Chemopreventive Efficacy of Sulindac Sulfone as a Selective Apoptotic Antineoplastic Drug in Human Head and Neck Squamous Cell Carcinoma Cell Lines: A Systematic Review.

Sulindac sulfone, an active metabolite of sulindac, a non-steroidal anti-inflammatory drug, has good anti-inflammatory potential. The antineoplastic effect of sulindac sulfone is mediated through a cyclooxygenase inhibitory mechanism, followed by apoptosis and inhibition of cell proliferation. Mounting studies have explored the anti-neoplastic effect of sulindac sulfone in various types of cancers in a dose-dependent manner. In this backdrop, we have conducted a systematic review to evaluate the efficacy and dose of sulindac sulfone as an anti-neoplastic agent in human head and neck squamous cell carcinoma cell lines (HNSCCs). In this study, we used a systematic literature review approach, and articles were searched in PubMed, and Medline with the keywords "sulindac sulfone," "anti-neoplastic activity," "chemopreventive," and "head and neck squamous cell carcinoma". A hand-search of journals was also performed. Articles were reviewed and analyzed. The analysis reveals that, based on the in vitro studies on various tumor models, the optimum concentration of sulindac sulfone which elicits anti-neoplastic effects is 200-800 µM. The anti-neoplastic effect is mediated through inhibition of cell proliferation and apoptosis. The results of our systematic review show that the anti-neoplastic activity of pharmacologic Sulindac sulfone is part of its dose-dependent activity, which can be safely employed in the therapy for human HNSCCs and would be responsible for a beneficial outcome of the treatment.

Conservative Management of a Rare Presentation of Mucosal Fenestration in a Four-Year-Old Child.

Mucosal fenestration refers to a window-like defect in the alveolar bone where the root of a tooth is denuded of its bony covering. Various causes ranging from trauma to chronic periapical or periodontal inflammation can produce such defects. This condition usually manifests either in adolescents or in extreme age group patients. The present case report is of a four-year-old boy who showed the presence of mucosal fenestration in the anterior maxillary gingivae in relation to teeth 51 and 61 (primary maxillary right and left central incisors as per the Fédération Dentaire Internationale (FDI) System) and was treated in a conservative and least invasive manner. Mucosal fenestration in the primary dentition phase can be treated in a conservative manner as opposed to any invasive treatment approaches, likely to instill fear or anxiety in a pediatric patient.