Diagnostic Accuracy of Contrast Enhanced Computed Tomography (CECT) in Cervical Lymph Node Metastasis of Oral Carcinoma: A Systematic Review and Meta-Analysis.

OBJECTIVE: To compare the diagnostic accuracy of Contrast Enhanced Computed Tomography (CECT) compared to conventional imaging modalities and histopathological investigation in cervical lymph node metastasis in adults through a novel meta- analysis. METHOD: The review protocol is registered under PROSPERO(CRD42021225704) and performed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis - Diagnostic Test Accuracy (PRISMA- DTA) checklist. Databases like PubMed, Google Scholar, EBSCOhost were searched from 2000 to 2023 to identify the diagnostic potential of CECT in cervical lymph node metastasis of oral carcinoma. True-positive, false-positive, true-negative, false-negative, sensitivity, specificity values were extracted or calculated if not present for each study. Quality of selected studies was evaluated based on Quality assessment of diagnostic accuracy studies (QUADAS)- 2 tool. Meta-analysis was performed in Meta-Disc 1.4 software and Review Manager 5.3 using a bivariate model parameter for the pooled sensitivity and pooled specificity. Additional analysis was performed in terms of positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and summary receiver operating characteristics (SROC) with Area Under Curve (AUC) and p<0.05 as statistically significant. RESULTS: Six studies were included for qualitative synthesis and as well as for meta-analysis. Two studies had high risk of bias while four studies had low risk of bias. 651 patients underwent CECT and were taken for meta-analysis. The meta-analysis revealed that CECT for diagnosing cervical lymph node metastasis had a pooled sensitivity of 71%, pooled specificity of 14% with 60% Area Under Curve (AUC). +LR of 0.84, -LR of 1.36 and DOR of 0.59. CONCLUSION: CECT has an overall fair diagnostic ability and is a valid and reliable tool in diagnosing the target condition overcoming high reliance on master specialized capacity for their execution and understanding like other conventional imaging techniques. CECT can be concluded for secondary level of prevention for cervical node metastasis of oral carcinoma under early diagnosis and prompt treatment. However, further standardized accuracy studies are indicated to improve the overall diagnostic accuracy of CECT.

The Synergistic Effect of Ozonated Oil and Desensitising Toothpaste on Dentinal Tubule Occlusion: An In Vitro Study.

Introduction Dentin hypersensitivity (DH) is the most common problem encountered by clinicians. It can be managed either by blocking neural activities or by occluding tubules. Ozonated oil facilitates the simple passage of desensitizing agents into dentinal tubules. Aim This study aimed to evaluate the effect of ozonated oil on dentinal tubule occlusion before and after the application of desensitizing toothpaste. Materials and methods The study was carried out in Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, India. The sample size of the study was 80. The first group contained specimens for control. The second group comprised specimens treated with ozonated oil. The third group comprised specimens being treated with a desensitizing agent. The fourth group contained specimens treated with both the desensitizing agent and ozonated oil. The specimens then received an acid challenge. The specimens were observed under a scanning electron microscope (SEM) before any therapy, after the application of the therapeutic agents and after the 37.5% ortho-phosphoric acid challenge. Results Inferential statistics to compare between the groups was calculated using one-way analysis of variance (ANOVA) statistics. Post-hoc Tukey's honestly significant difference (HSD) was performed to compare the groups. The mean scores of the partial tubular occlusion of Group 1, Group 2, Group 3 and Group 4 before the acid challenge were 0.035, 0.691, 0.564 and 0.368, respectively. The maximum score was obtained in the case of Group 2, which was statistically significant. The mean scores for partial tubule occlusion after the acid challenge for Group 1, Group 2, Group 3 and Group 4 were 0.055, 0.531, 0.733 and 0.142, respectively. There was evidence of maximum partial tubule occlusion after the acid treatment in the case of Group 3. The mean scores of Group 1, Group 2, Group 3 and Group 4 before the acid challenge were 0.019, 0.309, 0.442 and 0.609, respectively. The maximum score was obtained in the case of Group 4, implying a greater number of total tubular occlusions before the acid challenge. The mean scores of the total tubular occlusions after the acid challenge for Group 1, Group 2, Group 3 and Group 4 were 0.047, 0.465, 0.272 and 0.890, respectively. There was evidence of maximum tubule occlusion in the case of Group 4, which was statistically significant. Conclusion Overall, the application of a desensitizing toothpaste with ozonated oil holds promise as a potentially more effective treatment approach for DH. Further research and clinical studies may be needed to fully validate its efficacy and safety in dental practice.

Assessment of Oral Health-Related Quality of Life in Patients Receiving Corticobasal Dental Implants.

Background: Among various treatment modalities for tooth replacement, dental implants are considered the best one. This study assessed the effects of smoking, periodontitis, and diabetes on oral health-related quality of life (OHRQoL) in patients receiving corticobasal dental implants. Materials and Methods: One hundred twenty patients of either gender who received corticobasal dental implants were enrolled. All were subjected to Oral Health Impact Profile-20 (OHIP-20) for dental implant patients (OHRQoL questionnaire). The patient satisfaction level was measured on a scale with points ranging from 0 to 5. The value 0 indicates no satisfaction, whereas the value 5 shows highly satisfied. Results: Of 120 patients, males were 70 and females were 50. The overall satisfaction level was 4.92, articulation speech was 4.12, implants were 4.80, and construction was 4.88. The overall satisfaction, articulation speech, implants, and construction values in patients with and without diabetes were 4.90 vs 4.93, 4.56 vs 4.86, 4.76 vs 4.92, and 4.94 vs 4.83, respectively. The overall satisfaction, articulation speech, implants, and construction values in patients with and without smoking were 4.83 vs 4.91, 4.52 vs 4.88, 4.70 vs 4.82, and 4.12 vs 4.84, respectively. The overall satisfaction, articulation speech, implants, and construction values in patients with and without periodontitis were 4.72 vs 4.96, 4.52 vs 4.88, 4.73 vs 4.98, and 4.81 vs 4.95, respectively. The overall satisfaction, articulation speech, implants, and construction values in patients with one to three risk factors and control were 4.85 vs 4.96, 4.82 vs 4.94, 4.88 vs 4.97, and 4.76 vs 4.86, respectively. There was a significant difference in pain, infections and/or swelling, sleeping problems, problems with self-confidence, taste, chewing discomfort and/or difficulties, and influence on food choice before and after in patients treated with corticobasal dental implants (P < 0.05). Conclusion: The satisfaction level is higher after obtaining corticobasal dental implants in patients with diabetes, smoking, and periodontitis as compared to control. Thus, corticobasal dental implants may be considered alternate treatment options for these patients.

Comparative Evaluation of Pimecrolimus Cream 1% and Triamcinolone Aceonide Paste in Treatment of Atrophic-Erosive Oral Lichen Planus.

Objectives: This study was done to assess the effects of pimecrolimus cream 1% and triamcinolone aceonide paste in the treatment of atrophic-erosive oral lichen planus. Materials and Methods: A total of 100 patients diagnosed both clinically and histopathologically as lichen planus were considered in the present study. Subjects were classified into two groups. Group I: Patients in this group were treated with 1% pimecrolimus cream and Group II: Patients falling under this group were treated with triamcinolone acetonide in 0.1% concentration. Results: None of the patients reported worsening clinical signs and symptoms. No significant difference in efficacy and reduction in burning sensation of either pimecrolimus or trimcinolone acetonide was present. Conclusion: Present study found no significant difference in the efficacy of both the agents studied.

Assessment of Cytokine and Herpesvirus Level in Peri-implantitis and Healthy Patients.

BACKGROUND: The present study was conducted to assess level of cytokine and herpesvirus in peri-implantitis and healthy patients. METHODOLOGY: Fifty patients with healthy dental implant (Group I) and dental implant with peri-implantitis (Group II) were enrolled. The level of interleukin (IL)-1 ß, IL-2, IL-4, IL-6, MCP-1 and tumor necrosis factor-α (TNF-α), and herpesvirus was estimated. RESULTS: The mean IL-1 ß level was 1.54 in Group I and 5.12 in Group II, IL-2 was 0.05 in Group I and 0.02 in Group II, IL-4 was 0.018 in Group I and 0.0021 in Group II, IL-6 was 0.83 in Group I and 0.92 in Group II, MCP-1 was 64.5 in Group I and 23.1 in Group II, and TNF-alpha was 1.54 in Group I and 1.05 in Group II. There was a significant higher level of TNF-alpha in virus + patients (P < 0.05). CONCLUSION: The cytokine level was increased in patients with peri-implantitis as compared to patients with healthy dental implants. Virus-positive patients exhibited higher cytokine levels than virus-negative patients.

Oral Submucous Fibrosis: Correlation of Clinical Grading to Various Habit Factors.

OBJECTIVES: The aim of this study was to correlate the clinical grading of oral submucous fibrosis (OSMF) with various habit factors and to observe the habit factors associated with the severity of OSMF. MATERIALS AND METHODS: This study was carried out in the Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, Bhubaneswar, Odisha, India. Two hundred patients clinically diagnosed with OSMF were included in the study. The observations were tabulated and subjected to statistical analysis using chi-square test and Spearman's rank correlation test. RESULTS: A total of 200 subjects participated in the study of which 182 were males and 18 were females. Forty-eight males and nine females had Grade I OSMF. One hundred nineteen males and eight females had Grade II OSMF. Fifteen males and only one female had Grade III OSMF. On the basis of functional staging, the total participants in stage I, stage II, and stage III were 185, 14, and 1, respectively. The participants having Grade I, Grade II, and Grade III OSMF with functional staging I were 57, 122, and 6, respectively. The participants having Grade II and Grade III OSMF with functional staging II were 5 and 9, respectively. CONCLUSION: It is alarming that nearly half of the total subjects were in the younger age group and were having OSMF. Also, as the age increased, the subjects were found to be more attracted to consuming areca nut derivatives in the form of betel quid with or without tobacco. It is recommended that community-oriented outreach programs on oral health awareness be developed, emphasizing children who represent the upcoming future, to avoid/quit areca nut and its derivatives.

Assessment of the Anterior Loop of the Mandibular Canal Using Cone-Beam Computed Tomography in Eastern India: A Record-Based Study.

OBJECTIVE: The aim of this study was to assess the presence and course of the anterior loop (AL) in an Odisha sample population using cone-beam computed tomography (CBCT) and to accurately identify and analyze the length, height, and diameter of AL in male and females. MATERIALS AND METHODS: CBCT images from 1000 patients obtained for various clinical indications were randomly selected and evaluated to determine the presence, length, height, and diameter of the AL. The various parameters were then compared based on gender, age, and the side of the mandible. The data were analyzed using the Chi-square test, independent t-test, multiple post hoc procedure, and one-way ANOVA test. RESULTS: An AL was identified in 9.7% of the cases, and its mean length ranged from 1.8 to 4.8 mm. The loop had a greater mean length and was significantly more prevalent in males. The diameter ranged from 1 to 4 mm and height ranged from 7.8 to 15.1 mm. The AL was most commonly found in the middle-aged patients (39-48 years) which attributed to around 27.83%. CONCLUSION: In this study, a lower prevalence of the AL of the mandibular canal was found. Being an anatomical variation, an exact evaluation of the AL must be established using the imaging techniques prior to any surgical procedure.

Comparative Study of Micronuclei Count in Patients with Different Tobacco-related Habits using Exfoliated Buccal Epithelial Cells: A Tool for Assessment of Genotoxicity.

AIM: To study and compare the genotoxic effects of tobacco using micronuclei count in individuals with different tobacco-related habits. MATERIALS AND METHODS: A cross-sectional study was done comprising 200 individuals, divided into four groups. Group I: 50 subjects with history of tobacco chewing, group II: 50 subjects with a history of smoking tobacco, group III: 50 subjects with a history of both tobacco chewing and smoking, and group IV: 50 subjects without any habits as controls (age-matched). The study groups were individually further divided into three subgroups which comprised of subjects with history of substance abuse for less than 5, 5 to 10, and greater than 10 years. Exfoliated cells from the buccal mucosa of the subjects were collected and stained using Giemsa stain. A total of 1,000 cells were examined for each case and micronuclei frequency was scored according to the guidelines given by Tolbert et al. Results: The mean number of micronuclei count was 18.28 ± 10.0 in group I (smokeless tobacco users), 11.38 ± 6.3 in group II (subjects with history of tobacco smoking), 22.44 ± 9.8 in group III (subjects with history of using both smokeless and smokable form of tobacco), and 4.86 ± 2.4 in the control group. The statistical difference was found to be highly significant (p < 0.001). Similarly, based on the duration, highly significant difference was notable in the mean number of micronuclei in subjects who had a history of substance abuse for more than 10 years. CONCLUSION: A significantly higher micronucleus frequency was found in smokeless tobacco users than in smokers and controls. Micronuclei assay in the exfoliated buccal cells is a useful and minimally invasive method for monitoring early genotoxic damage. CLINICAL SIGNIFICANCE: Micronuclei assay can be used to detect genotoxic damage at the earliest and, if intervened at this point, may prevent frank malignancy, morbidity, and mortality.

Estimation of Salivary and Serum Lactate Dehydrogenase in Oral Submucous Fibrosis.

AIM AND OBJECTIVES: The objective of the present study was to estimate the serum and salivary lactate dehydrogenase (LDH) levels in patients with oral submucous fibrosis (OSMF) and to study the association between serum and salivary LDH levels and mouth opening, frequency of habit, and duration of habit in patients with OSMF. MATERIALS AND METHODS: Participants were divided into two groups: Group I - case group diagnosed with OSMF and Group II - the control group. Unstimulated whole saliva was collected from all the participants. The International Federation of Clinical Chemistry method was carried out with the help of LDH (P-L) kit (Crest Biosystems, Goa). Collection of blood sample was done under aseptic precautions and processed for LDH. The data were analyzed using SPSS software 2010 (version 19, IBM, Armonk, NY, USA). Descriptive statistics including mean, range, standard deviation, and percentage were used along with unpaired t-test and Pearson's correlation test. RESULTS: All the participants were male and were in the age range of 18-60 years, with a mean age of 28.63 ± 10.39 years. The mean salivary LDH levels in patients with OSMF were 1057.30 ± 640.12 µg/dl and in the control group were 668.25 ± 498.45 µg/dl. The mean serum LDH level in patients with OSMF was 408.35 ± 158.35 µg/dl as compared to the control group was 313.05 ± 82.69 µg/dl. The Pearson's correlation coefficient between serum LDH and frequency of habit, duration of habit, and mouth opening was found to be 0.55, 0.53, and 0.69, respectively. The Pearson's correlation coefficient between salivary LDH and frequency of habit, duration of habit, and mouth opening was found to be 0.33, 0.04, and 0.13, respectively. The Pearson's correlation coefficient between salivary LDH and serum LDH was found to be -0.18. CONCLUSIONS: There was a significant increase in the serum and salivary LDH in OSMF patients as compared to controls; the salivary LDH did not seem to correlate with frequency of the habit, duration of the habit, or mouth opening of OSMF patients. However, serum LDH was found to correlate directly with frequency of the habit and mouth opening in OSMF patients. Hence, based on the results of the present study, it can be hypothesized that serum LDH is a better biological marker than salivary LDH in the evaluation of OSMF.

Awareness of hepatitis B infection among healthcare students in a private medical college in Odisha.

BACKGROUND: The emergence of the blood-borne pathogens and the increasing number of infected patients and the increasing interest in dental health care compel the dental professionals to have thorough knowledge about communicable diseases and the MBBS and nursing students are always at risk because of their profession. As hepatitis B infection is a major health hazard throughout the world, healthcare students should have through knowledge about this disease. Setia et al. had conducted a similar kind of study in Punjab in which the sample size was smaller and it included only the interns, whereas the present study was conducted to assess the level of knowledge, attitude, and behavior about hepatitis B infection among healthcare students of all academic years because they are indulged in clinical work since third year of their curriculum. MATERIALS AND METHODS: A cross-sectional survey was conducted of all the students starting from 1(st) year to final year and the interns of MBBS, BDS, and nursing at KIIT University. The questions were obtained from a study performed in Turkey in 2010 and were modified by an infection control expert. Questions in multiple choice format were in English and it was a self-administered questionnaire consisting of three parts (knowledge, attitude, behavior). Then, ethical clearance for the study was obtained from the institutional ethical committee, KIMS. Subsequently, the students were well informed and explained about the study. Students who voluntarily wanted to participate were included in the study. Questionnaire containing 20 questions to assess the level of knowledge, attitude, and behavior about hepatitis B was distributed among the students. Data were compiled and statistical analysis was done. RESULTS: The response rate was 83% (N = 332). In our study, majority (96.99%) were aware of transmission of HBV infection by blood, body fluid, and secretion. The level of knowledge was higher in MBBS students than BDS and nursing students (MBBS > BDS > nursing). Attitude toward the disease was higher in MBBS students than BDS and nursing students (MBBS > BDS > nursing), whereas behavior was higher in BDS students than MBBS and nursing students (BDS > MBBS > nursing). CONCLUSION: In our study, overall knowledge and attitude toward hepatitis B infection were higher in MBBS students than in dental and nursing students, whereas behavior of dental students toward the disease was quite satisfactory than MBBS and nursing students.