Assessment of correlation between clinical staging, functional staging, and histopathological grading of oral submucous fibrosis.

BACKGROUND: Oral submucous fibrosis (OSMF) is a premalignant condition with a greater prevalence in countries such as India. Various classifications have been put forth by multiple authors to determine the clinical, functional, and histopathological grade of the disease. The classification systems have greatly helped to determine the treatment modality for the patients. Understanding the correlation between the various classifications will help us determine the course of the disease, management, and prognosis of OSMF. This study assesses the correlation between clinical, functional, and histopathological grading of OSMF. AIM: To assess the correlation between clinical staging, functional staging, and histopathological grading of OSMF. MATERIALS AND METHODS: Thirty patients with clinical and histopathological diagnosis of OSMF were assigned into clinical stage, functional stage, and histopathological grade. The correlation between these three stages assigned was studied. STATISTICAL ANALYSIS: The degree of agreement between the clinical, functional, and histopathological classifications was quantified by the Weighted Kappa statistics. Correlation between the three classifications was done using Kendall's tau and Spearman's correlation coefficient.There was a good agreement and statistically significant correlation between clinical and functional grading. There was a poor agreement and no significant correlation between clinical and histopathological grading. There was a poor agreement and no significant correlation between functional and histopathological grading.

Assessment of cytogenic damage in the form of micronuclei in oral epithelial cells in patients using smokeless and smoked form of tobacco and non-tobacco users and its relevance for oral cancer.

CONTEXT: Early detection of cytological damages may help in reduction of morbidity and mortality in patients with oral cancer. AIMS: (1) The primary aim of this study is to assess the cytogenic damage in the form of micronuclei (MN) in patients with smokeless and smoked tobacco using habit. (2) The secondary aim of this study is to compare the MN score in patients using tobacco and patients with no tobacco habit. (3) To find out incidence of MN according to duration and frequency of tobacco usage. SETTINGS AND DESIGN: This is a clinical study. MATERIALS AND METHODS: A total of 100 patients each with the habit of smokeless tobacco (SLT) chewing, smoked tobacco usage and with no habit were included in the study. Epithelial cell smears were prepared and slides were stained with Papanicolaou stain. Scoring of at least 1000 cells was done and a MN frequency score was assigned for exfoliated oral mucosal cells. STATISTICAL ANALYSIS: Analysis of variance and post hoc tests were used. RESULTS: The difference between the total number of cells with MN was not appreciable between the smokeless and smoked tobacco groups, though the total number of MN was higher in subjects using SLT. Total number of cells with MN and the total number of MN were significantly lower in non-tobacco users when compared with tobacco users. There was very weak positive correlation between the total number of MN as per the duration and frequency of the tobacco habit. CONCLUSION: The use of smokeless and smoked tobacco are associated with cytotoxic and genotoxic effects. SLT seems to cause more damaging effects than the smoked form.

Acellular dermal matrix seeded with autologous gingival fibroblasts for the treatment of gingival recession: a proof-of-concept study.

BACKGROUND: One of the most common esthetic concerns associated with periodontal tissues is gingival recession. There are multiple periodontal plastic surgery approaches documented in the literature for the treatment of such defects. With the tremendous advances being made in periodontal science and technology, tissue engineering could be considered among the latest exciting techniques for recession management. METHODS: In this split-mouth, controlled, double-masked clinical case series, 20 sites from 10 patients with Miller Class I or II recessions affecting canines or premolars in the maxillary arch were selected. One tooth in each patient was randomized to receive either a subepithelial connective tissue graft (SCTG) (control group) or an acellular dermal matrix allograft (ADMA) seeded with autologous gingival fibroblasts (test group) under a coronally positioned flap. Clinical parameters, including recession depth, probing depth, clinical attachment level, width of keratinized tissue, attached gingiva, and plaque scores, were recorded by a calibrated examiner at baseline and 3 and 6 months. The inflammation of grafted sites was scored, and the healing time was calculated. The final esthetic outcome of treated sites was assessed by the root coverage esthetic score at the end of 6 months. RESULTS: There were no significant differences between test and control sites for all measured clinical parameters. However, the test sites demonstrated less inflammation in the early postoperative period. CONCLUSION: Within the limits of this case series, the results indicate that an ADMA seeded with autologous gingival fibroblasts by tissue-engineering technology may be explored as a substitute to an SCTG for the treatment of Miller Class I and II recession defects.