PDCD4 and MIR-21 are promising biomarkers in the follow-up of OED in liquid biopsies.

This research aims to examine the impact of programmed cell death 4 (PDCD4), microRNA-21 (miR-21) and microRNA-208a (miR-208a) transcripts, and protein levels on oral epithelial dysplasia (OED) development in oral squamous cell carcinoma (OSCC). METHODS: The research investigation involved the collection of saliva, blood, and tissue samples from a total of 20 patients diagnosed with OSCC, 15 patients diagnosed with OED, and 15 healthy individuals. PDCD4, miR-21, and miR-208a expression was performed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). PDCD4 protein levels were assessed using enzyme-linked immunosorbent assay (ELISA) in both saliva and blood samples. For statistical analysis, the Kruskal-Wallis test and the Spearmen rank test were utilised. RESULTS: PDCD4 expression levels were considerably lower in patients with OSCC and OED (p < 0.05) in three biological samples. In contrast, miR-21 expression was higher in OED and OSCC patients. Patients with low PDCD4 mRNA levels and strong miR-21 expression had a significant connection (p < 0.05) with tumor size and depth. CONCLUSIONS: Examining PDCD4 and miR-21 transcript levels may help detect the transition from OED to OSCC. This work suggests that PDCD4 and miR-21 expression levels in liquid biopsies may be biomarkers for OED monitoring in the future.

Assessment of Relationship between Hemodynamic Changes and Anxiety in Patients During Lower Third Molar Surgery.

OBJECTIVE: To investigate the relationship between anxiety and hemodynamic changes in patients who have undergone impacted third molar surgery under local anaesthesia. STUDY DESIGN: Observational clinical study. PLACE AND DURATION OF STUDY: Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey, from January 2018 to December 2019. METHODOLOGY: Normotensive patients aged over 18 years, not using antidepressant medicine and ASA I included. A total of 83 patients were monitored and operated on for impacted third molar surgery. Blood pressure, pulse, and oxygen saturation values of the patients were noted at eight different stages during the surgery. Only the mesioangular impacted lower third molars of the patients were removed by a surgical operation. STAI forms were given before the operation. RESULTS: There is a significant difference between values of blood pressure, pulse, and oxygen saturation and gender (p<0.05). However, there was found to be an increased blood pressure in male patients while an increase in pulse and oxygen saturation was observed in female patients (p<0.05). CONCLUSION: Male patients were more concerned than female patients by having higher blood pressure which may cause longer postoperative bleeding. KEY WORDS: Anxiety, Impacted third molars, Dental surgery, Hemodynamic changes.

Evaluation of the Efficacy of Different Concentrations of Dextrose Prolotherapy in Temporomandibular Joint Hypermobility Treatment.

PURPOSE: The aim of this study was to compare and evaluate the efficacy of different concentrations of dextrose prolotherapy for the treatment of temporomandibular joint (TMJ) hypermobility. PATIENTS AND METHODS: A prospective, randomized clinical trial including patients with subluxation or dislocation was performed. The study comprised 40 patients. Patients were randomly divided into 4 groups: control group, 10% dextrose, 20% dextrose, and 30% dextrose group. Patients in all groups received injections into 4 different areas of each TMJ in 4 sessions at monthly intervals. Visual analog scale of TMJ pain intensity, maximum mouth opening (MMO), joint sounds, and frequency of luxations were recorded preoperatively and postoperatively after 1 month of last injection. The collected data were then statistically analyzed. RESULTS: Each group showed postoperatively significant improvement in TMJ pain, significant decrease in both MMO and joint sound. Besides that, TMJ locking was not observed in any patient during the follow-up period. There were no statistically significant differences throughout the study intervals between the groups. CONCLUSION: It was concluded that there was no significant difference between control group and dextrose groups and there is no superiority of any concentration of dextrose over the others in TMJ prolotherapy, and all treatment procedures were efficient in improvement of clinical symptoms related to TMJ hypermobility. If dextrose is used as a proliferant, it can be said that 10% dextrose can be sufficient in TMJ hypermobility treatment.

Does laterally rotated flap design influence the short-term periodontal status of second molars and postoperative discomfort after partially impacted third molar surgery?

PURPOSE: To assess the influence of the surgical removal of partially impacted third molars (3Ms) and compare the effects of a 3-cornered laterally rotated flap (LRF) with primary closure (flap 1) and an envelope flap with secondary closure (flap 2) on the short-term periodontal status of the adjacent second molars (2Ms). We also assessed the postoperative complications after removal of the partially impacted 3M. MATERIALS AND METHODS: A split mouth, randomized clinical study was designed. The study sample included patients with bilateral partially impacted 3Ms. The primary predictor variable was the type of flap design (flaps 1 and 2). The primary outcome variable was periodontal status (gingival recession [GR], probing depth [PD], plaque index [PI], and gingival index) of the 2Ms measured preoperatively and 90 days postoperatively. The secondary outcome variables were postoperative complications, including pain, facial swelling, alveolitis, and local wound infection. The other variables included gender, position of the 3Ms, and surgical difficulty. We performed descriptive, comparative, correlation, and multivariate analyses. RESULTS: The sample included 28 patients aged 18 to 28 years. The GR, PD, and PI values with the flap 2 design were greater than those with the flap 1 design (P < .05). Facial swelling with the flap 1 design was significantly greater than with the flap 2 design on the second postoperative day (P < .05). The pain levels with the flap 1 design were significantly greater than those with the flap 2 design on the first and second postoperative days (P < .05). According to the multivariate regression analyses, flap design was closely related to the periodontal status of the 2Ms and postoperative discomfort. CONCLUSION: The results of the present clinical study have shown that the flap design in partially impacted 3M surgery considerably influences the early periodontal health of the 2Ms and postoperative discomfort. However, although the 3-cornered LRF design might cause more pain and swelling, it could be the method of choice for partially impacted 3M surgery because of the early periodontal healing.

Impact of chlorhexidine mouth rinse use on postextraction infection via nitric oxide pathway.

OBJECTIVE AND DESIGN: Nitric oxide (NO) has been linked to inflammatory reactions, tissue destruction, host defense, and wound healing in oral diseases. It is known that arginase enzyme controls the synthesis of NO through arginine depletion. This study evaluated the arginase-NO pathway alteration in response to tissue injury after dental extraction surgery and the effect of postoperative use of 0.2% chlorhexidine gluconate rinse (CHX). MATERIALS AND METHODS: This study included 28 individuals who had impacted mandibular third molars. They were randomly divided into two groups. Group A was comprised of 13 individuals who used postoperative CHX (0.2%) rinse, while group B included 15 individuals who did not use postoperative CHX rinse. For each patient, periodontal inflammatory status was evaluated. Salivary and gingival tissue samples were obtained before and 1 h and 1 week after the surgery to determine the NO level and arginase activity using spectrophotometric methods. RESULTS: NO level of tissue samples displayed an insignificant decrease in both groups postoperatively. However, arginase activity of tissue samples was significantly higher in group B compared to group A 1 week after surgery (p

MAGE-A as a novel approach in the diagnostic accuracy of oral squamous cell cancer: a case report.

BACKGROUND: The aim of this case report is to introduce the combined use of brush biopsy and measurement of MAGE-A expression in the diagnosis of oral squamous cell carcinoma (OSCC). CASE REPORT: We report of a 49-year old male patient who was referred to our department with a persistent-suspicious looking leukoplakia. Brush biopsy and an incisional biopsy were performed following clinical diagnosis. Histopathological examination revealed no malignancy. Expression analysis of melanoma-associated antigens A (MAGE-A) using real time RT-PCR was applied to brush biopsy materials because of the high prevalence of MAGE-A determined previously in OSCC's. Results indicated significant MAGE-A3 and A4 expression pattern. Therefore, the lesion was excised completely and an early invasive carcinoma was identified. CONCLUSION: These results emphasize the role of brush biopsy using a tumor marker with a high expression frequency combined with a high sensitive and high specific detection system in the early diagnosis of OSCC, particularly in widespread leukoplakias.

A novel multiple-marker method for the early diagnosis of oral squamous cell carcinoma.

OBJECTIVE: Melanoma associated antigens-A (MAGE-A) expression is highly specific to cancer cells. Thus, they can be the most suitable targets for the diagnosis of malignancy. The aim of this study was to evaluate the sensitivity of multiple MAGE-A expression analysis for the diagnosis of oral squamous cell carcinoma (OSCC). METHODS: Total of 70 OSSC and 20 normal oral mucosal (NOM) samples of otherwise healthy volunteers were examined for the expression of 10 different single antigens out of 12 different MAGE-A subtypes by highly sensitive reverse transcriptase polymerase chain reaction (RT-PCR) methods. The results were correlated to clinicopathological parameters of tumor samples. RESULTS: Expression of MAGE-A was restricted to OSCC. The expression frequency of single antigen was between 10% and 55%. However, expression rate was increased up to 93% by the elevated number of genes examined. A significant correlation was found between the expression of MAGE-A and malignancy (p = 0.0001). In addition, multiple MAGE-A detection has also correlated to the incidence of lymph node metastasis, grading and advanced clinical stages. CONCLUSIONS: Analysis of multiple MAGE-A expression is more sensitive than the analysis of a single MAGE-A for the diagnostic evaluation of OSCC. Multiple MAGE-A expression analysis may be a very sensitive method to be used for the diagnosis even in the early stage of OSCC.

Diagnostic and therapeutic relevance of NY-ESO-1 expression in oral squamous cell carcinoma.

BACKGROUND: Cancer/testis antigen 1B (NY-ESO-1) is exclusively expressed in various types of tumor but not in healthy normal tissue, except testis, and induces strong cellular and humoral immune responses. Therefore, it represents an ideal target for diagnostic and immunotherapeutic applications. The aim of the study was to investigate the expression of NY-ESO-1 in oral squamous cell carcinoma (OSCC) to determine its impact as a diagnostic parameter or a therapeutic target for oral cancer. PATIENTS AND METHODS: A total of 65 OSCC and 20 normal oral mucosal samples of otherwise healthy volunteers were included in this study. Expression of NY-ESO-1 was determined using reverse transcriptase polymerase chain reaction (RT-PCR). The results were correlated to diagnosis and clinicopathological parameters. RESULTS: NY-ESO-1 was expressed in 27.7% of the investigated tumor samples, but not in normal oral mucosal. The correlation between NY-ESO-1 expression and malignancy was significant (p=0.008). The prevalence of NY-ESO-1 expression was significantly associated with tumor size (p=0.033), but not with histological grading, positive lymph node status or clinical stage of disease. CONCLUSION: NY-ESO-1 expression is restricted to OSCC, clearly indicating malignancy. However, the expression rate of this antigen is too low for clinical application but it might be a useful additional biomarker within a multiple marker system for the diagnosis of OSCC. In addition, NY-ESO-1 might be a candidate for immunotherapy and polyvaccination in patients suffering from OSCC.

Early findings of a novel established molecular diagnostic technique for the prediction of malignant transformation in leukoplakia.

To date, there are no objective parameters regarding the early prediction of malignant transformation in leukoplakia. Expression analysis of melanoma-associated antigens (MAGE-A) can differentiate between healthy and already malignant transformed tissues. Thus, expression analysis may also be used as an additional diagnostic tool for oral pre-malignant lesions to monitor potential malignant changes. In this study, four specimens collected from the same patient within a year were examined. Specimens were taken from the part of the lesion that displayed a rapid progression from fibroma to oral squamous cell carcinoma (OSCC). Clinically and histopathologically, the oral lesion was first diagnosed as fibroma with inflammatory infiltration, then as leukoplakia with hyperplasia, then as leukoplakia with severe dysplasia, and lastly as OSCC. Expression of MAGE-A1, -A3, -A4, -A6, -A10 and -A12 was investigated in the frozen tissue specimens using RT-PCR and quantitative real-time RT-PCR. There was no expression of MAGE-A in the specimen of fibroma with inflammatory infiltration. However, four genes were expressed by the second specimen of leukoplakia with hyperplasia. With the exception of MAGE-A1, all antigens were expressed in the specimens, which were histopathologically diagnosed as leukoplakia with severe dysplasia and OSCC. Expression analysis of six different MAGE-A genes indicated a high potential for malignant change in the specimens diagnosed as leukoplakia that eventually developed into OSCC. Thus, analysis of MAGE-A expression can predict malignant transformation in leukoplakia.

Expression of melanoma-associated antigens in oral squamous cell carcinoma.

BACKGROUND: Melanoma-associated antigens-A (MAGE-A) are expressed in a variety of tumors but not in normal tissues. Thus, their detection is highly specific to cancer cells, which makes them potential targets for the diagnosis, prognosis and also immunotherapy of neoplastic diseases. METHODS: To determine the expression pattern and potential role of MAGE-A antigens in oral squamous cell carcinoma (OSCC), expression patterns of MAGE-A1-A6 and A12 were analyzed in 55 OSCC and 20 healthy oral mucosa using high-sensitive reverse transcription-nested polymerase chain reaction (RT-nPCR). RESULTS: The 85.45% of tumor specimens expressed at least one of these genes. A significant correlation between the expression of MAGE-A1-A6 and A12 and malignancy was ascertained (P = 0.0001). On the contrary, none of the normal mucosal specimens expressed one of the MAGE-A subtypes. Antigen expression did not correlate with clinicopathological parameters, such as TNM classification, grading and clinical stage of OSCC. CONCLUSIONS: Multiple simultaneous detection of MAGE-A1-A6 and A12 expression has been found to be more specific and sensitive than the detection of single MAGE-A antigen for the diagnostic and prognostic evaluation of OSCC. In addition, monitoring the expression of several MAGE-A subtypes may determine suitable immunotherapeutic targets. Subsequently, coexpressed genes may be warranted for developing polyvalent vaccines.

Expression of MAGE-A12 in oral squamous cell carcinoma.

Melanoma associated-A antigens (MAGE-A) are silent in normal tissues except testis. However, they are activated ina variety of different tumors. Thus, their expression is highly specific to cancer cells. Reverse transcription-nested polymerase chain reaction (RT-nPCR) is a highly sensitive technique that has been used successfully for the detection of MAGE genes in tissue samples. The aim of the study is to analyze the expression rate of MAGE-A12 in oral squamous cell carcinoma (OSCC) using a high sensitive RT-nPCR. Total of 57 tissue samples obtained from patients with OSCC and 20 normal oral mucosal (NOM) probes of otherwise healthy volunteers were included to this study. No expression of MAGE-A12 was observed in the non-neoplasticNOM tissues. MAGE-A12 was expressed in 49.1% of the investigated tumor samples. The correlation between malignant lesion and MAGE-A12 detection was significant (p<0.001). It is concluded that results of this study may indicate MAGE-A12 asa useful additional diagnostic marker especially for the early detection of OSCC distinguishing neoplastic transformation and detection of occult and/or rare disseminated cancer cells. In addition, MAGE-A12 expression in OSCC may also determine anew immunotherapeutic target and might be warranted to develop vaccine for OSCC

An unusual presentation of ossifying fibromyxoid tumor of the mandible: a case report.

A 13-year-old boy who complained rapid swelling on the left side of mandible is presented. Histopathological examination revealed ossifying fibromyxoid tumor (OFMT). OFMT is a rare soft-tissue neoplasm that occurs usually in the subcutaneous tissue of the extremties. Head and neck involvement is relatively rare. In this case, we present the diagnosis, surgical treatment and long-term follow-up of an OFMT due to its unusual site of occurrence. The precise clinical behavior of atypical and malignant types of OFMTs is still unclear. Thus, histopathology report is important, leading surgeon to decide how often and how long to follow-up patient with OFMT.

The effect of dental profile on daily functions of the elderly.

The aim of the study was to evaluate statistically dentition and its effect on daily functions for a group of elderly volunteers. The study was conducted on 144 elderly people (86 males, 58 females) living in different nursing homes in Ankara, Turkey. Their ages varied between 60 and 100 years. Data assessed as dentition variables were number of teeth remaining and prosthesis use. Nearly 55% of the residents were edentulous and removable prosthesis users. The mean number of remaining teeth in subjects aged 60-69 was highest for all age groups in both sexes. The level of education and dental insurance of these subjects were also correlated with the dentition of elderly subjects. We found a statistically significant increase in the number of removable prosthesis users among educated and insured subjects. Functional capacity was better when the subjects had more remaining teeth or a removable prostheses. It is revealed by this study that healthy and good dentition prevents the decline of daily function and improves the social interaction and general well being of the elderly.

The early tissue response to titanium and LactoSorb screws.

Fractures of the maxillofacial region are common in the elderly people. Titanium and LactoSorb screws are the widely accepted materials for use in the maxillofacial fractures. This study was undertaken to evaluate the early tissue response following the insertion of both titanium and LactoSorb screws composed of 82% PLLA and 18% PGA in an elderly animal model. In this study, 22 titanium and 22 LactoSorb screws were applied to calvaria of 44 guinea pigs that were 10-11 months old. Animals were sacrificed on postoperative days 3, 7, 14, 30 and 60. Screws were retrieved with surrounding bone tissue and the specimens were prepared for routine histologic examination. All the specimens were evaluated by light microscopy. Histometric analysis revealed that there was no significant difference between LactoSorb and titanium screws for the new bone formation. The biodegradation of LactoSorb screws was not complete by the end of day 60. In conclusion, both materials were well tolerated and induced bone formation without causing adverse tissue response in an elderly animal model. Our results suggest that both LactoSorb and titanium miniplates and screws can be used safely, regardless of the increasing age. However, LactoSorb may be the first choice as it does not require a second operation for removal and has late biodegradation in elderly that keeps its support for a relatively longer time during fracture healing.

Histological evaluation of changes in the temporomandibular joint after direct and indirect trauma: an experimental study.

Direct or indirect trauma to the temporomandibular joint (TMJ) may cause several injuries such as fibrous adhesion, ankylosis and fracture. The aim of this study was to examine and compare the histological changes of TMJ and adjacent soft tissue after direct or indirect trauma to TMJ. In this study, a total of 35 healthy young adult guinea pigs were exposed to direct and indirect trauma to their TMJ, and histologic evaluation was done after 24 h, 7, 15 and 45 days. Hemorrhage was the most frequent complication, following that enlargement of the disc, adhesion of the disc to the condyle and fracture of the condyle were seen in both groups. There were regenerative changes in adjacent muscles of the TMJ in indirect trauma group when compared to direct trauma group. Regenerative changes were more obvious on days 15 and 45. As a result, it may be suggested that when a trauma comes to the maxillo-mandibular complex, even TMJ is indirectly affected, TMJ and its adjacent soft tissues should also be examined clinically and followed closely.

Patterns of third molar impaction in a group of volunteers in Turkey.

The aim of this study was to investigate the different variables in mesio-vertically positioned impacted or erupted third molars in a group of volunteers in Turkey to determine the angular changes and levels of eruption radiographically using standardised panoramic radiographs. There were 213 volunteers with impacted and erupted third molars included in this study, most of whom were dental students. Standardised panoramic radiographs were taken from all the volunteers. The radiographic parameters included angulation of tooth, level of eruption, development of root, mesiodistal crown width, retromolar space, and gonial angle. Statistical analysis was done using the t-test for independent groups. It was found that the mesiodistal angulation of third molars was significantly greater while the retromolar space of third molars was significantly smaller in the impacted group (P<0.05). There was also a significant difference in retromolar space/third molar crown width ratio (P<0.05).