used. Four sections each from all 45 samples were stained with ALDH1, CD44, SOX2 and OCT4, respectively, by immunohistochemistry. The acquired data were analyzed and evaluated using the Chi-square test and unpaired t-test and the P < 0.05 was taken significant. Results: ALDH1 and SOX2 expression percentages showed statistically significant differences among study groups (P < 0.05). Statistical comparison of percentage expression of CD44 and OCT4 between OED and normal was nonsignificant (P > 0.05). Co-expression of all four markers was found in 15 cases of OED with none of the normal cases showing co-expression. Conclusion: The expression of CSC markers in OED and normal mucosa differs significantly with co-expression of all four markers located only in dysplastic tissues. Until now, no single protein marker has been able to unequivocally identify the CSCs. Thus, a panel of putative CSC markers will help in identifying the patients with high risk for malignant transformation in OED.

Human Papilloma Virus and Cancer Stem Cell markers in Oral Epithelial Dysplasia-An Immunohistochemical Study.

OBJECTIVES: To study the correlation between the putative cancer stem cell (CSC) markers aldehyde dehydrogenase 1 (ALDH1), cluster of differentiation 44 (CD44), sex-determining region Y-box 2 (SOX2), and octamer-binding protein 4 (OCT4) and human papilloma virus (HPV) infection using p16, the surrogate marker of HPV in oral epithelial dysplasia (OED) and normal mucosa. METHODS: Five sections each from 40 histopathologically diagnosed cases of different grades of OED and 10 cases of normal oral mucosa without dysplasia were immunohistochemically stained with p16, ALDH1, CD44, SOX2, and OCT4, respectively. RESULTS: Expression of ALDH1 and SOX2 was significantly increased in OED cases, whereas CD44 and OCT4 expression was increased in normal mucosa. P16-positive OED cases showed upregulation of ALDH1 and OCT4 expression as compared to p16-negative cases, while CD44 and SOX2 expression was downregulated in p16-positive OED cases; however, the results were not statistically significant. CONCLUSION: The present study indicated a suggestive link between p16 and cancer stem cell marker expression in HPV-associated OED, and that p16 has a significant role in CSC progression in OED. This is the first study to evaluate the expression of putative CSC markers in HPV-associated OED. However, low study numbers are a potential limiting factor in this study.

The prevalence of developmental anomalies among school children in Southern district of Andhra Pradesh, India.

BACKGROUND: The developmental anomalies of oral cavity are malformations affecting dental and oral tissues. Anomalies of teeth can be associated with primary, mixed or adult dentitions. Anomalies are the results of perturbations in the developmental stages of tissues which may be influenced by genetic and/or environmental factors. AIM AND OBJECTIVES: The primary objective of this study was to estimate the prevalence of oral and dental anomalies among school attending children in Chittoor and Kadapa districts of Andhra Pradesh. The secondary objective of this study was to compare occurrence of anomalies based on the age stratification to denote primary, mixed and adult dentitions. MATERIALS AND METHODS: A total of 5000 school children, aged 3-15 years were invited to participate in the study. Information regarding age, sex, level of school education, brushing and hygiene habits were collected using a questionnaire. Intra- and extra-oral examinations were conducted by trained dental surgeons. Clinical data were collected by a single examiner and the details of these anomalies were recorded on the data sheet of the study. The obtained data were statistically analyzed using Chi-square test. RESULTS: Overall prevalence of developmental anomalies was 11.40% and documented 14 types of anomalies. The prevalence of documented anomalies is as follows: tongue-tie 197 (3.90%), dental fluorosis 171 (3.40%), high frenal attachments 156 (3.10%), cusp of Carabelli 14 (0.30%), supernumerary teeth 11 (0.20%), microdontia 4 (0.10%), congenitally missing teeth 4 (0.10%), lip pits 3 (0.08%), fusion 2 (0.04%), retained deciduous teeth 2 (0.04%) and one case of angular cheilitis, cleft lip and cleft palate, talon cusp, amelogenesis imperfecta (0.02%). The prevalence of dental anomalies was 18.10% in 3-5 years, 52.30% among 6-12 years and 29.6% in 13-15 years. Chi-square test was statistically significant (P = 0.003). CONCLUSIONS: Tongue-tie was the most frequent oral tissue developmental anomaly and fluorosis was the most common developmental anomaly affecting dental tissue. The prevalence rate of the study was compared with studies published from other geographical regions in India. The variations in the reported prevalence of developmental anomalies are probably related to genetic and environmental conditions.

Maxillary tumour as first sign of endocrine abnormality: A report of a rare case.

Brown tumour is a non-neoplastic giant cell lesion resulting as a complication of hyperparathyroidism (HPT). HPT usually results from increased secretion of parathyroid hormone (PTH). We present a rare case of brown tumour of anterior maxilla presenting as a first sign of previously undiagnosed secondary HPT, to emphasise that giant cell lesions of jaw bones should routinely be screened for PTH levels to rule out underlying endocrine abnormalities and oral manifestation is the earliest manifestation of many systemic diseases and careful evaluation of oral cavity by physician gives information to underlying systemic pathology.

Central odontogenic fibroma of simple type.

Central odontogenic fibroma (COF) is an extremely rare benign tumor that accounts for 0.1% of all odontogenic tumors. It is a lesion associated with the crown of an unerupted tooth resembling dentigerous cyst. In this report, a 10-year-old male patient is presented, who was diagnosed with central odontogenic fibroma of simple type from clinical, radiological, and histopathological findings.

Adenoid cystic carcinoma of palate: A case report and review of literature.

Adenoid cystic carcinoma is an uncommon, slow growing malignant salivary gland tumor that is characterized by wide local infiltration, perineural spread, propensity to local recurrence and distant metastasis. In this paper, the authors present a case of adenoid cystic carcinoma affecting the palate and involving the maxillary sinus in a 60-year-old male patient along with a brief review of literature.