Evaluation of Salivary Lactate Dehydrogenase as a Prognostic Biomarker in Tobacco Users with and without Potentially Malignant Disorders of the Oral Cavity.

Background Oral squamous cell carcinoma (OSCC) is a deadly disease that develops in a multistage process and is often preceded by oral potentially malignant disorders (PMDs), of which many are caused by tobacco usage. It is associated with a shift from an aerobic to anaerobic glycolytic pathway, and hence an increase in lactate dehydrogenase (LDH) levels is seen. The objective of this study was to estimate and correlate the level of salivary LDH in healthy individuals with tobacco users (with or without PMDs). Methods A total of 78 patients were selected from the Department of Oral Medicine and Radiology, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India, and were divided into three groups of 26 patients each, namely controls, tobacco users without PMD, and tobacco users with PMD. A total of 1 mL of unstimulated saliva was collected from each patient using the spit method. Sample was subjected to centrifugation at 2,500 rpm, and salivary LDH was quantified by a standard kit (LDH-P kit, DIALAB, Neudorf, Austria) using an autoanalyzer. Results There was a statistically significant ( p < 0.001) gradual increase in the level of LDH in controls (267 ± 27.64 U/L), tobacco users without PMD (391 ± 80.53 U/L), and tobacco users with PMD (706.1 ± 199 U/L). Increase in the LDH level was also noted with increased duration and frequency of the habit. Conclusion LDH can potentially be used as a promising biomarker in the very early stages of progression toward oral cancer caused by tobacco use.

Application of cone beam computed tomography in facial soft tissue thickness measurements for craniofacial reconstruction.

CONTEXT: The paradigm shift from two- to three-dimensional imaging has marked the beginning of a new era in diagnosis. Newly developed cone-beam computed tomography (CBCT) designed specifically to visualize maxillofacial pathologies is being used in forensic investigations also. Facial reconstruction is a specialized forensic technique to identify the deceased from the unknown skull. It is dependent on population-specific facial soft tissue thicknesses. AIMS: This study aims to propose the mean dataset of facial soft tissue thickness for South Indian population by utilizing CBCT. It also aims to evaluate the sex and racial differences in the values if any. SETTINGS AND DESIGN: This descriptive study was conducted on CBCT scans of South Indians. MATERIALS AND METHODS: Eighty CBCT scans of South Indian adults aged 18-80 years were selected. Facial soft tissue thickness measurements at 34 craniometric landmarks were carried out. STATISTICAL ANALYSIS: Descriptive statistics was done. Student's t-test estimated the differences of soft tissue thickness between the sexes; bilateral measurements and also racial differences. Tukey's honest significant difference test was used for multiple comparisons among Indian studies. RESULTS: Males had thicker soft tissue than females in most of the landmarks. Differences in the bilateral soft tissue thicknesses were negligible. Indians had thicker facial tissues than the Koreans and CBCT was found efficient in measuring soft tissue thickness. CONCLUSION: The present study provides facial soft tissue thickness dataset using CBCT which will be useful in forensic facial reconstructions of South Indian population as well as in maxillofacial and plastic reconstructive surgeries.

Momentousness of the Mental Loop: A Comparative Study.

BACKGROUND AND PURPOSE: To assess the anterior (aAL) and caudal (cAL) extensions of Anterior loop (AL) of Inferior alveolar nerve (IAN) using Digital Panoramic (DP) and Cone Beam Computed Tomography (CBCT) for its presence and dimensions in various age groups, genders, right and left sides of the mandible and between dentulous and edentulous patients. METHODS: A 1-year retrospective comparative study between DP and CBCT to assess the extensions of AL of IAN was conducted on individuals referred to a private imaging center located in Bengaluru, South India. 360 mandibular sites were examined using DP and CBCT to assess the presence and dimensions of AL. RESULTS: Results showed higher frequency of AL in CBCT compared to DP. Also there was a decreasing frequency of AL with increasing age and an insignificant difference in frequency between males and females. Bilateral looping was most common, aAL was more frequent on the left side and cAL on the right of the mandible. Statistically higher frequency in dentate group compared to edentulous. A decreasing mean value with increasing age and higher mean values in CBCT than DP. No significant difference in mean values among males and females or between the dentulous and edentulous groups. Higher mean values in CBCT compared to DP on the left side of the mandible compared to the right. CONCLUSION: Choosing mental foramen as reference for termination of IAN could result in injury to AL; low sensitivity and specificity of DP compared to CBCT in assessing frequency and extent of AL underlines its inadequacy, while CBCT can be performed with comparable resolution, to accurately analyze AL.

Assessment of serum copper, iron and immune complexes in potentially malignant disorders and oral cancer.

Potentially malignant disorders (PMDs) of oral cavity and oral cancer remain a cause of serious concern despite intensive research and development. Diet and immunity have been identified to play a crucial role as modifying factors in these diseases. Our study intended to explore this relationship by estimating and comparing the serum levels of copper, iron and circulating immune complexes (CICs) in patients diagnosed with PMDs and oral cancer and normal healthy individuals. In this study, 40 histopathologically diagnosed cases of PMDs and oral cancer were included along with 30 healthy controls and 5 ml of venous blood was drawn using venipuncture. Serum estimation of copper, iron and CIC then followed using the colorimetric and spectrophotometric methods. The data obtained was subjected to statistical analysis using one way ANOVA and Pearson's Product-Moment Correlation Test. The mean serum copper level was measured as 138.98 ± 10.13µg/100ml in the PMD group and 141.99 ± 21.44 µg/100ml in the oral cancer as compared to 105.5 + 18.81µ/100ml in the controls. The mean serum CIC levels was highest in the oral cancer (9.65 ± 0.16OD470) followed by the PMD group (0.18 + 0.21 OD470) and least in the control group (0.048 ± 0.02OD470). Whereas, the serum levels of iron showed a significant decrease in the PMD group (110.9 ± 10.54 µg/100ml) and the oral cancer group (114.29 ± 25.83 µg/100ml) as compared with the control group (136.85 ± 14.48 µg/100ml). There was no positive correlation obtained between the three groups with respect to the chosen parameters indicating that the variables were independent of each other. It can be thus be ascertained that trace elements like copper and iron as well as humoral responses (CICs) have a close relationship with PMDs and oral cancers.

Assessment of serum copper, iron and immune complexes in potentially malignant disorders and oral cancer

Abstract Potentially malignant disorders (PMDs) of oral cavity and oral cancer remain a cause of serious concern despite intensive research and development. Diet and immunity have been identified to play a crucial role as modifying factors in these diseases. Our study intended to explore this relationship by estimating and comparing the serum levels of copper, iron and circulating immune complexes (CICs) in patients diagnosed with PMDs and oral cancer and normal healthy individuals. In this study, 40 histopathologically diagnosed cases of PMDs and oral cancer were included along with 30 healthy controls and 5 ml of venous blood was drawn using venipuncture. Serum estimation of copper, iron and CIC then followed using the colorimetric and spectrophotometric methods. The data obtained was subjected to statistical analysis using one way ANOVA and Pearson's Product-Moment Correlation Test. The mean serum copper level was measured as 138.98 ± 10.13µg/100ml in the PMD group and 141.99 ± 21.44 µg/100ml in the oral cancer as compared to 105.5 + 18.81µ/100ml in the controls. The mean serum CIC levels was highest in the oral cancer (9.65 ± 0.16OD470) followed by the PMD group (0.18 + 0.21 OD470) and least in the control group (0.048 ± 0.02OD470). Whereas, the serum levels of iron showed a significant decrease in the PMD group (110.9 ± 10.54 µg/100ml) and the oral cancer group (114.29 ± 25.83 µg/100ml) as compared with the control group (136.85 ± 14.48 µg/100ml). There was no positive correlation obtained between the three groups with respect to the chosen parameters indicating that the variables were independent of each other. It can be thus be ascertained that trace elements like copper and iron as well as humoral responses (CICs) have a close relationship with PMDs and oral cancers.

Salivary IgG assay to detect Helicobacter pylori infection in an Indian adult population.

BACKGROUND: Helicobacter pylori infection, the commonest chronic bacterial infection in humans, causes chronic gastritis, peptic ulcer, and possibly gastric carcinoma and lymphoma. Recently, investigators have focused on its role in the development of extra-gastrointestinal diseases with oral manifestations. H. pylori infection can be diagnosed by various methods. Of late, H. pylori IgG antibodies have been detected in saliva using enzyme-linked immunosorbent assay (ELISA). However, local validation of serological test is needed before implementing a test in different populations. AIMS: To detect anti H. pylori specific immunoglobulin G (IgG) antibodies in saliva of adult patients with gastrointestinal symptoms by ELISA, to diagnose H. pylori infection in such patients by histopathology, and to evaluate the diagnostic accuracy of the immunoassay as compared to histopathologic diagnosis. METHODS: The study included 40 adult patients with gastrointestinal symptoms suggestive of peptic ulcer disease. Saliva samples were analyzed for anti H. pylori IgG using EIAgen H. pylori IgG kit. Histopathologic diagnosis using gastric biopsy samples was the gold standard. RESULTS: The sensitivity and specificity of the test were 79.31% and 63.64%, respectively. The positive and negative predictive values were 85.19% and 53.85%, respectively. The accuracy of EIAgen H. pylori IgG kit for salivary detection of anti H. pylori IgG antibodies was found to be 75%. CONCLUSION: EIAgen H. pylori IgG assay is a noninvasive, moderately accurate, and sensitive method for the detection of H. pylori infection in saliva. Salivary anti H. pylori IgG test prior to endoscopy is a useful screening test for seroepidemiological studies.