Expression of HER-2/neu in oral squamous cell carcinoma

Background: HER-2/neu is a member of the human epidermal growth factor (HER) family of transmembrane tyrosine kinases, which is significantly associated with the pathogenesis of various cancer types. The aim was to evaluate the expression of HER-2/neu in oral squamous cell carcinoma (OSCC) as a potential biomarker to target antigens for specific immunotherapy in OSCC.Methods: One hundred and forty histologically diagnosed OSCC cases were identified. Four to five-micrometer thick formalin-fixed, paraffin-embedded tumor sections were stained with Haematoxylin and Eosin (H and E). Histological grade was assessed according to WHO/Broders classification, while tumors were staged according to the American Joint Committee on Cancer (AJCC) TNM classification from stage I to IV. Immunohistochemistry was performed by using Rabbit monoclonal antibody against HER-2/neu (EP700Y, cell marquee and diluted 1:50). FISH was performed on positive cases using Vysis PathVysion HER-2 DNA probe (Abbott USA). Probes consist of LSI HER gene spectrum orange and control probe CEP 17 spectrum green.Results: In this study, males were mostly effected (64.3%) with buccal mucosa (49%) to be the commonly involved site for OSCC. Majority of cases were moderately differentiated (62.1%) and 50.7% tumors were Stage IV. HER-2/neu was found to be positive (2+) in one case of OSCC, however weak to moderate complete membrane staining was observed in \u3e10% of the tumor cells. One hundred and thirty nine cases were HER-2/neu negative. FISH analysis of HER-2/neu positive cases also showed gene amplification (Her2-neu/ CEp 17 = 225/33 = 7.2).Conclusions: The study showed disparity in the expression of HER-2/neu in OSCC, which is due to multiple reasons. Therefore therapy against HER-2/neu in OSCC is debatable

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Influence of polyurethane resin dies on the fit and adaptation of full veneer crowns

Context: Polyurethane resin is a possible alternative to type IV dental stone for fabrication of indirect restorations however its dimensional accuracy is questionable. Aim: The aim was to investigate the dimensional accuracy of silica filled polyurethane resin die material by evaluating the marginal fit and adaptation of indirect gold castings. Settings and Design: Experimental, in vitro study. Materials and Methods: Totally 40 copper plated replicas of a nickel chrome master die analogous to a veneer gold crown preparation were made and impressions recorded using polyvinylsiloxane material. Twenty impressions were poured in type IV dental stone (control group (Vel-mix, Kerr, UK) and the remaining (n = 20) in silica filled polyurethane die material (test group) (Alpha Die MF, CA, USA). Gold castings were fabricated for each die using standardized techniques. The castings were seated on their respective copper plated dies, embedded in resin and sectioned. The specimens were analyzed by measuring marginal opening and the area beneath the casting at a ×63 magnification and using image analysis software. Statistical Analysis Used: Data were analyzed using a Student′s t-test. Results: No significant difference was observed between the experimental groups (P > 0.05). The mean marginal opening for type IV, dental stone and polyurethane resin, was 57 ± 22.6 μm and 63.47 ± 27.1 μm, respectively. Stone displayed a smaller area beneath the casting (31581 ± 16297 μm 2 ) as compared to polyurethane resin (35003 ± 23039 μm 2 ). Conclusions: The fit and adaptation of indirect gold castings made on polyurethane and type IV dental stone dies were comparable

Simplified management of anterior worn dentition

Tooth wear has started to affect a greater number of younger people. Its precautions, symptoms, and treatment modalities therefore have to be well understood. This case study presents a patient with severe tooth wear that had led to displeasing esthetics. Surgical crown lengthening and composite restorations were performed after the provision of a stabilizing splint. This helped to improve the esthetics considerably leaving the patient satisfied. The aim of this case study is to portray an approach to how even a patient with severe tooth wear can have access to an esthetically pleasing dentition

Attitude and awareness of dentist towards resin bonded bridges in Saudi Arabia

Statement of the problem: Resin bonded bridges (RBBs) offer a conservative approach to tooth replacement. However, the use of this treatment option has been limited. Therefore, the aim of this study was to assess the knowledge and attitude of dentists in Saudi Arabia, including general dental practitioners (GDPs) and prosthodontic and restorative specialists (SPs), toward RBBs. Methods: In this cross-sectional study, questionnaires designed to survey knowledge of RBB performance factors were distributed to GDPs and SPs (n = 400). Specifically, opinions of GDPs and SPs regarding clinical, mechanical, technique- and patient-dependent performance factors of RBBs were obtained. Average significance and Chi-square tests were used to identify the frequency, pattern, and significance of the response variables identified. Results: A majority (65.3%) of the subjects reported using RBBs in less than 10% of their prosthodontic cases. The most common reason for the limited clinical application of RBBs was perceived poor retention (23.45%). In addition, SPs regarded the influence of enamel structure, number of pontics, cement type, RBB design, and surface treatment as “very significant” factors with respect to RBB survival. Overall, a statistically significant difference was observed between the responses of GDPs and SPs regarding their knowledge of performance factors for RBBs. Conclusion: In comparison to SPs, GDPs reported greater disagreement with current standards for RBB success factors. Moreover, 60% of SPs and 71% of GDPs used RBBs for less than 10% of their prosthodontic cases. Therefore, continuing education opportunities are needed for practicing dentists, and undergraduate students need to receive greater exposure to the clinical application of RBBs. Keywords: Attitude, Awareness, Clinical performance, Resin bonded bridges, Dental practitioner, Specialis

Effect of self-etching ceramic primer on bond strength of zirconia-reinforced lithium silicate ceramics

This study evaluated the effect of self-etching ceramic primer (SECP) on shear bond strength (SBS) of zirconia-reinforced lithium silicate (ZLS) ceramics. Two hundred and seventy block-specimens of two types of ZLS ceramics and one type of lithium disilicate (LS) ceramics were prepared. Ninety blocks of each material were divided into three groups (n = 30), namely group 1: no surface treatment (control), group 2: hydrofluoric acid (HF), silane-based primer (S), and group 3: SECP. Resin cement was applied, and light-cured for build-up. Shear bond strength (SBS) test was used. Half of the bonded specimens (n = 15) were tested after storage in distilled water for 24 h, whereas the other half were tested after 5000 thermo-cycles. The failure modes were evaluated using scanning electron microscope (SEM). The SBS values for samples treated with SECP and HF + S within the respective materials were statistically comparable (p > 0.05). Thermocycling significantly reduced the SBS (p < 0.05) for all ceramic materials in groups 2 and 3. Mixed failure followed by adhesive failure were the most common failure modes in groups 2 and 3, whereas pretest failure was only detected in group 1. Considering the limitations of the study, with respect to in vitro bond strength, the SECP is an alternative for the conditioning of internal surface of glass ceramics

Osteogenic Differentiation of Periodontal Ligament Stem Cells Seeded on Equine-Derived Xenograft in Osteogenic Growth Media

Background and Objectives: The duration of bone turnover is critical, and different time points help in identifying the optimal endpoint of treatment duration. However, investigating the combination of xenograft and stem cells to allow tissue regeneration within an ideal time duration remains an under-investigated topic. The current study aimed to assess the impact of equine-derived xenograft bone blocks in assisting the human periodontal ligament stem cells (PDLSCs) to demonstrate osteogenic differentiation (collagen type 1 expression and calcium deposition) within an osteogenic growth media. Materials and Methods: Human PDLSCs were acquired commercially and seeded onto xenograft bone blocks. After the 14th and 21st day of culture, enzyme-linked immunoassay (ELISA) was utilized for the detection and quantification of levels of collagen type I, while the mineralization assessment (deposition of calcium) was conducted by staining the PDLSCs with Alizarin Red S (ARS). The statistical comparison between the means and standard deviations of study groups were evaluated using analysis of variance (ANOVA). Results: ELISA assessment revealed an upsurge in the expression of collagen type I for PDLSCs cultured with xenograft after 14 and 21 days compared to the controls (intergroup comparisons significant at p &lt; 0.05). Similar findings were obtained for mineralization assessment and on ARS staining. PDLSCs cultured with xenograft bone blocks presented an increased deposition of calcium compared to their control counterparts (intergroup comparisons significant at p &lt; 0.05). Conclusions: PDLSCs embedded in xenograft bone blocks inside an osteogenic growth medium demonstrated greater osteogenic differentiation potential after 14 and 21 days. This superior osteogenic differentiation capability was evident by increased collagen type I expression and more significant calcium deposition at the 14th and 21st days after culture

Dentin Bond Integrity of Filled and Unfilled Resin Adhesive Enhanced with Silica Nanoparticles—An SEM, EDX, Micro-Raman, FTIR and Micro-Tensile Bond Strength Study

The objective of this study was to synthesize and assess unfilled and filled (silica nanoparticles) dentin adhesive polymer. Methods encompassing scanning electron microscopy (SEM)—namely, energy dispersive X-ray spectroscopy (EDX), micro-tensile bond strength (µTBS) test, Fourier transform infrared (FTIR), and micro-Raman spectroscopy—were utilized to investigate Si particles’ shape and incorporation, dentin bond toughness, degree of conversion (DC), and adhesive–dentin interaction. The Si particles were incorporated in the experimental adhesive (EA) at 0, 5, 10, and 15 wt. % to yield Si-EA-0% (negative control group), Si-EA-5%, Si-EA-10%, and Si-EA-15% groups, respectively. Teeth were set to form bonded samples using adhesives in four groups for µTBS testing, with and without aging. Si particles were spherical shaped and resin tags having standard penetrations were detected on SEM micrographs. The EDX analysis confirmed the occurrence of Si in the adhesive groups (maximum in the Si-EA-15% group). Micro-Raman spectroscopy revealed the presence of characteristic peaks at 638, 802, and 1300 cm−1 for the Si particles. The µTBS test revealed the highest mean values for Si-EA-15% followed by Si-EA-10%. The greatest DC was appreciated for the control group trailed by the Si-EA-5% group. The addition of Si particles of 15 and 10 wt. % in dentin adhesive showed improved bond strength. The addition of 15 wt. % resulted in a bond strength that was superior to all other groups. The Si-EA-15% group demonstrated acceptable DC, suitable dentin interaction, and resin tag formation