Survival among treated tongue cancer patients: a single-center experience.

OBJECTIVE: To describe overall survival (OS) and disease-free survival (DFS) in a cohort of tongue cancer patients, together with the corresponding demographic, tumor and surgical characteristics. METHODS: A retrospective study was made of 205 consecutive patients with primary tongue cancer subjected to surgery and adjuvant therapy according to the stage of the disease, in Hospital Clínico Universitario Virgen de la Arrixaca (HUVA) (Murcia, Spain) during the period 2000-2020. Survival was evaluated based on the Kaplan-Meier method, and the existence of significant differences between the different study variables was analyzed using the log-rank test. Cox regression analysis was performed for the identification of risk factors. RESULTS: In relation to overall survival, 72.6% of the patients survived for a mean time of 14.43 years [standard error (SE) = 0.74; 95% CI: 12.98-15.87], with a cumulative survival rate of 49.8 ± 3%. Survival was reduced by the presence of tumor adjacent to resection margins [hazard ratio (HR) 2.20; 95% CI 1.09-4.43] (p = 0.028) and infiltrated resection margins (HR 3.86, 95% CI 1.56-9.57) (p = 0.004). Lymphadenectomy in turn increased survival (HR 0.15; 95% CI 0.06-0.42) (p < 0.001). In relation to disease-free survival, 55.3% of the patients suffered no relapse over a mean period of 9.91 years (SE = 0.66; 95% CI: 8.61-11.2), with a cumulative survival rate of 26.6% ± 8.4%. CONCLUSIONS: In tongue cancer patients, overall and specific survival were reduced in the presence of infiltrated resection margins. Lymphadenectomy in turn improved survival compared with patients in which this procedure was not carried out.

Diagnostic Infrared Thermography of the Tongue and Taste Perception in Patients with Oral Lichen Planus: Case-Control Study.

Oral lichen planus (OLP) is a chronic inflammatory disease of autoimmune origin that affects the skin and mucous membranes. The aim of this study was to assess the effectiveness of infrared thermography (IRT) as a diagnostic tool in patients with oral lichen planus (OLP), as well as disturbances in taste perception, in cases with and without tongue involvement. A case-control study was carried out in a sample of 87 patients divided into three groups: healthy individuals (controls; n = 43), OLP patients without involvement of the tongue (n = 24), and OLP patients with involvement of the tongue (n = 20). The patient symptoms and the clinical characteristics of the lesions were assessed. Four thermal images of the tongue were obtained using IRT: dorsum, right and left lateral surface, and tip of the tongue. General taste perception capacity and subjective sweet, acid, salty, and bitter sensation were evaluated in all three groups. There were no statistically significant differences in the IRT values among the three groups (p ≥ 0.05). In the OLP patients with involvement of the tongue, significantly higher values were observed in the mixed forms of the disease (p = 0.032). The OLP patients with and without involvement of the tongue showed no significant alterations in taste sensation (p = 0.69). IRT may serve as a complementary tool for assessing the activity of OLP with involvement of the tongue. However, more research is needed in this field.

Experiences, perceptions, and decision-making capacity towards oral biopsy among dental students and dentists.

The dentist plays a crucial role in identifying oral lesions as it is their responsibility to conduct the clinical examination for diagnosing diseases in this anatomical region. Dentists should be able to perform simple oral biopsies when this procedure is necessary. However, several studies point out that dentists lack experience and perceive themselves incapable of performing biopsies. This analytical cross-sectional study aimed to assess participants' experiences and perceptions regarding a continuing education activity focused on the biopsy procedure. The secondary aim was to evaluate their ability to determine when a biopsy is indicated. The sample consisted of 228 individuals: 143 dentists and 85 undergraduate dental students who completed questionnaires related to a lecture held in May/2021, as part of the continuing educational activities of the "Red May" Project. Participants completed two questionnaires: the first assessed their experience and self-confidence in performing oral biopsies, whereas the second evaluated their capacity to define when the biopsy is indicated by means the evaluation of 10 clinical cases. The results reveal no significant difference in the percentage of correct answers between dental students and dentists. Regarding the frequency of performing the biopsy procedure, most respondents (69.7%) reported doing so rarely or never. Furthermore, while 31.6% of the participants stated that they perform biopsies depending on the case, 68.4% prefer to refer patients to specialists, such as professionals in Stomatology/Oral Medicine. These findings highlight limitations in the educational preparation of the study population concerning biopsy procedures, oral lesions, and their management. They also indicate a concerning tendency to overestimate knowledge in this area. Thus, this study emphasizes the importance of continuing education and underscores the need to revise academic curricula and provide complementary education for all dental professionals.

Preliminary Evaluation Salivary Biomarkers in Patients with Oral Potentially Malignant Disorders (OPMD): A Case-Control Study.

INTRODUCTION: Oral potentially malignant disorders (OPMD) are lesions associated with an increased risk of transformation (MT) into cancer. OBJECTIVE: A study was made of the salivary levels of adenosine deaminase (ADA), ferritin (FRR) and total proteins (TP) in healthy individuals and in patients with oral potentially malignant disorders (OPMD), assessing the potential role of saliva as a diagnostic tool. METHODS: A total of 91 subjects participated in the study, divided into two groups-59 patients with OPMD (oral leukoplakia or oral lichen planus) and 32 healthy controls-with measurements being made of salivary ADA, ferritin (FRR) and total proteins (TP). RESULTS: There were no significant differences in salivary mean ADA between the OPMD group 0.85 ± 2.18 UI/I and the controls 0.71 ± 1.72 UI/I (p = 0.934), though the levels of both FRR mean OPMD, 12.66 ± 10.50 (µg/L), versus control, 7.19 ± 4.44 (p = 0.001), and TP, 23.41 ± 17, versus control, 14.15 ± 15.19, were significantly higher in the OPMD group (p = 0.001). Patients with oral lichen planus showed significant differences in terms of FRR (p = 0.009) and TP (p = 0.003). The ferritin in LPO with a cut-off point of 8.5C showed a sensitivity and specificity of 54.3% and 82.3, respectively. The area under the curve (AUC) was 0.69 (95% confidence interval (95% CI): 0.58-0.82; p = 0.003). CONCLUSIONS: Ferritin and total proteins may constitute potential salivary biomarkers for oral lichen planus, though further studies are still needed in this field. In addition, saliva testing is a reliable and noninvasive diagnostic tool and appears to be a reliable strategy offering an interesting alternative for the screening of large populations.

Epigallocatechin-3-gallate improves the biocompatibility of bone substitutes in dental pulp stem cells.

BACKGROUND: The Biocompatibility between osteoprogenitor cells and bone substitutes is necessary for cell differentiation and osteogenesis. The aim of this study was to assess the in vitro effect of bovine (Geistlich BioOss®), porcine (OsteoBiol Gen-Os®) and beta-tricalcium phosphate (Cerasorb M®) bone substitutes, and their combination with polyphenol epigallocatechin-3-gallate (EGCG), upon cultured dental pulp stem cells (DPSCs). METHODS: The DPSCs were isolated from third molars extracted from healthy individuals and seeded with 5 mg/ml of Bio-Oss® (BO), Gen-Os® (GO) and Cerasorb® (CE) in combination with EGCG 1 µM. The effects were evaluated based on cell viability / cytotoxicity assay (MTT, cell viability staining test), cell migration, scanning electron microscopy (SEM), and alkaline phosphatase (ALP) activity. RESULTS: BO and CE produced negative effects upon cell viability and migration, and GO and CE resulted in deficient cell adhesion. On the other hand, all the biomaterials exerted no negative effects upon ALP activity. Interestingly, the addition of EGCG reverted the cytotoxic effect and the loss of migration capacity in the BO and CE groups, and improved cell adhesion in the GO and CE groups. Furthermore, EGCG promoted an overall increased in ALP activity. CONCLUSION: The addition of EGCG to the tested biomaterials BO, GO and CE reverts their negative impact on DPSCs, and improves their biocompatibility with cultured DPSCs. The use of EGCG, thus, appears to be a promising strategy for restoring and enhancing the osteoconductive properties of BO, GO and CE in bone regeneration treatments.

Effect of Photobiomodulation on Atrophic-Erosive Clinical Forms of Oral Lichen Planus: A Systematic Review.

INTRODUCTION: Oral lichen planus is a chronic autoimmune inflammatory disease of unknown origin, characterized by various clinical forms of which the atrophic-erosive causes patients the greatest symptomatology. For this reason, there are different treatments that improve the associated signs and symptoms. One of these therapies is photobiomodulation (PBM), which, although new, has a high level of acceptance in dentistry based on evidence. However, there are inconsistent results in its application against lichen planus. The aim of this review was to evaluate the effect of photobiomodulation and its effectiveness as a therapeutic alternative for atrophic-erosive lesions. MATERIAL AND METHODS: The databases PubMed, Google Scholar and Cochrane Library were searched to identify studies investigating the photobiomodulation treatment in atrophic-erosive lesions of oral lichen planus. A total of 294 articles were identified, published between 2017 and 2022, and then evaluated; 7 articles that met all the inclusion criteria were included in this study. RESULTS: The type of laser light source used in PBM was the diode laser (four cases), the Nd-YAG laser at the same wavelength of 1064 nm (two cases) and the He-Ne laser (one case). The minimum and maximum wavelengths used were 630 nm and 1064 nm, respectively. Most studies used lesions treated with topical corticosteroids as a control group. The follow-up times of the studies were highly variable. CONCLUSIONS: Photobiomodulation is a treatment that competently combats oral lichen planus lesions by improving signs and symptoms, with no known adverse reactions so far, which makes it more beneficial compared to more conventional therapies, such as corticosteroids, for which side effects have been found.

Hemodynamic and ventilatory changes in pediatric patients with special needs: A comparative clinical study.

Background: Very limited data are available on the hemodynamic and ventilatory changes during sedation and general anesthesia using bispectral index (BIS) monitoring in intellectually disabled children. The purpose was to determine the hemodynamic and ventilatory changes after propofol and sevoflurane administration in children with special needs (CSN) versus healthy children (HC) during dental treatment. Material and Methods: Forty pediatric patients needing dental treatment were allocated into two groups: children without systemic disease (healthy children [HC]) and mentally disabled children (children with special needs [CSN]). Sevoflurane in oxygen (100% oxygen, 5 l/min) and continuous propofol infusion (target-controlled infusion [TCI], 2 µg/ml) were used as sedative agents, and 2% lidocaine with 1:80,000 adrenaline was used as local anesthesia in both groups. Heart rate (HR), oxygen saturation (SaO2), respiratory rate (RR), exhaled carbon dioxide (CO2), blood pressure (BP) and bispectral monitoring (BIS) values were recorded during the entire dental treatment procedure. Results: A statistically significant decrease in systolic BP, diastolic BP and RR was observed, with no significant differences between the healthy and disabled groups. In contrast, the HR and BIS values were lower in the CSN group than in the healthy patients (p ≤ 0.05). Conclusions: Patients with special needs had lower HR and BIS values than healthy patients, while BP, SaO2 and exhaled CO2 showed similar results in both groups. Key words:Bispectral index, hemodynamic changes, ventilatory changes, pediatric patients, special needs.

Recurrence of Oral Leukoplakia after CO2 Laser Resection: A Prospective Longitudinal Study.

AIM: The aim of this study is to assess the efficacy of CO2 laser treatment in oral leukoplakia and to analyse the recurrence rate of oral leukoplakia lesions at 18-month follow-up. MATERIALS AND METHODS: A prospective clinical study regarding CO2 laser treatment for oral leukoplakia was conducted, in which 39 patients with a total of 53 oral leukoplakias were included. Follow-up was performed at 18 months post-surgery and the following variables were studied: sex, age, associated risk factors, clinical classification, size, location and presence of epithelial dysplasia, recurrence, and rate of malignant transformation after resection. RESULTS: In the analysis of the final results 18 months after baseline, a treatment success rate of 43.75% was observed. Oral leukoplakia recurred in 54.17% of cases, and 2.08% of leukoplakias progressed to cancer. Among all the studied variables (age, tobacco use, size, location, clinical type or histology), no significant differences were found with regard to recurrence. CONCLUSION: The use of CO2 laser therapy to treat leukoplakia lesions is sufficient to remove such lesions. However, parameters that can assess recurrence need to be sought.

Naturally-Occurring Bioactives in Oral Cancer: Preclinical and Clinical Studies, Bottlenecks and Future Directions.

Oral cancer (OC) is the eighth most common cancer, particularly prevalent in developing countries. Current treatment includes a multidisciplinary approach, involving chemo, radio, and immunotherapy and surgery, which depends on cancer stage and location. As a result of the side effects of currently available drugs, there has been an increasing interest in the search for naturally-occurring bioactives for treating all types of cancer, including OC. Thus, this comprehensive review aims to give a holistic view on OC incidence and impact, while highlights the preclinical and clinical studies related to the use of medicinal plants for OC prevention and the recent developments in bioactive synthetic analogs towards OC management. Chemoprophylactic therapies connect the use of natural and/or synthetic molecules to suppress, inhibit or revert the transformation of oral epithelial dysplasia (DOK) into oral squamous cell carcinoma (OSCC). Novel searches have underlined the promising role of plant extracts and phytochemical compounds, such as curcumin, green tea extract, resveratrol, isothiocyanates, lycopene or genistein against this malignancy. However, poor bioavailability and lack of in vivo and clinical studies and complex pharmacokinetic profiles limit their huge potential of application. However, recent nanotechnological and related advances have shown to be promising in improving the bioavailability, absorption and efficacy of such compounds.

Thermography as a Non-Ionizing Quantitative Tool for Diagnosing Burning Mouth Syndrome: Case-Control Study.

OBJECTIVES: Thermography is an imaging technique based on the acquisition and analysis of thermal data. The present study evaluates the use of tongue infrared thermography (IRT) as a tool for the diagnosis of burning mouth syndrome (BMS). MATERIAL AND METHODS: An IRT study was carried out in patients diagnosed with BMS according to the criteria of the International Association for the Study of Pain (n = 32) and in healthy controls (n = 35). Burning sensations, dry mouth and taste disturbances were assessed, and three temperature values were recorded for each tongue surface (dorsal, right lateral, left lateral and tip), along with body temperature and environmental temperature. RESULTS: A statistically significant difference was recorded in the temperature of the dorsal surface of the tongue between the BMS group and the controls (p = 0.01). The area under the curve (AUC) was 0.731 (95% CI: 0.402-0.657; p = 0.003). The sensitivity and specificity obtained was 62% and 77%, respectively. CONCLUSIONS: Infrared thermography appears to be useful as a complementary tool for the diagnosis of BMS, though further studies are needed in this field.

Efficacy of Photobiomodulation in Reducing Symptomatology and Improving the Quality of Life in Patients with Xerostomia and Hyposalivation: A Randomized Controlled Trial.

Objectives: To evaluate the efficacy of photobiomodulation (PBM) treatment in patients with xerostomia and hyposalivation and assess their quality of life over a one year of follow-up. Material and methods: A single-blind randomized controlled trial. A total of 60 patients with xerostomia were included (30 PBM cases and 30 placebo controls). Photobiomodulation was performed with a diode laser (810 nm, 6 J/cm2), while the controls underwent simulated treatment. One weekly session was carried out for a total of 6 weeks (total six sessions). The study parameters were recorded at baseline, after three and six weeks, and at one year post-treatment. Xerostomia was assessed using a salivary flow visual analog scale (VAS) and the Xerostomia Inventory (XI). The Hospital Anxiety and Depression (HAD) scale, Oral Health Impact Profile (OHIP-14), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were also administered. Results: The patients subjected to PBM therapy showed a significant improvement of xerostomia based on the drainage test, and of oral quality of life (p < 0.001). The depression score of the HAD (HAD-D) and the ESS showed improvement, though without reaching statistical significance (p > 0.05). The placebo group showed significant changes in the xerostomia VAS score at 6 weeks (p = 0.009), with no variations in any of the other studied parameters (p > 0.05). The beneficial effects of the diode laser in the PBM group persisted at one year post-treatment. Conclusions: Photobiomodulation with the diode laser is effective in patients with xerostomia and hyposalivation, and thus should be taken into account as a treatment option.

Effect of thermal and chemical treatments used for SARS-COV-2 inactivation in the measurement of saliva analytes.

The present study aims to assess the effects of thermal and chemical inactivating procedures, that can be used for SARS-CoV-2 inactivation, on different salivary analytes. SDS-Polyacrylamide Gel Electrophoresis (SDS-PAGE) protein profile and a panel of 25 specific biomarkers of oxidative status, stress, metabolism and tissue damage were evaluated in samples subjected to different treatments: thermal (65 °C or 92 °C) and chemical with detergents [sodium dodecyl sulphate (SDS), Triton X-100 or NP-40]. Salivary SDS-PAGE profile was most affected by heating at 92 °C, with three and two protein bands decreasing and increasing their expression levels, respectively. This treatment also affected the results of several enzymes, with some of them being also affected by heating at 65 °C and incubation with SDS. The use of Triton X-100 or NP-40 resulted in increased values of cortisol, triglycerides and glucose, not affecting the other tested biomarkers. The present results will help researchers and clinicians to select the best protocols to work in safe conditions with saliva, taking into account the target analyte planned to be measured.

Response to Treatment with Melatonin and Clonazepam versus Placebo in Patients with Burning Mouth Syndrome.

Objective: to evaluate the efficacy of melatonin and clonazepam versus placebo in patients with burning mouth syndrome (BMS). Methods: a prospective double-blind study was carried out in patients with BMS and randomized to three groups: melatonin (1 mg once a day), clonazepam (0.5 mg/twice a day), or a placebo once a day, for 8 weeks. The clinical changes were evaluated, including xerostomia, the Oral Health Impact Profile 14 (OHIP-14) score, Pittsburg Sleep Quality Index, and the Hospital Anxiety and Depression Scale (HADS). Oxygen saturation and heart rate were recorded, with an analysis of salivary biomarkers in the forms of oxytocin, ferritin, adenosine deaminase (ADA), total proteins, and alpha-amylase. Results: a total of 64 patients were analyzed. A significant decrease in burning sensation was recorded with melatonin (7.8 ± 1.54 pre-treatment, 5.78 ± 2.54 post-treatment; p < 0.001) and clonazepam (8.75 ± 1.2 pre-treatment, 5.5 ± 3.6 post-treatment (p < 0.01). With regard to quality of life (OHIP-14), significant improvements were observed before and after the administration of melatonin (p < 0.001) and clonazepam (p = 0.001). On the other hand, with regard to the changes in salivary biomarkers following treatment, negative correlations were found between oxytocin and drainage (r = −0.410; p = 0.009) and between the HADS-D score and ferritin (r = −0.312; p = 0.05). While salivary amylase showed positive correlation with heart rate (r = 0.346; p = 0.029) and oxygen saturation (r = 0.419; p = 0.007). Conclusions: melatonin and clonazepam were shown to be effective at reducing the burning sensation and improving quality of life. Both drugs were found to be safe, with no major adverse effects in patients with BMS. Melatonin may be regarded as an alternative treatment for patients with BMS, though further studies are needed to confirm its effectiveness.

A Stimulator of the Salivary Excretion Based on Physical Vibration of the Parotid Glands.

Oral dryness causes significant health problems both functional (difficulty speaking, chewing and swallowing) and structural in teeth (increased number of infections) and oral mucosa. The main objective of this study is to show an alternative treatment to help stimulate the salivary secretion thus improving the quality of life of the patient. In this study, a salivary stimulation equipment using vibrotactile stimuli is shown. The system has been placed bilaterally in the parotid glands and assessed the efficacy of the salivary secretion by sialometry before and after the stimulation. The new proposal is capable of stimulating salivary secretion, in a significative way after 7 minutes of use, at least in the cases analyzed, and fulfills low-cost, easy-to-use, and safe technical restrictions. In this setting, this paper suggests the performance of a deep clinical trial to measure the exact efficacy of the prototype and the times and frequencies needed to state the optimal treatment depending in each case.

The Effect of an Informative Video upon Anxiety and Stress in Patients Requiring an Oral Biopsy: A Randomized Controlled Study.

OBJECTIVE: The use of multimedia tools improves patient understanding of surgical procedures, reduces anxiety and increases satisfaction. The present study evaluates the impact of an audiovisual intervention (video) upon anxiety and stress in patients requiring an oral biopsy. MATERIAL AND METHODS: A prospective randomized clinical trial was carried out in patients requiring an oral biopsy. The control group (n = 60) received verbal standard information while the experimental group (n = 60) received information in the form of a video. The following data were recorded: gender, age, educational level and hemodynamic parameters (blood pressure, heart rate and blood oxygen saturation). The following questionnaires were used to assess anxiety and stress before and after the biopsy procedure: Corah's Modified Dental Anxiety Scale (MDAS), the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: The final study sample consisted of 120 patients, of which 65.8% were women and 34.2% men, with a mean age of 40.5 ± 15.3 years. At the end of the study, the experimental group presented a significantly lower MDAS score than the control group (p = 0.041). The STAI score also showed a significant decrease with respect to the control group at the end of the study (p = 0.012). There were no statistically significant changes in the hemodynamic parameters in either group. CONCLUSIONS: The video constituted a useful and easy tool for reducing anxiety among patients requiring an oral biopsy.

Photodynamic Therapy, Photobiomodulation and Acetonide Triamcinolone 0.1% in the Treatment of Oral Lichen Planus: A Randomized Clinical Trial.

Objective: To evaluate the efficacy of photodynamic therapy (PDT) and photobiomodulation (PBM) in the treatment of oral lichen planus (OLP) in comparison with the use of topical corticosteroids. Material and methods: Sixty patients with OLP were randomized to three groups: group 1 photodynamic therapy applied once a week for four sessions, with orabase cream; group 2 low-power laser application with orabase cream; and group 3 inactive laser with triamcinolone acetonide 0.1%. Patient pain was evaluated, and the Thongprasom severity score, the Oral Health Impact Profile-14 (OHIP-14), and the Hamilton anxiety and depression scale at one and three months of follow-up. (ClinicalTrials.gov Identifier: NCT05127083). Results: Pain decreased significantly over time in all groups, though the symptoms relapsed over follow-up at one and three months in group 3. The OHIP-14 score improved significantly in groups 1 and 2 (p < 0.05), and this improvement was maintained after three months. Lesion resolution evaluated by the Thongprasom score at one month showed significant differences between groups 1 and 3 (p = 0.032) and between groups 2 and 3 (p = 0.024). Conclusions: Photodynamic therapy and photobiomodulation once a week for four weeks are safe and non-invasive treatment options, with the important advantage of lacking adverse effects. Further studies are needed to confirm it.

A Clinical Study on the Efficacy and Tolerability of a New Topical Gel and Toothpaste in Patients with Xerostomia: A Randomized Controlled Trial.

OBJECTIVE: xerostomia is a very common problem in the general population. The objective of this study was to determine the efficacy of a new gel and toothpaste in patients with xerostomia, analyze the role of salivary cytokines as biomarkers of xerostomia and assess the possible changes in salivary cytokines following treatment. MATERIALS AND METHODS: A randomized, controlled double-blind clinical study was carried out in 73 patients with xerostomia divided into two groups: placebo and active treatment (cymenol; tocopheryl acetate; D-panthenol; Aloe barbadensis; citrate tribasic dihydrate; fluoride) with oral gel and toothpaste three times a day for four consecutive weeks. The Thomson Xerostomia Inventory was applied, with the assessment of oral quality of life (OHIP-14) at baseline and after four weeks of application of the product. Sialometry was also performed in both groups, with analysis of the IL-1b, IL-6, IL-8 and TNFa levels in saliva. RESULTS: In the active treatment group, the xerostomia scores decreased significantly at the end of the study versus baseline, from 33.47 to 27.93 (p < 0.001). No significant decrease was recorded in the placebo group (34.5 to 32.75; p = 0.190). There were no adverse effects in either group. Regarding the saliva samples, the active treatment group showed significant differences in IL-6 concentration versus the control group (18.55 pg/mL (8-38.28) and 5.83 pg/mL (1.19-12.04), respectively; p = 0.002). No significant differences in salivary cytokines were observed in either the treatment group or the control group. CONCLUSIONS: The use of a new toothpaste and gel developed for patients with xerostomia proved effective, with greater symptom relief than in the placebo group. Further clinical studies involving longer time periods and larger samples are advisable in order to confirm the benefits of the described treatment.

Natural Coumarins: Exploring the Pharmacological Complexity and Underlying Molecular Mechanisms.

Coumarins belong to the benzopyrone family commonly found in many medicinal plants. Natural coumarins demonstrated a wide spectrum of pharmacological activities, including anti-inflammatory, anticoagulant, anticancer, antibacterial, antimalarial, casein kinase-2 (CK2) inhibitory, antifungal, antiviral, Alzheimer's disease inhibition, neuroprotective, anticonvulsant, phytoalexins, ulcerogenic, and antihypertensive. There are very few studies on the bioavailability of coumarins; therefore, further investigations are necessitated to study the bioavailability of different coumarins which already showed good biological activities in previous studies. On the evidence of varied pharmacological properties, the present work presents an overall review of the derivation, availability, and biological capacities of coumarins with further consideration of the essential mode of their therapeutic actions. In conclusion, a wide variety of coumarins are available, and their pharmacological activities are of current interest thanks to their synthetic accessibility and riches in medicinal plants. Coumarins perform the valuable function as therapeutic agents in a range of medical fields.

Role of Artificial Intelligence in the Early Diagnosis of Oral Cancer. A Scoping Review.

The early diagnosis of cancer can facilitate subsequent clinical patient management. Artificial intelligence (AI) has been found to be promising for improving the diagnostic process. The aim of the present study is to increase the evidence on the application of AI to the early diagnosis of oral cancer through a scoping review. A search was performed in the PubMed, Web of Science, Embase and Google Scholar databases during the period from January 2000 to December 2020, referring to the early non-invasive diagnosis of oral cancer based on AI applied to screening. Only accessible full-text articles were considered. Thirty-six studies were included on the early detection of oral cancer based on images (photographs (optical imaging and enhancement technology) and cytology) with the application of AI models. These studies were characterized by their heterogeneous nature. Each publication involved a different algorithm with potential training data bias and few comparative data for AI interpretation. Artificial intelligence may play an important role in precisely predicting the development of oral cancer, though several methodological issues need to be addressed in parallel to the advances in AI techniques, in order to allow large-scale transfer of the latter to population-based detection protocols.

Estimation of serum and salivary matrix metalloproteinase levels in oral squamous cell carcinoma patients: a systematic review and meta-analysis.

INTRODUCTION: Matrix metalloproteinases (MMPs) play a pivotal role in the cancer progression, invasion, and angiogenesis. AIM: This meta-analysis was conducted to evaluate the difference between oral squamous cell carcinoma (OSCC) patients and healthy controls in the serum and salivary MMP levels. MATERIAL AND METHODS: Four databases - Web of Science, PubMed, Scopus, and Cochrane Library - were searched up to March 2019. The pooled standard mean difference (SMD) and 95% confidence interval (CI) were obtained to explain the difference between the patients and controls in the salivary and serum MMP levels. Both Egger's and Begg's tests were considered as the significant publication bias. RESULTS: Thirteen case-control studies were included in the meta-analysis. Among the analyses of serum MMP levels, the serum MMP7 (SMD = 0.78; 95% CI: 0.15-1.41; p = 0.02) and MMP9 (SMD = 1.18; 95% CI: 0.51-1.84; p = 0.0005) levels were significantly higher in the OSCC patients than in the controls. In addition, the analyses of salivary MMP levels showed that the MMP1 (SMD = 0.46; 95% CI: 0.22-0.70; p = 0.0001) and MMP9 (SMD = 0.66; 95% CI: 0.19-1.12; p = 0.005) levels were significantly higher in the OSCC patients than in the controls. CONCLUSIONS: The meta-analysis showed that the serum MMP7 and MPP9 levels as well as the salivary MMP1 and MPP9 levels were significantly higher in the OSCC patients than in the controls.