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Background: Radiography plays an important role in detection of interproximal caries. The aim of study is to compare diagnostic ability of conventional film and photostimulable phosphor (PSP) with direct measurement using stereomicroscope in detecting proximal caries. Methodology: In this descriptive study - diagnostic test evaluation, 200 proximal surfaces of 100 extracted human posterior teeth were radiographed with dental X-ray unit. Evaluation of conventional and digital radiographs was performed twice by three observers. Carious lesions were classified based on a four-point scale (R0-R3) suggested by Abesi et al. Weighted kappa coefficients were calculated to assess intra- and interobserver agreement for each image set. Indices of diagnostic ability calculation were based on the first readings of the three observers. The scores were compared with the histological gold standard using receiver operating characteristic (ROC) analysis to evaluate diagnostic ability. Results: Intraobserver kappa coefficients calculated for each observer for each method of detecting caries ranged from 0.914 to 0.956. Interobserver kappa coefficients for each image set ranged from 0.8788 to 0.9583. The sensitivity and specificity of film for the first observer were 77.5% and 78.3% and for PSP were 77.5% and 80%, respectively. ROC analysis revealed that there were no statistically significant results (P > 0.05) between Az values for the two detection methods. Conclusion: PSP plate should be preferred over conventional films in detecting cavitated proximal caries. Further studies with more noncavitated proximal surfaces are required to conclusively establish the diagnostic ability of PSP over conventional film.
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Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with cell-mediated immune dysregulation. The aetiology of OLP has been studied extensively for decades. Viruses like Hepatitis C Virus (HCV), human papillomavirus (HPV), herpes simplex virus (HSV), and stress have been hypothesized to play a role in the pathogenesis and malignant transformation of OLP. HPV has been proved to be an etiological agent in oropharyngeal cancers and non-tobacco-associated leukoplakia. The role of human papillomavirus in the pathogenesis of OLP has to be studied extensively. Aim: This study aims to detect the presence of HPV 16 and HPV 18 DNA in the biopsy samples of OLP and also to determine the role played by the virus in the pathogenesis and malignant transformation of OLP. Materials and Methods: Biopsy samples comprising 30 OLP tissues were collected. The DNA was extracted by the cetyltrimethylammonium bromide method. Polymerase chain reaction was performed by using general primers to amplify the HPV E6 gene. Results: Twelve out of 30 (40%) OLP cases were positive for HPV DNA. A significant relation was found between HPV, site (buccal mucosa) and the type (reticular) of the lesion (P = 0.007). However, the difference between the percentage of HPV positive males and females was statistically insignificant (P = 0.852). Conclusion: This study confirmed the presence of high-risk HPV 16 and HPV 18 DNA in OLP. The study showed a significantly higher expression of HPV in erosive OLP when compared to reticular OLP, suggesting a possible role of HPV in the malignant transformation of OLP.
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Lichen planus (LP) is a chronic inflammatory mucocutaneous disease. The disease has a cell-mediated immune reaction which is precipitated by a specific trigger which turns the self-peptides antigenic. The role of human papillomavirus (HPV) in the malignant transformation of oral LP (OLP) has always been debated. Establishing a definitive part played by HPV in the malignant transformation of OLP, would possibly provide screening for the viruses, HPV vaccination, and antiviral therapy along with conventional treatment in LP which could improve prognosis. This systematic review is to assess the role of HPV in the malignant transformation of OLP. We performed a systematic search of PubMed, MEDLINE, and Google. The information was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All full-text papers that assessed the association of HPV in malignant transformation of OLP were considered eligible. The outcome parameter included the malignant transformation of OLP. We found a total of 19 studies from which five were found suitable for the review. Results from this systematic review showed HPV is associated with OLP. There is an increased prevalence of HPV in the erosive-atrophic (EA) variant of OLP compared to non-EA variant. There seems to be no strong evidence to prove the association between HPV and malignant transformation of OLP. Taking up the oncogenic potential of high-risk types and OLP as a potentially malignant disorder, more number of studies need to be performed on the dysplastic subtype of OLP and in those OLP lesions that progress to oral squamous cell carcinomas.
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BACKGROUND: The increased prevalence of fluorosis has led to a search for biomarkers of fluoride exposure. Among the biomarkers of sub-chronic exposure to fluoride, hair, fingernails, and toenails have the advantage of being noninvasively collected, easily transported, and stored. OBJECTIVE: The objective of this study was to comparatively evaluate coronal hair, fingernails, and toenails as biomarkers of fluoride exposure from drinking water; the study was designed as a population-based observational cross-sectional study. MATERIALS AND METHODS: A population-based observational cross-sectional study was conducted in 60 children (20 subjects per group) of ages 12-17 years in three villages of Nilakottai block, Dindigul district, Tamil Nadu, India (Thomaspuram, Bangalapatti, and Singampatti). The fluoride concentration in the household drinking water was analyzed and compared with the fluoride content in the coronal hair, fingernail, and toenail clippings, which was estimated by potentiometric method (fluoride-ion-selective electrode) and expressed in ppm (parts per million). A two-tailed probability value of P < 0.05 was considered significant. RESULTS: The mean fluoride concentration in drinking water was 0.63ppm in Thomaspuram, 1.63ppm in Bangalapatti, and 2.92ppm in Singampatti. The mean fluoride content in hair samples was 2.84ppm, 4.67ppm, and 6.53ppm; fingernail clippings was 2.99ppm, 4.94ppm, and 6.84ppm; and toenail clippings was estimated as 3.13ppm, 5.10ppm, and 7.24ppm in Thomaspuram, Bangalapatti, and Singampatti residents, respectively. The mean fluoride content in the hair, fingernails, and toenails was significantly higher as compared to the mean fluoride content in the drinking water (viz., toenail fluoride > fingernail fluoride > hair fluoride). CONCLUSION: Coronal hair, fingernails, and toenails are useful biomarkers for both sub-chronic and chronic fluoride exposure from drinking water. Due to ample sample availability and the highest fluoride content, toenails are the most suitable biomarkers of fluoride exposure from drinking water.