Role of Epidermal growth factor receptor in odontogenic epithelium and development of odontogenic lesions

Growth is a highly coordinated process which is sustained by several growth factors and apoptotic factors. Any disturbance in this delicate balance leads to pathologies and genes that have such potential to produce tumors when mutated are known as oncogenes. EGFR an important growth factor that is involved in several physiological processes is presently one of the most common genes in targeted cancer therapies. Though, its potential as an oncogene target in head and neck epithelial tumors like squamous cell carcinoma is gaining importance and opening doors to revolutionizing cancer treatment modalities, its role in other head and neck epithelia like odontogenic epithelia remains vague and needs attention. The present article highlights some of the key findings in our research evaluating the role of EGFR in physiologic odontogenic epithelium that is comprised within pericoronal follicles. The research involved study of immunohistochemical examination of 35 pericoronal follicles removed from patients with asymptomatic impacted tooth extractions. The follicles were assessed for intensity, percentage of staining and location of the EGFR stain. The follicles predominantly showed intense staining pattern and location of EGFR positivity in most epithelium and rests were combined both cytoplasmic and membrane positivity. These findings reemphasize the inherent proliferative potential present in follicles and their role in formation of odontogenic tumors like ameloblastomas in long term impacted teeth. The potential of EGFR as a treatment target in odontogenic tumors also remains plausible

Attitudes of general dental practitioners towards biopsy procedures

Objectives: A dentist is required to detect and recognise oral lesions and inform the patient accordingly by providing a diagnosis and adequate treatment plan. Biopsy serves as an important aid in achieving this goal; however, its use is not so widespread in general dental practice. The objective of the present study was to explore the attitudes of general dental practitioners in Belgaum city towards biopsy for diagnosis of oral lesions. Material and methods: A self designed questionnaire was administered to 74 general dental practitioners in Belgaum city, in the southern region of India, consisting of several items addressing the socio-demographic and professional aspects and their attitudes towards oral biopsy procedures. Results: The response rate was exceptionally high i.e. 90.54%. All the dentists felt that biopsy was an important tool in diagnosis of oral lesions but many still did not venture to undertake it on their own and preferred referring it to a specialist or higher care centre. This was mainly due to lack of experience and patient factors. There were also conflicting results regarding referral diagnostic pathology services and preservation of the biopsy specimens. Conclusion: This emphasizes the need for higher levels of importance to be placed on this aspect in undergraduate and postgraduate dental curriculum. Organisation of specific training or continuing dental education programmes to enhance their practical skills could aid in increasing the utility of this important tool in diagnosis of oral lesion

Innovation in health care – A roadmap for this paradigm shift

The increasing burden of disease, rising health-care costs, rise in the patients' and public's expectations, and aging population all emphasize the constraints in providing quality health care with limited resources. The ability to innovate will be the determining factor in the future of health-care organizations. The editorial gives an overview of the dimensions that come into play to develop an organizational culture or an innovation ecosystem in health science organizations

Role of Epidermal growth factor receptor in odontogenic epithelium and development of odontogenic lesions

Growth is a highly coordinated process which is sustained by several growth factors and apoptotic factors. Any disturbance in this delicate balance leads to pathologies and genes that have such potential to produce tumors when mutated are known as oncogenes. EGFR an important growth factor that is involved in several physiological processes is presently one of the most common genes in targeted cancer therapies. Though, its potential as an oncogene target in head and neck epithelial tumors like squamous cell carcinoma is gaining importance and opening doors to revolutionizing cancer treatment modalities, its role in other head and neck epithelia like odontogenic epithelia remains vague and needs attention. The present article highlights some of the key findings in our research evaluating the role of EGFR in physiologic odontogenic epithelium that is comprised within pericoronal follicles. The research involved study of immunohistochemical examination of 35 pericoronal follicles removed from patients with asymptomatic impacted tooth extractions. The follicles were assessed for intensity, percentage of staining and location of the EGFR stain. The follicles predominantly showed intense staining pattern and location of EGFR positivity in most epithelium and rests were combined both cytoplasmic and membrane positivity. These findings reemphasize the inherent proliferative potential present in follicles and their role in formation of odontogenic tumors like ameloblastomas in long term impacted teeth. The potential of EGFR as a treatment target in odontogenic tumors also remains plausible

Salivary growth differentiation factor-15 levels in oral leukoplakia and oral squamous cell carcinoma

OBJECTIVES: About 90% of oral cancers are oral squamous cell carcinomas (OSCC) whose appropriate treatment requires early diagnosis, based on knowledge about biomarkers which are expressed during the complex process of carcinogenesis. Growth differentiation factor-15 (GDF-15) has been considered an important serum and immunohistochemical marker in several cancers. Saliva has several advantages as a diagnostic biofluid. This research intends to evaluate the salivary GDF-15 levels in oral leukoplakia (OL) and in OSCC. MATERIALS AND METHODS: We estimated and compared levels of salivary GDF-15 in cases of OL, OSCC, and healthy controls. Study groups comprised 30 cases each of OL and OSCC. Control group comprised 30 healthy individuals. Saliva samples were assessed using the enzyme-Linked immunosorbent assay for GDF-15 levels. RESULTS: Salivary GDF-15 levels showed a gradual increase from healthy volunteers to cases of OL and highest GDF-15 levels were noted in OSCC group. Increase in concentration of GDF-15 was also noted with increasing grades of OSCC. CONCLUSION: Increased level of GDF-15 in premalignant cases reflects its antitumorigenic role, whereas its expression in later stages of OSCC demonstrates its protumorigenic role. The regulatory mechanism associated with GDF-15 may help in developing some novel therapeutic strategies based on its expression

Expression of p120-catenin expression in oral epithelial dysplasia and oral squamous cell carcinoma: An immunohistochemical study

Objective: Most oral squamous cell carcinoma (OSCC) are preceded by premalignant conditions that demonstrate histopathologically as epithelial dysplasia and their malignant potential of a lesion is mainly determined using various grading systems. Loss of p120 catenin (p120) or its phosphorylation destabilizes E-cadherin; thereby it regulates cadherin stability and turnover which could affect the cell adhesive and migratory capacity. Therefore, p120 is related to invasiveness and progression of various human epithelial many tumor types, including OSCCs. Methodology: The immunoexpression of p120 in 60 selected cases were grouped into; oral epithelial dysplasia (OED) (n = 40) and OSCC (n = 20). The cases were assessed by two independent observers. The p120 immunolabeling was analyzed using the parameters intensity, percentage and the location of the epidermal growth factor receptor staining. Results: In OED, there was p120 expression observed in 100% of cases with 62.5% cases showing preserved expression, i.e., >50%, whereas 15% showed reduced/downregulation of p120 catenin levels. Further, a variation within the grades was also observed. The low-risk group of OED showed a preserved expression seen with most of the cases having >50% expression (95%) positivity and in the high-risk cases, there was a marked reduction with 70% of the cases showing reduced expression (P < 0.01). This reduction in expression was more prominent in OSCC with 60% showing reduced expression, whereas 20% showed loss of expression. Conclusion: The presence of strong reactivity was seen in oral dysplasia and most of the well-differentiated OSCC, the infiltrating areas of aggressive OSCC showed decreased and/or total lack of immunostaining. The abnormal staining pattern of p120 can reflect loss/reduction of adhesion and could be used to identify the malignant potential of OED and aggressiveness in OED

Epithelial-mesenchymal transition - A fundamental mechanism in cancer progression: An overview

The epithelial-mesenchymal transition (EMT) has a significant role in embryogenesis. EMT is also implicated as a fundamental step development of invasive phenotypes associated with progression of cancer. EMT confers the cancer cells with migratory and invasive properties that allow them to come into the stroma, which creates a conducive environment for cancer progression and metastasis. Moreover, acquisition of EMT is linked with resistance to chemotherapy that could lead to recurrences and enhance the morbidity and mortality related to cancers. Consequently, EMT has been associated with carcinogenesis, invasion, metastasis, recurrence, and chemoresistance. Research into EMT and its role in cancer pathogenesis has advanced in a rapid pace, but since its participation shows considerable variation among different cancer types and the exact mechanism operative in different cancers remains ambiguous; EMT continues to be a significant issue for research. In this review, we present an overview of EMT, its role in cancer progression and the clinical implication of its identification

Sex assessment efficacy of permanent maxillary first molar cusp dimensions in Indians

Background: The human first maxillary molar provides clues about evolution and is functionally important. It has four main cusps, and each cusp has an independent growth pattern and different evolutionary background. Though less explored, the analysis based on measurement of each cusp appears to be more meaningful biologically than conventional measurements of the whole crown. Aim: This study aimed to demonstrate the extent of sexual dimorphism in permanent maxillary first molar cusp diameters and their potential utility in sex prediction among Indians using logistic regression analysis (LRA). Materials and Methods: The mesiodistal and buccolingual (BL) crown diameters along with cusp dimensions and cusp indices of right maxillary first molar were measured in an Indian sample (149 males, 151 females; age range of 18–30 years). The possible sex dimorphism in these parameters was evaluated, and LRA was performed to ascertain their usefulness in sex prediction. Results: BL crown dimension and the hypocone (distolingual) cusp showed the highest sexual dimorphism. The combination of metacone and hypocone, i.e., distal cusp diameters among cusp parameters showed the highest accuracy (61.3%). While, on combining all the crown and cusp diameters together the overall accuracy was raised (64.3%). Conclusion: This study supports the ontogeny hypothesis suggesting that early-forming mesial cusps demonstrate less sexual variation as compared to subsequently formed distal cusps in the maxillary molar. Though the sex identification accuracy for cusp diameters of the permanent maxillary first molar in Indians is relatively moderate (≈61%), it can be used as an adjunct for sexing of adult Indians in forensic contexts