In Vitro Study of Synergic Effect of Cisplatin and Low Molecular Weight Heparin on Oral Squamous Cell Carcinoma.

OBJECTIVES: To evaluate the possible synergic effect of cisplatin and low molecular weight heparin (LMWH) on oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Cisplatin and enoxaparin sodium, alone or in combination, were administered at doses of 1, 2, 4, 8 and 10 µM and 0.1, 0.5, 1, 5, 10, 50, and 100 µg/ml, respectively, to the H357 human OSCC line. The effects on cell viability and apoptosis were evaluated after 24, 48, and 72 h and on cell migration after 18 and 24 h. RESULTS: 10 µM concentration of cisplatin produced the greatest decrease in cell viability, with significant differences at 24 (p=0.009), 48 (p=0.001) and 72 h (p = 0.003); the 100 µg/ml dose of enoxaparin produced the greatest decrease in cell viability but without significant differences (p>0.05). When different concentrations of cisplatin and enoxaparin were combined, it was found that 100 µg/ml enoxaparin sodium produced the greatest synergic effect on cell viability reduction. In analyses of apoptosis and cell migration, it was found that the combination of cisplatin at 8 or 10 µM and 100 µg/ml enoxaparin produced a higher rate of apoptosis at 24, 48, and 72 h and a greater reduction in cell migration at 18 and 24 h. CONCLUSIONS: A combination of cisplatin and enoxaparin sodium shows a synergic effect that reduces cell viability and cell migration capacity and increases the apoptosis of human OSCC cells. CLINICAL RELEVANCE: Enoxaparin may be beneficial in chemotherapy for patients with OSCC; this finding requires further clinical and laboratory investigation.

Prevalence of human papillomavirus in the saliva of sexually active women with cervical intraepithelial neoplasias.

BACKGROUND: The main objective of this study was to estimate the prevalence of human papillomavirus-DNA (HPV-DNA) in the saliva of sexually active women with HPV-related cervical intraepithelial neoplasias (CIN) and compare the findings with a healthy control group. The secondary objectives were: 1) to determine the concordance between genital and oral HPV types in sexually active women with HPV-related CIN; 2) to analyze whether sexual habits influence the presence of HPV-related CIN; 3) to determine whether sexual habits influence the presence of oral HPV. MATERIAL AND METHODS: Saliva samples were collected from 100 sexually active women, 50 with HPV-related CIN and 50 healthy subjects presenting normal cytology. PCR assay was used to detect HPV-DNA. RESULTS: The prevalence of oral HPV infection in saliva samples was 14% in women with HPV-related CIN, while in the healthy group it was 12%, without statistically significant difference (p=0.766). As for the concordance between genital and oral HPV types in women with HPV-related CIN, concordance was only observed for HPV-16, whereby among 22 women with genital HPV-16, only one (4.54%) also presented oral HPV-16. Regarding the possible influence of sexual habits on the presence of cervical pathology and presence of oral HPV, it was found that marital status, age at first intercourse, number of lifetime sexual partners, and condom use are related with the presence of cervical pathology (p<0.001; p=0.017; p=0.002; and p<0.001, respectively); condom use was also found to be related to the presence of oral HPV (p<0.001). CONCLUSIONS: The prevalence of HPV-DNA in the saliva of sexually active women with HPV-related CIN is similar to healthy women. The concordance between genital and oral HPV types is low. Both the presence of cervical pathology and the presence of oral HPV are related to sexual habits. Wider sample size is required to confirm this results.

Attitudes of dental implantologists in Spain to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients.

BACKGROUND: The implantologists frequently prescribe antibiotics, analgesics and anti-inflammatories in dental implant surgery. The aims of this study were to evaluate the attitudes of implantologists in Murcia (Spain) to prescribing antibiotics, analgesics and anti-inflammatories in healthy patients during different implant dentistry procedures, and to see how these are influenced by individual dentist's academic level, professional experience, and ongoing training (attending courses or reading scientific literature on medication use). MATERIALS AND METHODS: This cross-sectional study included a total of 200 implantologists from the Murcia area (Spain), who each completed a two-page questionnaire consisting of 26 questions. RESULTS: The implant procedure in which most dentists (n=97) prescribed antibiotics was multiple implant surgery with flap raising, in which 55.6% of these 97 respondents used a prophylactic antibiotic regime for 7 days after implant placement. All subjects (n=200) prescribed analgesics for eight out of the eleven procedures included in the survey and anti-inflammatories in six. Dentists with higher academic levels or longer professional experience prescribed more antibiotics, but those who underwent continuous training (attending courses or reading scientific literature) reduced antibiotic prescription. CONCLUSIONS: Dentists often prescribed antibiotics, analgesics and anti-inflammatories in almost all implant procedures in healthy patients, but ongoing training reduced the frequency of antibiotic prescription in some procedures.

Salivary myeloperoxidase and malondialdehyde are increased in patients exhibiting an asymptomatic mandibular impacted third molar.

BACKGROUND: To determine whether saliva is a good means of evaluating concentrations of oxidative stress biomarkers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare biomarker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before extraction) with a healthy control, and to determine how biomarkers are modified by extraction. MATERIAL AND METHODS: 80 patients with one asymptomatic MITM and 80 healthy controls were included. Saliva samples were collected from all subjects (before extraction in the study group) to evaluate Myeloperoxidase (MPO) and Malondialdehyde (MDA) concentrations. Follicular tissues were obtained during surgery to measure biomarkers. One month after extraction, saliva samples were collected to assess changes of oxidative stress. RESULTS: Salivary MPO and MDA showed positive correlation with concentrations in follicular tissue (MPO: correlation coefficient=0.72, p=0.025; MDA: =0.92, p=0.001). Patients with asymptomatic MITMs showed higher salivary concentrations of oxidative stress biomarkers than healthy control subjects, with statistical significance for both MPO (p<0.001) and MDA (p<0.001). One month after extraction, salivary biomarkers decreased significantly in the study group (p<0.001). CONCLUSIONS: Salivary MPO and MDA are higher among patients with one asymptomatic MITM, but these levels decrease significantly one month after surgical extraction. The large decrease in oxidative stress biomarkers could justify third molar extraction despite the absence of symptoms.

Effects of topical applications of porcine acellular urinary bladder matrix and Centella asiatica extract on oral wound healing in a rat model.

OBJECTIVES: To evaluate the effects of topical applications of porcine acellular urinary bladder matrix (AUBM) and Centella asiatica extract (CAE) on the healing of tongue wounds in a rat model. MATERIALS AND METHODS: Wounds were made in the tongue using a punch tool in 64 male Sprague-Dawley rats, randomized into four groups (n = 16 per group): group 1 (control), group 2 (CAE), group 3 (AUBM mixed with orabase), and group 4 (orabase). No product was applied in group 1 and groups 2-4 received three daily topical applications. The animals were weighed on day 0 and at the time of euthanasia. Four rats in each group were euthanized at days 2, 7, 14, and 21 and the tongues were processed for: macroscopic morphometric analysis, myeloperoxidase (MPO) and malondialdehyde (MDA) levels, histological wound repair (degree of reepithelialization and inflammation), and CD31 positivity. RESULTS: The animals' weight gain, histological wound repair, and CD31 positivity from greatest to least were: AUBM > CAE > orabase > control. Percentage of tongue occupied by wound, MPO, and MPA levels from least to greatest were: AUBM < CAE < orabase < control, whereby the AUBM group showed significant differences (p ≤ 0.05) in comparison with the other groups on days 2, 7, 14, and 21 for percentage of tongue occupied by wound and MDA and on days 7, 14, and 21 for MPO. CONCLUSIONS: CAE is effective for oral tissue regeneration, while AUBM is an even more potent means of oral mucosa regeneration. CLINICAL RELEVANCE: AUBM may be beneficial to patients with oral wounds; this finding requires further clinical and laboratory investigation.

Oral status, quality of life, and anxiety and depression in hemodialysis patients and the effect of the duration of treatment by dialysis on these variables.

This study aimed is to evaluate the oral health status, quality of life, anxiety and depression among hemodialysis patients and to analyze the effect of the duration of dialysis on these variables. 120 patients on hemodialysis and 120 control subjects underwent oral examination, periodontal evaluation, xerostomia study using a Visual Analogue Scale (VAS), sialometry evaluation; quality of life (QOL) using the OHIP-14 questionnaire and anxiety/depression. Bleeding index, CPTIN, clinical attachment level, and probing depth were significantly higher in the hemodialysis group than the control group (p < 0.001). VAS scores were higher in patients on hemodialysis with significant differences in 6 of the 8 domains (p ≤ 0.05). Unstimulated whole saliva was significantly lower in hemodialysis patients than control subjects (p < 0.001). OHIP-14 scores showed significantly poorer QOL in patients on hemodialysis than control subjects (p = 0.042). Hemodialysis patients presented greater depression and anxiety than control (p < 0.001). Periodontal health was worse among the patients who had been in treatment >10 years, xerostomia and sialorrea was worse in patients treated for 5-9.9, and >10 years, QOL was worse in patients who had spent <1 year; depression and anxiety was greater among those treated for 1-2.9 years. In conclusion, Oral health, QOL, anxiety and depression are worse in patients on hemodialysis, and oral health deteriorates as the time spent in dialysis lengthens, but patients in treatment for <3 years presented the poorest QOL and the greatest anxiety and depression.

Incidence of peri-implantitis and oral quality of life in patients rehabilitated with implants with different neck designs: A 10-year retrospective study.

OBJECTIVES: To evaluate peri-implant bone loss, the presence of peri-implantitis, aesthetic satisfaction, and quality of life in patients with implant-based prosthetic restorations using implants with or without smooth necks, placed in different bone positions. MATERIALS AND METHODS: 400 patients received 1,244 implants: 515 with smooth neck monitored over an average of 6.44 ± 2.55 years and 729 without smooth neck monitored over 5.61 ± 2.52 years. Radiographic bone loss, presence of periimplantitis, implant loss, quality of life (OHIP-14), and patient satisfaction with prosthetic esthetics were evaluated, comparing groups. RESULTS: 120 implants developed peri-implantitis, 15 with a 2.5 mm smooth neck and 105 without smooth neck. Patients without smooth-necked implants showed a worse quality of life with statistically significant difference (p < 0.001). Patient satisfaction with prostheses was higher among the group without smooth neck. CONCLUSIONS: Implants with smooth polished necks would appear to suffer less bone loss and peri-implantitis, and lead to better patient quality of life. However, implants without smooth necks placed crestally led to higher patient satisfaction with aesthetics.

Effect of mobile phones on micronucleus frequency in human exfoliated oral mucosal cells.

OBJECTIVE: In the last two decades, the use of mobile phones has increased enormously all over the world. The controversy regarding whether radiofrequency (RF) fields exert effects upon biological systems is a concern for the general population. An evaluation is made of DNA damage and cytokinetic defects, proliferative potential, and cell death because of RF radiation emitted by mobile phones in healthy young users. STUDY DESIGN: This cohort study was carried out in 50 Caucasian mobile phone users. We collected two cell samples from each subject (a total of 100 cell samples), corresponding to the right and left cheek mucosa, respectively. Case histories and personal information were assessed, including age, gender, body height and weight, history of cancer, smoking and alcohol consumption, exposure to chemical carcinogens or radiation, and dietary habits. Sampling comprised cell collection from both cheeks with a cytobrush, centrifugation, slide preparation, fixation, and staining, followed by fluorescent microscopic analysis. A total of 2000 exfoliated cells were screened for nuclear abnormalities, especially micronucleus. RESULTS: No statistically significant changes were recorded in relation to age, gender, body mass index, or smoking status. A comparison of the results vs the control area according to the side of the face on which the mobile phone was placed, and in relation to the duration of exposure (years) to mobile phone radiation in the total 100 samples, yielded no significant differences. CONCLUSIONS: No genotoxic effects because of RF exposure were observed in relation to any of the study parameters.

Patient information preferences and behaviour in relation to oral biopsies.

Our aim was to study the impact of information on the behaviour of patients who were to have an oral biopsy specimen taken. Patients were randomly assigned either to be given the basic information about oral biopsy or a more extensive amount of information. The Krantz Health Opinion Survey was used as a measure of preferences in decisions made about oral biopsy, and we used a questionnaire to assess anxiety. A total of 260 patients were studied. The participants were satisfied with the information provided (both form and content), but significantly more of those given basic information would have liked to know more (p=0.02). We conclude that information exerts a clear effect on patients' attitude to oral biopsy. Provision of preoperative information leads to significantly less anxiety in all patients having a procedure under local anaesthesia. The results emphasise that patients need to be adequately informed about oral biopsy.

A novel application of the buccal micronucleus cytome assay in oral lichen planus: a pilot study.

BACKGROUND: The most important complication of oral lichen planus is malignancy transformation. OBJECTIVE: The aim of this study was to assess cellular and nuclear morphology in a group of patients with oral lichen planus measured by means of buccal micronucleus cytome assay. STUDY DESIGN: This study included thirty patients with a clinicopathological diagnosis of oral lichen planus (all with atrophic-erosive clinical forms of OLP) and thirty healthy control subjects. Both samples were similar in age and gender. The buccal micronucleus cytome assay protocol consisted of: cell collection from both cheeks with a cytobrush; cell centrifuge; slide preparation, fixation and staining followed by fluorescent microscope analysis. 2 × 10(6) exfoliated cells were screened for nuclear abnormalities: micronuclei, nuclear buds, binucleation, basal and differentiated cells, condensed chromatin, karyorrhectic cells, pyknosis and karyolytic cells. RESULTS: Patients with oral lichen planus showed significantly higher frequencies of micronuclei (p<0.001), nuclear buds (p<0.001), binucleated cells (p<0.021) than the control group. CONCLUSIONS: This method is an easy way for clinicians to assess DNA damage, proliferative potential of basal cells and cell death in buccal cells in cases of oral lichen planus.

Efficacy of topical Aloe vera in patients with oral lichen planus: a randomized double-blind study.

BACKGROUND: Different treatments have been used in application to symptomatic oral lichen planus (OLP), with variable results, perhaps caused by the refractory nature of the disease. The objective of this study was to evaluate the efficacy of the topical application of aloe vera (AV) in OLP compared with placebo. METHODS: A total of 64 patients with OLP were randomized in a double-blind study to either AV (32 patients) or placebo (32 patients), at a dose of 0.4 ml (70% concentration) three times a day. A Visual Analog Scale was used for rating pain, with the application of a clinical scale for scoring the lesions, the Oral Health Impact Profile 49 (OHIP-49), and the Hospital Anxiety-Depression (HAD) scale. The patients were evaluated after 6 and 12 weeks. RESULTS: No statistically significant differences were recorded between both groups in relation to pain after 6 and 12 weeks. In the AV group, complete pain remission was achieved in 31.2% of the cases after 6 weeks, and in 61% after 12 weeks. In the placebo group, these percentages were 17.2% and 41.6%, respectively. There were no adverse effects in any of the groups. In relation to quality of life, significant differences were observed between the two groups in the psychological disability domain and total OHIP-49 score. CONCLUSION: The topical application of AV improves the total quality of life score in patients with OLP.

A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain.

OBJECTIVES: This study describes the clinicopathological characteristics of a group of patients with oral lichen planus (OLP) in south-eastern Spain. MATERIALS AND METHODS: A retrospective descriptive study was made of 550 patients clinically and histopathologically diagnosed with OLP in the period 1991-2007. Patient gender, age, the prevalence of hepatitis C, symptoms and malignization were recorded. The clinical forms were classified as reticular-papular and atrophic-erosive. RESULTS: Of the 550 patients, 128 (23.3%) were men and 422 (76.7%) women. The mean age was 56.35 +/- 13.67 years (range 14-91). The prevalence of hepatitis C was 3.5%. The red clinical forms were the most frequent, with 359 cases (64.2%). The lesions were asymptomatic in 159 patients (28.9%). Five patients developed oral squamous cell carcinoma (0.9%); none of these subjects was smokers. CONCLUSIONS: Patients with OLP present different clinical manifestations. Women were more frequently affected by the disease, and the malignant transformation rate was under 1%.

Premalignant nature of oral lichen planus. A retrospective study of 550 oral lichen planus patients from south-eastern Spain.

The most important complication of oral lichen planus (OLP) is the development of squamous cell carcinoma (SCC)--this being an association that remains subject to controversy. This study aims to examine the incidence and clinical presentation of oral malignancies associated with OLP. A retrospective study was made of 550 patients diagnosed with OLP according to the criteria of the World Health Organization, in the period between 1991 and 2007, in south-eastern Spain 128 males (23.3%) and 422 females (76.7%). A clinical protocol was applied in all cases (sociodemographic data, habits and hepatitis C markers), with histological confirmation of the disease. Five of the 550 patients (0.9%) developed SCC. The mean duration of follow-up was 24+/-20.83 months. The tongue was the most common location. The exact incidence of malignant transformation of OLP is difficult to establish, due to the possible contribution of external risk factors that may be of relevance in oral malignancy.