Dysregulation of calcium homeostasis in cancer and its role in chemoresistance.

Globally, cancer, as a major public health concern, poses a severe threat to people's well-being. Advanced and specialized therapies can now cure the majority of people with early-stage cancer. However, emerging resistance to traditional and novel chemotherapeutic drugs remains a serious issue in clinical medicine. Chemoresistance often leads to cancer recurrence, metastasis, and increased mortality, accounting for 90% of chemotherapy failures. Thus, it is important to understand the molecular mechanisms of chemoresistance and find novel therapeutic approaches for cancer treatment. Among the several factors responsible for chemoresistance, calcium (Ca2+) dysregulation plays a significant role in cancer progression and chemoresistance. Therefore, targeting this derailed Ca2+ signalling for cancer therapy has become an emerging research area. Of note, the Ca2+ signal and its proteins are a multifaceted and potent tool by which cells achieve specific outcomes. Depending on cell survival needs, Ca2+ is either upregulated or downregulated in both chemosensitive and chemoresistant cancer cells. Consequently, the appropriate treatment should be selected based on Ca2+ signalling dysregulation. This review discusses the role of Ca2+ in cancer cells and the targeting of Ca2+ channels, pumps, and exchangers. Furthermore, we have emphasised the role of Ca2+ in chemoresistance and therapeutic strategies. In conclusion, targeting Ca2+ signalling is a multifaceted process. Methods such as site-specific drug delivery, target-based drug-designing, and targeting two or more Ca2+ proteins simultaneously may be explored; however, further clinical studies are essential to validate Ca2+ blockers' anti-cancer efficacy.

Interplay between dental caries pathogens, periodontal pathogens, and sugar molecules: approaches for prevention and treatment.

Globally, oral diseases affect nearly 3.5 billion people, accounting for 4.6% of the healthcare expenditure. Common oral diseases include dental caries and periodontal disease, associated with biofilms formed by cariogenic pathogens. Epidemiological studies associate carbohydrates with these diseases due to  the sugars metabolized by cariogenic pathogens. This review focuses on dental caries and periodontal pathogens, quorum sensing, lectin-carbohydrate interactions, and various sugar molecules. Cariogenic sugars significantly influence biofilms by enhancing pathogen adhesion, viability, and gene expressions associated with biofilm formation. Moreover, lectin-carbohydrate interactions contribute to biofilm stability. Disrupting these interactions is a potential strategy for oral disease prevention. The use of nanoparticles, such as quantum dots, provides novel insights into lectin-sugar interactions and the development of inhibitors. Additionally, nanomaterials like calcium phosphate nanoparticles neutralize acids and inhibit microbial growth. This overview emphasizes understanding the relationships between oral diseases, microbial communities, and sugars to devise preventive and therapeutic strategies against oral diseases.

Comparative analysis of trace elements in the saliva and serum of patients with oral submucous fibrosis and squamous cell carcinoma.

Of note, one third of oral cancer or oral tissue dysfunction cases are from India, primarily resulting from the consumption of Gutkha, a type of smokeless tobacco prevalent among several Indian populations. Gutkha is a mixture of tobacco, areca nut, slaked lime, catechu, spices, sweeteners and essences. Oral submucous fibrosis (OSMF), which is linked to the consumption of areca nut products and tobacco, is a chronic, precancerous condition of the submucosal tissues. OSMF transforms into oral squamous cell carcinoma (OSCC) at a rate of 7-13%. Gutkha also contains various trace elements, such as copper (Cu), zinc (Zn), selenium (Se) and molybdenum (Mo). Alterations in trace element levels in the body are associated with cancer progression. The present study aimed to determine the levels of serum and salivary trace elements in patients with OSMF and OSCC. A total of 80 patients were selected for the study and were divided into four groups of 20 patients in each (Group A, gutkha intake without OSMF; group B, gutkha intake with OSMF; group C, OSCC; and group D, control). The level of Cu was found to be increased and the levels of Zn, Se and Mo were decreased in the serum of patients with OSMF and OSCC compared with the controls. The salivary levels of these elements were lower compared with those in the serum. Age and sex had no significant effect on the levels of these trace elements. The results of the present study affirm the fact that serum and salivary trace elements are altered in pre-malignant and malignant lesions as the disease progresses. As the composition of saliva often varies, monitoring serum trace element levels as diagnostic and prognostic markers may aid in the early detection of the disease and in the management of the treatment efficacy.

Antibiotics Knowledge, Usage, and Prescription Patterns Among Dental Practitioners in Hyderabad, South India.

BACKGROUND: Antimicrobial resistance is a pertinent issue in the healthcare sector, accounting for 1.27 million patient deaths worldwide. Dental practitioners account for 3% to 11% of total antibiotic prescriptions. Therefore, this study aimed to specifically assess their knowledge of antibiotic prescriptions, guidelines, and clinical practices. METHOD: Before conducting this knowledge, attitude, and practice (KAP) survey, study approval was obtained from the Scientific Review Board of Saveetha Dental College and Hospitals, Chennai, India. A total of 200 participants were randomly selected from the list of Indian Dental Association (Hyderabad chapter), and dental colleges, dental conferences, and peer suggestions. We received a total of 130 responses by the end of the survey. RESULTS: The survey revealed gaps in practitioners' KAP. Of those surveyed, 83 (63.85%) of the practitioners kept themselves updated about antibiotic guidelines and news, but many (94, 72.31%) were unaware of the WHO's access, watch, reserve (AWaRe) and antimicrobial stewardship concepts (103, 79.23%). A total of 111 (85.38%) practitioners considered cross-reactions with other medications, yet only 28 (21.5%) practitioners tested patients for antibiotic sensitivity. While 64 (49.23%) practitioners encountered patients who did not respond to antibiotics, 84 (64.62%) practitioners encountered patients who demanded antibiotics. CONCLUSION: This study highlights the lack of awareness about the WHO's AWaRe classification and antimicrobial stewardship among the majority of dental practitioners across Hyderabad. Misuse or overuse of antibiotics was indicated in this survey by both patients and dental practitioners. Prioritizing updates on antibiotic knowledge and guidelines and awareness of their use is important. It is essential to educate patients about the ill effects of self-prescribing antibiotics. Dental practitioners need to consider cross-reactions and antibiotic-sensitivity testing before prescribing antibiotics. Labeling the sensitivity of a particular antibiotic for specific microbes on packaging can help reduce misuse and the use of antibiotics for the wrong indications.

Research and therapeutic applications of silk proteins in cancer.

Despite the availability of advanced treatments, cancer remains the second leading cause of death worldwide. This is due to the many challenges prevailing in the research field and cancer therapy. Resistance to therapy and side effects provide major hindrances to recovery from cancer. As a result, in addition to the aim of killing cancer cells, the focus should also be on reducing or preventing side effects of the treatment. To enhance the effectiveness of cancer treatment, many researchers are studying drug delivery systems based on silk proteins: fibroin and sericin. These proteins have high biocompatibility, biodegradability, and ease of modification. Consequently, many researchers have developed several formulations of silk proteins such as scaffolds, nanoparticles, and hydrogels by combining them with other materials or drugs. This review summarizes the use of silk proteins in various forms in cancer research and therapy. The use of silk proteins to study cancer cells, to deliver cancer drugs to a target site, in cancer thermal therapy, and as an anti-cancer agent is described here.

Silk Hydrogel for Tissue Engineering: A Review.

AIM: This review aims to explore the importance of silk hydrogel and its potential in tissue engineering (TE). BACKGROUND: Tissue engineering is a procedure that incorporates cells into the scaffold materials with suitable growth factors to regenerate injured tissue. For tissue formation in TE, the scaffold material plays a key role. Different forms of silk fibroin (SF), such as films, mats, hydrogels, and sponges, can be easily manufactured when SF is disintegrated into an aqueous solution. High precision procedures such as micropatterning and bioprinting of SF-based scaffolds have been used for enhanced fabrication. REVIEW RESULTS: In this narrative review, SF physicochemical and mechanical properties have been presented. We have also discussed SF fabrication techniques like electrospinning, spin coating, freeze-drying, and physiochemical cross-linking. The application of SF-based scaffolds for skeletal, tissue, joint, muscle, epidermal, tissue repair, and tympanic membrane regeneration has also been addressed. CONCLUSION: SF has excellent mechanical properties, tunability, biodegradability, biocompatibility, and bioresorbability. CLINICAL SIGNIFICANCE: Silk hydrogels are an ideal scaffold matrix material that will significantly impact tissue engineering applications, given the rapid scientific advancements in this field.

Age Estimation in Mixed-dentition Children, Using Cameriere's European Formula and Demirjian's Method: A Comparative Pilot Study.

AIM: The objective of the present investigation is to compare the accuracy of two methods of age estimation, Cameriere's European formula and Demirjian's method, in estimating the age of mixed-dentition children in Telangana. MATERIALS AND METHODS: Digital orthopantomographs (OPGs) of 36 children between the age of 7 years and 12 years were subject to analysis. All the OPGs were analyzed for dental age using both Cameriere's and Demirjian's methods for mixed dentition. Chronological age was calculated by subtracting the date of births from the date on which the OPGs were taken. STATISTICAL ANALYSIS: descriptive analysis was performed. The accuracies of both the methods (Cameriere's and Demirjian's) were evaluated by calculating the mean prediction error. Wilcoxon signed-rank test was performed for both methods of dental age estimation with chronological age and for boys and girls. Significance threshold was set at 5%. RESULTS: Cameriere method resulted in a mean prediction error of 0.579 for girls and 0.483 for boys. Demirjian's method resulted in a mean prediction error of 2.228 for girls and 2.046 for boys. CONCLUSION: In conclusion, as far as accuracy is concerned, Cameriere's European formula proved to be more accurate, according to the current investigation. SIGNIFICANCE: The significance of age estimation is reflected in various fields such as pediatric endocrinology, orthodontics, law, anthropology, archeology, and forensics where identification of unascertained human bodies is required (crime investigations, mass disasters). Demirjian's method is commonly employed for dental age estimation in pediatric dentistry, orthodontics, and forensic dentistry. Cameriere's method may serve as a more accurate and reliable method for dental age estimation. Key message: Cameriere's European formula proved to be better, in terms of accuracy, in determining the chronological age of mixed-dentition children in the region of Telangana, according to the current investigation.

Estimation of Dental Anxiety Levels Before and After Dental Visit in Children with Visual Impairment Using Modified Dental Anxiety Scale in Braille Text.

OBJECTIVE: Dental anxiety and fear of dental treatment in special children has been recognized as a public health dilemma. Dental anxiety (being the fear of unknown in a dental setting) would definitely have a substantial effect on the children with visual impairment. Assessment of the dental anxiety makes it possible to design intervention programs aimed at reducing the anxiety levels in children with visual impairment. Thus, the aim of this study was to assess the dental anxiety levels before and after dental visit in children with visual impairment using Modified Dental Anxiety Scale (MDAS) printed in braille. MATERIALS AND METHODS: A total of 144 institutionalized children with visual impairment in the age group of 6-13 years, residing at an institutionalized blind school, participated in the study. Dental anxiety was assessed pre- and post-dental-screening visit using MDAS printed in braille. Statistical analysis was performed using the Wilcoxon matched-pairs signed rank test. RESULTS: Of 144 children, just before dental screening visit, 78 (54.1%) had severe dental anxiety, 52 (36.11%) had mild anxiety, and 14(9.72%) reported no anxiety, whereas after dental education, only 28 (19.44%) had severe anxiety, 22 (16.66%) had mild anxiety, and 94 (63.88%) reported no anxiety. CONCLUSION: In our study, there was a significant decrease in dental anxiety after dental screening and education. Therefore, proper behavior management techniques and dental health education programs would decrease dental anxiety in children with visual impairment.

Distribution of Periodontal Pockets Among Smokers and Nonsmokers in Patients with Chronic Periodontitis: A Cross-sectional Study.

Context Cigarette smoking is a well-established risk factor for periodontitis and carries an increased risk for loss of periodontal attachment as well as bone loss. Aims The purpose of the present study was to investigate whether disease severity differs between smokers and nonsmokers in a group of chronic periodontitis patients by assessing the periodontal probing depth (PPD) and bleeding on probing (BOP). Materials and methods The study included 150 individuals, 75 smokers and 75 nonsmokers, in the age group of 35-60 years. Subjects with chronic periodontitis were selected and included in the study. Periodontal evaluation, including periodontal probing pocket depths and bleeding on probing, was performed on all four quadrants and at six sites per tooth using the Williams periodontal probe. The data were pooled from the anterior sextant and the posterior sextant as well as from the facial and lingual surfaces. Statistical analysis Comparisons were made between smokers and nonsmokers using the z-test (two-tailed test). Probing pocket depth categories 0-3 mm, 4-5 mm, 6-7 mm, and ≥8 mm and the proportion of sites having a pocket depth of ≥5 mm were used in the analysis. Results The mean percentage of sites that bleed upon probing was higher for nonsmokers as compared with smokers. Smokers had less shallow pockets (0-3 mm) than nonsmokers and more pockets of 4-7 mm (categories 4-5 mm, 6-7 mm). No significant differences were detected in the prevalence of pockets ≥8 mm. In the anterior, premolar, and molar regions, pockets of 6-7 mm were significantly more prevalent in smokers. The buccal and lingual sides also showed that smokers had more sites with deep probing depths ≥5 mm than nonsmokers. The data also showed that in the upper jaw, in the anterior and premolar teeth, the largest differences were found between smokers and nonsmokers. Conclusions From the results, it can be concluded that cigarette smoking results in periodontal tissue destruction in the different areas of the oral cavity, with the maximum periodontal destruction in the maxillary anterior and premolar region.

Prevalence of Dental Anxiety Level in 6- to 12-Year- Old South Indian Children.

BACKGROUND: Dental anxiety is one of the prime reasons for discouraging children to receive dental treatment. Measurement of the dental anxiety is very useful to know the prevalence level among 6- to 12-year-old children. Thus, the aim of the study was to determine the dental anxiety among 6- to 12-year-old children using Modified Dental Anxiety Scale (MDAS) score. MATERIALS AND METHODS: A total of 400 south Indian children in the age group of 6-12 years who had visited Dental College and Hospital were recruited in the study. Dental anxiety was measured before dental treatment using MDAS. Statistical analysis was performed using Wilcoxon signed rank test. RESULTS: Of the 400 children, 240 (61.5%) had severe dental anxiety, 92 (23%) had mild anxiety, and 78 (17%) had no anxiety. Females had higher anxiety level compared to males. Many study subjects answered that local anesthesia (LA) injection was considered most fearful. Dental anxiety was highest in smaller age groups. CONCLUSION: In our research, high percentage of children had dental anxiety, so counseling before dental visits is very important to reduce the dental anxiety among these 6- to 12-year-old children.

Comparative Analysis of Intravenous Midazolam with Nasal Spray for Conscious Sedation in Minor Oral and Maxillofacial Surgeries.

AIM: The aim of the current study was to evaluate the efficacy of nasal spray midazolam by collating it with conventional intravenous midazolam for conscious sedation in minor oral surgeries. MATERIALS AND METHODS: Sixty patients were selected randomly and divided into two groups: group A for intranasal midazolam atomized spray (n = 30) and group B for intravenous midazolam (n = 30). Physiological parameters, anxiety score, sedation rating, patient's cooperation score, and retrograde and anterograde amnesia were recorded for each patient during preoperative, intraoperative, and postoperative period. Final evaluation of safety and efficacy in the nasal and intravenous routes of midazolam drug during minor oral surgery was compared. RESULTS: In this study, both intranasal and intravenous groups showed decrease in systolic blood pressure and diastolic blood pressure intraoperatively but within physiological limits and increase in the average pulse rates in both the groups. The average oxygen saturation levels were maintained to normal range in both the groups. The average respiratory rate decreased in both intranasal and intravenous groups during surgical procedure. The preoperative to postoperative anxiety scores were decreased significantly in the both groups and there was no significant difference in pre- to postoperative anxiety scores between the groups. CONCLUSION: Both intravenous and intranasal administration of midazolam showed better patient cooperation, satisfaction, and clinical effectiveness. Intranasal midazolam spray is effective in the reduction of subjective stress, reliable anxiolysis while preserving protective reflexes.

Treatment of Stage I Hard Palate Cancer with High-Dose-Rate Brachytherapy Using Molds: Cost-Based Perspective.

INTRODUCTION: Treatment of T1N0M0 (T1 = greatest tumor size < 2 cm, N0 = regional lymph nodes not palpable by clinical examination, M0 = No evidence of distant metastasis) (Green FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M. AJCC Cancer Staging Manual. New York: Springer; 2002) lesions of hard palate carcinoma by radiotherapy carries equal results with the advantage of cosmesis and can avoid surgical complications. External beam radiotherapy (EBRT) will last for 6-8 weeks. Feasibility of high-dose-rate (HDR) intraoral mold brachytherapy is an alternative to EBRT, which is highly effective and reduces treatment time and is also cost-effective one, which can be practiced in a center without Linac facilities. MATERIALS AND METHODS: Custom-made surface molds were prepared for each patient with dental wax, and HDR after loading tubes were placed as per tumor volume. After simulation, with the help of simulation check films, treatment was planned with PLATO Treatment Planning System (TPS) and optimization was carried out. RESULTS: We treated six cases of T1N0M0 hard palate carcinoma by HDR intraoral mold brachytherapy. A total dose of 42-45 Gy in 14-15 fractions with 3 Gy per fraction, two fractions per day with a gap of minimum 6 h was administered between two fractions. (Gray [Gy] is the unit of absorbed dose of radiation by tissues. A total radiation dose of 42-45 Gy will be delivered as per radiobiological principles, in divided number of fractions, thereby the given dose of radiation will kill the major portion of the tumor cells, which were in various sensitive phases of cell cycle and at the same time, less damage to the normal tissues. The time between two fractions of radiation is 6 h, which is the experimentally proven optimal time for recovery of normal tissues from radiation damage and tumor tissues to enter into the sensitive phases of the cell cycle to radiation damage-late G2 and S phases). There was confluent mucositis and all the patients had a complete response and none of the patients had relapse. CONCLUSION: Early (T1N0M0) lesions of hard palate carcinoma with HDR intraoral mold brachytherapy will shorten overall duration of treatment time with excellent local control and toxicities as compared with EBRT.

A Comparative Study of Shear Bond Strength of Direct Bonding System with and without a Liquid Primer: An In Vitro Study.

BACKGROUND: A primer in dental bonding agents enhances the bond between the adhesive and the tooth by way of deriding the tooth surface of moisture and creating a hydrophobic surface for the adhesive to bond and by facilitating the flow of the adhesive into the etched tooth surface. In the orthodontic context, however, there have been debatable results in the published literature as to how significantly the use of primer affects the bond strength between the bracket and the tooth surface. AIMS: This study aimed to evaluate and compare the shear bond strength of two commercially available direct bonding systems with and without using liquid primer and to record their adhesive remnant index scores. SETTINGS AND DESIGN: A total of 100 natural human teeth, extracted for orthodontic therapies, had been selected as specimens for the study. They were equally divided into four categories. Two commercially available products were used to bond metallic orthodontic brackets to the teeth, both with the use of and without the use of a primer to test the shear bond strengths of the four types of adhesive-tooth complexes created. Shear bond strength was measured using universal testing machine, and Student's t-test was applied for the comparison of the results. MATERIALS AND METHODS: A total of 100 extracted human premolar teeth were divided into two groups: Group I and Group II, each of which contained two subgroups (with one subgroup pretreated with a primer and the other, not pretreated with the primer). All the teeth were divided equally among the subgroups and were mounted on color-coded acrylic blocks to aid in identification. Group I was bonded with Transbond XT Light Cure Adhesive (3M Unitek Orthodontic Products, Monrovia, California) and Group II was bonded using Phase II two-paste system (Reliance Orthodontic Products, Itasca, Illinois). The shear bond strength of Transbond XT Light Cure Adhesive used with Transbond XT primer and Phase II orthodontic two-paste system used with liquid primer was compared with that of those used without a liquid primer, respectively. The shear bond strength was evaluated using universal testing machine and the adhesive remnant scores were evaluated subsequently. The Student's t-test was applied for comparison of the two groups. STATISTICAL ANALYSIS: Descriptive statistics, such as mean, standard deviation, and a standard error, were calculated for Transbond XT used with and without primer and for Phase II two-paste system used with and without a liquid resin. The Student's t-test was applied for comparison of the two groups. RESULTS: In Group I, the mean bond strength of Transbond XT without primer (12.5272MPa, 95% CI: 11.76-13.68) was compared to that of Transbond XT with XT primer (13.2028MPa, 95% CI: 12.39-14.06). In Group II, the mean shear bond strength of Phase II two-paste system without primer (10.66MPa, 95% CI: 10.13-11.18) was compared to that of Phase II two-paste system with primer (10.66MPa, 95% CI: 10.13-11.18), and the values were statistically insignificant. CONCLUSION: The shear bond strength of the brackets bonded with Transbond XT and Phase II without using the liquid primer was sufficient enough to withstand the masticatory forces, which implies the elimination of liquid primer during bonding. CLINICAL SIGNIFICANCE: The development of the acid-etch technique and Bisphenol A-glycidyl methacrylate-based liquid resin has changed the practice of orthodontics over the years more than any other single principle formulated. Despite its wide popularity, the cytotoxicity, which stems from the use of liquid primer, needs attention.

Knowledge Analysis of Pit and Fissure Sealants among the Dental Students of South India.

AIM: This study aimed to assess the level of knowledge and attitudes for pit and fissure sealants among undergraduate Indian dental students. MATERIALS AND METHODS: A modified questionnaire consisting of 24 items was distributed to 280 undergraduate dental students comprising males and females of different years at MNR Dental College, Sangareddy, India. Descriptive statistics and Chi-square/Fisher's exact tests were used for statistical analysis. The data were computationally tested using Statistical Package for the Social Sciences (SPSS) Version 20, IBM SPSS Statistics software for Windows, Armonk, NY, USA. RESULTS: With the response rate at 100%, most of the respondents, i.e., 70.4%, were females and the remaining 29.6% were male. Regarding the level of study, 20.8% were in 3rd year, 43.8% in the 4th year, and 16.8% were in 5th year (internship). The respondents showed a reasonable level of knowledge about sealants, mostly being good with the theoretical concepts of the sealants. On the other hand, respondents showed insufficient knowledge about sealants in the clinical practice. CONCLUSION: Although a high proportion of undergraduate dental students showed adequate knowledge about dental sealants, there is a lag in putting that knowledge into work during the clinical practice. These findings suggest an urgent need of dental schools to include and/or update their curriculum regarding fissure sealants to reflect modern dental education that concentrates on evidence-based practice in pediatric dentistry and improve the dental health among the future generations by reducing the incidence of caries.

Ramsay Hunt Syndrome: A Diagnostic Challenge for General Dental Practitioners.

Ramsay hunt syndrome is not just a syndrome but it's rather an infectious disease caused by reactivation of latent varicella-zoster virus in geniculate ganglion. This was first explained by J. Ramsay Hunt as a triad of complications like otalgia, mucosal and cutaneous rashes with or without trigeminal facial palsy. The facial palsy can occur with characteristic vesicles along the path of nerve. We present a case of Ramsay Hunt syndrome in a 48-year-old male. The unilateral pattern of facial involvement and presence of vesicles assisted us for early diagnosis, distinguishing the syndrome with diseases mimicking other severe neurological illnesses and prompt treatment.

Clinical Utility of Serum Homocysteine and Folate as Tumor Markers in Oral Squamous Cell Carcinoma - A Cross-Sectional Study.

INTRODUCTION: Oral Squamous Cell Carcinoma (OSCC) is a common malignancy involving head and neck. Identifying the markers of molecular levels or biochemical markers involving the various metabolic reactions associated with the initiation and biological behavior of individual tumors are very important in diagnosis and prognosis. AIM: To measure and compare the levels of serum Homocysteine (Hcy) and serum folate in OSCC patients, smoking group and healthy subjects and also to assess the clinical utility of serum Hcy as a potential tumor marker in OSCC. MATERIALS AND METHODS: The study group comprised of 60 subjects, of whom 30 were classified as OSCC cases (GROUP I) and 15 were classified as smokers without OSCC (GROUP II). The control group included 15 healthy individuals without smoking habit (Group III). Hcy was measured with High Performance Liquid Chromatography (HPLC). Folate estimation was done by Chemiluminiscence Immuno Assay (CLIA). Comparison of mean Hcy and folate values among the groups was done using ANOVA with Post-Hoc Games Howell test. Gender was compared using Chi-square test. Comparison of mean age was using ANOVA with Post-Hoc Tukey's test. RESULTS: The mean serum folate level in OSCC patients was 5.34ng/mL, 7.68ng/mL in smoking group and 10.99ng/mL in control group. There was a significant difference in the mean serum folate levels among the three study groups (p<0.001). The mean serum Hcy in OSCC patients was 23.58µmol/L, 17.46µmol/L, in smoking group and 10.76µmol/l in controls. There was a significant difference in the mean serum Hcy levels among the three study groups (p<0.001). CONCLUSION: The present study found an interesting association with serum Hcy and folate levels in OSCC which could be useful as a biochemical "Tumor Marker" and thereby providing insights into the onset and progression of the disease.

Buccal Micronucleus Cytome Assay in Sickle Cell Disease.

INTRODUCTION: Sickle Cell Anaemia (SCA) is a commonly inherited blood disorder preceded by episodes of pain, chronic haemolytic anaemia and severe infections. The underlying phenomenon which causes this disease is the point mutation in the haemoglobin beta gene (Hbß) found on chromosome 11 p. Increased oxidative stress leads to DNA damage. DNA damage occurring in such conditions can be studied by the buccal micronucleus cytome assay, which is a minimally invasive method for studying chromosomal instability, cell death and regenerative potential of human buccal tissue. AIM: To evaluate genomic instability in patients with sickle cell disease by buccal micronucleus cytome assay. MATERIALS AND METHODS: The study included 40 sickle cell anemia patients (Group A) and 40 age and sex matched controls (Group B). Buccal swabs were collected and stained with Papanicolaou (PAP). Number of cells with micronucleus, binuclei, nuclear bud, pyknosis and karyolysis were counted in two groups as parameters for the evaluation of genome stability. RESULTS: All the analysis was done using t-test. A p-value of <0.001 was considered statistically significant. There was a statistically significant increase in micronuclei number in SCA patients when compared with controls. Karyolytic (un-nucleated) cell number in Group A was more than to those of the controls. CONCLUSION: The results might suggest that patients with sickle cell anaemia have genome instability which is represented by the presence of micronuclei in the somatic cells. Presence of apoptotic cells might only indicate the bodily damage to the tissue as a result of the disease.

Anaesthetic Efficacy of Topical Benzocaine Gel Combined with Hyaluronidase for Supplemental Intrapulpal Injection in Teeth with Irreversible Pulpitis- A Double Blinded Clinical Trial.

OBJECTIVE: Intrapulpal injection technique is one of the most commonly employed method to achieve profound pulpal anaesthesia during an endodontic procedure. To determine if the topical application of benzocaine gel along with hyaluronidase to the pulp chamber could reduce the pain felt with the intrapulpal injection technique. MATERIALS AND METHODS: Two hundred patients with chronic irreversible pulpitis undergoing endodontic treatment for mandibular first molars in which the primary anaesthetic technique failed were selected and randomly divided into 2 groups. In the control group intrapulpal injection was administered with backpressure. In the experimental group topical application of 20% benzocaine gel mixed with hyaluronidase was done over the exposed pulp following which intrapulpal injection was administered with backpressure. Pain assessment was done on a visual analogue scale. RESULTS: There was statistically significant difference (p<0.001) between the two groups. The mean value in the control group corresponded to the pain perception "strong", whereas that of the experimental group corresponded to the pain perception "weak". CONCLUSION: Topical application of 20% benzocaine gel mixed with hyaluronidase to the exposed pulp reduces the pain encountered with the intrapulpal injection.

Ameloblastic fibroma of the maxilla with bilateral presentation: report of a rare case with review of the literature.

Ameloblastic fibroma (AF) is an uncommon benign odontogenic tumour, with both epithelial and mesenchymal neoplastic proliferation. It occurs most frequently in the posterior region of the mandible, while its occurrence in the maxilla is extremely rare. They are usually encountered in children, emphasizing it as an important diagnostic consideration. Herein, we report the first case of a bilateral maxillary ameloblastic fibroma in a 2-year-old female child patient who presented with a chief complaint of swelling in the right mid facial region.

Osteochondroma of the palate: An interesting and an unusual case presentation.

A 40-year-old Indian male patient was referred to the Department of Oral and Maxillofacial Surgery with a slowly enlarging intra-oral, right-sided palatal swelling of one-year duration, with a previous diagnosis of osteochondroma. Extraorally, patient presented with a mild right-sided facial swelling. On intraoral examination, the palatal swelling was extending from the distal aspect of canine to the distal aspect of second molar with involvement of the maxillary tuberosity. The swelling was non-tender, bony-hard in consistency and covered by normal mucosa. The medical history was non-contributory with no relevant family history of any skeletal disease. Despite the attempt for complete removal of the tumor previously, it recurred within six months. The present article reports an extremely rare clinical case of endosteal (central) osteochondroma, manifesting itself as a radiopaque mass in the right posterior aspect of the palate.