Diagnostic and Therapeutic Challenges of a Large Tongue Lymphangioma in a Child: A Case Report

Lymphangiomas are rare, painless, benign tumors in infancy or early childhood resulting from a congenital malformation of the lymphatic vessels with variable clinical appearance. We report the case of a six-year-old male child who presented with a micronodular surface of the tongue, a burning sensation, difficulties during swallowing and mastication, as well as speech disturbances. Histological examination of the excised tongue specimen showed an angiomatous lesion of the lamina propria that comprised many wide thin-walled spaces. MRI examination revealed an area of disparate T2 signal maximum diameter of 2-3 cm with cystic texture in the middle and frontal left part of the tongue. The lesion was diagnosed as a lymphangioma and was managed through pre-operative embolization and surgery. Tongue lymphangiomas may lead to aesthetic problems, functional issues (like dysphagia, airway obstruction, and speech difficulties), psychological disturbances, poor oral hygiene, and occasional bleeding associated with oral trauma. A major fraction of patients also experience infections, often leading to a significant increase in lesion size. A combination of preoperative embolization and surgical excision could be chosen considering its large size and the age of the patient, and to further eliminate the possibility of recurrence. Early diagnosis and radical treatment are critical in its management.

Comparison of Effectiveness of Moringa Oleifera Leaves Extract Gel (2%) with Retino A (0.1%) Cream for Treatment of Oral Leukoplakia: Double Blinded Randomized Control Trial

AIM

The study aims to evaluate and compare the efficacy of Moringa oleifera leaf extract gel (2%) & Retino A cream (0.1%) in reducing the size of lesions in oral leukoplakia.

OBJECTIVES

The present study aimed to evaluate the efficacy of two interventions, Moringa oleifera mucoadhesive gel and Retino-A cream, in reducing the size of lesions in patients with oral leukoplakia. Specifically, the objectives were: (1) to assess the efficacy of Moringa oleifera mucoadhesive gel in determining the reduction in lesion size, (2) to assess the efficacy of Retino-A cream in determining the reduction in lesion size, and (3) to compare the efficacy of Moringa oleifera mucoadhesive gel (2%) in determining the change in lesion size in oral leukoplakia patients.

METHODS

Clinically diagnosed cases of oral Leukoplakia were included in this study. The sample size is 72. Thirty-six patients had lesion sizes ranging from 2- 4 cm, and 36 patients had lesion sizes ranging from 4.1 - 6 cm that were equally distributed in the case and control groups using the chit system. The case and control groups had 36 patients with an equal size range of lesions. The case and control group participants will be advised topical application of the intervention and Retino-A thrice daily using a sterile cotton bud.

RESULTS

M. oleifera gel (2%) was found to be more effective in the reduction in the size of the lesion as compared to Retino-A in the treatment of oral leukoplakia patients.

CONCLUSION

This study showed that M. oleifera mucoadhesive gel (2%) is an effective and safe treatment option for oral leukoplakia patients. It demonstrated a significant reduction in lesion size compared to Retino-A cream (0.1%) after 3 months of therapy, without any reported adverse effects. However, long-term follow-up studies are needed to evaluate its long-term effectiveness. The potent antioxidant property of M. oleifera makes it a promising candidate for further studies with concentration variations and in other potentially malignant oral disorders, such as lichen planus and OSMF. The development of chemotherapeutic drugs from M. oleifera for cancer treatment should also be considered. Overall, M. oleifera appears to be a promising natural alternative to synthetic drugs for the treatment of oral leukoplakia.

KEY WORDS

Leukoplakia, Oral leukoplakia, premalignant lesion, precancer, potentially malignant disorders.

Altered Presence of Cancer Stem Cell ALDH1/2 in Oral Leukoplakias and Squamous Cell Carcinomas

INTRODUCTION

Cancer stem cells (CSCs) are responsible for initiating the process of carcinogenesis by enabling the self-renewal and self-proliferation of the cancer cells. This study aimed to investigate the presence of epithelial cells with cancer stem cells characteristics (ALDH+) in the early stages of oral precancerous lesions (Oral Leukoplakias) and the frequency of these cells in the different stages of oral squamous cell carcinomas (OSCCs).

MATERIALS & METHODS

The aim of this study was the detection of the immunohistochemical pattern of expression of CSC protein-biomarker ALDH1&2 (sc-166362, Santa Cruz Co, Dallas, Texas, USA) in paraffin-embedded samples of 30 cases of leukoplakia of all degrees of dysplasia and 21 cases of oral squamous cell carcinomas (OSCC) of all degrees of differentiation compared to the histologically normal oral epithelium. The samples were retrieved from 2009-2019 from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. The samples were evaluated through a three-tier scale (positive cells Ι: 6-35%, ΙΙ: 36-70%, ΙΙΙ: 71-100%). Statistical analysis was performed through SPSS Pearson Chi-square, and the significance level was set at 0.05 (p=0.05).  Results: The staining of ALDH1&2 was observed mildly in the cell membrane of cells in the stratum spinosum of the normal epithelium and the cell membrane of cells in the stratum basale of the normal epithelium, characteristically at the interface point with the basal membrane. ALDH1&2 were expressed significantly more in the OSCC than in the leukoplakia (p-value=0.0001) and the normal epithelium (p-value=0.0001). Mainly, ALDH1&2 were expressed significantly more in the severely and moderately dysplastic oral leukoplakia compared to the mildly dysplastic and non-dysplastic leukoplakia (p-value=0.001).

DISCUSSION

The characteristic expression of ALDH in potentially malignant oral and OSCC lesions suggests the presence of CSCs and their possible implication in the early stages of oral tumorigenesis, even at the stage of oral leukoplakia.

Impact Strength of Various Types of Acrylic Resin: An In Vitro Study

AIM

The aim of this study is to evaluate and compare the impact strength of conventional acrylic resin, high-impact acrylic resin, high-impact acrylic resin reinforced with silver nanoparticles, and high-impact acrylic resin reinforced with a zirconium oxide powder.

MATERIALS AND METHODS

A total of 60 samples were prepared of dimensions 60 mm length × 7 mm width × 4 mm thickness to test impact strength. Machined stainless steel dies of the same dimension were used to form molds for the fabrication of these samples. Of 60 samples, 15 samples were prepared each from conventional acrylic resin (Group A1), high-impact acrylic resin (Group A2), acrylic resin reinforced with silver nanoparticles (Group A3), and acrylic resin reinforced with zirconium oxide powder (Group A4). Izod-Charpy pendulum impact testing machine was used.

RESULTS

The impact strength of group A1 was in the range of 2.83-3.30 kJ/m² (M = 3.12 kJ/m², SD = 0.16), group A2 was in range of 5.10-5.78 kJ/m² (M = 5.51 kJ/m², SD = 0.18), group A3 was in range 3.18-3.56 kJ/m² (M = 3.37 kJ/m², SD = 0.11), and group A4 was in range 7.18-7.78 kJ/m² (M = 7.5 kJ/m², SD = 0.18). Statistical analysis using one-way ANOVA and t-test revealed significant differences (p < 0.001).

CONCLUSION

High-impact acrylic resin reinforced with zirconium oxide powder has the highest impact strength.

CLINICAL SIGNIFICANCE

This research sheds light on the usefulness of novel filler materials in clinical prosthodontics.

Efficacy of Spirulina 500 mg vs Triamcinolone Acetonide 0.1% for the Treatment of Oral Lichen Planus: A Randomized Clinical Trial

AIM

The present study aimed at evaluating the efficacy of spirulina 500 mg in reducing the burning sensation and lesion size in oral lichen planus (OLP).

MATERIALS AND METHODS

A total of 60 subjects who attended the oral medicine specialty clinic with histopathologically confirmed OLP and having symptoms of burning sensation were recruited for the study. They were randomly divided into two groups: group A (30) subjects were prescribed Spirulina 500 mg twice daily along with only a week application of topical triamcinolone acetonide 0.1% thrice daily; group B subjects were prescribed topical triamcinolone acetonide 0.1% alone thrice daily for 8 weeks. Both the groups were followed up posttreatment monthly for three consecutive months.

RESULTS

Data were recorded, and statistical analysis by using ANOVA one-way test, and Chi-square test were performed, which showed statistically significant p-value (<0.005) for the parameters "burning sensation" and "size of the lesion". When compared between groups, group A showed a favorable outcome of the intervention.

CONCLUSION

Spirulina 500 mg supplementation twice daily could be effective adjunct therapy with steroids to treat OLP.

CLINICAL SIGNIFICANCE

This research allowed us to delve into spirulina as one of the treatment modalities for OLP. Further studies are needed as it is a rich source of proteins and vitamins and demonstrates potent anti-inflammatory, immunomodulatory, and antioxidant actions.

Silk Hydrogel for Tissue Engineering: A Review

AIM

This review aims to explore the importance of silk hydrogel and its potential in tissue engineering (TE).

BACKGROUND

Tissue engineering is a procedure that incorporates cells into the scaffold materials with suitable growth factors to regenerate injured tissue. For tissue formation in TE, the scaffold material plays a key role. Different forms of silk fibroin (SF), such as films, mats, hydrogels, and sponges, can be easily manufactured when SF is disintegrated into an aqueous solution. High precision procedures such as micropatterning and bioprinting of SF-based scaffolds have been used for enhanced fabrication.

REVIEW RESULTS

In this narrative review, SF physicochemical and mechanical properties have been presented. We have also discussed SF fabrication techniques like electrospinning, spin coating, freeze-drying, and physiochemical cross-linking. The application of SF-based scaffolds for skeletal, tissue, joint, muscle, epidermal, tissue repair, and tympanic membrane regeneration has also been addressed.

CONCLUSION

SF has excellent mechanical properties, tunability, biodegradability, biocompatibility, and bioresorbability.

CLINICAL SIGNIFICANCE

Silk hydrogels are an ideal scaffold matrix material that will significantly impact tissue engineering applications, given the rapid scientific advancements in this field.

Hypertonic Saline Use and Traditional Nasal Irrigation: A Possible Preventative Measure against COVID-19

Saline nasal irrigation (SNI) is a clinically established treatment that has been used to manage upper respiratory infections and allergies; there is also some indication that it may be effective in the setting of coronavirus disease-2019 (COVID-19). The possible advantages of SNI include the following benefits due to the well-known antiviral impact of sodium chloride (NaCl) and the mechanical cleansing effect arising from the irrigation method. First, there will most likely be a decrease in COVID-19 infection rates; second, illness severity will be lowered; and third, community transmission will be mitigated. Despite the need for more concentrated research into these aspects, public health organizations should emphasize alternate infection mitigation measures such as SNI in light of the ongoing COVID-19 problem, low global vaccine supply, and the rapid introduction of SARS-CoV-2 variants. Keywords: Community transmission, COVID-19, Pandemic, Prevention, Saline, SARS-CoV-2.

Severe Acute Respiratory Syndrome Coronavirus 2 Nosode: A Potential Alternative Vaccine Platform

Besides conventional vaccinations, viable alternatives are needed to elicit an immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We propose and highlight the value of a homeopathic approach known as the "nosode" for the prevention of coronavirus disease-2019 (COVID-19). Nosode is an extract prepared from disease-affected tissues which is subsequently processed and administered as an antidote for the same medical condition. This concept might be a crucial therapeutic approach for viral infections since infected tissues contain a wide range of important viral antigens that could induce a functional host response via immunological sensitization. Thereby, nosode preparation produced from SARS-CoV-2-affected tissues may provide protection against COVID-19. "SARS-CoV-2 nosode" warrants more scientific investigation as a viable alternative vaccination platform. Keywords: COVID-19, Nosode, SARS-CoV-2, Variolation.

Yogic-humming: A Respiratory Defense Booster for COVID Times

The traditional Indian healthcare system of Yoga contains a wealth of health-promotional practices-some of which are based on "humming." "Humming" is produced when a wordless sound is forced to exit through the nose while keeping the mouth either fully closed or nearly closed; it is a low, prolonged, and buzzing sound. In humming practices like "Bhramari pranayama" (normal inhalation followed by lengthened exhalation + bee-like humming), there is a full-mouth closure,1 and in practices like "OM chanting" (normal inhalation followed by lengthened exhalation +OM humming), there is a near-closure. Besides these, other mantra-oriented practices also generate a similar humming effect.

Invasive oral squamous cell carcinoma induced by concurrent smokeless tobacco and creamy snuff use: A case report

Oral squamous cell carcinomas (OSCC) are caused by chronic tobacco abuse. In this regard, the carcinogenic potential of smoking and smokeless forms of tobacco, including chewing tobacco and moist/dry snuff, has been widely documented. However, the effects of tobacco-containing products such as creamy snuff on oral health have not been widely reported. Here, we report on the clinical presentation of a patient with OSCC induced by concurrent chewing tobacco and creamy snuff use. The development and progression of mucosal carcinogenesis in the context of mixed tobacco use habits is discussed. With the increased availability of newer tobacco-containing products, it is important for clinicians to be aware of these products in the marketplace, including dentifrices and nicotine pouches, and counsel their patients regarding their health risks.

Impact of COVID-19 Lockdown on Oral Oncology-related Outpatient Volume at Indian Dental Institutions

AIM AND OBJECTIVE

This study aimed to evaluate the impact of the lockdown on oral oncology-related out-patient volume at Indian dental institutions.

MATERIALS AND METHODS

The total number of newly diagnosed cases of oral submucous fibrosis, oral leukoplakia, oral lichen planus, and oral cancers, recorded at two dental institutional settings before lockdown (January-March 2020) and after lockdown (June-August 2020), were included retrospectively and compared.

RESULTS

The study included a total of 797 cases at both institutions. At Institution-I, a total of 312 cases were recorded before the lockdown, and 63 cases were recorded after the lockdown. At Institution-II, a total of 311 cases were reported before lockdown, and 111 cases were recorded after lockdown. Comparisons between the pre-lockdown and post-lockdown data yielded a significant change in the proportions of oral sub-mucous fibrosis, oral leukoplakia, oral lichen planus, and oral cancers at both institutions (Chi-square test; p < 0.001). Following the lockdown, a substantial reduction was observed in the proportion of oral submucous fibrosis (OSMF) cases at both institutions, and the proportion of oral cancers increased at both institutions. There was a significant difference between the proportions of cases reported before lockdown at both institutions (p < 0.001). However, after-lockdown, no such differences were noted (p = 0.69); the absence of significance could most likely be due to the low sample size or low-power during the post-lockdown period.

CONCLUSION

The oral potentially malignant disorders (OPMD) and oral cancer (OC) patient volumes reduced substantially following lockdown. During the post-lockdown period, the proportion of oral cancers increased, whereas the proportion of OSMF cases decreased. Results indicate that OPMD and oral cancer patients were impacted differently by the lockdown.

CLINICAL SIGNIFICANCE

This study provides insight into the impact of lockdown and highlights the importance of reestablishing oral oncology-related patient care. A vital discussion is also provided on useful compensatory strategies that may reduce delays during the ongoing crisis. How to cite this article: Panta P, Reddy P, Misra SR, et al. Impact of COVID-19 Lockdown on Oral Oncology-related Outpatient Volume at Indian Dental Institutions. J Contemp Dent Pract 2021;22(5):501-505.

Florid Cemento-osseous Dysplasia: A Report of Two Cases and Literature Review

AIM

This report aims to provide the clinical and radiographic features of two symptomatic Indian patients with florid cemento-osseous dysplasia (FCOD), along with a discussion of the differential diagnosis, potential challenges, and therapeutic implications.

BACKGROUND

FCOD is a rare, multifocal, periapical, and bilateral condition involving the premolar and molar region of the posterior mandible and sometimes the maxilla.

CASE DESCRIPTION

The first patient is a 30-year-old female with a recent history of dental pain. The patient was otherwise healthy and the medical history was unremarkable. The second patient is a 50-year-old female with a history of orthodontic therapy. Radiographic evaluation using cone-beam computed tomography (CBCT) revealed bilateral involvement of the posterior mandible, sparing the entire maxilla in both patients Clinical significance: For a pathognomonic condition like FCOD, a radiology survey alone is often sufficient to arrive at the final diagnosis, and therefore surgical interventions should ideally be avoided.

Meditation and Yoga-assisted Alteration of Dietary Behavior as a Useful Strategy for Limiting Zoonotic Pandemics: A Novel Insight

Vegetarian diets are known to have significant positive effects on personal and planetary health and are likely to curb zoonotic infection transmission. We propose that minimizing meat consumption should become an essential dietary shift in the post-COVID-19 era. To date, however, there is limited knowledge concerning suitable methods that could catalyze this change on a global scale. Meditation and Yoga are practical and easy to implement psychomodulatory strategies that can naturally trigger vegetarianism and related eating behaviors, lowering our reliance on animal meat. Decreasing dependence on animal meat reduces the need for animal markets and may substantially minimize the likelihood of spillover (passage of viruses from animal reservoirs into human populations). Global implementation of these strategies, in our opinion, can add to spiritual wisdom, compassion, and cooperative human behavior, thus reducing the encroachment of wild-life reserves and animal exploitation. The application of these ancient Indian approaches represents a novel and focused strategy toward curbing zoonotic pandemics. Keywords: Coronavirus disease-19, Meat-eating, Meditation, Pandemics, Viral spillover, Yoga.

Do saline water gargling and nasal irrigation confer protection against COVID-19?

This report provides a perspective on the relevance of saline water gargling and nasal irrigation to the COVID-19 crisis. While there is limited evidence concerning their curative or preventive role against SARS-CoV-2 infection, previous work on their utility against influenza and recent post-hoc analysis of the Edinburgh and Lothians Viral Intervention Study (ELVIS) provide compelling support to their applicability in the current crisis. Saline water gargling and nasal irrigation represent simple, economical, practically feasible, and globally implementable strategies with therapeutic and prophylactic value. These methods, rooted in the traditional Indian healthcare system, are suitable and reliable in terms of infection control and are relevant examples of harmless interventions. We attempt to derive novel insights into their usefulness, both from theoretical and practical standpoints.

Diode laser assisted excision of a gingival pyogenic granuloma: A case report

Pyogenic granuloma is a non-neoplastic, exuberant, reactive lesion seen in response to local irritation or trauma caused by dental calculus, bacterial plaque, caries and restorations, with a strong predilection for the gingiva. It is among the frequently encountered oral lesions, occurring at a challenging oral site, the gingiva. Herein, we report a 71-year-old medically compromised Caucasian female who presented with a relatively large lobulated pyogenic granuloma on the buccal gingiva of the maxillary molar-premolar region. Total surgical excision was performed with an 840nm diode laser followed by the placement of hyaluronate gel and relevant periodontal dressing. Two weeks after surgical excision, complete healing was observed, but patient denied replacement of dental restoration. After 4 months of follow-up, an overall reduction of associated teeth mobility was also observed, with a minor recurrence in gingival inflammation. The objective of this report is to briefly review clinical, radiographic and histological findings of pyogenic granuloma along with a detailed discussion on its management through a diode laser.

Salivary Gland Stem Cells and Tissue Regeneration: An Update on Possible Therapeutic Application

The aim of this review is to combine literature and experimental data concerning the impact of salivary gland (SG) stem cells (SCs) and their therapeutic prospects in tissue regeneration. So far, SCs were isolated from human and rodent major and minor SGs that enabled their regeneration. Several scaffolds were also combined with "SCs" and different "proteins" to achieve guided differentiation, although none have been proven as ideal. A new aspect of SC therapy aims to establish a vice versa relationship between SG and other ecto- or endodermal organs such as the pancreas, liver, kidneys, and thyroid. SC therapy could be a cheap and simple, non-traumatic, and individualized therapy for medically challenging cases like xerostomia and major organ failures. Functional improvement has been achieved in these organs, but till date, the whole organ in vivo regeneration was not achieved. Concerns about malignant formations and possible failures are yet to be resolved. In this review article, we highlight the basic embryology of SGs, existence of SG SCs with a detailed exploration of various cellular markers, scaffolds for tissue engineering, and, in the later part, cover potential therapeutic applications with a special focus on the pancreas and liver. Keywords: Salivary gland stem cells, Stem cell therapy, Tissue regeneration.

A Holistic Intervention for Oral Lichen Planus

Oral lichen planus (OLP) is a chronic immune-mediated, inflammatory, and psychosomatic condition that frequently affects the oral mucosa in a typical bilateral pattern, often noticed in middle-aged females.1 It involves the buccal, lingual, and/or gingival mucosa and is also an oral potentially malignant disorder (OPMD). OLP is associated with etiological factors ranging from viruses like hepatitis C, systemic factors like thyroid disorders,2 local factors like dental plaque, calculus and cuspal trauma, to deep rooted, often underestimated, psychological triggers. OLP is routinely encountered in oral medicine clinics and is sometimes accompanied by the simultaneous involvement of skin, nails, genitals, and/or mucous membranes. Although OLP is multifactorial in origin, a large share of these presentations can be attributed chiefly to psychological factors like stress, anxiety, and depression. OLP is even more striking as its genesis, progression, and exacerbation closely mirror the dynamics of emotional disturbance.

Reverse Koebnerization in a linear oral lichenoid lesion: A case report

The spectacle of Koebner’s phenomenon (KP) is interesting in that trauma precipitates a subset of pathologically distinct conditions, indicating the subtle interplay between sensitization and dermato-mucosal integrity. KP is interesting because, if factors initiating it are controlled, then it may be possible to prevent these debilitating conditions through induction of reverse Koebnerization. Herein, we present a report of a patient with an erosive lesion, localized to the occlusal plane on buccal and lingual mucosa, that interestingly subsided following 1 week after a dental scaling procedure. This report analytically describes the role of dental calculus and cuspal trauma as important triggers surrounding the genesis of oral lichenoid lesion and oral lichen planus. An engaging discussion on these closely related enigmatic entities forms the central theme of this report.

Use of Tilapia Hepcidin in Oral Cancer Therapeutics: A Proposal

Tilapia hepcidin (TH), an antimicrobial peptide (AMP) derived from tilapia (Oreochromis mossambicus) forms an important component of the fish innate immune defense.1 However, the functionality of TH is not just limited to its antimicrobial actions, significant applications in cancer research remain an area to be explored. Antimicrobial peptides derived from fish and shrimp demonstrated anticancer activities in addition to their previously discovered antimicrobial action. Three hepcidin-like AMPs can be isolated from tilapia, namely TH1-5, TH2-2, and TH2-3. Of these, TH1-5 and TH2-3 have shown potent antitumor activity.2.

Early and rapid detection of UCHL1 in the serum of brain-trauma patients: a novel gold nanoparticle-based method for diagnosing the severity of brain injury

The clinical diagnosis of traumatic brain injury (TBI) is based on neurological examination and neuro-imaging tools such as CT scanning and MRI. However, neurological examination at times may be confounded by consumption of alcohol or drugs and neuroimaging facilities may not be available at all centers. Human ubiquitin C-terminal hydrolase (UCHL1) is a well-accepted serum biomarker for severe TBI and can be used to detect the severity of a head injury. A reliable, rapid, cost effective, bedside and easy to perform method for the detection of UCHL1 is a pre-requisite for wide clinical applications of UCHL1 as a TBI biomarker. We developed a rapid detection method for UCHL1 using surface plasmon resonance of gold nanoparticles with a limit of detection (LOD) of 0.5 ng mL-1. It has a sensitivity and specificity of 100% each and meets an analytical precision similar to that of conventional sandwich ELISA but can be performed rapidly. Using this method we successfully detected UCHL1 in a cohort of 66 patients with TBI and were reliably able to distinguish mild TBI from moderate to severe TBI.

Plagiarism, P-hacking, and Predatory Journals: Toxic Triple Ps of Scientific Publications

The advent of digitalization has led to a rapid surge in literary publications. The increase in publications has not been matched by adequate screening from regulatory authorities. This, in turn, has caused a surge in unverified scientific data. Digital literature serves as the most predominant source of information for students of this generation. Although sources for the literature mandated in the curriculum are enlisted by the Institution, such guidelines do not extend for online sources. The major reason for students referring to invalid sources of information is due to the simplicity of presentation which is generally accomplished by the intentional/unintentional omission of key elements of the original work. Keywords: Ethics, P-hacking, Plagiarism, Predatory journals, Publications, Research.

Usage Analysis of WhatsApp for Dentistry-related Purposes among General Dental Practitioners

INTRODUCTION

To assess the knowledge and extent of WhatsApp usage for dentistry related purposes among general dental practitioners (GDPs).

MATERIALS AND METHODS

A cross-sectional study was conducted among 105 randomly selected GDPs from Pune, Maharashtra, India. Data was collected in a personalized manner by means of validated questionnaire. Results and observations: A total of 105 dentists participated in the survey: 96.19% of dentists had WhatsApp installed in their phones; 67.32% of dentists sought second opinion on WhatsApp; 60.29% of dentists received prompt replies, while 38.23% received late replies; 98.52% of dentists sent clinical photographs and radiographs for second opinion. 88.11% of dentists were a part of various 'dentistry related groups' and 72.27% of dentists told that patients ask their queries on WhatsApp. 36.76% of GDPs obtained verbal consent from the patients for sending clinical materials for second opinion. Majority of population of GDPs 63.23% (43) did not obtain any form of consent from the patients.

CONCLUSION

Majority of GDPs uses WhatsApp for 'dentistry related purposes' and it has become an integral part of their day-to-day practice. GDPs should obtain written consent before sending clinical materials for second opinion.

CLINICAL SIGNIFICANCE

Till date, the extent of WhatsApp usage by general dental practitioners was not reported in the literature. It appears that, WhatsApp application has become an integral part of general dental practice in India. By virtue of this, obtaining second opinion, taking appointments and solving queries of patients are no longer a time consuming events. In future, instant messaging services might play major role in providing efficient services in health care industry.

New Directions for Oral Submucous Fibrosis Research: Whole Evaluation for Holistic Rehabilitation!

Oral submucous fibrosis (OSF) is an oral potentially malignant disorder (OPMD) associated with prolonged betel-quid (BQ) use. It affects both physiological and psychological dimensions, leading to a significant morbidity. Some challenges in OSF research include: Assessment and correction of: (i) Quality of life, (ii) burning sensation, and (iii) nutritional deficiency. There are numerous medical treatments for OSF, but most of them fail to offer complete rehabilitation. This is because some underpinnings of this condition like "mental factors" that contribute to habit continuation at root level, "poor quality of life," and "nutritional deficiencies" are still uncorrected. We believe that OSF must be managed at the "mind and body" level to accomplish holistic rehabilitation. Herein, we briefly describe the general condition of OSF patients, and highlight the possibility of a novel telomere-based assessment of psychosocial stress, and support use of meditation to counter excessive "telomere shortening" which is linked to oral cancer. We also expand the current view on "burning sensation" in OSF from an entire physical concept to a possibility of mental factors, and finally recommend rich, micronutrient supplementation (through diet) to counter free radical production within the hypoxic oral epithelium.

"Mind" in Betel-quid Use and Related Disorders

Oral squamous cell carcinoma is characterized by a unique predisposing state called oral potentially malignant disorders (OPMDs). Wide variety of carcinogenic insult in the form of detrimental habits can contribute to the causation of variety of OPMDs.1,2.

MTA1 expression in human cancers - Clinical and pharmacological significance

Remarkably, majority of the cancer deaths are due to metastasis, not because of primary tumors. Metastasis is one of the important hallmarks of cancer. During metastasis invasion of primary tumor cells from the site of origin to a new organ occurs. Metastasis associated proteins (MTAs) are a small family of transcriptional coregulators that are closely associated with tumor metastasis. These proteins are integral components of nuclear remodeling and deacetylation complex (NuRD). By virtue of being integral components of NuRD, these proteins regulate the gene expression by altering the epigenetic changes such as acetylation and methylation on the target gene chromatin. Among the MTA proteins, MTA1 expression is very closely correlated with the aggressiveness of several cancers that includes breast, liver, colon, pancreas, prostate, blood, esophageal, gastro-intestinal etc. Considering its close association with aggressiveness in human cancers, MTA1 may be considered as a potential therapeutic target for cancer treatment. The recent developments in its crystal structure further strengthened the idea of developing small molecule inhibitors for MTA1. In this review, we discuss the recent trends on the diverse functions of MTA1 and its role in various cancers, with the focus to consider MTA1 as a 'druggable' target in the control of human cancers.

The Possible Role of Meditation in Myofascial Pain Syndrome: A New Hypothesis

BACKGROUND OF HYPOTHESIS

Myofascial pain syndrome (MPS) is the most common musculoskeletal pain disorder of the head and neck area. In the past, several theories were put forth to explain its origin and nature, but none proved complete. Myofascial pain responds to changing psychological states and stress, anxiety, lack of sleep, anger, depression and chronic pain are direct contributional factors. Myofascial pain syndrome may be considered as a psychosomatic disorder. There are numerous accepted palliative approaches, but of all, relaxation techniques stand out and initiate healing at the base level. In this article, the connection between mental factors, MPS and meditation are highlighted. Recent literature has shed light on the fundamental role of free radicals in the emergence of myofascial pain. The accumulating free radicals disrupt mitochondrial integrity and function, leading to sustenance and progression of MPS. Meditation on the other hand was shown to reduce free radical load and can result in clinical improvement. 'Mindfulness' is the working principle behind the effect of all meditations, and I emphasize that it can serve as a potential tool to reverse the neuro-architectural, neurobiological and cellular changes that occur in MPS.

CONCLUSIONS

The findings described in this paper were drawn from studies on myofascial pain, fibromyalgia, similar chronic pain models and most importantly from self experience (experimentation). Till date, no hypothesis is available connecting MPS and meditation. Mechanisms linking MPS and meditation were identified, and this paper can ignite novel research in this direction.

Adenoid cystic carcinoma of the palate: case report and review of literature

Adenoid Cystic Carcinoma (ACC) is a rare tumor constitutes for less than 1% of head and neck malignancies and 10% of all salivary gland tumors. Palate is the most common site to be involved in the oral cavity followed by parotid gland and submandibular gland. They are usually asymptomatic, slow growing, characteristically shows infiltrative growth and perineural invasion. This paper reports a case of Adenoid Cystic Carcinoma in a 35 year old female man reported with a swelling on the left side of palate involving the hard and soft palate since 8 months which was diagnosed histopathologically and review of literature of the peculiar clinical, and histopathological features.