Recognizing the salivary panomics for the clinical application in oral potentially malignant disorders.

Oral cancer arises as a result of multistep carcinogenic progress from precursor lesion to oral squamous cell carcinoma through collective mutational process occur in the stem cells of mucosal epithelium. The detection of such oral potentially malignant disorders (OPMDs)/cancer in subclinical level will greatly improve the prognosis of a patient. The highly specific and sensitive salivary biomarkers have functioned in detection, prediction, surveillance and therapeutic monitoring of the diseases of interest. The aim of the review is to appraise various salivary biomarkers for the clinical utility in OPMDs. An electronic web-supported search was performed via PubMed, ScienceDirect and Google Scholar search engine since the year 2015-2019. A total of 28 research articles were selected for the review after screening and assessment. The various genomic, transcriptomic, proteomic, metabolomic and miscellaneous markers were analyzed and their characteristics and clinical application in OPMD patients were discussed. miR-21, miR-31, miR-84, H3F3A mRNA + IL-8P, matrix metalloproteinase-9, chemerin, tumor necrosis factor-alpha, cytokeratin-10, ornithine + O-hydroxybenzoate + R5F, 8-hydroxy-2-deoxyguanosine, malondialdehyde, Vitamin E and Vitamin C are identified as potential markers for OPMD patients. Scientifically validated, reliable and economical clinical biomarkers in OPMDs would serve as evidence-based treatment from patient point of view. Further longitudinal studies are needed to verify the accuracy and validate the applicability of these diagnostic/prognostic markers. Saliva has been reported as a valuable noninvasive valuable tool in biomarker identification. Recent advancements in salivary biomarker identification techniques lead to various potential biomarkers with precise outcome. The utilization of these biomarkers for the clinical application in OPMDs depends on the feasibility and personal choice of the clinician.

The Combined Effect of Bioactive Glass and Platelet-Rich Fibrin in Treating Human Periodontal Intrabony Defects - A Clinicoradiographic Study.

BACKGROUND: Platelets are richest source for cytokine and growth factors which are two important components for the re-establishment of bone and maturation of the soft tissue. AIMS AND OBJECTIVE: The additive effect of PRF along with a synthetic bone graft material in treating human intrabony periodontal defects has been evaluated in this study. The appropriate use of platelet-rich fibrin (PRF) as an alternate comfortable graft material to restore the lost periodontal tissues has been well documented and has given clinically promising outcome. MATERIALS AND METHOD: Platelet-rich fibrin (PRF) is prepared from patient's own blood which is autologous in nature. Perio Glas (PG) is an easy to use synthetic absorbable osteostimulative as well as osteoconductive bone graft material. The selected 30 sites were randomly divided into two groups such as Test (15 sites using PRF) and Control (15 sites without PRF). RESULTS: At the end of Six months, the post-operative evaluations revealed significant reduction in PPD and gain in CAL. Radiographic evidence of bone formation was also noticed. The incorporation of PRF with synthetic bone graft (perioglas) produces effective and rapid periodontal regeneration with improved healing in intrabony osseous defects. The PRF group showed a mean Radiographic Defect Fill (RDL) of 1.24 ± 0.04 compared with 0.79 ± 0.07 of control group which is statistically significant. CONCLUSION: This combination technique can be used as an alternate grafting modality for the treatment of intrabony periodontal defects with satisfactory clinical consequences.

Sequential Removal of a Large Odontoma in the Angle of the Mandible.

Odontomas are the commonly occurring benign tumors of the jaw, which are odontogenic in origin. Lesion originates as the dental components are laid down in a disorganized manner, due to failure of normal morphodifferentiation. They are considered as hamartomatous developmental malformations rather than a true neoplasm. Mostly, these asymptomatic lesions are discovered as an incidental finding. Large odontomas may give rise to local disturbances, such as eruption delay of permanent teeth, asymmetric tooth eruption, malpositioning, displacement, resorption, or occasional devitalization of adjacent teeth. Odontomas may erupt into the mouth and tend to be associated with impacted teeth and other cystic lesions. The odontomas have a tendency to become symptomatic due to local infection such as sinusitis, infected adjacent tooth, and the exposure of tumor to oral environment. The aim of this paper is to elucidate the primary features and treatment of these lesions, depending on published data and individual witness.

Apprising the diverse facets of Platelet rich fibrin in surgery through a systematic review.

CONTEXT: Comprehensive reviews on clinical applications of Platelet rich fibrin (PRF) in surgery are limited despite its extensive utilization resulting in a dearth of knowledge on its effectiveness. Hence this article focuses on shedding light to the various applications of PRF pertaining to surgery through a systematic review. OBJECTIVE: The systematic review is aimed at evaluating the value of PRF in different areas of surgery. DATA SOURCES: A systematic review of articles sourced from MEDLINE-pubmed (2008-2017(July)) was done. Additional articles were searched through GOOGLE SCHOLAR and SCIENCE DIRECT. Search terms such as Platelet rich fibrin; Platelet rich fibrin, surgery; Platelet concentrate; second generation concentrate; Applications of PRF in surgery were used. STUDY SELECTION: Systematic reviews, Randomized control trials, Pilot studies and Case reports were included. Non English articles, in-vitro and animal studies were excluded. DATA EXTRACTION: Independent sourcing of articles by 3 authors using a set of predefined criteria. DATA SYNTHESIS: Out of the 25 articles covering various surgical procedures that met the inclusion criteria, positive outcomes were noted in most. Although categorization into one specific type of study was not done, the overall success rate with PRF usage was 78%.No differences between test and control groups were observed in 2 studies and 3 studies showed no significant improvements with the usage of PRF. LIMITATIONS: The systematic review did not categorize the study designs while evaluating success rates which might be considered as a shortcoming as case reports were also included. CONCLUSIONS: The future propositions are vast and point towards innovative applications of this bio-material possibly in transplant and burn cases if a method of obtaining large amounts can be devised. However since we rely on evidence-based results, further long term studies are needed in distinct areas of applications to decisively prove its effectiveness.

Application of platelet rich fibrin for management of an electrosurge induced osteonecrosis involving maxillary alveolus.

BACKGROUND: Application of principles of electrocautery for hemostasis dates back to prehistoric times. Its modern implementation in various fields of general and head and neck surgeries have been well documented. However its usage in minor oral surgical procedures has gained popularity only recently. Complications associated with electro-surgery in the dental field are relatively rare and there is insufficient literature on its management. CASE REPORT: We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars. DISCUSSION: Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration. CLINICAL IMPLICATIONS: Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.

Multiple bony overgrowths in the mouth - report of two cases.

Tori and exostoses are benign bony protuberances that arise from bone surfaces in the oral cavity. The etiology of these growths has been implicated as multifactorial, but no consensus has been reached so far. These painless overgrowths seldom present as a complaint in the dental office unless functional or esthetic complications set in, and there is a fear for cancer. Here we discuss two rare cases where bony overgrowths present in the mouth were extensive and multiple.

Radiographic assessment of the prevalence of pulp stones in Malaysians.

INTRODUCTION: The aim of this study was to determine the prevalence of pulp stones in the Malaysian population using radiographs, and to assess the association of pulp stones with gender, age, tooth type, dental arch and tooth status. Occurrence of pulp stones among the three races in Malaysia (Malay, Chinese and Indians) was also studied. METHODS: A retrospective study was performed from a random sample of 361 dental records in AIMST Dental Centre, Faculty of Dentistry, AIMST University, Kedah, Malaysia. Data were collected from patient files and 507 intraoral periapical radiographs. All radiographs were examined by an oral radiologist to identify pulp stones and associated factors. Statistical analysis was performed using the Pearson chi-square test. RESULTS: Of the 361 patients, 205 were female and 156 were male. Pulp stones were identified in 162 (44.9%) subjects in 1 or more teeth and in 280 (15.7%) teeth of the total 1779 teeth examined. Pulp stones were found significantly more in molars and teeth that were not intact (carious/restored/both carious and restored). There was no significant correlation with sex, increasing age, dental arches, and ethnic races. CONCLUSIONS: The prevalence of pulp stones in the Malaysian population studied was 44.9%. Pulp stones were more often seen in teeth that were restored or affected with caries. These findings require further investigation.

Sleep bruxism associated with nocturnal enuresis in a 6-year-old child.

BACKGROUND: Bruxism is the involuntary grinding of teeth that occurs during sleep or wake time. The prevalence of bruxism in children and adolescents is high when compared to the adult population. CLINICAL PRESENTATION: This article presents a case report of sleep bruxism in a 6-year-old child. The interesting finding here was its association with nocturnal enuresis (NE)/bedwetting. CONCLUSION/CLINICAL RELEVANCE: NE could be a predisposing factor for sleep bruxism in children, as it causes emotional stress and has a negative impact on a child's self esteem. Psychological support and techniques for overcoming NE, like a scheduled waking program at night helps children with these problems by alleviating the associated stress. In addition, NE and bruxism are often associated with other sleep disorders, such as obstructive sleep apnea syndrome, and hence, child bruxers require careful medical evaluation to rule out such potential interactions.