Changes in the lesion surface suggesting transformation of oral potentially malignant disorders to malignancy – a report of eight cases

Background In the case of oral potentially malignant disorders (OPMD), the possibility of malignant transformation of the lesion necessitates a decision on the need for an additional biopsy at each visit. Among many clinical characteristics, change on the lesion surface is one of the important factors that determine the need for additional biopsy at each visit. The purpose of the study was to provide information on the characteristics of lesions related to malignant transformation during the follow-up period of OPMD. Methods Eight patients (four men and four women) with OPMD that transformed into malignancy during long-term follow-up were included and their mean age was 65.8 ± 12.4 years. Clinical information and histopathological diagnosis were investigated at the initial visit and during the long-term follow-up period. The focus was on information on changes on the lesion surface at the time the lesion was confirmed to be malignant. The period from initial diagnosis to dysplasia and from dysplasia to malignancy was also investigated. Results The OPMD diagnoses were oral lichen planus or oral lichenoid lesions (n = 2), oral leukoplakia (n = 5), and hyperplastic candidiasis (n = 1). During the follow-up period of the lesions, when dysplasia was obtained by additional biopsy, changes in the lesions consisted of an increase in the size of the white or red area. The lesion surface of the OPMD showed verrucous, papillary, exophytic, corrugated, and ulcerative changes at the time of malignancy diagnosis. The period for the initial lesion to become dysplasia, from dysplasia to malignancy, and from the initial lesion to malignancy was very variable. Conclusions Attention should be paid to verrucous, papillary, exophytic, corrugated, and ulcerative changes on the lesion surface of OPMD. Considering that the period for OPMD to become malignant is highly variable, a longer follow-up of the lesion is necessary

타액대체제가 타액 효소 활성에 미치는 영향

Many of the protective functions of saliva can be attributed to the biological, physical, structural, and rheological characteristics of salivary glycoproteins. Therefore, the development of ideal saliva substitutes requires understanding of the rheological as well as biological properties of human saliva. In the present study, we investigated the changes of salivary enzymatic activities by saliva substitutes and compared viscosity of saliva substitutes with human saliva. Five kinds of saliva substitutes such as Moi-Stir, Stoppers4, MouthKote, Saliva Orthana, and SNU were used. Lysozyme activity was determined by the turbidimetric method. Peroxidase activity was determined with an NbsSCN assay. α -Amylase activity was determined using a chromogenic substrate, 2-chloro-p-nitrophenol linked with maltotriose. The pH values of saliva substitutes were measured and their viscosity values were measured with a cone-and-plate digital viscometer at six different shear rates. Various types of saliva substitutes affected the activities of salivary enzymes in different ways. Stoppers4 enhanced the enzymatic activities of hen egg-white lysozyme, bovine lactoperoxidase (bLP), and α-amylase. Saliva Orthana and SNU inhibited bLP activity and enhanced α-amylase activity. MouthKote inhibited α-amylase activity. 타액의 보호작용은 주로 타액 당단백질의 생물학적, 물리적, 구조적 성질 및 유동학적 성질과 관련이 있다. 그러므로 이상적인 타액 대체제의 개발을 위해서는 인체 타액의 생물학적 성질 뿐만 아니라 유동학적 특성을 이해하여야 한다. 본 연구의 목적은 타액 대체제가 인체 타액에 존재하는 효소의 활성에 미치는 영향을 파악하고 다양한 타액 대체제의 점도와 인체 타액의 점도를 비교하기 위해서 시행되었다. Moi-Stir, Stoppers4, MouthKote, Saliva Orthana 및 서울대학교치과병원 타액 대체제(SNU)를 사용하였으며, lysozyme 활성은 turbidimetric 법으로, peroxidase 활성은 NbsSCN 법으로, α-amylase 활성은 maltotriose와 결합된 2-chloro-p-nitrophenol를 사용하여 시행하였다. 타액 대체제의 pH를 측정하였으며 cone-and-plate 형태의 점도계를 이용하여 다양한 전단율에서 점도를 측정하였다. 본 연구에 사용된 다양한 타액 대체제는 타액 효소 활성에 각기 다른 영향을 미쳤다. Stoppers4는 hen egg-white lysozyme, bovine lactoperoxidase (bLP) 및 α-amylase 활성을 증가시켰고, Saliva Orthana와 SNU는 bLP 활성은 저해하였으며 α-amylase 활성은 증가시켰다. MouthKote는 α-amylase 활성을 저해하였으며, Moi-Stir는 bLP와 α-amylase 활성을 저해하였다. 타액 대체제의 pH는 타액 대체제의 종류에 따라 매우 달랐다. Stoppers4, MouthKote 및 Saliva Orthana는 낮은 전단율에서는 인체 타액보다 낮은 점도를 높은 전단율에서는 인체 타액보다 높은 점도를 나타내었다. Moi-Stir와 SNU는 인체 타액보다 매우 높은 점도를 나타내었다.This study was supported by grant no. 04-2001-0530 from the Seoul National University Dental Hospital Research Fund

Oral manifestations in vitamin B12 deficiency patients with or without history of gastrectomy

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract Background The purpose of this study was to compare clinical features of vitamin B12 deficiency patients with a history of gastrectomy to those without a history of gastrectomy. Methods Twenty-two patients with vitamin B12 deficiency were included. Patients chief complaints, oral manifestations, blood examination results, and past medical histories were reviewed. Results Eleven patients had a history of gastrectomy and 11 did not. The chief complaint was glossodynia in all patients. No significant differences were observed between the two groups regarding age, sex, symptom duration, or plasma vitamin B12 level. Erythema and depapillation of the tongue were the most common findings, however less common among patients without a history of gastrectomy. Two patients with a history of gastrectomy and 5 patients without a history of gastrectomy had normal oral mucosa. Patients with a history of gastrectomy were more anemic. Oral symptoms of the majority of patients responded to antifungals and vitamin B12 replacement. The suggested etiologies for vitamin B12 deficiency in the patients without a history of gastrectomy were gastritis, medications, diet, autoimmunity, and early gastric cancer. Conclusions Vitamin B12 deficiency and its associated etiological factors should be considered in patients with glossodynia, even those whose oral mucosa appears normal and who lack a history of gastrectomy

Clinical factors affecting salivary transferrin level, a marker of blood contamination in salivary analysis

Abstract Background Diagnostic value of whole saliva may be compromised when blood contamination is present in saliva samples. Measuring transferrin level in saliva samples has been used for detecting the level of blood contamination in saliva. The aim of this study was to investigate the validity of transferrin as a proper biomarker for blood contamination in whole saliva. Methods Thirty younger (mean age: 25.9 ± 2.1 years) and twenty older (mean age: 65.1 ± 9.0 years) females were included. The index reflecting overall gingival inflammation (total gingival index), salivary flow rate, and salivary concentration and secretion rate of transferrin of each subject were analyzed. Results Salivary transferrin concentrations and secretion rates were higher in the younger females than in the older ones despite a lower total gingival index in the younger females. The total gingival index showed no significant correlations with the concentration or secretion rate of transferrin in either unstimulated or stimulated whole saliva of younger and older subjects. The salivary concentration of transferrin showed negative correlations with the flow rate of saliva in both the younger and older groups. There were significant positive correlations between the salivary concentrations and secretion rates of transferrin in both the younger and older groups. Conclusions Salivary transferrin levels could be affected by other factors as well as the level of blood contamination. The influences of age, gonadal hormones, salivary flow rate, and chewing performance need to be considered when using the salivary level of transferrin as a blood contamination marker

Use of hand-held laser scanning in the assessment of craniometry

The intra- and inter-examiner reliability was evaluated for hand-held 3D laser scanning technology when it was combined with localization of landmarks for craniometry. The data from the laser surface scanning were compared with those of conventional direct measuring. Using thirty unidentified skulls requested for individual identification, measurements were taken of the line distances from lambda to 26 landmarks, and also for seven breadth parameters. For the laser surface scanning, two examiners performed replicate measurements with an interval of 1 week. In the conventional direct measuring, the first examiner took replicate measurements with a 1-week interval. To assess intra- and inter-examiner reliabilities, the intraclass correlation coefficient was used. Analysis of variance with repeated measures for each parameter was performed to compare the conventional method with the 3D scanning method. Both the 3D scanning and conventional methods showed excellent intra-examiner reliabilities, and the 3D laser scanning method also showed excellent inter-examiner reliability. A statistical difference between the two examiners was found only in nasal breadth in the 3D laser scanning method. There was no significant difference between the two measuring methods, though the 3D laser scanning method tended to give a slightly lower reading. Collectively, the 3D laser scanning method with point localization is a useful method with excellent reliability, and it can replace the conventional direct measuring method in craniometry

Age estimation by occlusal tooth wear

The purpose of the present investigation was to test the accuracy of a new scoring system in recording tooth wear for age estimation. The material consisted of dental stone casts of 383 volunteers who had sound premolars and molars with normal occlusion. The degree of occlusal wear for all preolar and molar teeth was scored with the new system. The high intra- and inter-examiner concordances showed that the new score system was very reliable. The degree of tooth wear showed a significant positive correlation with age in each and every examined tooth of both males and females. Tooth wear scores of males were higher than those of females. Calculating tables for age estimation were designed and the accuracy of age estimation was obtained with the General Linear Models procedures. Our system could provide estimation of an individual's age within ±3 years in 42.4% of males and 49.4% of females, within ±5 years in 61.8% of males and 63.3% of females. When the subjects were divided into two age groups and data were re-treated, the accuracy of age estimation was increased. Collectively, it was shown that our new system for scoring tooth wear is a reliable and accurate method for age estimation

Peroxidase가 Lysozyme 활성에 미치는 영향

It is well known that many antimicrobial proteins in saliva interact with each other. The purpose of the present study was to investigate the interactions of lysozyme with peroxidase in the aspects of enzymatic activity in vitro. The interactions of lysozyme with peroxidase were examined by incubating hen egg-white lysozyme (HEWL) with bovine lactoperoxidase (bLP). The influence of peroxidase system on lysozyme was examined by subsequent addition of potassium thiocyanate and hydrogen peroxide. Lysozyme activity was determined by turbidity measurement of a Micrococcus lysodeikticus substrate suspension. Peroxidase activity was determined with an NbsSCN assay. The Wilcoxon signed rank test was used to analyze the changes of enzymatic activities compared with their controls. bLP at physiological concentrations enhanced the enzymatic activity of HEWL (P ＜ 0.05) and its effect was dependent on the concentration of peroxidase. However, HEWL did not affect the enzymatic activity of bLP. Thiocyanate did not affect the enzymatic activity of HEWL, either. The addition of potassium thiocyanate and hydrogen peroxide did not lead to additional enhancement of the enzymatic activity of HEWL. The changes of hydrogen peroxide concentration in the peroxidase system did not affect the enzymatic activity of HEWL. Collectively, despite an in vitro nature of our study, the results of the present study provide valuable information on the interactions of lysozyme and peroxidase in the aspects of enzymatic activity in oral health care products and possibly in the oral cavity. 타액에 존재하는 여러 항균물질은 상호작용을 통하여 부가적이거나 상승작용을 나타내고 때로는 저해작용을 나타내는 것으로 알려져 있다. 본 연구는 in vitro 상에서 lysozyme과 peroxidase 사이의 상호작용을 효소활성 측면에서 조사하고자 시행되었다. Lysozyme과 peroxidase의 상호작용은 hen egg-white lysozyme (HEWL)과 bovine lactoperoxidase (bLP)를 혼합하는 방법으로 조사되었고, peroxidase system이 lysozyme에 미치는 영향은 potassium thiocyanate와 hydrogen peroxide를 추가적으로 첨가하는 방법으로 조사되었다. Lysozyme 활성은 Micrococcus lysodeikticus 기질용액의 혼탁도 변화를 측정하는 방법으로 측정되었고, peroxidase 활성은 NbsSCN 법으로 측정되었다. Wilcoxon signed rank 법을 이용하여 lysozyme과 peroxidase 효소활성 변화를 대조군과 비교하였다. 생리적 농도범위에서 bLP는 HEWL의 효소활성을 증가시켰으며 (P ＜ 0.05), 그 효과는 bLP의 농도증가에 따라 영향을 받았다. 하지만 HEWL는 bLP의 효소활성에 영향을 주지 못하였다. Thiocyanate는 HEWL의 효소활성에 영향을 주지 못하였고, potassium thiocyanate와 hydrogen peroxide를 추가한 peroxidase system도 HEWL 효소활성의 추가적인 상승을 유도하지는 못하였으며, hydrogen peroxide의 농도변화도 영향을 미치지 못하였다. 본 연구의 결과는 타액 항균물질을 포함하고 있는 구강건강용품이나 구강에서 lysozyme과 peroxidase의 상호작용을 이해하는데 필요한 중요한 정보를 제공해준다.This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea, A050054

Salivary levels of IL-1 beta, IL-6, IL-8, and TNF-alpha in patients with burning mouth syndrome

Objective To compare salivary IL-1β, IL-6, IL-8, and TNF-α levels between patients with burning mouth syndrome (BMS) and controls. Design Forty female patients with BMS (mean age: 61.6 ± 10.1 years) and 20 female control subjects (mean age: 65.1 ± 9.0 years) were included in the study. Unstimulated (UWS) and stimulated whole saliva samples (SWS) were collected and their flow rates were determined. Salivary IL-1β, IL-6, IL-8, and TNF-α levels and total protein concentration were also determined. Salivary transferrin level was determined to investigate the level of blood contamination in saliva samples. Gingival index of the subjects was also examined. Student's t-test, Pearson's correlation analysis, and analysis of covariance were used. Results No significant differences were found in the salivary levels of IL-1β, IL-6, IL-8, and TNF-α in BMS patients compared with controls. Salivary flow rates and their total protein concentrations did not differ significantly between the groups. The levels of salivary cytokines and total protein concentration correlated significantly with the level of blood contamination in both UWS and SWS. Conclusion There were no differences in the salivary levels of IL-1β, IL-6, IL-8, and TNF-α in BMS patients compared with controls. Cytokine levels in whole saliva were affected mainly by the amount of blood contamination.This study was supported by the Korea Research Foundation Grant funded by the Korean Government (MOEHRD) (KRF- 2007-313-E00495). Funding: This study was supported by the Korea Research Foundation Grant funded by the Korean Government (MOEHRD) (KRF-2007-313-E00495)

The Relationship between Oral Candida carriage and the secretor status of blood group antigens in saliva

Objective The aim of the study was to investigate the relationship between oral Candida carriage and the secretor status of blood group antigens. Study design Unstimulated whole saliva and oral rinse samples were obtained from 180 healthy subjects. These samples were plated on Sabourauds dextrose agar media to determine oral Candida carriage. Sodium dodecylsulfate polyacrylamide gel electrophoresis and immunoblotting were performed on whole saliva samples to determine the secretor status of blood group antigens. Results The oral Candida carriage rate was found to be 45.0%. The sensitivity of the concentrated rinse culture proved to be superior. Oral Candida carriage was not significantly related to the blood group or secretor status of ABH or Lewis antigens. No significant relationship was found between oral Candida carriage and salivary flow rate. However, smoking affected oral Candida carriage. Conclusion Oral Candida carriage in healthy individuals is not significantly related to blood group or secretor status

Experimental salivary pellicles on the surface of orthodontic materials

The purpose of this study was to define the composition of salivary pellicles that form on the surfaces of orthodontic materials and to further investigate whether qualitative differences exist between the composition of adsorbed salivary pellicles that form on 3 different orthodontic materials: stainless steel bracket metal, elastomeric ligature ring, and bracket bonding resin. Experimental pellicles were formed by incubating these materials in fresh human parotid or submandibular-sublingual saliva for 2 hours. Pellicles were extracted with sodium dodecyl sulfate buffer and lyophilized. They were then subjected to sodium dodecyl sulfate—polyacrylamide gel electrophoresis and immunoblotting to identify the adsorbed salivary components. Remarkable differences in the profiles of pellicle components were found, dependent on the type of orthodontic materials. The pellicle components on the bracket metal were almost the same as those found on the elastomeric ligature ring. Salivary protein adsorption patterns to bonding resin showed different features. Distinct differences were also found between the surface-binding affinities of the same salivary proteins from different glandular salivas. These results may be explained on the basis that binding sites for specific proteins on the surfaces of the materials are covered by molecules of submandibular-sublingual saliva, probably mucins. The results of this study provide valuable information concerning initial bacterial adhesion to the surfaces of orthodontic materials, as well as information that could be used in the development of orthodontic materials with enhanced surface properties. (Am J Orthod Dentofacial Orthop 2001;119:59-66