Radio frequency analysis of partially grafted immediate dental implant with and without use of static magnetic field: An in vivo study.

Background: Replacement of missing teeth with dental implants represents one of the most successful treatment modalities in modern dentistry. Patients desire for a shorter treatment time has made clinicians to attempt loading implants early or immediately after placement. The primary stability is determined by density and mechanical properties of the bone, the implant design, edentulous site complications, and the surgical technique. Various researchers have tried to achieve faster osseointegration static magnetic field is one of them. So the aim of this study was to investigate whether Static magnetic field created by using safer magnets was useful to promote osseointegration. Materials and Methods: Subjects were selected according to the predetermined inclusion and exclusion criteria in two groups (20 in each group). Conventional implant placement protocol was used and implant placement was performed and grafting was done. Magnetic healing cap was used in group I and conventional healing cap in group II. Implant stability assessment using radio frequency analyser was assessed at 2, 3 and 4 months on interval. Result: Mann-Whitney U test revealed that there was significant difference was observed between the groups I and II at 2, 3 and 4 months of interval (P < 0.001). Static magnetic field improve osseointegration in group I as compared to group II. Conclusion: The present double-blinded RCT showed significantly improved implant stability and osseointegration in implants which were stimulated by static magnetic field by using magnetic healing cap as compared to implants with conventional healing cap.

Molecular Signatures of Tumour and Its Microenvironment for Precise Quantitative Diagnosis of Oral Squamous Cell Carcinoma: An International Multi-Cohort Diagnostic Validation Study.

BACKGROUND: Heterogeneity in oral potentially malignant disorder (OPMD) poses a problem for accurate prognosis that impacts on treatment strategy and patient outcome. A holistic assessment based on gene expression signatures from both the tumour cells and their microenvironment is necessary to provide a more precise prognostic assessment than just tumour cell signatures alone. METHODS: We reformulated our previously established multigene qPCR test, quantitative Malignancy Index Diagnostic System (qMIDS) with new genes involved in matrix/stroma and immune modulation of the tumour microenvironment. An algorithm calculates and converts a panel of 16 gene mRNA expression levels into a qMIDS index to quantify risk of malignancy for each sample. RESULTS: The new qMIDSV2 assay was validated in a UK oral squamous cell carcinoma (OSCC) cohort (n = 282) of margin and tumour core samples demonstrating significantly better diagnostic performance (AUC = 0.945) compared to previous qMIDSV1 (AUC = 0.759). Performance of qMIDSV2 were independently validated in Chinese (n = 35; AUC = 0.928) and Indian (n = 95; AUC = 0.932) OSCC cohorts. Further, 5-year retrospective analysis on an Indian dysplastic lesion cohort (n = 30) showed that qMIDSV2 was able to significantly differentiate between lesions without transformation and those with malignant transformation. CONCLUSIONS: This study validated a novel multi-gene qPCR test on a total of 535 tissue specimens from UK, China and India, demonstrating a rapid minimally invasive method that has a potential application for dysplasia risk stratification. Further study is required to establish if qMIDSV2 could be used to improve OPMD patient management, guide treatment strategy and reduce oral cancer burden.

Diagnostic significance of serum and salivary lipid levels in oral precancer and oral cancer.

INTRODUCTION: Lipids are one of the major constituents of the cell. Variations in the serum lipids have been considered a cofactor of carcinogenesis, as lipids play a crucial role in cell integrity. Saliva is an ultrafiltrate of plasma and correlates with the serum, which may be used as an alternate method of serum lipid level estimation. The study was conducted to find any correlation between serum and salivary lipid levels and to evaluate the changes in serum and salivary lipid levels in oral precancer and cancer patients. AIMS AND OBJECTIVES: This study aimed to evaluate the changes in serum and salivary lipid levels in oral precancer and cancer patients and to correlate salivary lipid levels with serum lipid levels. MATERIALS AND METHODS: The study was an in vivo study conducted on randomly selected 129 patients with oral cancer and oral precancer. The selected subjects were divided into four groups as Group 1 - healthy control, Group 2 - oral submucous fibrosis, Group 3 - leukoplakia, and Group 4 - oral cancer. Serum and salivary lipid levels were estimated biochemically and statistically analyzed for any correlation with oral precancer and cancer. RESULTS: Lipid level estimation showed no statistically significant difference on comparison of intergroup serum and saliva total cholesterol level and high-density lipoproteins among all four groups, whereas intergroup comparison of serum and saliva triglycerides (TG) levels among the four groups showed a statistically significant difference in saliva TG level. The correlation of serum and salivary lipid levels showed a significant positive correlation. CONCLUSION: In the present study association between serum/salivary lipid levels and oral precancer and oral cancer could not be established. A positive association was there in serum and salivary lipids hence salivary lipid levels may be used as a noninvasive technique for serum lipid level estimation.

Generalizability of deep learning models for dental image analysis.

We assessed the generalizability of deep learning models and how to improve it. Our exemplary use-case was the detection of apical lesions on panoramic radiographs. We employed two datasets of panoramic radiographs from two centers, one in Germany (Charité, Berlin, n = 650) and one in India (KGMU, Lucknow, n = 650): First, U-Net type models were trained on images from Charité (n = 500) and assessed on test sets from Charité and KGMU (each n = 150). Second, the relevance of image characteristics was explored using pixel-value transformations, aligning the image characteristics in the datasets. Third, cross-center training effects on generalizability were evaluated by stepwise replacing Charite with KGMU images. Last, we assessed the impact of the dental status (presence of root-canal fillings or restorations). Models trained only on Charité images showed a (mean ± SD) F1-score of 54.1 ± 0.8% on Charité and 32.7 ± 0.8% on KGMU data (p < 0.001/t-test). Alignment of image data characteristics between the centers did not improve generalizability. However, by gradually increasing the fraction of KGMU images in the training set (from 0 to 100%) the F1-score on KGMU images improved (46.1 ± 0.9%) at a moderate decrease on Charité images (50.9 ± 0.9%, p < 0.01). Model performance was good on KGMU images showing root-canal fillings and/or restorations, but much lower on KGMU images without root-canal fillings and/or restorations. Our deep learning models were not generalizable across centers. Cross-center training improved generalizability. Noteworthy, the dental status, but not image characteristics were relevant. Understanding the reasons behind limits in generalizability helps to mitigate generalizability problems.

Role of fractal analysis in detection of dysplasia in potentially malignant disorders.

BACKGROUND: Fractal analysis is, a noninvasive method, used to determine the intricate characteristics of the matter. Oral leukoplakia (OL), a potential malignant disorder, has definite propensity to turn in to malignancy. In such lesions, fractal dimension analysis (FDA) could be helpful in the early detection of malignant transformation. OBJECTIVES: To determine the efficacy of fractal dimension analysis in detecting malignancy potential of oral leukoplakia. MATERIALS AND METHODS: After ethical clearance, we enrolled 121 patients in our study. Lesions were photographed before and after toluidine staining. Image J software was used to analyze fractal dimensions (FDs) of digital image and results were compared with biopsy. RESULTS: Fractal dimension value is significantly higher in leukoplakia with dysplastic changes. FD values increase as age of patients increases. FD value in leukoplakia with different tobacco products showed more positive correlation with surti/khaini abusers. CONCLUSION: Fractal dimension analysis is a useful method in determination of complication in OL cases and can be used as an effective, noninvasive screening tool at primary healthcare centers for early intervention.

Estimation of salivary and serum basic fibroblast growth factor in treated and untreated patients with oral squamous cell carcinoma.

OBJECTIVE: The purpose of this study was to evaluate salivary and serum basic fibroblast growth factor (bFGF) level in OSCC patients to provide a reliable biomarker for the early detection, monitoring, and prognosis of OSCC patients. MATERIALS AND METHODS: The study enrolled 90 subjects, equally grouped as recently diagnosed & untreated OSCC patients (Group I), treated OSCC without any recurrence (Group II) & as control (Group III). Enzyme-linked immunosorbent assay was employed to measure bFGF concentrations in saliva and serum samples of all three groups. The results were tabulated and analyzed statistically. RESULTS: Group I showed high-level of bFGF expression profile in saliva (8.80 ±â€¯1.26 pg/ml) whereas the levels of bFGF in group II (2.69 ±â€¯0.17 pg/ml) and Group III (3.17 ±â€¯0.43 pg/ml) are significantly lower than group I. Serum bFGF levels were also high in group I (6.33 ±â€¯0.81 pg/ml) and decreased significantly in group II (3.52 ±â€¯0.45 pg/ml) however, the control group showed elevated range of levels (7.63 ±â€¯0.88 pg/ml). CONCLUSIONS: This study demonstrates the reliability of salivary bFGF marker as diagnostic as well as prognostic marker. Serum bFGF could also be used as prognostic marker only in Oral Squamous cell carcinoma patients.

Assessment of the quality of life and performance status in patients with oral submucous fibrosis in central India.

BACKGROUND AND AIMS: Measuring quality of life in patients with oral submucous fibrosis is of utmost importance in assessing treatment outcomes. This study examined the impact of oral submucous fibrosis and its treatment on the quality of life and performance status of persons with oral submucous fibrosis. METHODS: Quality of life was measured in patients with oral submucous fibrosis using the European Organization for Research and Treatment of Cancer Quality of Life head and neck 35 Questionnaire (EORTC QLQ-C35); performance status was measured by Performance Status Scale for Head and Neck Cancer Patients (PSS-HN), at four points in time: baseline, one month, two months and three months after start of treatment. RESULTS: At the end of third month Group A and Group B showed 78% and 85% increase in mouth opening respectively. While the burning sensation of oral mucosa was decreased by 72% and 88% in group A and group B respectively (Z>1.96, P<0.05), there were significant differences in patients' quality of life and functioning at three points in time (P < 0.05). CONCLUSION: The European Organization for Research and Treatment of Cancer Quality of Life head and neck 35 Questionnaire and Performance Status Scale for Head and Neck Cancer Patients can be used successfully in potentially malignant disorders like oral submucous fibrosis. The results in this study will surely be a good guide forother studies on oral submucous fibrosis.

Evaluation of salivary flow rate and gustatory function in HIV-positive patients with or without highly active antiretroviral therapy.

OBJECTIVES: The aim of this study is to evaluate the salivary flow rate and gustatory changes in HIV-positive patients on highly active anti-retroviral therapy (HAART) and without HAART. We also correlated CD4 count and salivary flow rate and gustatory function in both groups. METHODS: Sample size for each group was thirty. After obtaining informed consent, we measured salivary flow rate using Schimer's method and gustatory function using four tastants (sweet, sour, bitter, and salty) of different concentrations. The readings were recorded at 0 month, 2nd, 4th, and 6th month interval. The data obtained was statistically analyzed. RESULTS: The mean salivary flow rate was decreased more in Group I as compared to Group II. The mean identification score for sweet, salty, sour, and bitter was significantly higher in Group II than Group I. The mean detection threshold score for sweet, salty, sour and bitter taste was comparatively higher in Group I than Group II. The Pearson's correlation analysis showed inverse relation between age and salivary flow rate in Group II. No significant correlation was observed in CD4 count and salivary flow rate. CONCLUSION: Along with routine oral health appraisal in seropositive patients, evaluation of salivary flow rate, and taste abnormalities should also be considered an integral part of patient assessment.

Erythematous candidiasis leading to systemic manifestations of human immunodeficiency virus co-infection with secondary syphilis: A diagnostic and therapeutic dilemma.

The intensification of human immunodeficiency virus (HIV) and rising frequency of immunocompromised individuals have resulted in a resurgence of opportunistic infections. The most common opportunistic oral fungal infection in HIV-positive individuals is oral candidiasis. The classical presentation is as white scrapable form called as thrush, which is easily diagnosed and treated. The clinician is presented with a diagnostic and management dilemma when these lesions appear in new facades such as erythematous candidiasis, the latter's prevalence with HIV and AIDS being well established. In this case report, we present a case of Erythematous Candidiasis, which was associated with type 1 HIV co-infected with syphilis. We highlight the diagnostic importance of a naive looking manifestation of the tongue which was followed by a series of challenging presentations of secondary syphilis. Since the patient had a negative Veneral Disease Research Laboratory and left us with a management dilemma, the article also features the importance of prozone phenomenon (seen in 2% cases of secondary syphilis), and it's higher association with HIV co-infected individuals. With confusing clinical oral manifestations associated with these diseases, the dentist might be the first person to encounter such lesions, who should be able to recognize erythematous candidiasis and correlate them with the underlying pathology.

Association of mandible anatomy with age, gender, and dental status: a radiographic study.

Introduction. Gonial angle and antegonial region are important landmarks in mandible which is influenced by gender, age, and dental status. The objective of this study was to evaluate the gonial angle, antegonial angle, and antegonial depth and to investigate their relationship to gender, age group, and dental status. Materials and Methods. A total of 1060 panoramic radiographs were evaluated: the dentulous group, 854 subjects and the edentulous group, 206 subjects. The patients were grouped into six age groups of 10-years each. Gonial angle, antegonial angle, and antegonial depth were measured from panoramic radiographs. Results and Discussion. Corelation of age with gonial angle, antegonial angle and antegonial depth was not significant. Significant difference in mandibular angle was found between males and females. Males had significantly smaller antegonial angle and greater antegonial depth than females. Significant difference was found for gonial angle, antegonial angle, and antegonial depth between right and left sides of mandible. Conclusion. Gonial angle, antegonial angle, and antegonial depth can be implicated as a forensic tool for gender determination but not suitable for age determination.

Estimation and comparative study of serum total sialic acid levels as tumor markers in oral cancer and precancer.

BACKGROUND: Tumor markers are a major part of the secondary prevention and thus the detection of malignancies. Neoplasms often have an increased concentration of sialic acid on the tumor cell surface and are shed or secreted by some of these cells which increase the concentration in blood. MATERIALS AND METHODS: The study was conducted on 90 subjects equally divided into three groups viz, healthy individuals, oral cancer and precancer. The estimation of serum total sialic acid level was done according to Plucinsky et al by resorcinol reagent method. The statistical analysis was carried out by using SPSS 10.0 software. RESULTS: The mean serum total sialic acid (TSA) level in oral precancer and oral cancer group was statistically significant (P<0.05). In oral cancer group when stage I and stage II were compared with stage III and stage IV, it was statistically significant (P<0.05). Histopathologically, oral cancer and precancer did not show statistically significant values (P>0.05). The present study also suggested that no correlation exists between habit of tobacco chewing / betel nut chewing / smoking or alcohol consumption with that of serum total sialic acid levels. CONCLUSION: Serum total sialic acid levels can be used as an adjunctive diagnostic marker in head and neck cancer.

Estimation of serum malondialdehyde in oral cancer and precancer and its association with healthy individuals, gender, alcohol, and tobacco abuse.

BACKGROUND: Tobacco and alcohol induces generation of free radicals and reactive oxygen species, which are responsible for high rate of lipid peroxidation. Malondialdehyde is the most widely used marker of lipid peroxidation. The aim of the study was to estimate serum malondialdehyde level in oral precancer, oral cancer, and normal individuals. MATERIALS AND METHODS: In this study serum malondialdehyde was measured according to the method of Ohkawa et al in 30 normal individuals and 30 patients each with histopathologically diagnosed oral precancer, and oral cancer. RESULTS: The mean serum malondialdehyde level in the control group was found to be 5.107 ± 2.32 ηmol/ml, whereas it was 9.33 ± 4.89 ηmol/ml and 14.34 ± 1.43 ηmol/ml in oral precancer and oral cancer, respectively. There was statistically significant increase in serum malondialdehyde levels in the oral precancer and oral cancer patients compared with the control group. CONCLUSION: Increased serum malondialdehyde in oral cancer and oral precancer would serve as a valuable marker for both preventive and clinical intervention, and may deserve further investigation for the early diagnosis, treatment, and prognosis.

Drug treatment of trigeminal neuralgia: a systematic review of the literature.

PURPOSE: This study undertook a systematic review of the literature on drug treatment of trigeminal neuralgia. METHODS: An electronic search was carried out for articles published between January 1960 to February 2005. Studies with high level of evidence were included. The levels of evidence of the articles were classified after the guidelines of the Oxford Centre for Evidence-Based Medicine. RESULTS: Of 770 publications, only 21 publications showed a high level of evidence (6 randomized controlled trials and 15 clinical trials/controlled clinical trials), with a total of 348 patients. A total of 749 publications were not included in the review as they showed a low level of evidence. CONCLUSIONS: Anticonvulsants are effective in treating trigeminal neuralgia; however, few studies with high levels of evidence were found. It is quite difficult to compare or even combine their outcomes in a scientifically meaningful manner. Due to insufficient research data, there is a need for high-quality randomized controlled trials in this area of medicine.