How Much Do We Know about Oral Cancer?-An Online Survey.

INTRODUCTION: Oral cancer (OC) is a disease with a high mortality rate due to its late recognition. Since the oral cavity is easily accessible for visual inspection, enabling early diagnosis, the education of healthcare workers about preventive oral examinations is critical. This research aimed to assess the level of participants' OC knowledge, as well as to raise awareness about this diagnosis. MATERIALS AND METHODS: The research was conducted as an online survey among students of dental medicine, students of medicine, doctors of dental medicine and doctors of medicine. The questionnaire was designed solely for the purpose of this study and consisted of 29 questions. The first part of the questionnaire consisted of general questions about the participants, whereas the questions in the second part addressed their knowledge and attitudes towards OC. RESULTS: The surveyed population comprised of 140 dental students, 105 medical students, 159 doctors of dental medicine and 100 medical doctors. The level of knowledge about OC among the participants is not yet satisfactory. The group of dental medicine students scored highest, while medical doctors showed the weakest knowledge. CONCLUSION: Additional education about OC for doctors of dental medicine and medical doctors is needed. This step will improve prevention and increase chances for early detection.

Serum Concentration of Vitamin D in Patients with Oral Lichen Planus.

Objectives: The vitamin D receptor is involved in immunologically mediated diseases such as oral lichen planus. Some studies suggest an association between lower vitamin D concentrations and a higher risk of inflammatory conditions such as oral lichen planus. The aim of this study was to investigate 1) whether there is a difference in serum vitamin D concentration in patients with oral lichen planus compared to patients in the control group, 2) whether there is a difference in serum vitamin D concentration in patients with erosive compared to non-erosive forms of oral lichen planus, 3) whether there is a difference in serum vitamin D concentration in patients with developed oral cancer and those without cancer. Material and Methods: The study included 68 patients, 34 with oral lichen planus and 34 healthy controls. Fasting venous blood was taken from each participant to determine serum concentrations of vitamin D. Results: The T-test results confirmed a statistically significant lower serum vitamin D concentration in patients with oral lichen planus compared to the control group (p=0.001). According to the results, a statistically significant lower serum vitamin D concentration was found in patients with erosive form OLP. All five patients with oral cancer, which was developed from erosive OLP, had low serum vitamin D concentrations. Conclusions: Determination of serum vitamin D concentration could be important for monitoring OLP patients to prevent the development of severe clinical manifestations of erosive OLP and the conversion of symptomatic lesions to oral cancer.

Increased prevalence of oral potentially malignant lesions among Croatian War invalids, a cross-sectional study.

Background: The main objective of this study was to investigate the frequency and type of oral pathological changes, oral subjective symptoms and the knowledge about oral cancer in the population of Croatian military invalids from the Homeland War. Material and Methods: A total of 102 Croatian military invalids from the Homeland War participated in the study. Data were collected on the presence of subjective symptoms in the oral cavity, and a detailed clinical examination of the oral mucosa was performed. Results: Almost half of the participants, 46 (45.1%), reported being smokers, and 64 (62.7%) consumed alcohol daily. Subjective symptoms in the oral cavity were reported by 25 (24.5%) of them. Pathological changes were found in 35 (34.3%) participants, of whom 14 (13.7%) had potentially malignant changes. Pathohistological findings confirmed the diagnosis of a potentially malignant lesion in 10 subjects and indicated the presence of moderate dysplasia in two, carcinoma in situ in one, and invasive carcinoma in one. Conclusions: Participants didn't show adequate knowledge of risk factors. Forty-one changes in the oral cavity were found in 35 subjects, and as many as 14 were potentially malignant. According to the participants, most dentists and family physicians don't thoroughly and regularly examine their patients' oral mucosa. Key words:Oral cancer, oral lichen planus, leukoplakia, erythroplakia, actinic cheilitis, Croatian Homeland War invalids.

Knowledge of Dental Students from Croatia, Slovenia, and Bosnia and Herzegovina about Dental Care of Oncology Patients.

The central role of the dentist in the treatment of oncology patients is to care for the patient's oral cavity before, during, and after radio/chemotherapy. The aim of this research was to determine the knowledge of dental students from five universities in three neighboring countries, Croatia (Split, Rijeka, and Zagreb), Bosnia and Herzegovina (Sarajevo), and Slovenia (Ljubljana), about oncology patients' dental care. A total of 140 students in their fourth, fifth, and sixth year of dental medicine studies participated in this research. A questionnaire with 36 specific questions was designed for this research and included questions about dental care of oncologic patients before, during, and after the oncology therapy. Most students are familiar with the incidence and most common type of head and neck tumors, while knowledge about tumor treatment and the side-effects of radiation therapy and/or chemotherapy is weak. Students did not show satisfactory knowledge about osteoradionecrosis, which is the most serious side-effect of radiotherapy; therefore, the emphasis on additional education should be greatest in this area. Teaching staff should be aware of lack of student knowledge and try to offer more information and practice in providing dental care for oncology patients.

Different Protocols of Photobiomodulation Therapy of Hyposalivation.

OBJECTIVE: Photobiomodulation (PBM) therapy has proved to be effective for a wide range of oral pathologies including oral dryness, but the literature still lacks reports of clinical trials and protocols. The purpose of our study was to evaluate the effects of different wavelengths of PBM on salivation in patients suffering from hyposalivation aiming at determination of optimal treatment protocol. MATERIALS AND METHODS: This study included 30 patients whose major salivary glands were treated with low-intensity diode laser BTL2000 (Medical Technologies, s.r.o., Czech Republic) during 10 consecutive days. Patients were randomly assigned into two groups, each of 15 patients, and treated with PBM of 830 nm and PBM of 685 nm, respectively. The whole unstimulated and stimulated saliva quantities were measured each day during 10 days, before and after laser treatment, and at 10th day after treatment was ended. RESULTS: Results have shown that the laser treatment significantly improves salivation (p < 0.0001) in both groups after 10 days treatment. The salivation also remains improved 10 days after the end of treatment. The patients treated with PBM of 830 nm have had continuously higher values of quantity of saliva. CONCLUSIONS: Our results have shown that both laser wavelengths were effective in increasing salivary flow rate, and the improvement in salivation was statistically significant. The effect of treatment could be observed 10 days after the completion of treatment, thus providing evidence not only of stimulative effect but also indicating regenerative potential of PBM therapy.

Involvement of IGF-2, IGF-1R, IGF-2R and PTEN in development of human tooth germ - an immunohistochemical study.

Insulin-Like Growth Factor 2 (IGF-2) is a peptide hormone essential for prenatal growth and development. IGF-2 exerts its mitogenic effects via Insulin-Like Growth Factor 1 Receptor (IGF-1R), and is eliminated by binding to Insulin-Like Growth Receptor 2 (IGF-2R). IGF-2 is also negatively regulated by Phosphatase and Tensin Homolog (PTEN), a phosphatase mutated in various tumors. Not much is known about the interplay between these factors during human odontogenesis. In this study, expression patterns of IGF-2, IGF-1R, IGF-2R and PTEN were analyzed by double immunofluorescence in incisor human tooth germs during the foetal period of development between the 7th and 20th gestational week. Throughout the investigated period, IGF-2 was mostly expressed in enamel organ, whereas mild to moderate expression of PTEN could be seen in dental papilla and parts of enamel organ. Expression of IGF-1R was ubiquitous and displayed strong intensity throughout the entire enamel organ. In contrast, expression of IGF-2R had rather erratic pattern in enamel organ and dental papilla alike. Expression patterns of IGF-2, IGF-1R, IGF-2R and PTEN in highly proliferative cervical loops, as well as in differentiating pre-ameloblasts and pre-odontoblasts of cusp tip region during the early and late bell stages when enamel organ acquires definitive shape, indicate importance of these factors in crown morphogenesis of human incisor. Taken together, our data suggest the involvement of IGF-2, IGF-1R, IGF-2R and PTEN in temporo-spatial patterning of basic cellular processes (proliferation, differentiation) during normal tooth development. They are also relevant for improving knowledge of molecular basis of human odontogenesis.

The prevalence of celiac disease in patients with geographic tongue.

BACKGROUND: Geographic tongue (GT) is a benign inflammatory condition usually involving the dorsal surface and lateral borders of the tongue. Numerous etiological factors of GT have been suggested, including immunological factors; genetic; atopic or allergic predisposition; emotional stress; and hormonal disturbances. GT may also coexist as one of the possible manifestations of celiac disease (CD). Therefore, the aim of this study was to investigate the prevalence of CD, positive serologic tests for CD screening, and HLA-DQ presence in patients with GT. METHODS: Tissue transglutaminase antibodies (anti-tTG), antibodies against gliadin (AGA), and human leukocyte antigen (HLA) typing were assessed for 60 GT patients and 60 healthy control subjects. The duodenal biopsy was performed in patients with positive serologic tests. RESULTS: We found that 9 (15%) GT patients were positive for IgA tTG, and in those patients histological changes consistent with CD were confirmed by duodenal biopsy. Only two of them reported the presence of gastrointestinal symptoms. There were statistically significant differences between the GT patients and control group for immunoglobulin (Ig) A tTG (P = 0.03), IgG tTG (P = 0.04), IgA AGA (P = 0.04), and IgG AGA (P = 0.02). CONCLUSION: The results of our study demonstrated the increased prevalence of CD in patients with GT. Therefore, the clinical oral examination should be considered a diagnostic tool, especially in atypical or silent forms of CD, since it may contribute to provide an early diagnosis.

Increased prevalence of celiac disease in patients with oral lichen planus.

OBJECTIVES: The aim of this study was to establish the prevalence of celiac disease (CD) in patients with erosive and reticular form of oral lichen planus (OLP) compared to healthy controls. MATERIALS AND METHODS: Tissue transglutaminase antibodies (anti-tTG) and antibodies against gliadin (AGA) were measured in the sera from 56 OLP patients and 57 healthy controls, who also underwent human leukocyte antigen (HLA) typing. The duodenal biopsy was performed in patients with positive serology, and a gluten-free diet was recommended if CD was confirmed. RESULTS: CD was diagnosed in eight OLP patients (14.29 %). Six OLP patients (10.71 %) were positive for immunoglobulin A (IgA) tTG. A statistically significant difference among the forms of oral lichen was observed for the IgA tTG (p = 0.03) and immunoglobulin G (IgG) tTG (p = 0.01). Higher frequencies of HLA-DQ2 and HLA-DQ8 were found in OLP patients compared to the control group. CONCLUSION: The prevalence of CD was higher in patients with OLP than in the control group. Therefore, increased efforts aimed at the early detection and dietary treatment of CD, among antibody-positive OLP patients, are advisable. CLINICAL RELEVANCE: Our study confirmed the increased frequency of CD among OLP patients. CD screening should be considered in OLP patients, since untreated CD can present many complications and reduce a patient's quality of life.

The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus.

BACKGROUND: In spite of all the efforts, recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) still have unexplained etiology. The role of anxiety, depression, and psychological stress in occurrence and intensity of symptoms in RAS and OLP patients has been investigated in this study. METHODS: A total of 110 patients with RAS in the acute phase and 112 patients with OLP also in acute phase participated in this study. All patients filled out questionnaires related to the primary disease (RAS/OLP) after which they took the following psychological tests: Beck Depression Inventory (BDI), The State-Trait Anxiety Inventory (STAI), and Ways of Coping Questionnaire (WCQ). RESULTS: According to multiple regression analysis, in patients with RAS, the highest correlation was found between results of the pain intensity and STAI test (ß= 0.66; p < 0.000). In the patients with OLP, the highest correlation was found between the level of hyperkeratosis and WCQ test (ß = 0.53; P < 0.000), inflammation and results of BDI test (ß = 0.33; P < 0.002), and results of dynia test and STAI test (ß = 0.31; P < 0.004). CONCLUSIONS: In this study, a high correlation between anxiety, depression, and psychological stress with symptoms of RAS and OLP has been observed.