Effectiveness of Injectable Platelet-Rich Fibrin in the Treatment of Oral Lichen Planus: A Systematic Review and Meta-Analysis.

Oral lichen planus (OLP) is a chronic inflammatory condition affecting the oral mucosa. The current review investigated the potential effectiveness of injectable platelet-rich fibrin (i-PRF) as a treatment for OLP when compared to other interventions. The current review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy was implemented across databases such as PubMed, Embase, Scopus, Web of Science, CINAHL, and Google Scholar. The search utilized a combination of Boolean operators (AND, OR) and Medical Subject Headings (MeSH) terms to capture relevant studies. Comparative clinical studies focusing on i-PRF as a treatment for OLP and other interventions were included. Outcomes assessed were pain, surface area of lesions, and patient satisfaction. Review Manager 5.4 was used for statistical analysis. The Risk of Bias 2.0 (RoB 2.0) tool was used to assess the methodological quality of the studies. Three studies were included for the final analysis. The findings indicated that both the i-PRF and comparison treatment groups demonstrated reductions in pain and lesion size. The post-treatment Visual Analogue Scale (VAS) scores showed a decrease in pain intensity, and there was an improvement in lesion extension in the i-PRF-treated sites. The results also revealed increased patient satisfaction with i-PRF treatment. Adverse effects were not reported or specified in the included studies. Quantitative analysis for pain (VAS) showed a mean difference of 0.38 (95% CI: 0.63-1.40), but there was no significant difference between the i-PRF and control groups at p=0.46. Though intragroup differences showed statistically significant differences between pre and post intervention, intergroup differences were not significant for any of the assessed outcomes. The findings from this study suggest that i-PRF holds promise as a potential treatment for OLP. The use of i-PRF resulted in pain reduction, lesion size improvement, and increased patient satisfaction. However, it is important to consider the limitations of the included studies, such as variability in study designs, small sample sizes, and the limited number of studies.

Comparison of Histological Changes in Tissue Specimens Kept in Tap Water, River Water and Seawater for Different Intervals of Time.

BACKGROUND: Forensic pathologists find it difficult to ascertain the actual reason for death and the actual mode of death in drowning cases. It is commonly acknowledged that not all people whose dead bodies are found in water perished from drowning. The medico-legal inquiry includes an important component that examines dead bodies collected from the water. The corpse's time in the water continues to be the main concern. This aids in determining the time of death, which is crucial to any medico-legal investigation. The traditional histological analysis of hematoxylin and eosin (H&E)-stained oral soft tissue can be crucial in the assessment of this feature. Hence, this study was done to compare histological changes in the tissue specimens kept in tap water, river water, and seawater for different intervals of time. MATERIALS AND METHODS: One hundred eighty specimens were obtained from 180 dead bodies and divided randomly into three categories. Category A consisted of 60 specimens submerged in tap water, Category B of 60 specimens submersed in river water, and Category C consisted of 60 specimens submerged in seawater. The specimens underwent routine histological processing and H&E staining. The microscopic evaluation of specimens was carried out at two hours and on the first, second, third, fourth, and fifth days of submersion. Details were recorded regarding the structural changes, cellular changes, connective tissue changes, changes in the basement membrane, and intensity of H&E staining. Once the process of routine histological processing and H&E staining was completed for each study specimen, an evaluation of microscopic changes in the tissue was made. RESULTS: The present study revealed that seawater preserved tissue best and for a longer period than river water and tap water. River water preserved tissue better than tap water. In pathologic tissue, details were preserved for much longer. It was noted that in squamous cell carcinoma, connective tissue was destroyed earlier than epithelium, in contrast to normal tissue where epithelium was destroyed before connective tissue. CONCLUSION: This study indicates that the medium of submersion in drowning victims affects the histopathological features. The time of death is an important aspect of forensic investigation. Considering this, all cases of drowning should be very carefully evaluated, and the medium taken into consideration while determining the time of death, as tissue degrades faster in freshwater than in seawater.

Expression analysis of cyclin D, Ki-67, MCM3 and MCM2 in oral squamous cell carcinoma.

The expression analysis of cyclin D1, Ki-67, MCM3 and MCM2 in oral squamous cell carcinoma to identify biomarkers is of interest. 45 formalin-fixed paraffin embedded tissue blocks collected from archives of Department of Oral and Maxillofacial Pathology and Oral Microbiology, Government Dental College and Hospital, Jamnagar, India were subjected to a retrospective cross-sectional immuno-histo-chemistry examination. 30 blocks of OSCC with histological diagnosis have 15 tissue blocks of well-differentiated oral carcinoma and 15 tissue blocks of moderately-differentiated oral carcinoma. 15 specimens of normal oral mucosa (NM) were also examined for comparison. In each of the categories, the immuno-histo-chemistry expression of cyclin D1, MCM 3, MCM 2, and ki67 was studied. Data shows that cyclin D1, Ki-67, MCM3 and MCM2 effectively indicate cellular proliferation for consideration as potential biomarkers of oral squamous cell carcinoma.

Evaluation of the Histological Changes in the Structure of the Minor Salivary Glands in Patients With Oral Submucous Fibrosis (OSMF).

BACKGROUND: The minor salivary glands (MSGs) are critical components of the mouth's delicate environment. The pre-malignant changes of oral submucous fibrosis (OSMF) have been associated with a decline in the quality of life and an uptick in the prevalence of oral malignancies. AIM: The aim was to provide evidence of the histological alterations in minor salivary gland structure seen in individuals with OSMF. METHODS AND MATERIALS: A total of 106 confirmed cases of OSMF were enrolled in the study. In order to perform an incisional biopsy, we first collected the patient's complete demographic and clinical history. Using a Vernier calliper, the inter-incisal distance was used to evaluate the mouth opening of the patients. An incisional biopsy of the buccal mucosa was carried out using a 6 mm diameter punch and local anaesthesia. After the appropriate demographic and medical information had been gathered. Acinar cells and the surrounding stroma of tissue slices were observed under a light microscope for alterations. The cytoplasm, nucleus morphology, cellular shape, mucin pooling, and acinar outline of acinar cells were all examined by the researchers. It was taken into account to classify OSMF histologically based on variations in juxta epithelial hyalinization. RESULTS: Multiple aetiologies for the symptoms of OSMF were reflected in the patient's histological abnormalities in the minor salivary glands. On the measurement of the diameter of acini, we discover that the average area of salivary gland acini in OSMF patients is smaller than in the normal group indicative of a decrease in size. The number of functional acini in OSMF is fewer than compared in the control group. CONCLUSION:  Because of the findings of this study, we now have a better understanding of the factors that play a role in the incidence of dryness of the oral and pharyngeal mucosa (OSMF), although it has to be mentioned that no major impact of OSMF on minor salivary glands was observed in our study.

A Cross-Sectional Assessment of Effects of Imprisonment Period on the Oral Health Status of Inmates in Ghaziabad, Delhi National Capital Region, India.

BACKGROUND: Incarcerated individuals usually exhibit high oral health needs than the average population. Several factors contribute to these needs both before incarceration and during the sentence itself. Inmates are a marginalized group, who are at a higher risk for a variety of medical, dental, and emotional disorders than the general population. The aim of the study was to assess of effects of the imprisonment period on the oral health status of inmates. MATERIAL AND METHODS: A total of 532 inmates with imprisonment up to three years, three to six years, and six to ten years were included in the study. Incidence and prevalence of dental caries, decayed, missing, filled teeth (DMFT) index, and periodontal and prosthetic status were evaluated in detail. RESULTS: Results showed that the prevalence of dental caries was relatively high among the convicts. It was found that 98.2% of the inmates had one or more teeth decayed. Additionally, 31.2% (pocket >4mm) of the inmates had poor periodontal status with 4.5% of the subjects having a loss of attachment score of 4-5mm or more. A total of 3.5% of the inmates had full dentures, either upper or lower arch. The relative need for full prosthesis was projected to be around 1.4% of the studied population. CONCLUSION: Within the limitations of the study, the authors found that dental healthcare delivered and received by the inmates is much below the acceptable limit. Additionally, the incidence of dental caries in inmates was unexpectedly higher with tooth decay in 98.2% of subjects. Hence, the need of the hour is to critically incorporate and reinforce our efforts with a special focus on the risk factors of oral health.

Salivary and Serum Aspartate Aminotransferases and Alanine Aminotransferases in Insulin-Dependent Diabetes Mellitus and Normal Children: A Comparative Study.

AIMS AND OBJECTIVES: The aim of the study was to estimate and compare aspartate aminotransferases (AST) and alanine aminotransferases (ALT) levels in saliva and serum of insulin-dependent diabetes mellitus (IDDM) and normal children, and the objective was to evaluate the significance of these enzymes in assessing the salivary gland injury in IDDM children. MATERIALS AND METHODS: The study group comprised of thirty children clinically and biochemically diagnosed for IDDM and thirty healthy children of similar age in the control group. Saliva and serum samples were collected and enzyme assay was performed by optimized ultraviolet test method (according to International Federation of Clinical Chemistry). The values obtained were subjected to statistical analysis using Mann-Whitney U-test for comparison of the variables and Karl-Pearson's coefficient test for correlation. The SPSS 16.0, (SPSS Inc., Chicago, USA) was used for statistical analysis. RESULTS: Higher values of AST (mean = saliva 91.60 IU/L) and ALT (mean = saliva 94.93 IU/L) were found in the saliva than in serum (AST serum = 15.83 IU/L) (ALT serum = 20.80 IU/L) among the patients and the differences were statistically highly significant (P = 0.001). A similar comparison in the control group did not show statistical significant difference (saliva - AST mean = 23.50 IU/L, ALT mean = 21.95 IU/L and serum - AST mean = 12.60 IU/L, ALT mean = 13.25 IU/L). On correlation between patient and normal group, greater values of AST and ALT were observed in saliva of patients and the difference was statistically highly significant ([AST-mean = patients 91.166 IU/L and controls = 23.500 IU/L] [ALT-mean = patients 94.933 IU/L and controls 21.950 IU/L]). The serum values of patients and controls did not show statistical difference. Although higher values of salivary ALT and AST were observed in patients with the disease for 0-5-year clinical duration (ALT mean = 100.21 IU/L and AST mean = 95.39 IU/L) than those with the disease for 6-10-year duration (ALT mean = 77.57 IU/L and AST mean = 77.28 IU/L), values were statistically nonsignificant. CONCLUSION: Elevated salivary AST and ALT levels in IDDM patients suggest the injury to salivary glands and could aid as a salivary marker for the involvement of salivary glands in IDDM.

Oral Leukoplakia: Clinicopathological Correlation and Its Relevance to Regional Tobacco-related Habit Index.

INTRODUCTION: A case control study was carried out to evaluate the synergistic effects of habits quantified by habit index and its effect and severity on the clinicopathological features of oral leukoplakia in a cohort of 100 patients visiting Triveni Dental College, Bilaspur, Chhattisgarh, India. MATERIALS AND METHODS: One hundred patients indulging in tobacco-related habits (smoking and smokeless forms) were categorized into two groups: A case/experimental group consisting of 50 patients presenting with oral leukoplakia lesion and a control group consisting of 50 patients with no clinical signs of oral leukoplakia. Habit index was calculated in both groups. Case group was further subjected to incisional biopsy of the lesion followed by histopathological examination. All the variables in the study were statistically analyzed for the mean, standard deviation, i.e., value of central tendency, z-test, test of significance, and Pearson's correlation (r-test). RESULTS: For p < 0.05 bidi habit index was significantly higher in the case group. Higher bidi habit index was evident in the severe stages of lesion ice, p < 0.001 (highly significant). The degree of dysplasia was higher with advancing clinical stage of the lesion. CONCLUSION: Higher bidi habit index in the case group contributed significantly for severe stages of lesion and thereby indicates its probable progression toward malignancy. Nonhomogenous leukoplakia of the speckled subtype exhibited moderate and severe epithelial dysplasia. Hence, quantification of tobacco-related habits and the clinical appearance of the premalignant lesion predict the risk of subsequent malignant transformation of the disease.

Evidence based demonstration of the concept of 'field cancerization' by p53 expression in mirror image biopsies of patients with oral squamous cell carcinoma - an immunohistochemical study.

OBJECTIVE: The main rationale for treatment failure and death of the patients with oral squamous cell carcinoma (OSCC) is loco-regional recurrence, development of second primary tumor (SPT) and metastasis, which could be well explained by concept of field cancerization. Identification of patients at high risk for development of SPT is an important part of research for cancer management. This study was designed keeping this aspect in mind and utilizing the increased expression of p53 as an indicator of existence of altered fields in mirror image biopsies of OSCC patients. DESIGN: Forty clinically diagnosed oral cancer patients were included in the study. Biopsy tissue samples from clinically diagnosed oral cancer patients (Group A) and the mirror image, clinically normal looking mucosa at corresponding contralateral anatomical site (Group B) were studied for histopathological evaluation and p53 immunoexpression. RESULTS: Tissue alterations were observed in Groups A and B. There was statistically significant (chi-square value - 126.6, p=0.0001) difference in grades of epithelial dysplasia and p53 immunoexpression in Group B. Spearman's Rank Correlation Coefficient shows non-significant positive correlation between epithelial dysplasia and p53 (r=0.28, p=0.05) in Group B. CONCLUSIONS: Evidence of presence of field cancerization, evaluated by histopathological alterations and enhanced p53 expression was observed in mirror image biopsies of OSCC patients. This could predict the altered state of oral mucosa secondary to carcinogen exposure. The realization of a genetically altered field as a cancer risk factor provides a new paradigm. It would be prudent to keep these patients under close observation and to advice them chemotherapeutic regimes.