Immunohistochemical expression of p21 in normal tissues of salivary gland, pleomorphic adenoma and carcinoma ex pleomorphic adenoma (undifferentiated and adenocarcinoma types)

Objective: Our study aimed to characterize alteration in the immunohistochemical expression of p21 in normal tissue of the salivary gland surrounding pleomorphic adenoma, the tumor cells of pleomorphic adenomas, and carcinoma arising in pleomorphic adenoma. Study design: A selected series of 29 cases of pleomorphic adenomas, and 27 cases of carcinoma ex-pleomorphic adenoma (undifferentiated and adenocarcinoma types) were examined. Results: The results showed that p21 expression was negative in the most components of normal tissue of the salivary gland surrounding pleomorphic adenoma, 24 cases out of 29 of the non tumour duct cells (82.8%), and 28 (96.6%) cases out of 29 of the acinar cells shows negative p21 expression. P21 expression in pleomorphic adenomas shows that 2 cases out of 29 (6.9%) strongly expressed in the duct cells. p21 was strongly expressed in carcinoma cells in 9 (33.3%) cases out of 27. Conclusion: Our data suggest that the strong nuclear staining as an indicator for altered p21, then the alteration of p21 expression would increase from pleomorphic adenoma to carcinoma arising in pleomorphic adenomas (6.9% versus 33.3%)

Immunohistochemical expression of oestrogens and progesterone receptors in carcinoma ex pleomorphic adenoma- undifferentiated and adenocarcinoma types

Cancer of the salivary gland is one of the common cancers in the head and the neck regions. This type of cancer develops in the minor and the major salivary glands, and it sometimes metastasizes to other organs, particularly the lung. Morphologic mimicry and similarity in the expression of steroid hormone receptors between salivary gland tumors and breast tumors are well-known phenomena and are occasionally debated in the field of surgical pathology. The expression of sex hormone receptors in some tumors suggests a role for these receptors in tumor pathogenesis and therapy. Previous studies of the expression of estrogens and progesterone receptors in salivary gland tumors have reported conflicting results. Objective: Our study aimed to characterize alteration in the immunohistochemical expression of estrogens receptor and progesterone receptor in the tumor cells of carcinoma arising in pleomorphic adenoma. Study design: 27 cases of carcinoma arising in pleomorphic adenoma (undifferentiated and adenocarcinoma types) were examined. Results: The results showed that 27 (100 %) of 27 cases had negative nuclear staining for either estrogens or progesterone receptors. Conclusion: Our data suggest that carcinomas arising in pleomorphic adenoma were not dependent on endocrine function

An immunohistochemical study of the distribution of p 16 protein in oral mucosa in smokers, non-smokers and in frictional keratosis

Objective: Our study aimed to characterize alteration in the immunohistochemical p16 expression in normal oral mucosa and non-neoplastic hyperproliferative disorders (i.e. frictional keratosis and mucosa from smokers). Study design: 43 specimen of oral mucosa were examined using immunohistochemistry. Results: In normal mucosa, there was strong positive nuclear staining in a proportion of fibroblasts and endothelial cells in the lamina propria, with variable expression in nuclei of the epithelial layer. However, when the patient?s tobacco smoking was examined, p16 nuclear staining in oral epithelium was seen in 4/20 (20%) of smokers and 0/23 (0%) of non-smokers. In every case of frictional keratosis (n=11), there was strong nuclear staining of some basal and supra-basal cells. In addition, there was strong nuclear staining of parakeratinizing squamous in a band above the spinous layer. In clinically normal oral epithelium of smokers and in frictional keratosis, basal and supra-basal cells expressed strong p16 nuclear staining which was absent in the control tissue examined. Conclusion: Our data suggest that p16 expression may be involved in the long-term loss of proliferation in cell senescence of oral mucosa

Immunohistochemical Expression of p53 in Pleomorphic Adenoma and Carcinoma Ex Pleomorphic Adenoma

Context. Immunohistochemical stains for p53 are used as a diagnostic marker associated with malignancy in several histologic types of salivary gland tumors. This marker may be useful in differentiating pleomorphic adenoma (PA) from carcinoma ex pleomorphic adenoma (CPA), as these tumors are often difficult to distinguish on the basis of morphology alone. Objective. to evaluate whatever inactivation of tumor suppressor gene (p53) increases with the tumor progression from normal salivary tissue to PA and eventually CPA. Design. Paraffin blocks of 29 cases of PA, which were surrounded by normal parotid gland, and 27 cases of carcinoma ex pleomorphic adenoma were retrieved and validated. In all cases of carcinoma ex pleomorphic adenoma, a PA “ghost” was identified, and the malignant element was either undifferentiated carcinoma or adenocarcinoma. Results. The results showed negative nuclear expression of P53 in normal parotid gland. Nuclear P53 was expressed strongly in 6/29 (20.7%) pleomorphic salivary adenoma and 10/27 (37%) carcinoma ex pleomorphic adenoma. Conclusion. Our data suggest that inactivation of p53 may play an important role in the evolution of pleomorphic salivary adenoma and carcinoma ex pleomorphic adenoma

A survey of dentists? practice in the restoration of the shortened dental arch

Objectives: The aim of this survey was to determine how a sample of dentists working in general dental practice in the UK sought to restore the mouths of patients who had shortened dental arches (SDAs). Study design: A survey was conducted over a period of six months on four commercial dental laboratories. Cases of SDAs comprising the anterior teeth and 2 to 4 premolars were examined; dental prescriptions were scrutinized and a special data collection form was completed accordingly. Results: A total of 140 SDA cases were examined. Most of these cases were for mandibular SDAs (88.6%). Of the recorded SDA cases, 67.2% were restored by cobalt-chromium based removable partial dentures (RPD); 25.7% were extended by acrylic-resin based RPDs; implants were provided to restore 8 SDA cases (5.7%); and only two SDA cases (1.4%) were extended by cantilevered fixed bridges. Neither the gender of the patient ([Chi (2)= 4.19, p>0.05) nor the length of the SDA ([Chi (2) = 6.51, p>0.05) influenced the choice of prosthesis to be implemented. Conclusions: It would appear from the results of this survey that among the different restorative treatment options for SDA, the RPD was the most popular treatment option for dentists surveyed in this UK study. Extending the SDA by either an implant-supported prosthesis or cantilevered fixed bridges did not appear to be a popular choice of treatment

Systematic Review with no Meta-analysis of Coronavirus COVID-19

AIMS: COVID-19 is a new virus which has spread to most countries in the world. Many papers have been published on the clinical manifestations of this virus. This paper concentrates only on the clinical cases and prognosis of COVID-19 presented in the literature. METHODS: Systematic review is done, and taken into consideration, all published papers in the literature related to COVID-19. Inclusion and exclusion criteria have been applied. RESULTS: Few papers have been determined after many filtrations of all published papers concerning inclusion and exclusion criteria to assess outcome of existing COVID-19. Most published papers or reports did not provide full details for each case. CONCLUSION: Most clinical description data in these reports are so limited and missing some of the critical elements such as the date of infection, source of infection, symptoms, diagnostic criteria, incubation of infection, transmission of infection, number of identified cases after contact with infected patients, and health workers are affected or not by treatment of infected patients, patient age, and type of study. No clear evidence of the treatment plan and the prevention and most data in literature depending on personal experience only which is different from country to others

COVID-19 Guidelines to Protect Healthcare Workers at Hospitals and Dental Professionals at Dental Office

BACKGROUND፡ Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. This study aimed to address the preventive procedures to protect healthcare workers at hospital to avoid COVID-19, and infection control procedures to protect dental professionals in dental office.METHODS: We conducted a search of published articles from PubMed, google scholar databases using key words such as COVID-19, healthcare worker, infection control, and dental practice. Relevant articles were identified and reviewed. Most published papers were clinical reports and case studies. We have selected some of the current published papers written in English in 2020.RESULTS: Infection control procedures to protect health workers at hospitals, and dental professionals at dental office were summurised and presented. Infection control procedures for healthcare workers at hospitals include Personal protective equipment, Korea filter (KF)94 respirator, goggles, face protector,disposable waterproof long-arm gown, and gloves, and others. Extra-protection procedures should be taken with old and vulnerable healthcare workers. Dental professionals should evaluate patients in advance before starting dental treatment. Aerosols generating procedures should be avoided and personal protective equipment should be used. Dental treatment should be restricted to emergency cases only.CONCLUSION: Old medical staff should be in safer distance to avoid infection, but young physicians and nurses should work at frontline as their immunity is better than their colleagues at old age. Screening patients and measurement of the body temperature are essential measures before dental treatment

The effect of radiotherapy on survival of dental implants in head and neck cancer patients

Objectives: To explore the current literature of the survival of dental implants in irradiated head and neck cancer patients considering the role of implant location, bone augmentation, dose of radiation and timing of implant placement. Study Design: Pubmed search was conducted to identify articles published between January 2000 and December 2014 and presenting data of dental implant survival with radiotherapy in head and neck cancer patients. Studies on animal subjects and craniofacial implants were excluded. Results: 18 articles out of 27 were eligible for inclusion in this systematic review. 12 out of 18 studies reported favorable outcome of dental implants and radiotherapy with survival rates between 74.4% and 97%. Seven out of ten studies comparing the survival rates according to site of implant placement reported that implants were found to osseointegrate with greater success in the irradiated mandible than irradiated maxilla. 5 studies which compared implant survival in irradiated native bone versus irradiated grafted bone reported that irradiated grafted bone showed a significantly reduced dental implant survival rate in comparison to irradiated native bone. 6 out of 18studies in which radiation doses exceeded 70 Gy reported lower survival rates of dental implants in comparison to the studies in which radiation doses were ≤70Gy. Higher survival rates were reported in 2 studies in which implants placement was before radiotherapy in comparison to the remaining 16 studies in which implants placement was after radiotherapy. Conclusions: Dental implants may be affected by radiotherapy especially when they are placed in maxilla, in grafted bone, or after radiation, however, they remain a functional option for rehabilitation of head and cancer patients. More prospective cohort studies and randomized controlled trails are still needed to draw more evidence based conclusion

Lip and oral lesions in children with Down syndrome: a controlled study

Background: Down syndrome (DS) is the most common chromosomal abnormality affecting numerous organs, including the orofacial region. The objective of the present study was to assess the prevalence of lip and oral soft tissue lesions, with particular emphasize on the incidence of fissured tongue, lip fissures and angular cheilitis, among individuals with DS in Yemen. Material and Methods: This controlled cross-sectional study included 50 children with DS (6-18 years), and 50 age- and gender-matched healthy controls. The prevalence of orofacial soft tissue lesions was evaluated in both groups. Data were analyzed by Chi-square and Fisher tests, and p <0.05 was considered to be statistically significant. Results: Ten orolabial lesions were identified among the subjects. The most frequently seen lesions were: Fissured tongue (78.0%), lip fissures (64.0%), angular cheilitis (38.0%) and Cheilitis (14.0%). The frequencies of these lesions were significantly higher in children with DS than healthy controls ( P < 0.001). Most of lip fissures were in the lower lip, and 80% of the fissures were in the midline. Conclusions: The prevalence of lip and oral lesions among individuals with DS is remarkably high. Hence, oral physicians should be more aware of the orofacial findings seen more frequently in this genetic disorder

Assessment of Knowledge Among the Physicians Regarding Dental Screening Prior to Chemotherapy and Radiotherapy

Objective:&nbsp;To evaluate the physicians\u27 knowledge regarding the referral for dental screening prior to chemotherapy and radiotherapy.&nbsp;Material and Methods:&nbsp;We conducted a cross-sectional study using simple random sampling among 468 physicians from various specialties with diverse experience levels from different regions in Saudi Arabia. A self-reporting questionnaire was distributed among the physicians, which consisted of questions assessing the physicians\u27 knowledge about oral health and complications in patients prior to chemotherapy and radiotherapy. Statistical analysis was done after the data was collected employing SPSS, and p&lt;0.05 was taken as significant.&nbsp;Results:&nbsp;Residents were more as expected (39.3%), followed by specialists (2.31%). The majority had a practice experience for more than five years (67.8%).&nbsp;The scores for the knowledge assessment showed that 51.3%, nearly half of the participants, had lower scores. The scores were statistically significant (p&lt;0.05).&nbsp;Conclusion:&nbsp;General physicians and specialists should be aware of the dental complications and associated diseases in patients with malignancies and those undergoing chemo and radiotherapy. It is proposed that more awareness should be raised among physicians to rectify this lapse