Estimation of nutrient (N and P) fluxes into Newark Bay, USA.

This study was conducted in northern New Jersey, USA, to estimate the nutrient fluxes from the Passaic River, the Hackensack River and other sources into Newark Bay and the nutrient residence time in Newark Bay. Bi-weekly total inorganic nitrogen (TIN) and orthophosphate concentration data in the Passaic River, the Hackensack River, and Newark Bay for over 15 years (2004-2019) were collected along with daily river discharge data from the public database. The annual TIN and orthophosphate (ortho-P) loading from the Passaic River ranged from 915 × 103 kg y-1 to 251 × 104 kg y-1 and 94 × 103 kg y-1to 372 × 103 kg y-1, respectively. The annual TIN and ortho-P loading from the Hackensack River ranged from 3.13 × 103 kg y-1 to 234 × 103 kg y-1 and 0.28 × 103 kg y-1 to 6.97 × 103 kg y-1, respectively. Seasonal variation results indicated that hurricane events highly increased TIN and ortho-P loading from riverine input and reduced residence time in Newark Bay.

Evaluation of serum neuron specific enolase levels among patients with primary and secondary burning mouth syndrome.

INTRODUCTION: Burning mouth syndrome is a painful condition of the oral cavity with ambiguous pathogenesis and diagnosis. Neuron-specific enolase is increased in several conditions including peripheral neuropathy of diabetes, ophthalmopathies, spinal cord injuries and tumors. Evidence on association of burning mouth syndrome and neuron-specific enolase is limited. AIM: This study aims to evaluate neuron-specific enolase levels in primary and secondary burning mouth syndrome patients and compare the levels of neuron-specific enolase with associated conditions in secondary burning mouth syndrome. METHODS: One hundred and twenty-eight patients of more than 18 years of age with no gender predilection and having clinical symptoms of burning mouth syndrome and 135 healthy subjects were included. All the patients fulfilled Scala's criteria for the diagnosis of burning mouth syndrome, including "primary" (idiopathic) and "secondary" (resulting from identified precipitating factors) burning mouth syndrome patients. Blood samples were obtained from burning mouth syndrome patients. Serum neuron-specific enolase was evaluated using enzyme-linked immunosorbent assay. To compare means and standard deviations, among primary and secondary burning mouth syndrome, data was analysed with analysis of variance and multiple comparisons test. RESULTS: The mean age of the study participants for burning mouth syndrome and healthy subjects was 53.30 and 51.6 years, respectively. Amongst the secondary burning mouth syndrome group, 32 (25%) of the patients had menopause, 15 (11.7%) had diabetes, eight (6.2%) of the patients had nutritional deficiency, seven (5.4%) had combined diabetes, menopause, and depression, six (4.6%) had combined diabetes and depression, four (3.1%) were diagnosed with Sjögren's syndrome. A minor percentage of 2.3% (three) had gastroesophageal reflux disease, while the remaining three (2.3%) patients in the secondary burning mouth syndrome group were on anti-depressants. There was a statistically significant increase in the levels of neuron-specific enolase in primary burning mouth syndrome as compared to the secondary burning mouth syndrome and healthy groups. Among the subgroups of secondary burning mouth syndrome, diabetic individuals showed a significant increase in neuron-specific enolase level when compared with other conditions in the secondary burning mouth syndrome patients.Discussion and conclusion: The raised serum neuron-specific enolase levels in patients suffering from primary burning mouth syndrome highlight a possible neuropathic mechanism. It was also increased in the sub-group of secondary burning mouth syndrome patients having diabetes. Although it cannot be ascertained whether the deranged values in the diabetic group were due to burning mouth syndrome or due to diabetes, the raised quantity of neuron-specific enolase in the primary burning mouth syndrome group is a reliable diagnostic indicator. Future studies on the assessment of neuron-specific enolase levels as a diagnostic tool for onset and management of primary and secondary burning mouth syndrome are recommended.

Effect of photodynamic therapy on the morphological changes of periapical inflammation: An experimental study in rats.

AIM: We aimed to explore the morphological changes with photodynamic therapy (PDT) in experimentally produced periapical lesions in rats, and to investigate if PDT used as an adjunct to conventional root canal debridement helps to enhance healing the inflammatory response around root apex of rats. MATERIALS AND METHODS: Sixty adult Sprague-Dawley male rats (70-90 days/140-160 g) were experimented. Pulp was removed from the mesial root of the first maxillary molar and left open to oral environment to allow the formation of periapical lesion. The rats were numbered and randomly divided into two groups: (i) PDT group (n = 30) received a single session of PDT with conventional debridement and, (ii) Control group (n = 30) received conventional debridement but with no PDT. PDT application involved the use of methylene blue photosensitizer for 5 min inside the root canals and irradiated with diode laser of 805 nm and 20 W power output for 90 s and sealed. After 4 weeks, the experimental rats were sacrificed by cervical dislocation. The maxillary first molar was then collected along with the surrounding tissue for further processing. Hematoxylin and eosin and immunohistochemical staining were used to observe the morphological effects. Proliferating Cell Nuclear Antigen (PCNA), STRO-1 and CD-44 were used as the primary antibodies for the immunohistochemical study. RESULTS: A reduction in inflammatory cells, which were mainly composed of lymphocytes, was observed in the periapical lesions after PDT. The number of PCNA-positive cells increased to approximately twice in the PDT as compared to the control group. These PCNA-positive cells included STRO-1 and CD-44 positive cells, indicating enhancement of wound healing and reduction in inflammatory cells. CONCLUSION: The findings of the present experimental study indicate that PDT application induced proliferation of PCNA-positive cells, which included STRO-1 and CD44-positive cells. This suggests that PDT may help to enhance healing periapical lesion, indicating the potential of PDT in the treatment of periapical periodontitis.

Expression of HER-2/neu in Oral Squamous Cell Carcinoma.

BACKGROUND: HER-2/neu is a member of the human epidermal growth factor (HER) family of transmembrane tyrosine kinases, which is significantly associated with the pathogenesis of various cancer types. The aim was to evaluate the expression of HER-2/neu in oral squamous cell carcinoma (OSCC) as a potential biomarker to target antigens for specific immunotherapy in OSCC. METHODS: One hundred and forty histologically diagnosed OSCC cases were identified. Four to five-micrometer thick formalin-fixed, paraffin-embedded tumor sections were stained with Haematoxylin and Eosin (H and E). Histological grade was assessed according to WHO/Broders classification, while tumors were staged according to the American Joint Committee on Cancer (AJCC) TNM classification from stage I to IV. Immunohistochemistry was performed by using Rabbit monoclonal antibody against HER-2/neu (EP700Y, cell marquee and diluted 1:50). FISH was performed on positive cases using Vysis PathVysion HER-2 DNA probe (Abbott USA). Probes consist of LSI HER gene spectrum orange and control probe CEP 17 spectrum green. RESULTS: In this study, males were mostly effected (64.3%) with buccal mucosa (49%) to be the commonly involved site for OSCC. Majority of cases were moderately differentiated (62.1%) and 50.7% tumors were Stage IV. HER-2/neu was found to be positive (2+) in one case of OSCC, however weak to moderate complete membrane staining was observed in >10% of the tumor cells. One hundred and thirty nine cases were HER-2/neu negative. FISH analysis of HER-2/neu positive cases also showed gene amplification (Her2-neu/ CEp 17 = 225/33 = 7.2). CONCLUSIONS: The study showed disparity in the expression of HER-2/neu in OSCC, which is due to multiple reasons. Therefore therapy against HER-2/neu in OSCC is debatable.

Immunohistochemical study of dental pulp cells with 3D collagen type I gel in demineralized dentin tubules in vivo.

Dental pulp cells (DPCs) represent good candidates for the regeneration of dental tissue. This study aimed to evaluate the growth and differentiation potential of DPCs cultured inside demineralized dentin tubules in vivo. Six green fluorescent protein-transgenic rats (body weight 100 g each) and thirty-two Sprague-Dawley (SD) male rats (body weight 250 g each) were used for DPC collection and dentin tubules preparation and transplantation, respectively. Third-passage DPCs with or without collagen gels were loaded into demineralized dentin tubules. Both types of grafts were transplanted into the rectus abdominis muscles of SD rats and were harvested after 21 days. The expression of alkaline phosphatase (ALP), bone sialoprotein (BSP), osteopontin (OPN), nestin, and dentin sialoprotein (DSP) was analyzed by immunohistochemistry. Histological analysis showed that DPCs in the collagen gel formed an osteodentin-like hard tissue matrix after 21 days. Increased positive immunoreactivity for ALP, BSP, OPN, nestin, and DSP was observed in experimental groups compared with control. Our results demonstrate that DPCs in collagen gel inside demineralized dentin tubules show increased growth and differentiation.

Efficacy of adjunctive photodynamic therapy on the clinical periodontal, HbA1c and advanced glycation end product levels among mild to moderate chronic periodontal disease patients with type 2 diabetes mellitus: A randomized controlled clinical trial.

AIMS: To evaluate the clinical periodontal, serum glycated haemoglobin (HbA1c) and levels of advanced glycation end-products (AGEs) in the gingival crevicular fluid (GCF) among patients with periodontitis and type 2 diabetes mellitus (DM) after photodynamic therapy (PDT) as an adjunct to full-mouth disinfection (FMD). MATERIALS AND METHODS: Thirty type 2 DM patients with mild to moderate periodontitis were divided into two main groups: Group-A receiving adjunctive PDT with FMD and Group-B receiving FMD alone. Full-mouth plaque index (PI), bleeding on probing (BOP), probing depth (PD), attachment level (AL) were recorded. Serum HbA1c was assessed among all participants using a HbA1c analyser kit. Levels of AGEs in GCF were determined using enzyme-linked immunosorbent assay. Clinical periodontal and metabolic parameters were assessed at baseline, 3 months and 6 months. Differences were compared using the Friedman test within the groups for different time points. Kruskal-Wallis test with Bonferroni correction test was applied for intragroup and multiple comparisons, respectively. RESULTS: All the clinical periodontal parameters showed significant reduction from baseline to 3 months (P < 0.05) and 6 months follow-up in both the groups (P < 0.01). Only PD showed statistically significant difference from baseline to 3 months in Group-A (P < 0.01). Mean percentage of HbA1c remained constant throughout the study period in both the groups. Mean level of AGEs significantly reduced in both the groups at all time-points. Mean AGEs level reduced slightly higher in Group-A compared to Group-B at 3 months follow-up. However, this difference was not statistically significant (P > 0.05). CONCLUSION: No additional benefit was seen in the improvement of clinical periodontal parameters and systemic (HbA1c levels) outcomes with PDT except that a minor reduction in the levels of AGEs in the GCF was observed with PDT in the short term.

Clinical efficacy of photodynamic therapy as an adjunct to scaling and root planing in the treatment of chronic periodontitis among cigarette smokers: A systematic review and meta-analysis.

BACKGROUND: The aim of the study was to evaluate the clinical efficacy of adjunctive photodynamic therapy (PDT) as compared to scaling and root planing (SRP) alone in the treatment of chronic periodontitis among cigarette smokers. METHODS: Electronic databases including EMBASE, MEDLINE, Cochrane Oral Health Group Trials Register and Cochrane Central Register of Controlled Trials were searched up to January 2019. Randomized clinical trials (RCTs) with data on comparison between adjunctive PDT compared to SRP in each group were included. Primary outcomes included clinical attachment level (CAL) gain, while secondary outcomes was probing depth (PD) reduction. The weighted mean differences (WMD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random and fixed effect models. RESULTS: A total of 5 RCTs were included. Two clinical trials were classified as having a low risk of bias and 3 clinical trials as high risk of bias. The overall effect for CAL gain (WMD= -0.088, 95% CI= -0.40 to 0.23, p = 0.58) and PD reduction (WMD= -0.35, 95% CI= -0.87 to -0.17, p = 0.18) was not statistically significant between PDT and SRP groups at follow-up, respectively. CONCLUSION: Within the limitations of this study, it remains debatable whether PDT as an adjunct to SRP is more effective in clinical attachment level gain as compared to SRP alone in cigarette smokers given that the available scientific evidence is weak.

Cytokine levels and their role in the etiopathogenesis of Burning Mouth Syndrome: A systematic review.

INTRODUCTION: Burning Mouth Syndrome is characterized by variable symptoms that include pain, burning and paraguesia in an otherwise healthy-appearing oral mucosa. Although the etiopathogenesis of Burning Mouth Syndrome is unknown, some studies provide evidence of subclinical inflammation leading to disrupted cytokine levels. AIM: To investigate the expression of cytokines and role in the etiopathogenesis of Burning Mouth Syndrome. METHODS: Online databases (MEDLINE and EMBASE) were searched from November 1986 to November 2018 for case control/cross-sectional studies comparing the levels of cytokines in patients with Burning Mouth Syndrome and healthy controls. RESULTS: A total of eight studies were included in the current review. Four studies were of high and four studies were of moderate quality. Seven studies evaluated IL-6, out of which four showed comparable results, two showed higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. Four studies assessed IL-2, out of which two reported comparable results whereas one study reported higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. IL-10 levels were measured in three studies that reported no significant differences in the levels between Burning Mouth Syndrome and healthy controls. DISCUSSION AND CONCLUSION: The etiopathogenesis of Burning Mouth Syndrome is multifactorial. Studies have provided scientific evidence that inflammation plays a key role in Burning Mouth Syndrome pathogenesis. However, whether up-regulation or down-regulation of specific cytokines contribute to the etiopathogenesis of Burning Mouth Syndrome remains debatable. Further high-quality studies with larger sample size and assessing a wider array of cytokines are warranted in order to obtain strong conclusions.

Systematic review and meta-analysis of double-blind, placebo-controlled, randomized clinical trials using probiotics in chronic periodontitis.

AIM: The aim of the present study was to evaluate the efficacy of probiotics as an adjunct to scaling and root planning (SRP) in the treatment of chronic periodontitis (CP). METHODS: The focused question of the study was: Does adjunctive use of probiotics yield better clinical periodontal outcomes compared to placebo/no treatment group in the treatment of CP? Electronic and manual literature searches were conducted up to December 2017 using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register. Forest plots were computed reporting weighted mean difference (WMD) of outcomes and 95% confidence intervals (CI). RESULTS: Seven clinical studies were included. Four studies showed additional benefits in reducing periodontal probing depth (PPD) and gaining clinical attachment level (CAL), whereas, three studies showed comparable clinical periodontal outcomes between probiotics and SRP/placebo. Significant heterogeneity was observed for PPD reduction and CAL gain. The overall mean difference for CAL gain between probiotics and placebo/SRP was significant (WMD = 1.41, 95% CI = 0.15-2.67, P = .028) at follow up. CONCLUSION: Adjunctive probiotics could result in additional benefits in CAL gain in CP. Nevertheless, further high-quality randomized clinical trials with microbiological outcomes are warranted to obtain strong conclusions in this regard.

Efficacy of photodynamic therapy or low level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus.

BACKGROUND: The efficacy of photodynamic therapy (PDT) or low level laser therapy (LLLT) in the treatment of oral lichen planus (OLP) is debatable. The aim of this study was to compare the effects of PDT, LLLT or topical corticosteroid application in the treatment of erosive-atrophic OLP. MATERIALS AND METHODS: Forty-five adult patients with erosive-atrophic biopsy-proven OLP on the tongue or buccal mucosa (size ≤3 cm) were randomly divided into three groups. Group-1: patients receiving PDT topical application of 50 µl toluidine blue (1 mg/ml) with micropipette and after 10 min treated by laser irradiation using GaAlAs laser (630 nm, 10 mW/cm2, continuous wave, spot size: 1 cm2); Group-2: patients receiving LLLT using diode laser (630 nm, 10 mW, continuous wave, spot size: 1 cm2); and Group-3: patients receiving topical corticosteroid applications consisting of dexamethasone (0.5 mg in 5 ml water) mouthwash for 5 min. Demographic data, type, and severity of the lesions and pain were recorded before and after treatment and then at the 1 year follow-up. RESULTS: There was a significant difference in sign score changes before and after the treatment in the PDT group (p = 0.03), LLLT group (p = 0.04) and in the control group (p = 0.02). There was a statistically significant difference between group-1 (p = 0.001) and group-2 (p = 0.001) against group-3 before and after treatment. Mean amount of improvement in pain was significantly greater in the control group in comparison with the PDT and LLLT groups (p < 0.001). The efficacy index of the PDT group improved significantly more than the LLLT (p = 0.001) and corticosteroid groups (p = 0.001). CONCLUSION: Within the limits of the present RCT, it is indicated that PDT and LLLT are effective in the treatment of erosive-atrophic forms of OLP in adult patients. However, further comparative clinical trials are needed to obtain strong conclusions in this regard.

S100 proteins in oral squamous cell carcinoma.

BACKGROUND: Controversy exists in the literature regarding the differential expression of S100 protein members and their functional correlations in oral squamous cell carcinoma (OSCC). The aim of the present study was to systematically review the expression of S100 protein family members among OSCC and healthy controls and to evaluate whether S100 protein members serve as diagnostic marker in OSCC. METHODS: Indexed databases were searched up to and including October 2017. Case-control/cross-sectional studies in human diagnosed clinically and/or histologically with OSCC and evaluated the expression of S100 protein family among OSCC and healthy controls were included. RESULTS: A total of 11 studies were included. Four studies were of good quality, 5 were of moderate and 2 were of poor quality. Five studies evaluated S100A2, A7 and A12 and showed overexpression of these protein levels in OSCC patients when compared to healthy controls. Three studies reported down-regulation of S100A1, A3, A6, A11, A13, A14, A16 and S100Z in OSCC patients as compared to healthy controls. Two studies reported overexpression of S100A9 and one study each reported overexpression of S100A4, A8, A10, and S100P in OSCCs as compared to healthy controls respectively. CONCLUSION: It remains debatable whether up-regulation or down-regulation of specific S100 protein members serves as a diagnostic marker in OSCC. With the findings of the present systematic review, the threshold for diagnostic levels of S100 proteins cannot be proposed. In addition, S100A7 protein could act as a potential OSCC marker. However, further case-control studies with larger sample size are required to obtain strong conclusion in this regard.

Non-surgical periodontal therapy reduces salivary adipocytokines in chronic periodontitis patients with and without obesity.

AIM: The aim of the present study was to assess the effect of scaling and root planing (SRP) on periodontal parameters and whole salivary resistin and interleukin (IL)-6 levels in chronic periodontitis (CP) patients with and without obesity. METHODS: Participants were divided into two groups; group 1 included obese and non-obese individuals with CP; and group 2 included obese and non-obese individuals without CP. In both groups, bleeding on probing (BOP) and probing depth (PD) ≥4 mm and whole salivary resistin and IL-6 levels were measured using enzyme-linked immunosorbent assay at baseline and 6 months after SRP. The number of missing teeth was counted, and marginal bone loss was measured on digital panoramic radiographs at baseline and 6 months' postoperatively. RESULTS: BOP was significantly higher among obese patients in group 1 than obese (P < .001) and non-obese (P < .001) individuals in group 2. At 6 months' follow up, BOP (P < .001) and PD ≥4 mm (P < .001) were significantly lower among obese and non-obese patients in group 1 than their respective baseline values. At 6 months' follow up, BOP (P < .001) and PD ≥4 mm (P < .001) were significantly higher among obese and non-obese individuals in group 1 compared with individuals in group 2. CONCLUSION: SRP is effective in reducing periodontal inflammation in CP patients with and without obesity. CP seems to be the primary factor that influences periodontal status and the expression of resistin and IL-6 levels in obese and non-obese patients.