Publications by authors named "Saranya Varadarajan"

31 Publications

Allicin May Promote Reversal of T-Cell Dysfunction in Periodontitis via the Pathway.

Int J Mol Sci 2021 Aug 25;22(17). Epub 2021 Aug 25.

Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India.

We evaluated the role of allicin in periodontitis using an in silico and in vitro design. An in silico docking analysis was performed to assess the plausible interactions between allicin and . The cytokine profile of gingival crevicular fluid (GCF) samples obtained from periodontitis patients was estimated by cytometric bead array. CD3+ lymphocytes isolated from the peripheral blood were sorted and characterized using immunomagnetic techniques. Cultured and expanded lymphocytes were treated with the GCF samples to induce T-cell exhaustion. Optimum concentrations of allicin were added to exhausted lymphocytes to compare the expression of and gene expression at baseline and post-treatment. Allicin was found to bind to the molecule as revealed by the in-silico experiment, which is possibly an inhibitory interaction although not proven. GCF from periodontitis patients had significantly higher concentrations of TNF-α, CCL2, IL-6, IFN-γ, and CXCL8 than controls. GCF treatment of CD3+ lymphocytes from the periodontitis patients significantly increased expression of T-cell exhaustion markers and . Allicin administration with GCF treatment resulted in significant lowering of the expression of exhaustion markers. Allicin may exert an immunostimulatory role and reverse immune-destructive mechanisms such as T-cell exhaustion.
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http://dx.doi.org/10.3390/ijms22179162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431528PMC
August 2021

The Expression of Allele Changes in NLRP3 (rs35829419) and IL-1β (+3954) Gene Polymorphisms in Periodontitis and Coronary Artery Disease.

Materials (Basel) 2021 Sep 6;14(17). Epub 2021 Sep 6.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Background: Inflammasomes have been shown to play a pivotal role in periodontal disease pathogenesis. However, their role in periodontitis subjects with coronary heart disease remains unclear. This study aimed to obtain the expression of NLRP3 (rs35829419) and IL-1β (+3954) gene polymorphisms in the subgingival plaque and blood samples of generalized periodontitis (GP) subjects with and without coronary heart disease (CHD).

Methods: A total of 70 subjects were grouped into two; GP and GP with CHD. Demographic variables and periodontal and cardiac parameters were recorded from both the groups. Subgingival plaque and blood samples were obtained from both the groups and were further subjected to the identification of NLRP3 (rs35829419) and IL-1β (+3954) expression and allele change using a conventional polymerase chain reaction (PCR) and gene sequencing (Sanger's method).

Results: Amongst the demographic variables, age and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. The NLRP3 (rs35829419) and IL-1β (+3954) genes showed a statistically significant association with allele change (frequency) among the groups. The general comparison of all the parameters with the allele change of NLRP3 (rs35829419) and IL-1β (+3954) in the subgingival plaque and blood samples showed statistically significant associations among the two groups.

Conclusion: The present study highlighted an allele change in IL-1β (+3954) gene polymorphisms which may play an important role in the pathogenesis of periodontitis and coronary heart disease.
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http://dx.doi.org/10.3390/ma14175103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8433916PMC
September 2021

Role of Periodontal Bacteria, Viruses, and Placental in Chronic Periodontitis and Preeclampsia-A Genetic Microbiological Study.

Curr Issues Mol Biol 2021 Jul 29;43(2):831-844. Epub 2021 Jul 29.

Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.

Previous studies assessed the involvement and impact of periodontal bacteria in preeclamptic women with chronic periodontitis. To explore further, the current study aimed to associate periodontal viruses and bacteria with levels in placental tissues of preeclamptic women with generalized chronic periodontitis. Four-hundred 45 pregnant women, 18-35 years of age, were selected and divided into four groups (controls, A, B, and C) where the Controls included 145 systemically and periodontally healthy pregnant women Group A-100 systemically healthy pregnant women with chronic periodontitis, Group B- 100 preeclamptic women with chronic periodontitis, Group C- 100 preeclamptic women without chronic periodontitis. Age, BMI, SES, and periodontal parameters such as PI, BOP, PPD, and CAL were noted. Periodontal pathogens such as , HSV, EBV, and HCMV were tested in subgingival plaque, placental tissues, and mir155. We observed that PI, BOP, PPD, CAL, and EBV were highly significant in Group B. We found a higher number of periodontal bacteria, viruses, and 155 in Group B showing a higher risk of preeclampsia. More genetic studies in this field are advised to ascertain the role of periodontopathogens and 155 in preeclampsia and periodontal inflammation. What is already known on this subject? Periodontal diseases pose an increased risk of developing preeclampsia and delivering preterm and/or low-birth-weight babies. What do the results of this study add? Periodontal variables such as PI, pocket depth, BOP, and clinical attachment levels, were found to be increased in the preeclamptic women with chronic periodontitis. The significant difference was seen in the relative fold expression of mir155 with higher gene expression of mir155 in groups B and A as compared to group C and controls. What are the implications of these findings for clinical practice and/or further research? In our study, 155 correlation with the periodontal parameters and periodontal pathogens further strengthen the evidence of periodontal inflammation as a risk of preeclampsia in pregnant women especially when associated with chronic periodontitis. 155 can be considered to be one of the genetic biomarkers and can be used as a diagnostic tool for the early detection of PE.
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http://dx.doi.org/10.3390/cimb43020060DOI Listing
July 2021

miRNA-146a and miRNA-126 as Potential Biomarkers in Patients with Coronary Artery Disease and Generalized Periodontitis.

Materials (Basel) 2021 Aug 20;14(16). Epub 2021 Aug 20.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

The present study aims to compare the levels of micro-RNA-146a and micro-RNA-126 in oral subgingival plaque and coronary plaque from artery walls in patients with coronary artery disease who suffer from generalized periodontitis. A total of 75 participants were selected and grouped into three categories of 25 patients each: GP+CAD, GP, and HP groups. GP+CAD consisted of patients diagnosed with generalized periodontitis (GP) and coronary artery disease (CAD). The GP+CAD group was further divided into two groups-GP+CADa: where subgingival plaque samples were collected; GP+CADb group: where coronary plaque samples were collected while the patient underwent a coronary artery bypass grafting surgery. The GP group consisted of 25 patients diagnosed with only generalized periodontitis. The HP group consisted of 25 systemically and periodontally healthy controls. miRNA-146a and miRNA126 levels were assessed in subgingival plaque (SP) samples from all groups. Results revealed that miRNA-146a was expressed at higher levels and miRNA-126 was downregulated in the GP+CAD group. microRNAs in subgingival plaque samples showed a significant correlation with the coronary plaque samples in the GP+CAD group. miRNA-146a and miRNA-126 were present in coronary artery disease patients with periodontitis. These micro-RNAs may serve as risk biomarkers for coronary artery disease and generalized periodontitis.
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http://dx.doi.org/10.3390/ma14164692DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398247PMC
August 2021

Taurodontism in maxillary and mandibular molars using cone beam computed tomography in a dental center in Saudi Arabia.

Ann Saudi Med 2021 Jul-Aug;41(4):232-237. Epub 2021 Aug 22.

From the Department of Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Jazan University, Jazan Saudi Arabia.

Background: Taurodontism is a dental anomaly characterized by altered crown root ratio that is often diagnosed by radiographic evaluation. A three-dimensional cone beam computed tomography (CBCT) can aid in the diagnosis and treatment of taurodontic teeth. Only one study has reported the prevalence of taurodontism in a Saudi population.

Objective: Determine prevalence and other characteristics of taurodontism in permanent maxillary and mandibular molars, by CBCT in a dental center in Saudi Arabia.

Design: Cross-sectional.

Setting: College of dentistry.

Subjects And Methods: The first and second molars, maxillary and mandibular, from study participants of Saudi origin from Jazan region of Saudi Arabia were evaluated for taurodontism based on the criteria of Shifman and Chanannel. The degree of taurodontism was determined by the taurodontism index. Results were tabulated for analysis and the chi-square test was applied for the differences between age groups, genders, and maxillary and mandibular teeth.

Main Outcome Measures: Characteristics of taurodontism.

Sample Size: 1839 teeth in 300 individuals.

Results: Taurodontism was seen in 24 (8%) of the study participants and in 71 teeth (3.9%). Taurodontism was significantly more prevalent in individuals between 21 and 40 years of age. Hypotaurodontism (67.6%, n=48) was most prevalent, followed by mesotaurodontism (23.9%, n=17) and hypertaurodontism (8.5%, n=6). The maxillary molars were more commonly involved than mandibular, but the results were not statistically significant. No significant differences in gender were observed.

Conclusions: Dental clinicians should be familiar with the condition due to the clinical implications in oral surgery, endodontics and prosthodontics. The possibilities of a complex root canal system, an additional canal, difficulties in canal negotiation, instrumentation and subsequent obturation can be challenging for the clinician.

Limitations: Conducted in a single dental center hence future studies with larger sample sizes in different regions of Saudi Arabia should be conducted to more accurately measure the prevalence.

Conflicts Of Interest: None.
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http://dx.doi.org/10.5144/0256-4947.2021.232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380279PMC
September 2021

COVID-19 pandemic and lock-down protocols: Impact in an indian tertiary cancer center.

Oral Oncol 2021 Aug 11:105484. Epub 2021 Aug 11.

Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, India. Electronic address:

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http://dx.doi.org/10.1016/j.oraloncology.2021.105484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354800PMC
August 2021

Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review.

Diagnostics (Basel) 2021 Jul 3;11(7). Epub 2021 Jul 3.

Department of Oral and Maxillofacial Sciences, Sapienza University, University of Rome, 00161 Rome, Italy.

Background: Ultrasonography is a non-invasive method of diagnosing periapical lesions while radiologic methods are more common. Periapical lesions due to endodontic infection are one of the most common causes of periapical radiolucency that need to be distinguished to help determine the course of treatment. This review aimed to examine the accuracy of ultrasound and compare it to radiographs in distinguishing these lesions in vivo.

Methods: This review process followed the PRISMA guidelines. A literature search of databases (PubMed, Scopus, Embase, and Web of Science) was conducted without any restrictions on time. Articles available in English were included. The selection was done according to the inclusion and exclusion criteria. The QUADAS-2 tool was used to assess the quality of the studies.

Results: The search provided a total of 87 articles, out of which, five were selected for the final review. In all the studies, ultrasound had higher accuracy in distinguishing periapical lesions. All the studies indicated a risk of bias, especially in patient selection.

Conclusion: Within limitations, the study indicates that ultrasound is a better diagnostic tool to distinguish periapical lesions compared to radiographs but further studies with well-designed, rigorous protocols and low risk of bias are needed to provide stronger evidence.
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http://dx.doi.org/10.3390/diagnostics11071208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303698PMC
July 2021

(Thunb.) Miers (Giloy) inhibits oral cancer cells in a dose-dependent manner by inducing apoptosis and attenuating epithelial-mesenchymal transition.

Saudi J Biol Sci 2021 Aug 27;28(8):4553-4559. Epub 2021 Apr 27.

Logical Life Science Private Limited, Pune, India.

Background: has been applied successfully as an anti-inflammatory, anti-diabetic, and even as an anti-cancer agent. Yet, to date, the application of Giloy has not been explored concerning oral cancer.

Objectives: To assess the effect of extract (TcE) on an oral cancer cell line.

Methods: AW13516 (oral cancer cell line) cells were treated with the prepared aqueous extract of TcE for 24 h at various concentrations ranging between 5 μg/ml and 100 μg/ml and compared with control (cells without treatment). Thee effect of the extracts on apoptosis was assessed by through Annexin V flow cytometry assay and Luminometry based assessment of Caspase 8, 9 and caspase 3/7 activity. RNA was isolated from treated cells and gene expression of selected metastatic genes (MMP1, MMP10, and CXCL8); epithelial-mesenchymal stem cell genes (TWIST1, SNAIL, ZEB1, Oct4) and stemness related genses (Nanog, Sox2) were analyzed by using a quantitative real-time PCR system. The experiments were performed in triplicates.

Results: Aqueous extract of TcE was found to induce apoptosis inducer in AW13516 cells in a concentration-dependent manner and was potent even at a low concentration of 5 μg/ml. The apoptosis induction was confirmed with the caspase activity assay. Treatment of the cells with the extract for 24 h exhibited a significant decrease in the expression of EMT genes in a dose-dependent manner without an effect on the metastatic genes.

Conclusion: Aqueous extract of TcE induces apoptosis-mediated cell death in the oral cancer cell line AW13516 while attenuating its potential for epithelial mesenchymal transition.
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http://dx.doi.org/10.1016/j.sjbs.2021.04.056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324948PMC
August 2021

Effect of Ascorbic Acid on Differentiation, Secretome and Stemness of Stem Cells from Human Exfoliated Deciduous Tooth (SHEDs).

J Pers Med 2021 Jun 22;11(7). Epub 2021 Jun 22.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.

Stem cells from human exfoliated deciduous teeth (SHEDs) are considered a type of mesenchymal stem cells (MSCs) because of their unique origin from the neural crest. SHEDs can self-renewal and multi-lineage differentiation with the ability to differentiate into odontoblasts, osteoblast, chondrocytes, neuronal cells, hepatocytes, adipocytes, etc. They are emerging as an ideal source of MSCs because of their easy availability and extraordinary cell number. Ascorbic acid, or vitamin C, has many cell-based applications, such as bone regeneration, osteoblastic differentiation, or extracellular matrix production. It also impacts stem cell plasticity and the ability to sustain pluripotent activity. In this study, we evaluate the effects of ascorbic acid on stemness, paracrine secretion, and differentiation into osteoblast, chondrocytes, and adipocytes. SHEDs displayed enhanced multifaceted activity, which may have applications in regenerative therapy.
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http://dx.doi.org/10.3390/jpm11070589DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304986PMC
June 2021

Genetic Polymorphisms of NLRP3 (rs4612666) and CARD8 (rs2043211) in Periodontitis and Cardiovascular Diseases.

Biology (Basel) 2021 Jun 27;10(7). Epub 2021 Jun 27.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Background: The existing data show that inflammasomes play a role in periodontal disease pathogenesis. However, their role in the pathogenesis of periodontitis and coronary heart disease remains unclear. This study had the objective of assessing NLRP3 (rs4612666) and CARD8 (rs2043211) gene polymorphisms in dental plaque and blood of generalized chronic periodontitis (CP) patients in the presence and absence of coronary heart disease (CHD).

Methods: A total of 70 subjects were divided into two groups, including CP and CP + CHD subjects. Demographic variables, periodontal, and cardiac parameters were recorded from both groups. Subgingival plaque and blood samples were obtained from both groups and were subjected to further molecular analysis for NLRP3 (rs4612666) and CARD8 (rs2043211) expression and allele change using conventional polymerase chain reaction (PCR) and gene sequencing (Sanger's method).

Results: Amongst the demographic variables, age, and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. NLRP3 (rs4612666) and CARD8 (rs2043211) genes showed a statistically significant association of allele change (frequency) among the groups. In general, when all of the parameters were compared to the allele change of the genes, statistically significant relationships were found between the two groups.

Conclusions: The present study expressed an allele change of the investigated genes which could profoundly affect the pathobiology of the two diseases under investigation.
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http://dx.doi.org/10.3390/biology10070592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301148PMC
June 2021

Linking periodontitis and adverse pregnancy outcomes through CD14+ CD16+ monocytes.

Med Hypotheses 2021 Aug 18;153:110637. Epub 2021 Jun 18.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Saudi Arabia. Electronic address:

One of the prevalent medical issues that deserve global attention is adverse pregnancy outcomes and preterm low birth weight deliveries which have a significant impact on neonatal health. Periodontitis has been implicated as a significant risk factor for adverse effects in pregnancy. Elevated levels of periodontal pathogenic bacteria and proinflammatory cytokines which are pathognomonic features of periodontitis are believed to cause placental infection and premature rupture of the amniotic membrane consequently leading to preterm delivery. The role of CD14+CD16+ monocytes as a causal link between periodontitis and adverse pregnancy outcomes has not been researched so far, although an elevation of these cells has been independently demonstrated in both conditions. With the available background information, this hypothesis attempts to derive a mechanistic link between periodontitis and adverse pregnancy outcomes through the participation of CD14+CD16+ monocytes.
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http://dx.doi.org/10.1016/j.mehy.2021.110637DOI Listing
August 2021

Viability of Quercetin-Induced Dental Pulp Stem Cells in Forming Living Cellular Constructs for Soft Tissue Augmentation.

J Pers Med 2021 May 18;11(5). Epub 2021 May 18.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Autogenous gingival grafts used for root coverage or gingival augmentation procedures often result in donor site morbidity. Living cellular constructs as an exogenous alternative have been proven to be associated with lower morbidity. With the available background information, the present study aims to assess if quercetin-induced living cell constructs, derived from dental pulp stem cells, have the potential to be applied as a tool for soft tissue augmentation. The characterized dental pulp stem cells (positive for CD73, CD90, and negative for CD34, HLA-DR) were expanded in Dulbecco's Modified Eagle's medium (DMEM) supplemented with 10 mM quercetin. The handling properties of the quercetin-induced dental pulp stem cell constructs were assessed by visual, and tactile sensation. A microscopic characterization using hematoxylin and eosin staining, and qRT-PCR-based analysis for stemness-associated genes (OCT4, NANOG, SOX2, and cMyc) was also performed. Dental pulp stem cells without quercetin administration were used as the control. Dental pulp stem cell constructs induced by quercetin easily detached from the surface of the plate, whereas there was no formation in the control cells. It was also simple to transfer the induced cellular construct on the flattened surface. Microscopic characterization of the constructs showed cells embedded in a tissue matrix. Quercetin also increased the expression of stemness-related genes. The use of quercetin-induced DPSC living constructs for soft tissue augmentation could provide an alternative to autogenous soft tissue grafts to lower patient morbidity and improve esthetic outcomes.
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http://dx.doi.org/10.3390/jpm11050430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158115PMC
May 2021

Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review.

Materials (Basel) 2021 May 6;14(9). Epub 2021 May 6.

Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy.

Objectives: To qualitatively and quantitatively review the use of melatonin as a topical/systemic formulation for the management of periodontitis.

Materials And Methods: PubMed; Scopus; and Web of Science databases were searched using the MesH terms "melatonin" and "periodontitis". Title and abstracts were screened to eliminate irrelevant and duplicate articles. The full text data of the screened articles were assessed using the selection criteria.

Results: Of 176 identified articles (PubMed-66; Scopus-56; Web of Science-52; Cross-reference-2), only 12 studies qualified to be included in the systematic review. Four studies assessed the independent effect of 1% topical melatonin formulation while 8 articles assessed the adjunctive use of systemic melatonin formulation (1-10 mg) following scaling and root planing (SRP). All studies showed an improvement in periodontal parameters such as pocket depth, clinical attachment loss, periodontal disease index, community periodontal index, gingival bleeding scores, and prognostic marker levels in saliva and serum. A meta-analysis of data from 2 studies revealed that 1-2 mg (systemic) melatonin supplementation reduced pocket depth; although the difference was not statistically significant and hence cannot be interpreted or used for conclusive evidence. Risk of Bias Assessment tool (RoBANS) and Cochrane Collaboration RoB tool elicited a high risk of bias in the included studies. GRADE (recommendation assessment, development, and evaluation) inferred a weak recommendation for the use of melatonin in periodontitis management.

Conclusions: Melatonin supplementation (topical and systemic) in periodontitis patients improved key periodontal parameters including pocket depth and clinical attachment loss.

Clinical Relevance: Melatonin could be a potential host modulatory agent for periodontitis management; although the data from the present review should be interpreted carefully due to the associated high risk of bias.
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http://dx.doi.org/10.3390/ma14092417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124881PMC
May 2021

Genetic Mutations Associated with Pierre Robin Syndrome/Sequence: A Systematic Review.

Mol Syndromol 2021 Apr 18;12(2):69-86. Epub 2021 Mar 18.

Community Dental Unit, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Pierre Robin syndrome/sequence (PRS) is associated with a triad of symptoms that includes micrognathia, cleft palate, and glossoptosis that may lead to respiratory obstruction. The syndrome occurs in 2 forms: nonsyndromic PRS (nsPRS), and PRS associated with other syndromes (sPRS). Studies have shown varying genetic mutations associated with both nsPRS and sPRS. The present systematic review aims to provide a comprehensive collection of published literature reporting genetic mutations in PRS. Web of Science, PubMed, and Scopus were searched using the keywords: "Pierre Robin syndrome/sequence AND gene mutation." The search resulted in 208 articles, of which 93 were excluded as they were duplicates/irrelevant. The full-text assessment led to the further exclusion of 76 articles. From the remaining 39 articles included in the review, details of 324 cases were extracted. 56% of the cases were sPRS, and 22% of the cases were associated with other malformations and the remaining were nsPRS. Genetic mutations were noted in 30.9% of the 300 cases. Based on the review, was found to be the most common gene associated with both nsPRS and sPRS. The gene mutation in sPRS was specific to the associated syndrome. Due to the lack of original studies, a quantitative analysis was not possible. Thus, future studies must focus on conducting large-scale cohort studies. Along with generating data on genetic mutation, future studies must also conduct pedigree analysis to assess potential familial inheritance, which in turn could provide valuable insights into the etiopathogenesis of PRS.
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http://dx.doi.org/10.1159/000513217DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114067PMC
April 2021

Reply to the letter regarding "Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis".

Bosn J Basic Med Sci 2021 May 9. Epub 2021 May 9.

5Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

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http://dx.doi.org/10.17305/bjbms.2021.6006DOI Listing
May 2021

Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis.

Bosn J Basic Med Sci 2021 04 2. Epub 2021 Apr 2.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

The objective of the present article was to qualitatively and quantitatively review the association between chronic mechanical irritation and oral squamous cell carcinoma (OSCC). PubMed, SCOPUS, and Web of Science databases were searched using the keyword combinations "chronic trauma and oral squamous cell carcinoma; chronic irritation and oral squamous cell carcinoma; chronic irritation and oral cancer; and chronic trauma and oral cancer." Duplicates and irrelevant articles were excluded after the title and abstract screening. The full texts of the remaining articles were assessed using selection criteria. A total of 375 (PubMed-126; SCOPUS-152; WOS-97) articles were screened, and 343 duplicates and irrelevant articles were excluded from the study. Only 9 of the remaining 32 articles met the selection criteria and were included in the qualitative analysis. Buccal mucosa and tongue, being highly prone to chronic irritation through the dental prosthesis, were the common sites for OSCC. Edentulous subjects with ill-fitting dentures were at a high risk of developing chronic irritation associated-OSCC. According to the Joanna Briggs Institute of risk assessment, eight of the nine included studies had a low risk of bias. The quantitative analysis showed a significant association (p < 0.00001) between the chronic oral mucosal irritation and OSCC with an overall risk ratio of 2.56 at a confidence interval of 1.96-3.35. Chronic oral mucosa irritation has a significant association with OSCC, and the nature of association could be that of a potential co-factor (dependent risk factor) rather than an independent risk factor.
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http://dx.doi.org/10.17305/bjbms.2021.5577DOI Listing
April 2021

Antimicrobial Efficacy of Silver Nanoparticles as Root Canal Irrigant's: A Systematic Review.

J Clin Med 2021 Mar 10;10(6). Epub 2021 Mar 10.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Removal of microbes is imperative during endodontic therapy. Due to their antimicrobial property, silver nanoparticles have been used for endodontic irrigation of the root canals. The objective of the present study was to provide a qualitative analysis of the published literature assessing silver nanoparticles as root canal irrigants. A search of PubMed, SCOPUS, Web of Science, and Embase databases was done without any time restriction. Articles published in English were included. Data were extracted and the risk of bias was assessed. Of the 154 studies identified, after screening according to the inclusion criteria, five in vitro studies were included. The results indicate that silver nanoparticles have an anti-microbial effect to varying degrees depending on certain factors. Within the limitations of the present studies that have a moderate to low risk of bias, an antimicrobial effect of silver nanoparticles is observed. Silver nanoparticles have the potential to be used as endodontic irrigants, although their efficacy depends on particle size and the duration of contact which require further investigation.
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http://dx.doi.org/10.3390/jcm10061152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999954PMC
March 2021

Assessing the Potential Association Between Microbes and Corrosion of Intra-Oral Metallic Alloy-Based Dental Appliances Through a Systematic Review of the Literature.

Front Bioeng Biotechnol 2021 15;9:631103. Epub 2021 Mar 15.

Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of Science were searched using keyword combinations such as microbes and oral and corrosion; microbes and dental and corrosion; microorganisms and oral and corrosion; microorganisms and dental and corrosion. Out of 141 articles, only 25 satisfied the selection criteria. s, sulfate-reducing bacteria, sulfate oxidizing bacteria, Veilonella, Actinomyces, were found to have a potential association with corrosion of intraoral metallic alloys such as stainless steel, titanium, nickel, cobalt-chromium, neodymium-iron-boron magnets, zirconia, amalgam, copper aluminum, and precious metal alloys. The included studies inferred an association between oral microorganisms and intra-oral metallic alloys-based dental appliances, although, it is vital to acknowledge that most studies in the review employed an simulation of the intra-oral condition.
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http://dx.doi.org/10.3389/fbioe.2021.631103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005604PMC
March 2021

Comparative Evaluation of Gingival Depigmentation by Scalpel, Electrosurgery, and Laser: A 14 Months' Follow-up Study.

J Contemp Dent Pract 2020 Oct 1;21(10):1159-1164. Epub 2020 Oct 1.

Department of Pedodontics and Preventive Dentistry, Tagore Dental College and Hospital, Chennai, Tamil Nadu, India.

Aim And Objective: The aim of the study was to compare three different techniques using scalpel, electrosurgery, and laser for gingival depigmentation in terms of pain, discomfort, duration of procedure, wound healing, and repigmentation.

Materials And Methods: Thirty patients in the age range of 24-38 years were briefed about the surgical procedure and an informed consent was obtained and they were randomly allocated into three groups of 10 individuals (5 males and 5 females) each: those undergoing depigmentation with scalpel (group I), electrosurgery (group II), and diode lasers (Biolase) (group III). Individuals of all three groups were asked to describe the level of pain and discomfort by using the visual analog scale (VAS) 2 hours, 24 hours, and 1 week postoperatively. Further, the groups were compared based on duration of procedure, wound healing, and repigmentation at the end of 14 months.

Results: All the groups showed a decrease in the pain levels, which was statistically highly significant 1 week postoperatively when compared 24 hours postoperatively. There was a statistically significant difference in the pain levels between the scalpel, electrosurgery, and lasers groups after 24 hours ( < 0.001), with the lasers group demonstrating significantly less pain and discomfort. There was significant difference between the groups with respect to the duration of procedure, with less mean time for completion of the procedure observed for group III. Furthermore, less time for wound healing was observed in group III as compared to other groups. Total 8 out 10 patients in group I, 7 out of 10 patients in group II, and 2 out of 10 patients in group III showed repigmentation at the end of 14 months.

Conclusion: The rising concern for esthetic demand of an individual requires the removal of hyperpigmented gingival areas to create a confident and pleasing smile, which could be easily attained by using laser.

Clinical Significance: Laser is an effective and fast tool that causes less pain, discomfort, faster healing, and delayed repigmentation compared with scalpel or electrosurgery for gingival depigmentation.
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October 2020

Reviewing the oral pigmented lesions of human immunodeficiency virus with emphasis on the effect of highly active antiretroviral therapy.

Dis Mon 2021 Sep 24;67(9):101167. Epub 2021 Feb 24.

College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, United States. Electronic address:

Acquired immunodeficiency syndrome a disease with high mortality rates is caused by the well-known human immunodeficiency virus. The disease is characterized by several opportunistic infections owing to the decreased CD4 lymphocyte counts. Oral manifestations of human immunodeficiency virus are vital as they are one of the early manifestations of the disease. Also, they serve as prognostic markers as they correlate with the CD4 lymphocyte counts of the affected individuals. Human immunodeficiency virus is not only common in the adult population but also can affect pediatric patients through vertical transmission. The initial therapeutic strategy for the management of the virus was only the prevention of opportunistic infections. Later in the mid-1990s, antiretroviral therapy was introduced but there was no significant improvement in prognosis. After the advent of combination therapy or the use of three antiretroviral drugs also known as highly active antiretroviral therapy, there has been a marked reduction in human immunodeficiency virus-associated mortality rates. The highly active antiretroviral therapy has several effects on the oral manifestations of the human immunodeficiency virus. The present paper aims to review the oral pigmented lesions associated with human immunodeficiency virus with an emphasis on the effect of highly active antiretroviral therapy.
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http://dx.doi.org/10.1016/j.disamonth.2021.101167DOI Listing
September 2021

Necrotizing periodontal diseases in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy: A review.

Dis Mon 2021 Sep 24;67(9):101168. Epub 2021 Feb 24.

College of Dental Medicine, Roseman University of Health Sciences, Utah, United States. Electronic address:

Human immunodeficiency virus-infected patients have depleted CD4 lymphocyte counts and are susceptible to a plethora of infections of bacterial, viral, and fungal etiology. In addition to a wide range of systemic manifestations, human immunodeficiency virus-infected patients also display several characteristic oral manifestations. Studies have shown a correlation between some of the oral manifestations and CD4 lymphocyte counts which in turn is an independent prognostic indicator. To tackle the human immunodeficiency virus numerous drugs have been discovered and implemented. To overcome any potential resistance, human immunodeficiency virus patients are prescribed highly active antiretroviral therapy, wherein a combination of antiretroviral regimens are used. Studies have shown that in addition to controlling the viral activity, the treatment regimen, has a significant effect on the oral manifestations of the human immunodeficiency virus-infected patients. The present paper highlights the effects of highly active antiretroviral therapy on periodontal diseases in human immunodeficiency virus-infected individuals.
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http://dx.doi.org/10.1016/j.disamonth.2021.101168DOI Listing
September 2021

Anticancer Effects of J. Presl, Cinnamaldehyde, 4 Hydroxycinnamic Acid and Eugenol on an Oral Squamous Cell Carcinoma Cell Line.

J Contemp Dent Pract 2020 Sep 1;21(9):1027-1033. Epub 2020 Sep 1.

Department of Medical Biochemistry, University of Madras, Taramani Campus, Chennai, Tamil Nadu, India.

Aim And Objective: The present study was conducted to assess the anticancer effects of J. Presl extract and its active constituents, such as cinnamaldehyde, 4 hydroxycinnamic acid, and eugenol on oral squamous cell carcinoma cell line.

Materials And Methods: Aqueous, ethanolic, and hydroalcoholic extracts of J. Presl (bark) were prepared using standardized protocols. Cinnamaldehyde, 4 hydroxycinnamic acid, and eugenol were quantified in the extracts. Total saponins, tannins, and polyphenols were quantified in the selected extracts. A commercially available SCC-25 cell line was cultured according to standard protocol. The anticancer effects of the extract, active compounds, and standard cisplatin were assessed by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cytotoxicity, acridine orange/ethidium bromide staining, DNA, fragmentation assay, cell cycle analysis by flow cytometry, and JC-1 staining (5,5',6,6'-tetrachloro1,1',3,3'tetraethylbenzimidazolylcarbocyanine iodide).

Results: The hydroalcoholic extracts demonstrated a higher quantity of the active ingredients cinnamaldehyde, 4 hydroxycinnamic acid, and eugenol. The selected extract and active compounds demonstrated anticancer effects via apoptosis induction and S-phase arrest. Apoptosis induction was exerted by the extract via alteration in mitochondrial membrane potential.

Conclusion: J. Presl and its active compounds exhibited anticancer effects on oral squamous cell carcinoma. Further studies in animal models have to be carried out to assess toxicity and effects.

Clinical Significance: The anticancer properties of J. Presl could be explored further for prevention and management of oral squamous cell carcinoma.
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September 2020

Hypothesizing the potential role of melatonin in inhibiting epithelial to mesenchymal transition in oral squamous cell carcinoma.

Med Hypotheses 2020 12 15;145:110346. Epub 2020 Oct 15.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

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http://dx.doi.org/10.1016/j.mehy.2020.110346DOI Listing
December 2020

Melatonin levels in periodontitis vs. the healthy state: A systematic review and meta-analysis.

Oral Dis 2020 Oct 15. Epub 2020 Oct 15.

Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

The aim was to provide a comprehensive qualitative and quantitative assessment of any potential differences in melatonin levels in periodontitis vs. the healthy state. The keyword combination "melatonin" AND "periodontitis" was searched in Web of Science, PubMed, and Scopus. Qualitative analysis and quantitative analysis were performed on articles satisfying the inclusion criteria. Only 14 studies were included in the systematic review, out of which only 10 had quantitative data compatible with a meta-analysis. Ten studies demonstrated low melatonin in periodontitis, three studies demonstrated an initial reduction in melatonin levels followed by elevation with worsening of periodontitis, and one study showed an elevation in melatonin levels in the transition from a healthy state to periodontitis. Grading of recommendations assessment, development, and evaluation revealed that all the included studies had low to very low overall evidence. The meta-analysis revealed a significant reduction (p < .0001) in salivary melatonin levels in chronic periodontitis (3.26 ± 3.44 pg/ml) compared with healthy controls (5.27 ± 5.39 pg/ml), with a mean difference of 2.65 ± 7.84 and a confidence interval of 1.94-3.36. The significantly lower salivary melatonin levels in periodontitis must be inferred with caution given the low quality of the included studies.
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http://dx.doi.org/10.1111/odi.13679DOI Listing
October 2020

The SARS-CoV-2 Virus may Remain Viable on Oral Appliances for up to 3 Days?

J Contemp Dent Pract 2020 Jun 1;21(6):597. Epub 2020 Jun 1.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia, Phone: +966 507633755, e-mail:

The SARS-CoV-2 virus has created havoc in the world by causing the COVID-19 pandemic. The affected patients exhibit fever, cough, and apnea. Hospitalization is often due to progressive respiratory distress, which, in a proportion of patients, had led to fatalities. The geriatric population is at a higher risk, because of their reduced immunity and the presence of comorbid conditions like diabetes mellitus, hypertension, and cardiovascular diseases. Health authorities have advocated social distancing as a method to contain the spread of this contagious disease. A landmark study has shown that the SARS-CoV-2 virus can remain viable on various surfaces like cardboard, stainless steel, plastic, and copper for a long duration. The research conducted by van Doremalen et al. has created an aerosolized environment using SARS-CoV-2 (105.25 50% tissue-culture infectious dose [TCID50] per milliliter) in a Goldberg drum using a 3 jet collision nebulizer and has exposed various materials such as cardboard, paper, stainless steel, plastic, and copper to the virus. The SARS-Cov-2 virus was found to be viable in aerosol for only 3 hours, although its presence on material surfaces lasted significantly longer, especially in stainless steel and plastic surfaces, wherein the virus was detected for up to 72 hours..
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June 2020

Depression, Anxiety, and Psychological Distress among Healthcare Providers during the Outbreak of the Life-threatening Coronavirus Disease (COVID-19).

J Contemp Dent Pract 2020 May 1;21(5):471-472. Epub 2020 May 1.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.

"The concept of total wellness recognizes that our every thought, word, and behavior affect our greater health and well-being. And we, in turn, are affected not only emotionally but also physically and spiritually."-.
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May 2020

EMMPRIN/BASIGIN as a biological modulator of oral cancer and COVID-19 interaction: Novel propositions.

Med Hypotheses 2020 Oct 9;143:110089. Epub 2020 Jul 9.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Extracellular matrix metalloproteinase inducer (EMMPRIN), which is also called BASIGIN/CD147, is a cell surface glycoprotein that belongs to the immunoglobulin superfamily and plays a significant role in intercellular recognition in immunology, cellular differentiation and development. Apart from ACE-2, recently EMMPRIN, has been regarded as a target for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) attachment and entry into the host cell. Since one of the routes of entry for the virus is the oral cavity, it becomes imperative to percept oral comorbidities such oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs) in terms of EMMPRIN as a target for SARS-CoV-2. In the present paper, it is proposed that OSCC, by the virtue of upregulation of EMMPRIN expression, increases the susceptibility to coronavirus disease (COVID-19). In turn, COVID-19 in OSCC patients causes exhaustion of EMMPRIN receptor due to binding with 'S' receptor leading to a downregulation of related carcinogenesis events. We proposed that in the ACE-2 depleted situation in OSCC, EMMPRIN receptor might get high jacked by the COVID-19 virus for the entry into the host cells. Apart from the anti-monoclonal antibody, it is recommended to explore the use of grape seed and skin containing mouthwash as an adjunct, which could also have anti EMMPRIN effects in patients with OSCC and OPMDs.
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http://dx.doi.org/10.1016/j.mehy.2020.110089DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346812PMC
October 2020

Comparison of penetrating depth of chlorhexidine and chitosan into dentinal tubules with and without the effect of ultrasonic irrigation.

J Oral Maxillofac Pathol 2019 Sep-Dec;23(3):389-392

Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

Background: Long term success of root canal treatment depends on complete removal of micro-organisms and their by-products. This can be effectively achieved by the ability of the irrigant to penetrate into the dentinal tubules, which is limited in the conventional mechanical debridement of the root canal system. Irrigant activation technique aids in movement of irrigants into the dentinal tubules.

Aim: To compare the depth of penetration of root canal irrigants into the dentinal tubules with and without ultrasonics using light microscope.

Materials And Methods: Forty noncarious mandibular premolars were used, all the tooth specimens were inoculated with an ATCC 29212 strain of E.faecalis and incubated under nutrient rich aerobic conditions at 37°C. Teeth were sectioned below the cementoenamel junction to obtain a standard length of 8 mm and instrumented with K-files, irrigated with 5.25% sodium hypochlorite and a final rinse of 17% EDTA. Teeth were divided into four groups of ten each. Group IA was irrigated with 2% Chlorhexidine (CHX) and agitated ultrasonically, Group IB was irrigated with 2% Chlorhexidine, Group IC was irrigated with 2% Chitosan and ultrasonically agitated, Group ID was irrigated with 2 % Chitosan. The tooth specimens were sectioned and subjected to gram staining and viewed under 100X oil immersion microscope. A micrometer grid was attached to the eyepiece to enable measurement of the depth of penetration of the irrigants. Group IA (2% Chlorhexidine with ultrasonic agitation) showed better penetration into the dentinal tubules as compared to Groups IB, IC, ID.

Results: Irrigation with 2% Chlorhexidine with ultrasonic agitation had depth of penetration into the dentinal tubules upto 2350 μm. 2% Chlorhexidine without ultrasonic agitation penetrated upto 1800 μm. Chitosan with ultrasonic agitation penetrated upto1250 μm and Chitosan without ultrasonic agitation penetrated upto 44.80 μm.

Conclusion: 2% Chlorexidine as irrigant with ultrasonic agitation was found to have maximum depth of penetration into the dentinal tubules when compared with Chitosan.
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http://dx.doi.org/10.4103/jomfp.JOMFP_194_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948069PMC
January 2020

Invitro Anti-mycotic Activity of Hydro Alcoholic Extracts of Some Indian Medicinal Plants against Fluconazole Resistant Candida albicans.

J Clin Diagn Res 2015 Aug 1;9(8):ZC07-10. Epub 2015 Aug 1.

Principal, College of Pharmacy, Sri Ramachandra University .

Background: Candidiasis is one of the most common opportunistic infections caused by Candida albicans. Fluconazole is the drug of choice for prevention and management of this condition. However, the emergence of fluconazole resistant candidal strains has become a major concern. Many herbs like fenugreek, cinnamon, papaya, oregano, garlic are rich in phytochemical constituents known to express antimycotic activity. With the available information, the present research study was carried out to assess the invitro anti-mycotic activity of hydro alcoholic extracts of Trigonella foenum-graecum seeds, Cinnamomum verum bark and Carica papaya leaves and seeds against fluconazole resistant Candida albicans.

Materials And Methods: Hydro alcoholic extracts of Trigonella foenum-graecum (seeds), Cinnamomum verum (bark), Carica papaya CO.2 strain (male and female leaves) and Carica papaya CO.2 strain (seeds) were prepared by maceration. The anti-mycotic activity of the prepared extracts against Candida albicans was assessed by agar well diffusion method. Three independent experiments were performed in triplicates and the mean and standard deviation were calculated. Minimum inhibitory concentration was determined.

Results: The results of the present study revealed that all the extracts exhibited anti-mycotic activity in a dose dependent manner and minimum inhibitory concentration of all the extracts was found to be 15.62 μg/ml.

Conclusion: The results of the present study shed light on the fact that plant extracts could be used not only as an alternate drug for management of fluconazole resistant candidiasis but also explored further for oral cancer prevention as a therapeutic adjunct.
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http://dx.doi.org/10.7860/JCDR/2015/14178.6273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576630PMC
August 2015
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