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Background Teeth serve many functions, and aesthetics is one of the most important aspects served by teeth, perceived by the limbic system of the human brain. The golden divine ratio is the unique proportion often correlated with beauty. The present study was devised to estimate the dimension of human permanent canines and approximation to the golden divine ratio. Materials and methods The present study included 47 extracted human permanent canines retrieved from the tooth repository of our institute's Department of Oral Biology. Using digital vernier calipers (Themisto TH-M61 digital vernier caliper, 0-150mm/ 6 inch, JIPVI Ecommerce Pvt. Ltd, India, 2022), the following measurements were taken: Mesio-distal and labiolingual dimensions of the crown, crown length, root length, root to crown ratio (R/C) and the tooth to root ratio (T/R). The data were analyzed using Statistical Package for Social Sciences (SPSS) software version 26. Results All the dimensions' mean and standard deviations were calculated for both maxillary and mandibular canines. While the means of mesio-distal and labiolingual dimensions of the crown approximated the values reported in the literature, there was some variation in crown and root lengths. The mean crown lengths of the upper and lower canines were 10.34mm and 9.76mm, respectively, while the root lengths were 16.52 and 15.54mm, respectively. The R/C of both sets and the T/R of the upper canine only followed the golden ratio. T/R of the lower canine was slightly higher (1.64) Conclusion Although the number of included teeth was less, owing to the fact that canines are rarely extracted, our results provided new values of canines for updation in a unique population. More studies are required for comparative anthropological data updates.
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INTRODUCTION: Among the epithelial malignancies of the head and neck region, oral squamous cell carcinoma (OSCC) arising from the oral mucosa is the commonest type. OSCC is common in the older population; however, recent epidemiological data indicate an increase in the incidence in the younger age group. The present study was designed to compare the clinicopathological characteristics of OSCC between young and old South Indian patients. METHODS: All the histopathologically confirmed cases of OSCC were retrieved from the department archives. Patients aged more than 40 years were considered Group I, and patients aged less than or equal to 40 were considered Group II. Age, gender, laterality, site, degree of keratinization, nuclear pleomorphism, pattern of invasion, lymphoplasmacytic infiltration, grade, tumor budding (TB), and tumor stroma ratio (TSR) were assessed. RESULTS: Among 510 patients reported with OSCC, 442 were aged above 40 years, and 68 were aged 40 years or younger. Nuclear pleomorphism, TB, and stroma-rich ratio were statistically higher in younger OSCC patients (p=0.00). CONCLUSION: The results of our study support the fact that OSCC in younger individuals is more aggressive. Targeting TB and tumor stroma could provide new strategies for the management of OSCC.
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Background Medicinal plants are traditionally used in Ayurveda, Unani medicine, and Siddha as primary sources of drugs, and mankind has exploited the therapeutic properties of these herbs throughout history. Coconut (Cocos nucifera), a common ingredient of Indian sub-continental cuisine, has been proven to possess various medicinal properties; similarly, wheatgrass (Triticum aestivum) is of greater medicinal value and is known as the powerhouse of nutrients and vitamins. These have been used individually, but there is limited data on the synergistic use of these products. Thus, the present in vitro study was designed to prepare an oral gel from the extract of C. nucifera and T. aestivum and to assess its cumulative anti-inflammatory and antioxidant activity. Materials and methods C. nucifera extract and T. aestivum extract were prepared separately, and gel formulation was done. The formulated gel was tested for its anti-inflammatory and antioxidant activity. Results The results of the present study demonstrated that the anti-inflammatory property of the gel formulation was greater as compared to the standard (diclofenac), with the highest percentage of inhibition of 90.1% at 50 µl. With regard to the antioxidant property, we found that it was comparable to the standard (ascorbic acid) at various concentrations, with greater activity at 50 µl. Conclusion The oral gel formulation of coconut (C. nucifera) and wheatgrass (T. aestivum) showed better anti-inflammatory and a comparable antioxidant activity. Thus, this formulation may be employed as an adjunct to the commercially available oral gel preparations.
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Background Artificial intelligence (AI) is a rapidly emerging field in medicine and has applications in diagnostics, therapeutics, and prognostication in various malignancies. The present study was conducted to analyze and compare the accuracy of three deep learning neural networks for oral squamous cell carcinoma (OSCC) images. Materials and methods Three hundred and twenty-five cases of OSCC were included and graded histologically by two grading systems. The images were then analyzed using the Orange data mining tool. Three neural networks, viz., InceptionV3, SqueezeNet, and VGG16, were used for further analysis and classification. Positive predictive value, negative predictive value, specificity, sensitivity, area under curve (AUC), and accuracy were estimated for each neural network. Results Histological grading by Bryne's yielded significantly stronger inter-observer agreement. The highest accuracy was found for the classification of poorly differentiated squamous cell carcinoma images irrespective of the network used. Other values were variegated. Conclusion AI could serve as an adjunct for improvement in theragnostics. Further research is required to achieve the modification of mining tools for greater predictive values, sensitivity, specificity, AUC, accuracy, and security. Bryne's grading system is warranted for the better application of AI in OSCC image analytics.
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Background This paper aims to descriptively present the clinico-demographic and pathological profile of 238 cases of oral submucous fibrosis (OSMF) with emphasis on the correlation between clinical and histopathological classification systems and the incidence of malignant transformation. Methods A total of 7098 oral biopsies were retrospectively retrieved over a period of 13 years, out of which 238 cases of OSMF were included in the present study. Data were analyzed for age, gender, habits, clinical symptoms, functional staging, histological staging, type and nature of epithelium, signet-ring cell changes, presence/absence of dysplasia or transformation squamous cell carcinoma, and treatment. Results Clinically and histologically, most cases were moderately advanced. Men outnumbered women. The prevalence of dysplasia was found to be 23.94% and the malignant transformation rate was estimated to be 13.8%. There was a significant correlation between clinical staging with age and histological grading. No correlation was found between histological staging and the age of the patients. Conclusions OSMF is a habit-related progressive chronic oral condition with a high malignant transformation rate. Multimodal treatment with auxiliary physiotherapy helps in the improvement of the clinical symptoms.
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Cancer stem cells (CSCs) are characterized by their capacity for self-renewal and differentiation. CD44 and CD24 are two commonly used markers to identify these CSCs. Despite the enormous amount of data available in the literature, their specificity and coexistence remain elusive in oral squamous cell carcinoma (OSCC). In the present review, we aimed to assess the diagnostic utility of the CD44/CD24 combination in tumor development and metastasis in OSCC. Two investigators independently performed a systematic search to identify all the relevant studies from various electronic databases. Out of 694 articles, 9 were found eligible for further evaluation. Details including the number of patients, gender, site, tobacco and alcohol consumption, histological stage, CD24 expression, CD44 expression, CD44/CD24 expression, nodal status, disease-free survival, and overall survival were extracted. CD44+CD24- expression was noted in 35/207 (16.9%) cases, CD44+CD24+ in 53/207 (25.6%) cases, CD44-CD24- in 49/207 subjects (23.67%), and CD44-/CD24+ in 70/207 (33.81%) cases. CD44 or CD24 or their co-expression did not correlate with the disease-free survival rate, and double negatives (CD44-/CD24-) demonstrated a higher overall survival than other immunotypes. CD44/CD24 profile may be used on small incisional biopsies to predict the outcome and treatment planning. This finding may help in developing new therapeutic targets to suppress cancer metastasis and provide a better long-term prognosis for patients diagnosed with OSCC.
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Background Ceramide (CER), known as a "tumor suppressor lipid," plays a crucial role in promoting apoptosis in cancer cells. Ceramide synthase 1 (CERS1), an enzyme responsible for CER synthesis, holds immense importance. Notably, studies have highlighted that reduced levels of CERS1 confer protection to oral squamous cell carcinoma (OSCC) cells against chemotherapeutic agents like cisplatin. However, there is a scarcity of literature exploring the precise role of CERS1 in OSCC. Further investigation is warranted to unravel the intricate relationship of CERS1 in malignant transformation. Aim To compare the salivary CERS1 levels in OSCC, oral leukoplakia (OLK), and healthy individuals. Materials and methods Salivary samples from 15 healthy individuals, OLK patients, and OSCC patients each were obtained and an enzyme-linked immunosorbent assay (ELISA) (MyBioSource, Inc., San Diego, CA) was performed to evaluate salivary CERS1 enzyme levels. Descriptive statistics and Kruskal-Wallis analysis were done using SPSS v23.0 software (IBM Corp., Armonk, NY). Results There was a significant decrease in salivary CERS1 enzyme levels in OSCC (2.08 +/- 0.36 ng/dl) compared to healthy individuals (6.42 +/- 0.42 ng/dl) and OLK patients (4.73 +/- 0.93 ng/dl) (p = 0.05). Conclusion In this study, it was found that CERS1 shows a steady decrease in OLK and OSCC. Further cohort studies with larger sample sizes are needed to provide a basis for the role of CERS1 in OLK and its malignant transformation to OSCC.
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The oral cavity has the second largest and most diverse microflora. A wide variety of bacteria, viruses, and fungi are present in the oral cavity. A significant number of studies have shown the important role of oral microflora in the initiation and pathogenesis of oral squamous cell carcinoma (OSCC). Microorganisms like Staphylococcus, Streptococcus, Neisseria, Prevotella, Fusobacterium, Porphyromonas, Herpes Simplex Virus I (HSV-1), Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV), Candida plays an important role in OSCC. Increased microbial load affects tumor initiation and progression through direct effects on the tumor cells and indirectly through manipulation of the immune system. But the mechanisms describing the steps of oral microflora initiating the OSCC remain an enigma. This systematic review aims to understand the potential carcinogenic effect of oral microflora on OSCC. A systematic literature search was done in PubMed and Google Scholar databases, and six studies were obtained, comprising 1267 participants. The incidence was evaluated as an odds ratio (OR) with a 95% confidence interval (95% CI) using review manager 5.2 software. Oral microflora increased 2.10-fold risk of oral squamous cell carcinoma (OR=2.10, 95% CI: 0.76, 5.84, P= 0.15, I2=86%, Ph<0.00001). In our subgroup analysis, there is a significant relation between Fusobacterium and oral squamous cell carcinoma (OR= 4.86, 95% CI: 0.99, 23.82, P=0.05, I2=0%, Ph= 0.84). Individuals with Epstein-Barr Virus infection exhibit increased incidence of oral squamous cell carcinoma (OR= 3.72, 95% CI: 1.97, 7.04, P=<0.0001, I2=0%, Ph= 0.82). The meta-analysis revealed that oral microflora increases the risk of oral squamous cell carcinoma.
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The objective of this systematic review was to investigate the expression of angiotensin converting enzyme 2 (ACE 2) in the head and neck region. We examined the evidence of the association of ACE 2 expression in oral tissues, salivary glands, and head and neck carcinoma. We searched Pub Med/Medline, Biorxiv, and Google Scholar to identify relevant literature. Studies reporting ACE 2 expression in human oral tissues and with a focus on head and neck carcinoma samples were included. From 110 studies, we extracted 15 studies analyzing the distribution and expression of ACE 2 in different head and neck tissues - olfactory mucosa and nasopharynx n=5, oral mucosa n=5, salivary gland n=5, head and neck squamous cell carcinoma patients n=3. ACE 2 was found to be expressed at a 4.43-fold increase in the head and neck region (OR, 4.43; 95% CI, 3.76-5.22; I2= 97%, Ph=<0.00001) when compared with controls (other tissues except for head and neck region). RNA expression of ACE 2 was 60% higher in head and neck squamous cell carcinoma patients than that in the normal tissues (OR=0.60, 95% CI, 0.04-9.26, Ph=0.00001). In conclusion, the meta-analysis of the studies indicated that ACE 2 is highly expressed in olfactory mucosa, nasopharynx, oral mucosa, and salivary glands. Furthermore, the results indicate that ACE 2 expression is increased in patients with head and neck cancer.
