Adjunctive techniques and diagnostic aids in the early detection of oral premalignant disorders and cancer: An update for the general dental practitioners

Emerging salivary biomarkers for early detection of oral squamous cell carcinoma

Oral cancer, particularly oral squamous cell carcinoma (OSCC), remains a leading cause of cancer-related morbidity and mortality, with delayed diagnosis being a major contributing factor. Although salivary biomarkers have been explored for over three decades, the need for reliable, non-invasive diagnostic methods that enable early detection and continuous monitoring of OSCC remains unmet. This review aims to provide an updated overview of the latest advancements in salivary biomarker research, focusing on emerging biomarkers such as interleukin-6, interleukin-8, microRNAs and DNA methylation patterns, as well as metabolites and microbiota, all of which show significant promise for early OSCC detection. In addition to discussing well-established biomarkers, we explore recent technological developments that increase the sensitivity and specificity of these biomarkers, such as mass spectrometry, multiplex assays, and nanobiosensors. These developments are complemented by the integration of artificial intelligence for data analysis, which enables more accurate, point-of-care diagnostics that could revolutionize oral cancer screening. This review not only consolidates current knowledge but also addresses the challenges that hinder the widespread clinical adoption of salivary diagnostics, such as saliva variability and assay standardization. By overcoming these barriers, salivary biomarker-based diagnostics have the potential to transform OSCC detection, offering a non-invasive, cost-effective solution that can improve early diagnosis and patient outcomes.

Turkish dental students' knowledge, attitudes, and awareness of oral cancer

PURPOSE

This survey aimed to assess the knowledge, attitudes, and awareness of dental students across multiple dental faculties in Turkey regarding oral cancer.

METHODS

The survey instrument, derived from the questionnaire developed by Horowitz et al., was translated into Turkish and distributed to participants. The survey consisted of 27 questions assessing participants' practices regarding oral cancer examination, their evaluation of patient risk factors, and their perceptions of their educational preparedness. Statistical analyses were conducted using IBM SPSS V23. The Fisher-Freeman-Halton test and Pearson Chi-Square test were employed for categorical data comparisons, while multiple comparisons were analyzed with the Bonferroni-corrected Z test. A significance level of p < 0.05 was applied.

RESULTS

The study enrolled a total of 603 dental students (239 males [39.6%] and 364 females [60.4%]) from 10 different dental faculties. Participants were distributed across three academic years, with 202 (33.5%) in the third grade, 280 (46.4%) in the fourth grade, and 121 (20.1%) in the fifth grade. The findings indicated that students demonstrated a high level of awareness regarding factors such as tobacco (98.7%), alcohol (82.9%), and ultraviolet (UV) exposure (94.5%). However, their knowledge appeared to be lacking in relation to other risk factors, including older age (74.9%) and Human Papillomavirus (HPV) infection (83.7%).

CONCLUSION

Overall, the study suggests that dental students in Turkey exhibit a moderate level of awareness concerning oral cancer. The outcomes of this investigation underscore the pressing need for enhancements in oral cancer education and training for undergraduate dental students. Furthermore, there is a visible need for the implementation of periodic, well-structured continuing professional development activities aimed at enhancing the oral cancer-related competencies of dental professionals in practice.

Molecular Targets of Plant-Derived Bioactive Compounds in Oral Squamous Cell Carcinoma

BACKGROUND

With a significant increase in both incidence and mortality, oral cancer-particularly oral squamous cell carcinoma (OSCC)-is one of the main causes of death in developing countries. Even though there is evidence of advances in surgery, chemotherapy, and radiotherapy, the overall survival rate for patients with OSCC has improved, but by a small percentage. This may be due, on the one hand, to the fact that the disease is diagnosed when it is at a too-advanced stage, when metastases are already present.

METHODS

This review explores the therapeutic potential of natural herbal products and their use as adjuvant therapies in the treatment of oral cancer from online sources in databases (PubMed, Web of Science, Google Scholar, Research Gate, Scopus, Elsevier).

RESULTS

Even if classic therapies are known to be effective, they often produce many serious side effects and can create resistance. Certain natural plant compounds may offer a complementary approach by inducing apoptosis, suppressing tumor growth, and improving chemotherapy effectiveness. The integration of these compounds with conventional treatments to obtain remarkable synergistic effects represents a major point of interest to many authors. This review highlights the study of molecular mechanisms and their efficiency in in vitro and in vivo models, as well as the strategic ways in which drugs can be administered to optimize their use in real contexts.

CONCLUSIONS

This review may have a significant impact on the oncology community, creating new inspirations for the development of more effective, safer cancer therapies with less toxic potential.

Salivary metabolomics in oral potentially malignant disorders and oral cancer patients-a systematic review with meta-analysis

OBJECTIVES

The aim of this systematic review and meta-analysis is to assess the diagnostic potential of salivary metabolomics in the detection of oral potentially malignant disorders (OPMDs) and oral cancer (OC).

MATERIALS AND METHODS

A systematic review was performed in accordance with the 3rd edition of the Centre for Reviews and Dissemination (CRD) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Electronic searches for articles were carried out in the PubMed, Web of Science, and Scopus databases. The quality assessment of the included studies was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS) and the new version of the QUADOMICS tool. Meta-analysis was conducted whenever possible. The effect size was presented using the Forest plot, whereas the presence of publication bias was examined through Begg's funnel plot.

RESULTS

A total of nine studies were included in the systematic review. The metabolite profiling was heterogeneous across all the studies. The expression of several salivary metabolites was found to be significantly altered in OPMDs and OCs as compared to healthy controls. Meta-analysis was able to be conducted only for N-acetylglucosamine. There was no significant difference (SMD = 0.15; 95% CI - 0.25-0.56) in the level of N-acetylglucosamine between OPMDs, OC, and the control group.

CONCLUSION

Evidence for N-acetylglucosamine as a salivary biomarker for oral cancer is lacking. Although several salivary metabolites show changes between healthy, OPMDs, and OC, their diagnostic potential cannot be assessed in this review due to a lack of data. Therefore, further high-quality studies with detailed analysis and reporting are required to establish the diagnostic potential of the salivary metabolites in OPMDs and OC.

CLINICAL RELEVANCE

While some salivary metabolites exhibit significant changes in oral potentially malignant disorders (OPMDs) and oral cancer (OC) compared to healthy controls, the current evidence, especially for N-acetylglucosamine, is inadequate to confirm their reliability as diagnostic biomarkers. Additional high-quality studies are needed for a more conclusive assessment of salivary metabolites in oral disease diagnosis.