Prognostic Ability of Expression of Myofibroblasts in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

AIM: To systematically review the existing scientific literature in providing a comprehensive, quantitative analysis on the prognostic ability of Cancer Associated Fibroblasts (CAFs) in Oral Squamous Cell Carcinoma (OSCC) a novel meta-analysis. METHODS: Review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in PROSPERO - CRD CRD42023467899. Electronic databases were searched for studies having data on effect of CAFs on overall survival rate and disease prognosis in patients with OSCC, oral epithelial dysplasia (OED) compared to normal healthy controls. Quality assessment of included was evaluated through Newcastle Ottawa scale (NOS) for included studies through its domains. The hazard ratio (HR) and risk ratio (RR) was used as summary statistic measure with random effect model and p value <0.05 as statistically significant. RESULTS: Twenty studies fulfilled the eligibility criteria and were included in qualitative synthesis and eighteen studies for meta -analysis. Included studies had moderate to low risk of bias. It was observed through the pooled estimate that overall survival rate - (HR) =2.30 (1.71 - 3.10) was lesser in group with high CAFs compared to low CAFs while pooled estimate through RR =1.53 (0.73 - 3.19) and RR = 5.72 (2.40 - 13.59) signified that overall survival rate was lower n OSCC patients with high CAF compared to patients with OED and healthy controls. Publication bias through the funnel plot showed asymmetric distribution with presence of systematic heterogeneity indicating presence of publication bias. CONCLUSION: Abundance of CAFs in tumor stroma of OSCC patients is associated with overall poor survival rate and poor disease prognosis. CAFs acts as a good prognostic and therapeutic marker in disease progression and advancements and should be assessed early to reduce patient's mortality and morbidity.

Assessment of knowledge, attitude and practices of tobacco cessation counselling and nicotine replacement therapy among dental professionals.

Background: Establishment of Tobacco Cessation Centres across all dental institutions has been made mandatory by the Dental Council of India. To make it a success, adequate knowledge and training, positive attitude and practices are expected by the dental health care professionals. Our study aims to assess the knowledge, attitude and practices of dentists towards Tobacco Cessation Counselling (TCC) and Nicotine Replacement Therapy (NRT). Materials and Methods: 200 participants (60 faculty members, 20 postgraduate students and 120 interns) participated in this cross-sectional study. A self-designed questionnaire of 27 questions was used to assess the knowledge, attitude and practices of the participants regarding TCC and NRT. A descriptive analysis of the data was done. Frequency and percentage were calculated for each variable. The data were processed and analysed using SPSS software version 19-SPSS Inc. Chicago, IL, USA. Results: 22% candidates were trained for TCC as opposed to 78% candidates who didn't have an idea about it. 65% participants knew about various agents which are used for NRT but many did not know how to prescribe them. 83.5% were not willing to spare time for tobacco cessation in their private practice. Only 12% were currently practising TCC or NRT at workplace. Conclusion: Inclusion of TCC in the undergraduate curriculum, training and updating of dental faculty and students regarding TCC and NRT will help in serving the noble cause.

Applied Artificial Intelligence for Tobacco Cessation in the Era of COVID-19: A Perspective.

COVID-19 has affected many health services including Tobacco cessation measures. To continue with the strategies used for the de-addiction of tobacco, we need to adapt to the changing times. The use of Artificial Intelligence will help dental health care professionals to reach a larger population, effectively implement measures for tobacco cessation, and meticulous follow-up of patients.

Adherence to the Consolidated Standards of Reporting Trials (CONSORT) Guidelines for Reporting Randomized Controlled Trials Related to Mandibular Third Molars.

PURPOSE: Randomized controlled trials (RCTs) are the backbone of evidence-based medicine. Despite the widespread acceptance of the Consolidated Standards of Reporting Trials (CONSORT), its use for reporting clinical trials in journals remains poor. The purpose of this study was to find out to what extent RCTs related to mandibular third molars have adhered to the CONSORT statement. METHODS: This study was carried out during April 2020 to June 2020. PubMed was used to retrieve RCTs related to mandibular third molars conducted during the last 5 years. The search terms used were mandibular third molar OR lower third molar OR impacted mandibular third molar AND randomized controlled trial. Each article was assessed for adherence to the CONSORT statement. RESULTS: Eighty unique articles were retrieved. The mean percentage adherence to the CONSORT statement noted was 60.26%. Of the 37 CONSORT items, only 4 items showed 100% adherence (2a, 2b, 4a, and 12a). The most underreported items were #10, 12b, 17a, 17b, 18, 19, 23 to 25. Of the 23 journals considered, 6 journals did not recommend CONSORT for reporting RCT in the "Instructions to Authors" guidelines. CONCLUSIONS: Within the limits of the study, it is clear that the RCTs related to third molar do not show 100% adherence to the CONSORT checklist. The editorial policy, peer reviewers, and researchers should endorse the use of the CONSORT checklist for transparent reporting of the RCTs.

A Comparative Study to Evaluate Efficacy of Curcumin and Aloe Vera Gel along with Oral Physiotherapy in the Management of Oral Submucous Fibrosis: A Randomized Clinical Trial.

Rationale (Hypothesis): The antioxidant,anti-inflammatory,immunomodulatory and anti-tumorigenic properties of natural plant's extracts like aloe Vera and curcumin  may produce beneficial therapeutic effects on OSMF patients and may lead to their symptomatic relief. Also, increase in the tissue elasticity with the help of oral physiotherapy excercises , would help in reinforcing increment in  mouth opening. AIM: The aim of the study is to compare the efficacy of Curcumin gel with Aloe Vera gel when both the gel are supplemented along with oral physiotherapy in the management of OSMF. MATERIALS AND METHODS: A study of parallel group trial design, using simple randomization technique, was conducted on confirmed cases of OSMF. Patients were divided into two groups, one group(30 patients) was given curcumin gel(Curenext) and other group (30 patients) aloe Vera gel (Aloe Vera 100% relief) and each group was asked to do same oral physiotherapy excercises supplementally. Follow-up was done for 6 weeks and patients were assessed on the basis of improvement in mouth opening and burning sensation at 2, 4, and 6 weeks. RESULTS: There was an improvement in both the parameters at subsequent visits, but the Aloe Vera gel showed better improvement than curcumin gel in burning sensation after 6 weeks of treatment which was highly statistically significant p < 0.01. CONCLUSION: Curcumin gel and Aloe Vera gel are effective in improving OSMF symptoms, but aloe Vera gel is more efficacious in burning sensation improvement without any side effects. Hence, we can advocate these drugs as adjuvant treatment in addition to the recommended treatment.

Melanotic Neuroectodermal Tumor of Infancy: A Rare Case Report.

A rare case melanotic neuroectodermal tumor of infancy occurring in 2-year-old girl affecting left maxilla is described. Computed tomography showed benign expansile type of lesion affecting left maxilla. The lesion was surgically excised completely. Histopathology confirmed the diagnosis of melanotic neuroectodermal tumor. Four months' follow-up showed no recurrence.

Myofibroblasts as important diagnostic and prognostic indicators of oral squamous cell carcinoma: An immunohistochemical study in normal oral mucosa, epithelial dysplasia, and oral squamous cell carcinoma.

BACKGROUND: Cancer invasion is a critical step for tumor growth and its progression. The focus on epithelial changes is shifting to increasing recognition that the microenvironment makes significant contributions to tumor progression. Stromal myofibroblasts play an important role in tumor invasion and metastasis due to its ability to modify the extracellular matrix. Based on this literary evidence, we carried out an immunohistochemical study to observe the expression of myofibroblasts in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). AIM: The aim of the study was to evaluate, compare, and correlate the presence of myofibroblasts in normal oral mucosa, oral epithelial dysplasia, and OSCC and to observe different patterns of myofibroblast arrangement using alpha-smooth muscle actin (α-SMA) as a marker, Thus assisting in early diagnosis, treatment, and prognosis of oral carcinomas. MATERIALS AND METHODS: Thirty-six cases including 12 cases of OSCC, 12 cases of epithelial dysplasia, and 12 cases of normal oral mucosa were stained with hematoxylin and eosin to confirm the diagnosis and immunohistochemically using α-SMA antibody. The slides were evaluated for positivity and intensity of staining. STATISTICAL ANALYSIS: The result was subjected to statistical analysis using Fisher's exact test. RESULTS: α-SMA expression in the stroma of squamous cell carcinoma was greater than its expression in epithelial dysplasia and normal oral mucosa.

Recurrent aphthous stomatitis: a review.

Recurrent aphthous stomatitis (RAS) is a common clinical condition producing painful ulcerations in oral cavity. The diagnosis of RAS is based on well-defined clinical characteristics but the precise etiology and pathogenesis of RAS remain unclear. The present article provides a detailed review of the current concepts and knowledge of the etiology, pathogenesis, and management of RAS.