Molecular targeted therapy, advanced treatment for cancers of the head-and-neck region: A systematic review.

Introduction: The foundation of oncology treatment as a single modality approach as well as the "multimodality" concept has been studied by statistical evaluation pre, during, and posttreatment to rule out their efficacy, expected prognosis, toxicity reactions, and overall survival for the patient. Such studies have also provided an appreciable amount of data for future custom utility. "Targeted therapy" is a cancer treatment that uses drugs but is different from traditional chemotherapy. It works by targeting cancer-specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. Researchers are developing drugs that target specific molecular changes. The drugs can block or turn off signals that tell cancer cells to grow and divide, keep cells from living longer than usual, and destroy the cancer cells. Aim: The aim of the study is to carry out a systematic review of clinical trials of molecular targeted therapy in the treatment of cancer. Objective: The objective of the study is to evaluate the efficacy of molecular targeted therapy in the treatment of head-and-neck cancers. Materials and Methods: A group of keywords was preselected to search for scientific articles on a web-based database of PubMed. Only completed randomized controlled trials published in the past 5 years in the English language were included with open access. All the selected articles were subjected to the Cochrane bias tool and PRISMA guidelines to extract results. Results: Among 4 studies specifying the progression-free survival (PFS) for comparing the groups treated either using targeted therapy or other modality/placebo, 50% of studies show a slight increase in PFS in the group treated with TT and other 50% show PFS increase in the non-TT group. Thus, insufficient evidence is furnished to provide a statement and acknowledged the expectancy of a disease-free period with or without the use of TT in the treatment of head-and-neck cancer. Conclusion: Considering very little information on enhanced effect and presence of evidence supporting an increased risk of adverse events, the addition of TT to treatment is a question to the dilemma. A systematic review intends advantageous in providing foresight for oncologists concerning patient assessment and evaluation to defend inclination proceeding toward the treatment defined.

Evaluation of total glutathione-s-transferase levels in serum of patients with oral malignancy.

Introduction: Squamous cell carcinoma-related antigen is not always sensitive enough for the early detection of oral cancer which is why a new marker has been desired as a substitute to be applied for serum diagnosis of oral cancer. Reactive oxygen species (ROS) has been known to play an important role in carcinogenesis. Glutathione-s-transferases (GSTs) are a family of eukaryotic and prokaryotic phase-II metabolic isoenzymes involved in xenobiotic detoxification. This correlation of the ROS species function and their role in initiation and progression of cancer could be exploited as of diagnostic value. The biologic function of the GSTs in human head-and-neck squamous cell carcinomas has been studied by researchers at gross as well as molecular levels. Taking into consideration this scientific background, future scope and perspectives, we initiated this study. Materials and Methods: This study was performed as a prospective case-control in vitro analytical study with subjects (n = 40) fulfilling the prerequisite conditions and were compliant. The case group (n = 20) was subjects with histopathologically proven cases of oral malignancy and age- and sex-matched control group (n = 20). The enzyme GST was evaluated in sera of all participants and then comparison was done between two groups as well as correlation with histopathologic grading for oral malignancy. Results: The mean serum GST activity in oral cancer patients was significantly higher than that of the control group. The present study has compared the alterations of enzyme in relation to histopathological grading of oral malignancy and found increased serum GST activity of well-differentiated and moderately differentiated carcinomas than the poorly differentiated carcinoma in terms of mean. Conclusion: Increased expression of the enzyme, as reported in the present study, can be due to tumor burden which attributes to overproduction of GST by cancer cells. The major clinical significance of the present study is that it gives important information regarding a new tumor progression and prognosis marker.

Comparative analysis of platelet-rich fibrin membrane and 0.2% hyaluronic acid gel on healing following gingival depigmentation procedure.

Introduction: Platelet-rich fibrin (PRF) accelerates wound healing by promoting faster cicatricial tissue remodeling and excellent neovascularization. Hyaluronic acid (HA) being biocompatible, anti-inflammatory, and proangiogenic leads to improvement in the rate of wound healing. Aim: The aim of this study was to compare the effect of PRF membrane and 0.2% HA gel on wounds after gingival depigmentation surgery. Materials and Methods: This study was carried out on 30 systemically healthy individuals recruited from the pool of patients who visited the department of periodontology. After depigmentation procedure in every patient, the sites were divided into three even groups. Group A received PRF membrane and periodontal dressing, Group B received 0.2% HA gel application and periodontal dressing, and Group C served as a control group in which only periodontal dressing was placed. The individuals were evaluated for the healing index (HI) and Numerical Rating Scale (NRS) on the 3rd and 5th day. Epithelialization test (ET) was performed on the 5th day. Gingival biotype was reassessed and compared to preoperative value after 3 months. The clinical trial was expressed in terms of mean and standard deviation. Intra-group comparison and inter-group comparison were done through the Kruskal-Wallis ANOVA test. All statistical tests were performed through SPSS version 25.0 (IBM). Results: The inter-group statistical analysis concerning NRS, HI, and ET showed statistically significant results in Groups A and B compared to Group C (P < 0.05), while gingival biotype showed statistically significant results in Group A compared to Groups B and C. Conclusion: The use of PRF membrane and HA gel to protect the raw wound site of depigmented gingiva proved to be an effective approach, resulting in faster healing.

Estimation of serum immunoglobulin G and immunoglobulin A levels in oral submucous fibrosis patients.

Background: Oral submucous fibrosis (OSMF) is a disabling, chronic, insidious potentially malignant condition of the oral cavity seen predominantly in the Indian subcontinent. Due to the idiopathic nature and various immunological changes seen in some OSMF patients, it can be considered an autoimmune disorder. Hyperimmunoglobulinemia is often seen with OSMF. Aim and Objectives: (i) To estimate the serum immunoglobulin G (IgG) and immunoglobulin A (IgA) levels in OSMF patients; (ii) to correlate the serum IgG and IgA levels with age and gender of OSMF patients; (iii) to correlate the serum IgG and IgA levels with clinical stages of OSMF; (iv) to correlate the serum IgG and IgA levels with the content of the habit in OSMF patients. Materials and Methods: Serum samples were collected from a total of 50 patients (25 OSMF cases and 25 controls) of both genders and IgG and IgA levels were estimated by NEPHELOMETRY. Results: As compared to the control group, the mean serum IgG level was marginally increased among the OSMF patients and the mean serum IgA level was marginally decreased among the OSMF patients, but this was not statistically significant. Furthermore, there was only a weak correlation between serum immunoglobulins and content of the habit and no significant correlation was found between the serum IgG and IgA levels and age and sex of the OSMF patients. Serum IgG was increased and IgA was decreased with increasing stages of OSMF. Conclusion: The results of the present study suggested that there is an alteration in serum immunoglobulin levels in OSMF patients as compared to the control group.

Assessment of Accessory Canals and Foramina in the Mandibular Arch Using Cone-Beam Computed Tomography and a New Classification for Mandibular Accessory Canals.

OBJECTIVES: The objectives of the study include the following: (i) to assess the presence of accessory canals and foramina in the body of the mandible using cone-beam computed tomography (CBCT), (ii) to evaluate the location, number, diameter, and length of accessory canals in the body of the mandible, and (iii) to propose a new classification for mandibular accessory canals based on the location. METHODS: A total of 50 (25 males and 25 females) CBCT scans were analyzed in three anatomical planes and three-dimensional (3D) reconstructions for the exact number, location, diameter, and accessory length canals and accessory foramina in the body of the mandible. The statistical analysis used was an independent t-test. RESULTS: Out of 50 CBCT scans, a total of 243 accessory canals and 245 accessory foramina were found. About 53% of accessory canals and foramina were found in males, while 47% were observed in females; 89% were evident in the anterior region, and only 11% were in the posterior region. The majority (64%) of the medial lingual canals had a diameter greater than or equal to 1 mm, while only 32% of accessory canals had a diameter of less than 1 mm (p < 0.05). The mean length of median lingual canals in females was 1.2910 ± 0.2582 mm and 2.6438 ± 0.5288 mm in male subjects. Mandibular accessory canals are classified broadly into anterior and posterior accessory canals, which have further subdivisions. CONCLUSION: CBCT plays a dynamic role in determining the mandible location of various neurovascular structures, including accessory canals and foramina. Female subjects were observed with more accessory canals and foramina and more common in the anterior region than in the posterior region.

Implementation of meta-analysis approach, comparing conventional radiotherapy, and proton beam therapy treating head and neck cancer.

INTRODUCTION: Radiation therapy is commonly used in the treatment of head and neck cancer in both the definitive and postoperative settings. Proton therapy, due to its intrinsic physical properties, has the ability to reduce the integral dose delivered to the patients while maintaining highly conformal target coverage. MATERIALS AND METHODS: .A literature search was performed on scientific databases, and Preferred Reporting Items for Meta-Analyses guidelines were followed to compute results. Only original studies were selected. Selected studies were used to extract some proposed data for comparison, dosimetry, site, complications, and survival. RESULTS: Proton beam therapy technology can be used against the conventional radiotherapy and shows satisfactory results. Yet conventional therapy is not less advantageous considering the amount of work available for any cross interpretations. CONCLUSION: Comparative preplanning could be beneficial considering multiple therapies for ruling out the best treatment outcomes that could be expected.

An institutional survey for knowledge-based and self-awareness assessment in temporomandibular joint disorders among dental students.

CONTEXT: Temporomandibular joint disorders (TMDs) have been recognized as one of the most common causes of nondental orofacial pain. Various studies have been reported in literature regarding the relationship between prevalence of signs and symptoms of TMDs and gender, suggestive of female predilection; however, none of the studies have yet been reported to suggest the relationship between knowledge about temporomandibular joint (TMJ) and TMDs and self-awareness of its signs and symptoms. AIM: To find a relationship between the level of knowledge about TMJ and TMDs and self-awareness of its signs and symptoms. SETTINGS AND DESIGN: This study was designed as an institutional survey. The study sample comprised 491 undergraduate and postgraduate (PG) students, consisting of 90 males and 401 females with age ranging between 18 and 32 years. SUBJECTS AND METHODS: Two sets of questionnaire were distributed among the students. STATISTICAL ANALYSIS USED: Statistical analysis was performed with the help of Epi Info (TM) 3.5.3, descriptive statistical analysis, test of proportion, Chi-square test, one-way analysis of variance, Tukey's test, and knowledge index. RESULTS: It was observed that there was a gradual increase in the level of knowledge about TMJ and TMDs and self-awareness of its signs and symptoms from the 1st year to PG students. CONCLUSIONS: A direct relationship exists between the level of knowledge about TMJ and TMDs and self-awareness of its signs and symptoms.

Peripheral ossifying fibroma: Series of five cases.

Peripheral ossifying fibroma (POF) is a reactive lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars. It originates from the cells of the periodontal ligament. The definitive diagnosis is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. Surgical excision is the treatment of choice, though the recurrence has been reported. We present a clinical, radiological and histological review of five cases of POF diagnosed and treated at our institute.

Achondroplasia with oligodontia: Report of a rare case.

Achondroplasia is considered as a form of skeletal dysplasia/dwarfism that manifests with stunted stature and disproportionate limb shortening. Achondroplasia is of special interest in the field of dentistry because of its characteristic craniofacial features. It has been considered as the most common short-limbed dwarfism syndrome. Very few authors have reported the presence of oligodontia in achondroplastic patients. The present paper reports a rare case of oligodontia in a young, female, achondroplastic patient.

Dentigerous cyst associated with an impacted mesiodens: report of 2 cases.

Dentigerous cysts are the most common developmental cysts of the jaws, most frequently associated with impacted mandibular third molar teeth. Dentigerous cysts around supernumerary teeth, however, account for 5% of all dentigerous cysts, with most developing around a mesiodens in the anterior maxilla. This report describes two cases of a dentigerous cyst associated with an impacted mesiodens. Both of the patients complained of swelling in the maxillary anterior region. Radiographic examination revealed an impacted mesiodens surrounded by a large corticated radiolucency in both cases. A provisional diagnosis of infected odontogenic cyst was made. The cysts were enucleated with the removal of the mesiodens in the two cases. Histopathological examination confirmed the diagnosis of infected dentigerous cyst associated with an impacted mesiodens in both cases. The patients remained asymptomatic, and no complications were noted.