Comparative evaluation of clinical attachment and alveolar bone levels in patients with infrabony pockets treated by conventional and microsurgical approach - a randomized clinical trial.

Objectives: The aim of the present study is to evaluate and compare healing outcomes, probing pocket depth (PPD) reduction, clinical attachment, and alveolar bone level following Modified Widman Flap (MWF) with and without 4× prismatic loupe in infrabony pockets. Methods: Patients having at least one infrabony pocket with PPD ≥5 mm and angular bone loss ≥3 mm bilaterally were randomly assigned to a microsurgical (test) group with MWF using 4× magnifying loupes and conventional (control) group by MWF only. At baseline, 3 and 6 months plaque index, bleeding index, PPD, and relative clinical attachment level were taken. The healing outcome was evaluated with a healing index by Landry. Pain score was assessed with Visual Analog Scale (VAS). The percentage of defect depth (DD) reduction was assessed by cone beam computed tomography (CBCT) and periapical radiograph. Continuous data between groups were analyzed using an unpaired "t" test. Within-group comparison was done using repeated measures analysis of variance followed by multiple pairwise comparisons and paired "t" test. Results: There was a statistically significant (P = 0.004) reduction in intrabony DD in each group evaluated through CBCT. The mean VAS score after 1 week of surgical procedure was 3.67 at the conventional site compared to 2.9 at the microsurgical site, which was statistically significant (P = 0.004). Statistically significant (P ≤ 0.05) healing scores were observed for microsurgery group (84.6% after 1 week) compared to control group (15.4% after 1 week). Conclusion: Although blinding of patients and surgeons was difficult and healing indices used are subjective, it can be concluded that microsurgery under 4× magnifying loupe is as effective as conventional MWF in the treatment of infrabony pockets but clinical parameters are greatly enhanced by microsurgery with improved healing and less patient discomfort.

Lobular capillary hemangioma with an intraosseous feeder vessel through an accessory buccal foramen in the mandible: A unique case report.

The aim of this case report is to present a unique and rare finding in a 29-year-old male with the chief complaint of swelling in the gums related to the back teeth of the lower left jaw, since 20 days. In the absence of any alarming findings on the intraoral periapical radiograph and blood profile, an excisional biopsy of the provisionally diagnosed pyogenic granuloma was planned with a high-power diode LASER (Light Amplification by Stimulated Emission of Radiation). Following the excision, an unusual amount of bleeding was encountered from a single point on the buccal cortical plate between the teeth #35 and #36. On reevaluating the left face with advanced radiodiagnostic methods, an accessory buccal foramen was reported distal to #35 which housed a thin, tortuous, and aberrant branch of the inferior alveolar artery. The swelling was histopathologically diagnosed as lobular capillary hemangioma, and the aberrant artery was labeled as its feeder vessel. The patient had no episode of recurrence until 2 years of follow-up.

DEAD-box RNA helicases with special reference to p68: Unwinding their biology, versatility, and therapeutic opportunity in cancer.

In the era of advancement, the entire world continues to remain baffled by the increased rate of progression of cancer. There has been an unending search for novel therapeutic targets and prognostic markers to curb the oncogenic scenario. The DEAD-box RNA helicases are a large family of proteins characterized by their evolutionary conserved D-E-A-D (Asp-Glu-Ala-Asp) domain and merit consideration in the oncogenic platform. They perform multidimensional functions in RNA metabolism and also in the pathology of cancers. Their biological role ranges from ribosome biogenesis, RNA unwinding, splicing, modification of secondary and tertiary RNA structures to acting as transcriptional coactivators/repressors of various important oncogenic genes. They also play a crucial role in accelerating oncogenesis by promoting cell proliferation and metastasis. DDX5 (p68) is one of the archetypal members of this family of proteins and has gained a lot of attention due to its oncogenic attribute. It is found to be overexpressed in major cancer types such as colon, brain, breast, and prostate cancer. It exhibits its multifaceted nature by not only coactivating genes implicated in cancers but also mediating crosstalk across major signaling pathways in cancer. Therefore, in this review, we aim to illustrate a comprehensive overview of DEAD-box RNA helicases especially p68 by focusing on their multifaceted roles in different cancers and the various signaling pathways affected by them. Further, we have also briefly discoursed the therapeutic interventional approaches with the DEAD-box RNA helicases as the pharmacological targets for designing inhibitors to pave way for cancer therapy.

The DEAD-box RNA helicase DDX5 (p68) and ß-catenin: The crucial regulators of FOXM1 gene expression in arbitrating colorectal cancer.

Forkhead box M1 (FOXM1), a vital member of the Forkhead box family of transcription factors, helps in mediating oncogenesis. However, limited knowledge exists regarding the mechanistic insights into the FOXM1 gene regulation. DDX5 (p68), an archetypal member of the DEAD-box family of RNA helicases, shows multifaceted action in cancer progression by arbitrating RNA metabolism and transcriptionally coactivating transcription factors. Here, we report a novel mechanism of alliance between DDX5 (p68) and the Wnt/ß-catenin pathway in regulating FOXM1 gene expression and driving colon carcinogenesis. Initial bioinformatic analyses highlighted elevated expression levels of FOXM1 and DDX5 (p68) in colorectal cancer datasets. Immunohistochemical assays confirmed that FOXM1 showed a positive correlation with DDX5 (p68) and ß-catenin in both normal and colon carcinoma patient samples. Overexpression of DDX5 (p68) and ß-catenin increased the protein and mRNA expression profiles of FOXM1, and the converse correlation occurred during downregulation. Mechanistically, overexpression and knockdown of DDX5 (p68) and ß-catenin elevated and diminished FOXM1 promoter activity respectively. Additionally, Chromatin immunoprecipitation assay demonstrated the occupancy of DDX5 (p68) and ß-catenin at the TCF4/LEF binding element (TBE) sites on the FOXM1 promoter. Thiostrepton delineated the effect of FOXM1 inhibition on cell proliferation and migration. Colony formation assay, migration assay, and cell cycle data reveal the importance of the DDX5 (p68)/ß-catenin/FOXM1 axis in oncogenesis. Collectively, our study mechanistically highlights the regulation of FOXM1 gene expression by DDX5 (p68) and ß-catenin in colorectal cancer.

Comparative evaluation of effect of injectable platelet-rich fibrin with collagen membrane compared with collagen membrane alone for gingival recession coverage.

BACKGROUND: Collagen membrane and platelet-rich fibrin (PRF) have emerged as vital biomaterials in the field of periodontal regeneration. Minimally invasive techniques are being preferred by most periodontists, as it is patient compliant with fewer post-surgical complications as compared to conventional surgical techniques. Thus, in this study we have evaluated the effect of injectable PRF (i-PRF) with collagen membrane compared with collagen membrane alone using vestibular incision subperiosteal tunnel access (VISTA) technique for gingival recession coverage. AIM: To compare the efficacy of VISTA using collagen membrane with collagen membrane soaked in injectable PRF for gingival recession coverage. METHODS: A split mouth randomized controlled clinical trial was designed;13 subjects having at least 2 teeth indicated for recession coverage were enrolled in this study. The sites were randomly assigned to control group (VISTA using collagen membrane alone) and the test group (VISTA using collagen membrane with i-PRF). The clinical parameters assessed were pocket depth, recession depth (RD), recession width (RW), relative attachment level, keratinised tissue width (KTW), keratinised tissue thickness (KTT), and percentage root coverage. RESULTS: RD showed a statistically significant difference between the test group at 3 mo (0.5 ± 0.513) and 6 mo (0.9 ± 0.641) and the control group at 3 mo (0.95 ± 0.51) and 6 mo (1.5 ± 0.571), with P values of 0.008 and 0.04, respectively. RW also showed a statistically significant difference between the test group at 3 mo (1 ± 1.026) and 6 mo (1.65 ± 1.04) and the control group at 3 mo (1.85 ± 0.875) and 6 mo (2.25 ± 0.759), with P values of 0.008 and 0.001, respectively. Results for KTW showed statistically significant results between the test group at 1 mo (2.85 ± 0.489), 3 mo (3.5 ± 0.513), and 6 mo (3.4 ± 0.598) and the control group at 1 mo (2.45 ± 0.605), 3 mo (2.9 ± 0.447), and 6 mo (2.75 ± 0.444), with P values of 0.04, 0.004, and 0.003, respectively. Results for KTT also showed statistically significant results between test group at 1 mo (2.69 ± 0.233), 3 mo (2.53 ± 0.212), and 6 mo (2.46 ± 0.252) and the control group at 1 mo (2.12 ± 0.193), 3 mo (2.02 ± 0.18), and 6 mo (1.91 ± 0.166), with P values of 0.001, 0.001, and 0.001, respectively. The test group showed 91.6%, 81.6%, and 67% root coverage at 1 mo, 3 mo, and 6 mo, while the control group showed 82.3%, 66.4%, and 53.95% of root coverage at 1 mo, 3 mo, and 6 mo, respectively. CONCLUSION: The use of minimally invasive VISTA technique along with collagen membrane and injectable form of platelet-rich fibrin can be successfully used as a treatment method for multiple or isolated gingival recessions of Miller's class-I and class-II defects.

Effect of platelet rich fibrin on stability of dental implants: A systematic review and meta-analysis.

Objective: The aim of the study is to provide a systematic review of the potential evidence for the effect of platelet rich fibrin (PRF) on stability of dental implants. Methods: A systematic review was performed based on the Preferred Reporting Items for Systematic review and Meta-analysis. An extensive and comprehensive electronic search was carried out from January 2000 to March 2021, independently by author in PUBMED, Cochrane Central Register of Controlled Trials, Google Scholar, Scopus, Embase, and Web of Science irrespective of publication status, date, or language. For any registered ongoing or completed but unpublished trial, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and Cochrane Oral Health's Trials Register websites were searched. Randomized, controlled, and clinical trials which assessed the stability of implant with and without use of PRF using Osstell device by radiofrequency analysis were selected. Results: The electronic and manual search yielded 630 studies. In all the eight included studies implant stability was measured using same ISQ units by Osstell device. Meta-analysis was carried out in six studies that had similar comparisons and reported the same outcomes at same time interval. Random effect models have shown pooled mean difference of 4.49 (95% CI 1.22-7.76) for 1-week post-insertion, 3.65 (95% CI 2.21-5.09) for 4-week post insertion, 3.25 (95% CI 0.03-6.47) for 8-week post-insertion, and 2.79 with 95% CI of 0.48, 5.10 for 12-week post-insertion. Conclusions: The present systematic review suggests that PRF is effective in improving secondary implant stability with certain limitations and displays possible implication for clinical practice.

Hydroxychloroquine- A new treatment option for erosive oral lichen planus.

CONTEXT: Oral Lichen planus (OLP) is a chronic, debilitating, immune-mediated disease whose management is considered a challenge in medical science. AIMS: To quantitatively evaluate the effect of administration of enteral hydroxychloroquine (HCQS) as a monotherapy for six months on the extent and severity of erosive OLP using reticular score, erythema score and ulcerative score (REU score), and to subjectively evaluate the success of HCQS as a therapeutic drug for OLP-e using Tel Aviv-San Francisco Scale, visual analogue scale (VAS) and severity of burning sensation (BURN score). SETTINGS AND DESIGN: Prospective clinical trial. METHODS AND MATERIAL: A total of 45 subjects received 200 mg of HCQS bid for six months. REU, VAS, BURN scores and Tel Aviv-San Francisco Scale readings were taken at the beginning of the study (baseline) and three- and six-month intervals post administration of enteral HCQS. Subjects were examined for any adverse drug outcomes for one year after the cessation of enteric HCQS therapy. Data were analysed with SPSS version 25. RESULTS: There was a stark reduction in REU, VAS and BURN scores during the study period, with a statistically significant reduction (P < 0.05) seen at three- and six-month time intervals as compared to baseline. Further, the mean of change in R, E and U scores showed a statistically significant difference, with the highest reduction seen at baseline to six-month time interval. The Tel Aviv-San Francisco Scale showed 70%-100% remission in disease in more than 70% of subjects. CONCLUSIONS: Enteral HCQS can be considered a viable treatment option for the enigma that is erosive OLP.

RNA helicase p68 deploys ß-catenin in regulating RelA/p65 gene expression: implications in colon cancer.

BACKGROUND: RelA/p65 a crucial member of NF-κB signaling pathway plays diverse role in mediating oncogenesis. Limited knowledge prevails on the mechanistic insights of RelA gene regulation. RNA helicase p68 apart from being a vital player of RNA metabolism acts as a transcriptional coactivator of several oncogenic transcription factors including ß-catenin and is highly implicated in cancer progression. In this study, we aim to discern the molecular mechanism of how an RNA helicase, p68 deploys a major oncogenic signaling pathway, Wnt/ ß-catenin to regulate the expression of RelA, an indispensable component of NF-κB signaling pathway towards driving colon carcinogenesis. METHODS: Immunoblotting and quantitative RT-PCR was performed for determining the protein and mRNA expressions of the concerned genes respectively. Luciferase assay was employed for studying the promoter activity of RelA. Chromatin immunoprecipitation was used to evaluate the occupancy of transcription factors on the RelA promoter. Immunohistochemical analysis was conducted using FFPE sections derived from normal human colon and colon cancer patient samples. Finally, a syngeneic colorectal allograft mouse model was used to assess physiological significance of the in vitro findings. RESULTS: p68, ß-catenin and RelA proteins were found to bear strong positive correlation in normal and colon carcinoma patient samples. Both p68 and ß-catenin increased RelA mRNA and protein expression. p68, ß-catenin and Wnt3a elevated RelA promoter activity. Conversely, p68 and ß-catenin knockdown diminished RelA promoter activity and led to reduced RelA mRNA and protein expression. p68 was perceived to occupy RelA promoter with ß-catenin at the TCF4/LEF (TBE) sites thereby potentiating RelA transcription. p68 and ß-catenin alliance positively modulated the expression of signature NF-κB target genes. Enhanced NF-κB target gene expression by p68 was corroborated by findings in clinical samples. Tumors generated in mice colorectal allograft model, stably expressing p68 further reinforced our in vitro findings. CONCLUSIONS: We report for the first time a novel mechanism of alliance between p68 and ß-catenin in regulating the expression of RelA and stimulating the NF-κB signaling axis towards driving colon carcinogenesis. This study unravels novel modes of p68-mediated colon carcinogenesis, marking it a potential target for therapy.