Prevalence of oral potentially malignant disorders associated with habits in Puducherry - a Cross-sectional study

Tobacco and betel quid are the most common cause of oral cancer in India. Very often oral cancers are preceded by a visible oral precursor lesion called as potentially malignant disorder (PMD). Aim: The aim of this study was to assess the prevalence of oral PMDs associated with habits in urban and rural areas of Puducherry Union territory, India. Methods: A cross-sectional descriptive study in urban and rural areas of Puducherry was conducted. The study group comprised of 450 patients with positive history of oral habits. A standard structured questionnaire was designed to record information about demographic details, socioeconomic status, type, duration and frequency of habits followed by clinical oral examination by single trained and calibrated examiner to detect the presence of PMD. Statistical analysis used: EpiData software (version 3.1). Descriptive statistics were presented for all variables. Pearson's Chi-Square test and adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated to estimate the suspected risk factors for PMD by using multivariate logistic regression analysis. P-value of ≤ 0.05 was considered to be statistically significant. Results: Prevalence of habit associated oral PMD was 64.2%. Females were more prone to develop PMDs (68.3%) as compared to males (62.8%). PMD was more common in the age group of 51-60 years (69.2%). Smoking with alcohol consumption was the most common oral habit. Habits, socio-economic status and diet were significantly associated with development of oral PMDs in our study population. Multivariate logistic regression analysis showed that chronic betel quid chewing and smoking were significant risk factors for PMD. Increased frequency of vegetable consumption reduced the risk of PMD. Conclusions: Oral PMD were observed in more than half of the subjects with oral habits in Puducherry. Clearly, there is an increased risk of PMD with increased duration of tobacco and betel quid use in this region. Patients and public need to be educated regarding PMD and encouraged to quit habits so as to prevent high risk population from developing cancer

Observer variability in the grading of oral epithelial dysplasia

Background: Various grading systems have been suggested in the literature by different authors to determine the severity of dysplastic features. Histopathological grading is subjective with low reproductivity and lacks sensitivity. Aim: To determine the inter observer and intra observer variability in diagnosing oral epithelial dysplasia using different grading systems. Materials and methods: Three oral pathologists from the Department the Oral pathology, GDC Srinagar observed the same 30 consecutive sections of oral epithelial dysplasia. Each reviewing pathologist asked to grade each case on the basis of WHO (2005) and binary grading system (2006) at different time intervals and was repeated twice. Results: The inter observer variability ranged from poor to slight in WHO system and slight to fair in binary system whereas the intra observer variability ranged from slight to fair in WHO system and fair in the binary system. Conclusion: Grading of oral epithelial dysplasia is subjective and has been shown not to be highly reproducible. The binary grading system verified to have better inter observer and intra observer agreement in the present study than the WHO grading system.

Effectiveness of crystallization test in screening of potentially malignant oral disorders and oral cancer

This study aims to determine the effectiveness of crystallization test in screening of oral potentially malignant disorders (PMDs) and oral cancer. Materials and Methods: Thirty patients of oral PMD, 30 patients of oral cancer and 40 normal healthy people were selected. One drop of blood was collected and added to 1 cc of double-distilled water at room temperature to get a final dilution of 6% hemolyzed blood. 0.1–0.2 cc of this blood sample is added to 10 cc of 20% cupric chloride solution and further is subjected to crystallization test. Results: In the normal healthy group, the pattern was typical with an eccentrically placed center of gravity with needles arranged in radiating fashion. Whereas in oral PMD and cancer groups, there was “transverse form” formation. This test had sensitivity and specificity of about 83.33% and 86.84% for PMDs group and 96.30% and 86.84% for oral cancer group respectively. Conclusion: Crystallization test was found to be sensitive, reliable, economical and less-invasive procedure for screening of oral PMDs and oral cancer.

Clinical significance of CD44 and CD133 expression in oral potentially malignant disorder and oral squamous cell carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to investigate the expression and relationship of CD44 and CD133 in normal oral mucosa, oral potentially malignant disorder (OPMD), and oral squamous cell carcinoma (OSCC). This work also analyzes the relationship between such expression and clinical factors. This study intends to evaluate the clinical value of using CD44 and CD133 as indices to evaluate the carcinogenic potential of OPMD.</p><p><b>METHODS</b>Clinical data from 60 patients with OPMD, 60 patients with OSCC, and 10 cases of normal oral mucosa were analyzed. Double immunohistochemical analysis was applied to investigate the expression of CD44 and CD133 in paraffin sections of normal oral mucosa, OPMD, and OSCC tissues. Subsequently, the relationships between such expression and clinical factors were analyzed.</p><p><b>RESULTS</b>The positive rates of CD44 expression in the normal oral mucosa, OPMD, and OSCC tissues were 100.00%, 96.67%, and 71.67% (P<0.05), respectively. Meanwhile, the positive rates of CD133 expression in the normal oral mucosa, OPMD, and OSCC tissues were 0.00%, 35.00%, and 63.33% (P<0.05), respectively. The expression of CD44 and CD133 was found to be correlated (P<0.05). Such expression was related to the clinical stages and lymphatic metastasis of OSCC (P<0.05).</p><p><b>CONCLUSIONS</b>CD44 and CD133 can be used individually as clinical indices to evaluate the carcinogenic potential of OPMD.
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A Brief Overview of Oral Potentially Malignant Disorder.

Cancer of the oral cavity is one of the most common cancers. Oral cancer is still only detectable at a late stage, and the survival rate for an oral cancer patient has essentially remained unchanged over the past three decades. This study is concentrated on the oral precancerous lesions which are commonly seen in dental clinics and to give the general practitioners Knowledge for early detection of these lesions. A literature search was conducted using Medline, accessed via the National Library of Medicine PubMed interface, searching for articles relating to the precancerous oral lesions written in English.