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OBJECTIVE: To develop and validate the Oral Lichen Planus-Disease Activity Scale (OLP-DAS) for assessing overall disease activity of OLP. METHODS: The OLP-DAS was created by refining the Thongprasom criteria, incorporating inputs from the literature and expert review, and integrating pain assessment. Content validity was evaluated in a virtual meeting with 8 Oral Medicine specialists. Reliability and validity of the final version were examined. Seventeen OLP subjects were assessed for disease activity by 10 investigators using the OLP-DAS, Oral Disease Severity Score (ODSS), OLP-Investigator Global Assessment (OLP-IGA), and Reticular-Erythema-Ulcerative (REU) scale. Convergent validity was assessed by rating 160 OLP subjects using the OLP-DAS, ODSS, and OLP-IGA. Inter-rater and intra-rater reliability, along with convergent validity, were analyzed using intraclass correlation coefficients (ICCs) and Spearman's rank correlation coefficients (rs). RESULTS: The final OLP-DAS achieved excellent content validity indices. Inter-rater and intra-rater ICCs for total OLP-DAS scores were 0.93 and 0.96, respectively. Total OLP-DAS scores exhibited strong positive correlations with the ODSS and OLP-IGA (rs = 0.94 and rs = 0.76; P < 0.001, respectively). The OLP Severity Index (OLP-SI), a component of the OLP-DAS, showed very strong positive correlations with OLP disease activity parameters of the ODSS (rs = 0.90; P < 0.001). CONCLUSIONS: The OLP-DAS is a valid and reliable clinician-reported outcome measure (CROM) for evaluating OLP disease activity. CLINICAL RELEVANCE: The OLP-DAS, as a standardized CROM for OLP, is valuable for both routine clinical assessments and research applications.
Assuntos
Líquen Plano Bucal , Índice de Gravidade de Doença , Humanos , Líquen Plano Bucal/diagnóstico , Feminino , Masculino , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Medição da Dor , Adulto , IdosoRESUMO
OBJECTIVE: N6-methyladenosine is the most frequent mRNA modification in eukaryotic cells. It is catalyzed by the methyltransferase complex, methyltransferase-like 3 (METTL3). Previous studies have revealed that METTL3 plays a role in various cancers. However, there is limited information about the roles of METTL3 in oral epithelial dysplasia (OED). This study determined METTL3 expression in normal oral mucosa (NOM), OED, and oral squamous cell carcinoma (OSCC) by immunohistochemistry. MATERIALS AND METHODS: Twenty formalin-fixed paraffin embedded specimens each of NOM, OED, and OSCC were included. The expression pattern, the number of positive cells, the staining intensity, and the histochemical score (H-score) of METTL3 were investigated. STATISTICAL ANALYSIS: The data were analyzed by using one-way analysis of variance, chi-squared test, and a Kruskal-Wallis test. A p-value < 0.05 indicated statistically significant. RESULTS: The METTL3 expression in NOM was observed in the basal, parabasal, and lower layers of epithelium. In low-grade OED, METTL3 was expressed in the lower epithelial layers and partially presented in the spinous layer. However, in high-grade OED, METTL3 expression was observed in the lower layers, spinous layers, and upper layers of dysplastic epithelium. For OSCC, METTL3 immunostaining was presented in both the peripheral and central cells of the tumor islands. All NOM samples showed weak-to-moderate METTL3 staining intensity, while the moderate-to-strong METTL3 staining intensity was observed in 95% of both OED and OSCC specimens (p < 0.05). The percentage of METTL3 positive cells and H-score was highest in OSCC, followed by OED and NOM, respectively (p < 0.05). Interestingly, H-score was greater in high-grade OED (209.8 ± 18.61) when compared with low-grade OED (162.1 ± 38.93) (p < 0.05). CONCLUSION: METTL3 expression in OED and OSCC was more outstanding than in NOM, suggesting possible roles for OED and OSCC pathogenesis. Additionally, METTL3 expression may be an indicator for OED progression to OSCC.
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Purpose: N6-Methyladenosine (m6A) modification is involved in the tumorigenesis of various cancers. However, the roles of RNA m6A demethylases, fat mass and obesity-associated protein (FTO), and AlkB homolog 5 (ALKBH5) in oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) remain unclear. This study focuses on FTO and ALKBH5 expression by using immunohistochemistry. Material and methods: Twenty specimens each of OED, OSCC, and normal oral mucosa (NOM) were included. The expression pattern, the number of positive cells, the cell-staining intensity, and the histochemical scoring (H-score) were examined and analyzed. Results: In all the OED and OSCC specimens, FTO and ALKBH5 were mainly expressed with moderate to strong staining intensity in the nuclei of the abnormal epithelial cells, respectively. Regarding the NOM, both RNA demethylases showed mild cell staining intensity and was present in 50-60% of the specimens. Interestingly, the percentage of cell positivity, the cell-staining intensity, and the H-score of the FTO and ALKBH5 in NOM, OED, and OSCC were increased, respectively (p < 0.001). There was also a positive correlation between the FTO and ALKBH5 expressions in OSCC (r = 0.62, p = 0.003), but not in the NOM and OED. Conclusion: These results suggest a possible prognostic role of FTO and ALKBH5 expression in the malignant transformation of OED and tumor progression. Further studies are needed to elucidate the mechanisms underlying the roles of FTO and ALKBH5 in carcinogenesis.
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AIM: Denture stomatitis (DS) is a common inflammatory reaction in denture wearers. The severity of palatal inflammation in DS is believed to be related to Candida colonization. The present study evaluated the presence of Candida at the palatal and the denture surface. The factors associated with DS were also investigated. MATERIALS AND METHODS: Eighty-two denture wearers were evaluated for DS based on Newton's classification. The samples were collected from palatal mucosa and the denture surface for Candida culture. The predisposing factors associated with DS were also assessed by questionnaire and by oral and dental prosthesis examination. RESULTS: Thirty patients showed no signs of DS (36.59%), while 52 patients (63.41%) had DS. Candida was detected in 81.71% of all patients and specifically in 26.83% and 54.88% of non-DS and DS patients, respectively. The proportion of patients with a large amount of Candida at the palatal mucosa in the DS group (40.38%) was higher than in the non-DS group (26.67%) but not significantly different (P > 0.05). The amounts of Candida among the different Newton types also showed no statistically significant differences (P > 0.05). Candida was also detected on the denture surface of the non-DS (34.15%) and DS patients (57.32%). The amounts of Candida on the denture surface between the two groups showed no statistically significant difference (P > 0.05). The predisposing factors related to DS included the absence of occlusal rest and poor denture stability (P < 0.05). CONCLUSIONS: In this study, no association between the amount of Candida and DS was found. Mycological examination may be useful for the detection of Candida-induced DS and management. However, further study is required to establish a protocol for antifungal drugs prescription in the treatment of Candida-induced DS among the Newton type.
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OBJECTIVE: Cathepsin B (Cat-B), a cysteine protease, and cystatin A (Cys-A), a protease inhibitor, are involved in the immune response. This study determined Cat-B and Cys-A expression in oral lichen planus (OLP) by immunohistochemistry. MATERIALS AND METHODS: Thirty specimens each of OLP and healthy gingiva (HG) were included. The expression pattern, the number of positive cells, the staining intensity, and the immunoreactive score (IRS) of Cat-B and Cys-A were investigated. The data were analyzed by using unpaired t-test, Chi-square, and Spearman's rank correlation. RESULTS: The Cat-B expression in OLP was observed as cytoplasmic staining in the epithelial cells, whereas Cys-A expression was exhibited in the nucleus and cytoplasm of the epithelium. An increase in Cat-B staining intensity was also observed in the basal cells. Conversely, the high staining intensity of Cys-A was observed in the stratum spinosum, but not the stratum basale. In HG, Cat-B expression demonstrated a relatively consistent intensity in the epithelial layer. The Cys-A expression in HG was similar to OLP with a lower staining intensity. The mean percentage of positive cells and the IRS score of Cat-B and Cys-A in OLP were significantly higher than HG (P < 0.05). There was no correlation between Cat-B and Cys-A levels in OLP. Interestingly, Cat-B expression in erosive OLP was greater than in non-erosive OLP (P < 0.05). CONCLUSION: The Cat-B and Cys-A expression in OLP was more outstanding than in HG, suggesting possible roles for the process of OLP pathogenesis. In addition, Cat-B expression may be an indicator of the disease severity.
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BACKGROUND: Malignant transformation of oral lichen planus (OLP) was reported particularly in erosive type, however, it remains inconclusive. Cathepsin L was shown to promote tumor growth and invasion in many cancers. Therefore, cathepsin L expression in erosive and non-erosive OLP compared with oral epithelial dysplasia and oral squamous cell carcinoma (OSCC) were investigated. METHODS: Thirty specimens of OLP (15 cases each of erosive and non-erosive OLP), 10 cases of oral epithelial dysplasia and 10 cases of OSCC were included. Ten healthy gingiva specimens were served as controls. All specimens were stained with cathepsin L antibody using immunohistochemistry technique. RESULTS: Cathepsin L was expressed in all OLP and OSCC cases. In oral epithelial dysplasia and healthy gingiva, the expression was found at 90% and 50% respectively. The percentage of positive cells was the highest in erosive OLP (27.26 ± 12.09%), followed by non-erosive OLP (20.85 ± 7.43%), OSCC (20.15 ± 15.70%), oral epithelial dysplasia (9.24 ± 7.00%) and healthy gingiva (2.27 ± 5.65%). Most of non-erosive OLP cases showed mild staining intensity while erosive OLP and OSCC showed moderate staining intensity. Cathepsin L was mainly expressed at basement membrane zone and inflammatory cells of OLP. In OSCC, the expression was found in tumor islands and keratin pearls. In oral epithelial dysplasia and normal gingiva, cathepsin L expressions were low and presented in scattered pattern in both epithelium and connective tissue. CONCLUSION: According to the patterns of expression in this study, cathepsin L could be implicated in pathogenesis and severity of OLP.
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BACKGROUND: Osteotome sinus floor elevation (OSFE) is used to increase the bone volume at the site of the maxillary sinus through the transalveolar approach. However, there is uncertainty regarding the necessity of the use of grafting material in order to maintain the space for new bone formation. OBJECTIVE: This study aimed to evaluate new bone formation 6 months after osteotome sinus floor elevation without grafting and to evaluate the correlations between residual bone height (RBH), implant protrusion length (IPL), and endo-sinus bone gain (ESBG). MATERIAL AND METHODS: Thirty-one implants (27 patients) from area 14-17 and 24-27 were included in the study. All implants had a history of OSFE without grafting, with cone beam computed tomography (CBCT) taken prior to the surgery. The clinical examination and radiographic examination using CBCT were performed again 6 months after implantation. The RBH, new bone level, ESBG, and IPL were measured. Paired sample t test and Pearson correlation were used to analyze the data. RESULTS: The average RBH before surgery was 7.14 ± 1.07 mm and 6 months after surgery was 8.95 ± 1.17 mm. There was a significant increase in new bone formation in the 6 months following surgery (p < 0.05). The average ESBG and IPL were 1.8 ± 0.79 mm and 2.02 ± 0.73 mm, respectively. There was a significant positive correlation between the IPL and ESBG (p < 0.05) while there was a negative correlation between RBH and ESBG. This study also demonstrates a decrease in the percentage of bone formation in relation to IPL as the IPL increases. The survival rate of the implant was 100%. CONCLUSION: Significant new bone formation can be detected around the implant site 6 months after implantation using OSFE technique without grafting. There is a negative correlation between the RBH and ESBG. While IPL is correlated to ESBG and appears to be the influencing factors of bone formation changes in the maxillary sinus. The preliminary radiographic results suggest that OSFE technique without grafting in combination with optimal IPL can provide sufficient bone height for implant support with a 100% implant survival rate.