Diagnosis of oral potentially malignant disorders: Overview and experience in Oceania.

The diagnosis and management of oral potentially malignant disorders (OPMD) should be the same the world over, but there are important nuances in incidence, aetiological factors, and management opportunities that may lead to differences based on ethnogeography. In this review, we update and discuss current international trends in the classification and diagnosis of OPMD with reference to our experience in various regions in Oceania. Oceania includes the islands of Australia, Melanesia (including Papua New Guinea, Fiji, Solomon Islands, Micronesia and Polynesia (including New Zealand, Samoa, Tonga) and hence has diverse populations with very different cultures and a range from well-resourced high-population density cities to remote villages.

Adaptive e-learning platforms can improve student performance and engagement in dental education.

PURPOSE: Knowledge of normal tissue architecture is essential for one of the vitally important graduate competencies in dentistry, which is the recognition and appropriate referral of patients with oral mucosal and jawbone abnormalities for timely management and improved outcomes. The aim of this study was to examine the effect of online adaptive lessons on improving perceived and measured student performance, motivation, and student perceptions in dental education. METHODS: This mixed-method study was conducted on year 1 and year 3 undergraduate dental students. Adaptive lessons supplementing a number of histology topics were designed and made available. Adaptive lesson scores and analytics, exam scores on topics that were supplemented by adaptive lessons (Experimental Questions), and those that were not (Control Questions) were compared among the year 1 students (n = 43). A validated questionnaire including Likert-type scales about the student attitudes and perceptions toward adaptive lessons followed by open-ended questions was administered to year 1 and 3 students (n = 57). RESULTS: Students obtained significantly higher scores in experimental exam questions than control exam questions (p = 0.01). A significantly larger number of students perceived that the adaptive lessons improved their knowledge of the subject (p < 0.001). CONCLUSIONS: The adaptive lessons employed in this study showed significant potential to improve student engagement, motivation, perceived knowledge, and measured exam performance. These are particularly important findings especially amid the COVID-19 pandemic as institutions transitioned to online education in lieu of face-to-face classes to comply with recommendations from Health Authorities.

Tunicamycin-induced endoplasmic reticulum stress up-regulates tumour-promoting cytokines in oral squamous cell carcinoma.

AIMS: Signal transducer and activator of transcription (STAT)-3 lies at the convergence point of key pathways involved in many malignancies including oral squamous cell carcinoma (OSCC). Endoplasmic reticulum stress (ERS) and the unfolded protein response have been shown to be involved in the pathogenesis and progression of different cancers by influencing key cellular processes such as apoptosis. We investigated the differential expression of STAT3 pathway-related genes and proteins under ERS in OSCC. METHODS: Three normal oral keratinocyte (NOK) and three OSCC cell lines were subjected to tunicamycin to induce ERS for 24 h or to the vehicle medium as control. A pathway-focussed array was used to analyse the modulation of STAT3 pathway gene expression under ERS using qPCR. The expression of key regulated proteins was investigated in the cell lines using immunocytochemistry and in 76 OSCC and 9 normal oral mucosa (NOM) tissue samples using tissue microarray technology and immunohistochemistry. RESULTS: ERS resulted in up-regulation of interleukin-6 receptor (IL6R) gene in NOK cell lines (p = 0.001) and IL5 (p = 0.005) and IL22 (p = 0.024) in OSCC cell lines. Greater STAT3 (p = 0.019) and leukaemia inhibitory factor receptor (p = 0.042) protein expression was observed in treated than untreated NOK cell lines. CONCLUSIONS: The gene and protein regulation patterns show that ERS plays a role in modifying the tumour microenvironment in OSCC by up-regulating tumour-promoting cytokines.

Oral cancer risk factors in New Zealand.

Oral cancer constitutes the majority of head and neck cancers, which are the fifth most common malignancy worldwide, accounting for an estimated 984,430 cases in 2012. Between 2000 and 2010, there were 1,916 cases of OSCC in New Zealand with a male to female ratio of 1.85:1, and an age-standardised incidence rate of 42 persons per 1,000,000 population. This article presents an overview of the main risk factors for oral and oropharyngeal cancers and their prevalence in New Zealand. Alcohol consumption is the most prevalent risk factor in New Zealand, followed by tobacco. Given the high prevalence of these two risk factors and their synergistic effect, it is important for doctors and dentists to encourage smoking cessation in smokers and to recommend judicious alcohol intake. Research is needed to determine the prevalence of use of oral preparations of tobacco and water-pipe smoking in New Zealand, especially due to changing demography and increases in migrant populations. UV radiation is also an important risk factor. Further investigations are also needed to determine the prevalence of oral and oropharyngeal cancers attributable to oncogenic HPV infection.

Oral and maxillofacial pathology submitted to Rizgary Teaching Hospital: a 6-year retrospective study.

INTRODUCTION: The majority of surveys concerning oral pathology accessions have focused on specific pathological categories or particular age groups, and few studies have analysed the whole range of specimens submitted for histopathological examination. An analysis of all oral pathology submitted to the Department of Histopathology in Rizgary Teaching Hospital in Erbil, Iraq, during the 6-year period 2008-2013, was performed. METHODS: Histopathology samples (excluding smears) from the maxillae, mandible, salivary glands, the lips and oral mucosa, the tongue, the hard and soft palate and uvula, and the pillars of the fauces were included. The specimens were grouped into six diagnostic categories: oral mucosal and skin pathology; benign neoplasms; malignant neoplasms; non-neoplastic salivary gland disorders; cysts; and miscellaneous pathology. RESULTS: The total number of oral and maxillofacial specimens was 616 of 20,571 specimens. One-third of the oral and maxillofacial specimens were in the mucosal and skin pathology category, followed by benign neoplasms (24.2%) - of which 26.8% were odontogenic tumours and 42.6% were salivary gland tumours - and malignant neoplasms (n = 100, 16.2%). Neoplastic (n = 62) and non-neoplastic (n = 41) salivary gland disorders accounted for 16.7% (n = 103) of the specimens submitted, whereas odontogenic cysts (n = 34) and tumours (n = 40) comprised 5.5% and 6.5% of all biopsies. CONCLUSIONS: Many of our findings are consistent with those reported in the literature. However, a relatively larger proportion of neoplastic lesions were found in our cohort and in other Iraqi centres. Of concern to practising clinicians in Iraq is that one in 10 biopsies submitted was a squamous cell carcinoma and three in 20 accessions were malignant.