Development of field cancerization in the clinically normal oral mucosa of shisha smokers.

OBJECTIVES: This study aimed to investigate the changes that occur in the oral mucosa of shisha smokers and compare them to cigarette smokers, nonsmokers and smokers of both shisha and cigarettes and to detect whether these changes could be detected biochemically in saliva. METHODS: Four groups of subjects were included in our study (16 in each group); cigarette smokers, shisha smokers, nonsmokers and smokers of both. A salivary sample and a mucosal biopsy were obtained from each subject. Salivary detection of CYFRA 21-1 was performed on each salivary sample. The mucosal biopsy was examined by routine H&E techniques. Furthermore, immunohistochemical expression of p53 was studied in all cases. RESULTS: A statistically significant difference in p53 expression was present between nonsmokers and the three smoker groups. However, no statistically significant variation was present between the 3 smoker groups. Furthermore, no statistically significant changes were found in the CYFRA 21-1 levels among the four groups. CONCLUSION: Shisha smoking has the same damaging effect on the oral mucosa as cigarette smoking. Furthermore, no correlation was detected between the histological findings and the salivary biomarker used (CYFRA 21-1).

Comparative study between laser and conventional techniques for class V cavity preparation in gamma-irradiated teeth (in vitro study).

OBJECTIVE: The purpose of this study was to compare laser with conventional techniques in class V cavity preparation in gamma-irradiated teeth. METHODS: Forty extracted human teeth with no carious lesions were used for this study and were divided into two main groups: Group I (n = 20) was not subjected to gamma radiation (control) and Group II (n=20) was subjected to gamma radiation of 60 Gray. Standard class V preparation was performed in buccal and lingual sides of each tooth in both groups. Buccal surfaces were prepared by the Er,Cr:YSGG laser (Waterlase iPlus) 2780 nm, using the gold handpiece with MZ10 Tip in non-contact and the "H" mode, following parameters of cavity preparation - power 6 W, frequency 50 Hz, 90% water and 70% air, then shifting to surface treatment laser parameters - power 4.5 W, frequency 50 Hz, 80% water and 50% air. Lingual surfaces were prepared by the conventional high-speed turbine using round diamond bur. Teeth were then sectioned mesio-distally, resulting in 80 specimens: 40 of which were buccal laser-treated (20 control and 20 gamma-irradiated specimens) and 40 were lingual conventional high-speed bur specimens (20 control and 20 gamma-irradiated specimens). RESULTS: Microleakage analysis revealed higher scores in both gamma groups compared with control groups. Chi-square test revealed no significant difference between both control groups and gamma groups (p=1, 0.819, respectively). A significant difference was revealed between all 4 groups (p=0.00018). CONCLUSION: Both laser and conventional high-speed turbine bur show good bond strength in control (non-gamma) group, while microleakage is evident in gamma group, indicating that gamma radiation had a dramatic negative effect on the bond strength in both laser and bur-treated teeth.

Comparative study between laser and conventional techniques for class V cavity preparation in gamma-irradiated teeth (in vitro study)

Abstract Objective: The purpose of this study was to compare laser with conventional techniques in class V cavity preparation in gamma-irradiated teeth. Methods: Forty extracted human teeth with no carious lesions were used for this study and were divided into two main groups: Group I (n = 20) was not subjected to gamma radiation (control) and Group II (n=20) was subjected to gamma radiation of 60 Gray. Standard class V preparation was performed in buccal and lingual sides of each tooth in both groups. Buccal surfaces were prepared by the Er,Cr:YSGG laser (Waterlase iPlus) 2780 nm, using the gold handpiece with MZ10 Tip in non-contact and the "H" mode, following parameters of cavity preparation - power 6 W, frequency 50 Hz, 90% water and 70% air, then shifting to surface treatment laser parameters - power 4.5 W, frequency 50 Hz, 80% water and 50% air. Lingual surfaces were prepared by the conventional high-speed turbine using round diamond bur. Teeth were then sectioned mesio-distally, resulting in 80 specimens: 40 of which were buccal laser-treated (20 control and 20 gamma-irradiated specimens) and 40 were lingual conventional high-speed bur specimens (20 control and 20 gamma-irradiated specimens). Results: Microleakage analysis revealed higher scores in both gamma groups compared with control groups. Chi-square test revealed no significant difference between both control groups and gamma groups (p=1, 0.819, respectively). A significant difference was revealed between all 4 groups (p=0.00018). Conclusion: Both laser and conventional high-speed turbine bur show good bond strength in control (non-gamma) group, while microleakage is evident in gamma group, indicating that gamma radiation had a dramatic negative effect on the bond strength in both laser and bur-treated teeth.

Lymphangiogenesis in Oral Squamous Cell Carcinoma: Correlation with VEGF-C Expression and Lymph Node Metastasis.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy that preferentially spreads to the cervical lymph node which, when involved, complicates the anticancer therapy and threatens the patient life. It was suggested that lymph node metastasis may be facilitated by lymphangiogenesis. VEGF-C is one of the most important lymphangiogenic inducers that promotes the lymphatic vessels growth and supports the survival of adult lymphatic endothelial cells. METHODS: Lymphatic vessels density (LVD) and LV morphometry were digitally evaluated using D2-40. The expression of VEGF-C was also assessed using immunohistochemistry and real-time polymerase chain reaction in 6 normal oral mucosa cases and 72 cases of OSCC. The correlation between LVD and LV morphometry, VEGF-C, and lymph node metastasis was statistically assessed. RESULTS: A positive cytoplasmic expression of VEGF-C was detected in both epithelial and connective tissue cells in 97% of OSCC, while all normal tissues reacted negatively. A greater expression of VEGF-C was associated with larger and more dilated LV and lymph node metastasis but not with LVD. CONCLUSION: VEGF-C is actively involved in the invasion and metastasis of OSCC via inducing morphological changes in LV. VEGF-C may be a promising target for anticancer therapy.

Assessment of the effect of low-energy diode laser irradiation on gamma irradiated rats' mandibles.

OBJECTIVE: The purpose of the present study was to evaluate the biostimulative and regenerative effects of low intensity laser irradiation (LILT) (applied before or after initiation of radiotherapy) on gamma irradiated rats' jaw bones. METHODS: Forty eight male Albino rats were equally divided into two groups: group 1, in which the left side of the mandible was subjected to three successive sessions of laser (LILT) prior to whole body gamma radiation (2Gy/3 fractions/week) and group 2, received whole body gamma radiation (2Gy/3 fractions/week) prior to three successive sessions of laser applied to left side. The right side of both groups was used as gamma irradiated non-lased control group. Each group was then subdivided into four equal subgroups (a, b, c, d) according to the time of scarification (3, 7, 14, 21 days respectively). Specimens were subjected to histological, histomorphometric and scanning electron microscopic examinations. RESULTS: Thin irregular bone trabeculae and widened marrow spaces were identified in the control group. The lased sides of groups 1 and 2 demonstrated regular, thick and continuous bone trabeculae. Ultrastructurally, collagen fibres of the control group appeared irregularly arranged and more spaced compared to groups 1 and 2. Normal-sized osteocytic lacunae were seen in the lased groups, as compared to the wide lacunar spaces noted in the control group. Histomorphometric analysis showed a significant increase in the area of bone trabeculae, as well as the width of compact bone, for the lased groups. CONCLUSIONS: LILT seemed to attenuate the radiation-related damage in alveolar bones.

Association of macrophages with angiogenesis in oral verrucous and squamous cell carcinomas.

BACKGROUND: Tumor-associated macrophages (TAMs) are a major cellular component of human cancers, yet there is still no consensus as to their role in cancer growth and angiogenesis. METHODS: The association between TAMs and angiogenesis was investigated in formalin-fixed, paraffin-embedded archival material of oral squamous cell carcinoma (OSCC) and oral verrucous carcinoma (OVC). TAMs shown by immunohistochemistry for CD68 and microvessels demonstrated by immunohistochemistry for CD31 were quantified using an image analyzer computer system. RESULTS: TAMs were observed in all studied specimens. The area percentage of CD68 immunoreactivity and microvessel density (MVD) were significantly lower in OVC compared with the different grades of OSCC (P = 0.0009), (P = 0.0045). Both parameters increased in high-grade malignancy of OSCC. Linear regression analysis revealed a positive correlation between the area percentage of CD68 immunoreactivity and the MVD in the studied tumors. CONCLUSIONS: Increased TAMs is associated with angiogenesis and higher histopathological grades in oral cancer.

Ultrastructural and histomorphometric alterations of rat jaw bones after experimental induction of lathyrism.

OBJECTIVE: The aim of this study was to investigate the effect of beta-aminopropionitrile (beta-APN), present in Lathyrus sativus (L. sativus) seeds consumed in drought prone areas, on the maxillary and mandibular bones of rats. DESIGN: Eighteen rats were used; they were divided into experimental group (12 rats) and a control group (6 rats). In the experimental group, lathyrism was induced by a once daily subcutaneous administration of beta-APN at a dose of 5mg in 0.4ml distilled water per 100g of body weight for 40 days. The specimens were examined histologically, histomorphometrically and ultrastructurally. RESULTS: Histopathological examination of lathyritic rats showed that both mandible and maxillae were significantly affected. Irregular bone trabeculae with wide medullary cavities and abundant marrow spaces were observed. Focal resorptive areas lined with osteoclasts were also present. Histomorphometric analysis showed a decrease in the area percentage of bone in lathyritic rats as compared to the control. This decrease was statistically significant only in the mandible (p=0.018). Moreover, a significant increase in the number of osteoclasts (p=0.014, 0.012) and resorptive bays (p=0.013, 0.002) was detected in the maxillae and mandible of the experimental group, respectively. Ultrastructurally, there was a significant difference in the microarchitecture of the collagen fibres in lathyritic rats compared to the control. The collagen fibres in the lathyritic group appeared disorganized, fewer in number and more spaced. CONCLUSIONS: This study provided evidence for lathyritic disturbances in bone architecture. These disturbances are likely to affect mineralization and bone strength as well.