Oral Mucosa Research Articles

Proposal of a modified technique of Nikolsky's sign in oral autoimmune vesiculobullous diseases.

Nikolsky's sign, originally described for skin lesions, presents challenges when applied to the oral mucosa. To address this, a modified Nikolsky's sign has been proposed specifically for the oral mucosa. In this variant, a gentle breath of air from the air syringe embedded in the dental unit is used to inflate a pre-existing collapsed blister (non-induced technique). Alternatively, in the induced technique, a healthy peri-lesion mucosal site is gently scratched with a blunt dental tool, and after a few minutes, air is blown on the same area to inflate any newly formed blister. The sign is considered positive if a blister is raised from the blown surface. The described modified Nikolsky's sign improves the visualization of oral vesicles and blisters in a cost-effective, easy, and minimally invasive manner. Its elicitation can aid in referring patients to specialized tertiary care units.

Controlling Alveolar Bone Loss by Hydrogel‐Based Mitigation of Oral Dysbiosis and Bacteria‐Triggered Proinflammatory Immune Response

AbstractPeriodontitis is a chronic infection where abnormal host‐microbiota interactions alter the oral microbiome, trigger a proinflammatory immune response, and cause inflammatory alveolar bone loss. While antibiotics are occasionally necessary for treating periodontitis, their use must be carefully managed to prevent the development of drug resistance and oral dysbiosis. Therefore, it's crucial to develop new treatment strategies for periodontitis that reduce antibiotic dependence while effectively controlling the inflammation triggered by bacteria. In this study, a hydrogel is engineered by grafting cationic polyamidoamine dendrimers (PAMAM‐G3) onto the oxidized carboxymethyl cellulose (OCMC) backbone, resulting in an injectable cationic hydrogel (OCMC‐PAMAM‐G3, O‐P). This hydrogel can capture anionic microbial‐associated molecular patterns (MAMPs), such as lipopolysaccharides (LPS) and cell‐free DNA (cfDNA). These findings reveal that using O‐P application circumvents the disruption of the oral mucosa microbiome caused by traditional antibiotics. Additionally, this hydrogel can mitigate inflammatory alveolar bone loss in a ligature‐induced periodontitis mouse model by alleviating the LPS/cfDNA‐TLR4/9 pathway. Moreover, topical administration of O‐P hydrogel has no significant adverse effects on the oral mucosa microbiome while improving the local subgingival microbiome. The study highlights a strategy targeting MAMPs while avoiding antibiotics, as it can mitigate the bacteria‐triggered proinflammatory immune response and potentially preserve oral dysbiosis.

Enhancing linezolid activity in the treatment of oral biofilms using novel chitosan microneedles with iontophoretic control

This study aimed to prepare and assess active microneedle (MN) patches based on a novel biomaterial and their effective coupled (physical and electrical) transdermal delivery of a model drug (Linezoid). Modified MN patches (e.g. fabricated from Linezoid, boronated chitosan, polyvinyl alcohol and D-sorbitol) were engineered using a vacuum micromoulding method. Physicochemical, FTIR (Fourier transform infrared), in-silico, structural and thermal analysis of prepared formulations were conducted to ascertain MN quality, composition and integrity. In-vitro mechanical tests, membrane toxicity, drug release, antibiofilm, ex-vivo mucoadhesion, insertion and in-vivo antibiofilm studies were performed to further validate viability of the coupled system. Optimized MN patch formulation (CSHP3 - comprising of 3 % w/v boronated chitosan, 3.5 % w/v PVA and 10 % w/w D-sorbitol) exhibited sharp-tipped, equi-distant and uniform-surfaced micron-scaled projections with conforming physicochemical features. FTIR analysis confirmed modification (i.e., boronation) of chitosan and compatibility as well as interaction between CSHP3 constituents. In-silico analysis indicated non-covalent interactions between all formulation constituents. Moreover, boronated chitosan-mucin glycoprotein complex showed a stronger bonding (∼1.86 times higher CScore) as compared to linezolid-mucin counterpart. Thermal analysis indicated amorphous nature of CSHP3. A ∼ 1.42 times higher tensile strength was displayed by CSHP3 as compared to control (i.e., pure chitosan, polyvinyl alcohol and D-sorbitol-based MN patch). Membrane toxicity study indicated non-toxic and physiological compatible nature of CSHP3. Within 90 min, 91.99 ± 2.3 % linezolid was released from CSHP3. During release study on agarose gel, CSHP3-iontophoresis treatment resulted in a ∼ 1.78 and ∼ 1.20 times higher methylene blue-covered area and optical density, respectively, within 60 min as compared to CSHP3 treatment alone. Staphylococcus aureus biofilms treated with CSHP3 exhibited 65 ± 4.2 % reduction in their mass. CSHP3 MN patches remained adhered to the rabbit oral mucosa for 6 ± 0.15 h. Mucosa treated with CSHP3 and CSHP3-iontophoresis combination showed a generation of pathways in the epithelium layers without any damage to the underlying lamina propria. Eradication of Staphylococcus aureus from oral mucosal wounds and complete tissue regeneration was recorded following 7-day treatment using CSHP3-iontophoresis coupled approach.

Clinical and Psychological Implications of Genital Vitiligo in a Thai Population.

The understanding of genital vitiligo among Thai individuals is limited. This study evaluated the clinical presentation, quality of life, and sexual health consequences of genital vitiligo. This cross-sectional, questionnaire-based study involving vitiligo patients aged 18 years or older with past or present genital involvement was conducted at Siriraj Hospital. It also measured aspects of sexual health and quality of life. The mean age of the 41 participants was 48.2 years, and 24 (58.5%) were males. All participants presented with genital vitiligo. In males, the penile shaft (45.8%), scrotum (45.8%), and glans (33.3%) were predominantly affected. In females, the mons pubis (64.7%), labia majora (23.5%), and labia minora (23.5%) were frequently involved. Both sexes reported afflictions in the pubic area (41.5%), inguinal region (36.6%), buttocks (34.1%), and oral mucosa (34.1%). Itching was the principal symptom in 26.8% of the patients. The median Dermatology Life Quality Index scores were significantly different (females 6, males 3.5). Compared with their male counterparts, females exhibited lower self-esteem (41.2% vs 29.2%), greater apprehension about marriage (11.8% vs 8.3%), and embarrassment about sexual activities (23.5% vs 16.7%). Remarkably, 65.9% of patients had not discussed their genital vitiligo with their doctors, and 51.2% of physicians had not inquired about or examined for genital involvement. Genital vitiligo adversely impacts quality of life and self-esteem, particularly among female patients. The lack of discourse between patients and physicians highlights a need for increased awareness and proactive clinical investigations to enhance patient care and satisfaction.

A multiplex microbial profiling system for the identification of the source of body fluid and skin samples

Determining the source of body fluids is crucial in forensic investigations, as it provides valuable information about suspects and the nature of the crime. Microbial markers that trace the source of tissues and body fluids based on site specificity and temporal stability are often used effectively for this purpose. In this study, a multiplex system comprising seven microbial markers (Finegoldia magna, Corynebacterium tuberculostearicum, Cutibacterium acnes, Haemophilus parainfluenzae, Streptococcus oralis, Prevotella melaninogenica and Faecalibacterium prausnitzii) was developed to distinguish between skin, saliva, and feces samples. Based on these markers, the system produces electropherograms that are specific for each sample type. We collected 492 samples from six different skin sites (palm, antecubital crease, inguinal crease, cheek, upper back, and toe web space), the buccal mucosa, and stool were collected to further test the system. Beta diversity analysis revealed distinct clustering among the three sample groups. Additionally, skin microenvironment cluster analysis was used to identify skin sites accurately. This analysis classified skin samples into four distinct microenvironments: dry, moist, oily, and foot. Finally, we established a machine learning prediction model based on random forest regression to identify the skin microenvironment, achieving an overall prediction accuracy of 79 %. The multiplex system developed in this study accurately identifies the sources of body fluids, and the skin microenvironment. These findings offer new insights into the application of microbial markers in forensic science.

Oral fast dissolving films made with alginate and whey protein for resveratrol delivery

Resveratrol is a natural polyphenol with low bioavailability because of poor hydro-solubility and extensive first-pass effect. The delivery to oral mucosa via oral fast dissolving films (OFDFs) is a useful administration route to bypass the first-pass metabolism through direct adsorption into the systemic circulation. In this study, the OFDFs was fabricated with loading of excessive and soluble resveratrol in various ratios of whey protein isolate (WPI) and alginate. The solubility of resveratrol was improved in the presence of WPI and/or alginate, which was further affected by glycerol. The OFDFs were characterized in term of thickness, disintegration time, intermolecular interaction, structure, mechanical properties and thermal degradation. At a glycerol/biopolymer ratio of 1:2 and the WPI/alginate ratios between 5:1 and 1:1, the OFDFs disintegrated within 30 s and completely dissolved within 60 s, containing 30–50 μg/cm2 dissolved resveratrol in water. The permeation percentage of 89% was the most at the WPI/alginate ratio of 3:1. Oral mucosa permeation of resveratrol in OFDFs was significantly greater than that in the corresponding film solution. The films exhibited fast disintegration and promotion of resveratrol permeation. These results demonstrate that WPI and alginate were effective in the preparation of OFDFs for enhancing the permeability of resveratrol. It is thus suggested that biopolymer-based OFDFs are potential carriers for oral delivery of polyphenols.

Genetic Influences of Proinflammatory Cytokines on Pain Severity in Patients with Temporomandibular Disorders.

This case-control study investigated single nucleotide polymorphism (SNP) genotypes (CXC motif chemokine ligand 8 (CXCL8): rs2227306 and rs2227307 and tumor necrosis factor (TNF): rs1800629) in 85 patients with pain-related temporomandibular disorders (TMDp) and 85 controls to explore their associations with TMDp presence, pain intensity (low/high), and the presence of chronic arthralgia/myalgia. TMDp was diagnosed using a validated protocol, and polymorphisms were genotyped from buccal mucosa swabs using TaqMan assays. High pain intensity individuals had an increased risk for carrying minor allele "G" (rs2227307) and "T" (rs2227306) compared to controls (76% vs. 55.3%, p = 0.012; 72% vs. 54.1%, p = 0.030, respectively). Carriers of the minor allele "G" (rs2227307) were more prevalent in TMDp patients with arthralgia compared to controls (70.30% vs. 55.30%, p = 0.037). According to logistic regression, the most important predictors for high pain intensity were minor allele "G" of rs2227307 (OR 2.435, 95% CI 1.123-5.282), increasing age (OR 1.038, 95% CI 1.002-1.075), and female sex (OR 4.592, 95% CI 1.289-16.361). The explored gene polymorphisms were not significant risk factors for TMDp presence. These findings highlight the importance of genetic variations, particularly rs2227307, in understanding the diverse clinical manifestations of temporomandibular disorders.

Physicochemical characterization of novel okra mucilage/hyaluronic acid-based oral disintegrating films for functional food applications

Oral disintegrating films (ODFs) offer a patient-friendly approach with enhanced convenience and rapid onset of action over various health benefits. ODFs are fabricated for geriatric, pediatric, and individuals facing swallowing challenges. The present work aims to fabricate and characterize ODFs mainly composed of okra mucilage (OM), hyaluronic acid (HA), vitamin-C-loaded bioactive glass nanoparticles (VBG NPs), and clove essential oil. A bio-inspired method was employed to synthesize VBG NPs using fructose template. The nutrient analysis of OM depicted that it is a rich source of protein, carbohydrates, magnesium, and flavonoids (quercetin), accounting for its antioxidant activity. The physicochemical characteristics of the ODFs studied using contact angle measurement, surface pH, opacity, and in vitro disintegration time revealed that ODFs disintegrated rapidly in simulated saliva. The neutral surface pH of ODFs indicates their non-irritant behaviour to the oral mucosa. VBG NPs and essential oil (EO) addition enhance the thermal and mechanical properties. Further, EO infusion in the film matrix resulted in the porous and antibacterial nature of the functional film as revealed by FE-SEM micrographs and antibacterial disk diffusion assay respectively. The obtained novel nutrient-rich ODF is hemocompatible with a hemolysis rate (HR%) <5 % and suitable for functional food applications.

Lysophospholipase D activity on oral mucosa cells in whole mixed human saliva involves in production of bioactive lysophosphatidic acid from lysophosphatidylcholine

We reported that lysophosphatidic acid (LPA) is present at 0.8 μM in mixed human saliva (MS). In this study, we examined the distribution, origin, and enzymatic generation pathways of LPA in MS. LPA was distributed in the medium and cell pellet fraction; a true level of soluble LPA in MS was about 150 nM. The soluble LPA was assumed to be generated by ecto-type lysophospholipase D on exfoliated cells in MS from LPC that originated mainly from the major salivary gland saliva. Our results with the albumin-back extraction procedures suggest that a significant pool of LPA is kept in the outer layer of the plasma membranes of detached oral mucosal cells. Such pool of LPA may contribute to wound healing in upper digestive organs including oral cavity. We obtained evidence that the choline-producing activity in MS was mainly due to Ca2+-activated lysophospholipase D activity of glycerophosphodiesterase 7.

Aerosolized e-liquid base constituents induce cytotoxicity and genotoxicity in oral keratinocytes.

Electronic cigarette (e-cigarette) use among adults in the United States continues to rise. Particularly concerning is the impact of e-cigarette aerosol inhalation on the oral mucosa. Aerosols are derived from a heated e-liquid base of propylene glycol/glycerin (PG/G) often mixed with nicotine and chemical flavors. Of note, harmful and potentially harmful constituents (HPHCs), including metals and volatile organic compounds, have been detected in e-cigarette aerosols. It remains unknown, however, whether aerosols exclusively derived from e-liquid PG/G are detrimental to oral keratinocytes. The present study analyzed toxicological outcomes in normal oral keratinocytes exposed to model nicotine-free, unflavored PG/G e-liquid aerosols. Cell viability/cytotoxicity, genotoxicity, and immunoblotting assays were conducted in NOKSI, a gingiva-derived oral keratinocyte cell line, following exposure to model e-liquid aerosols or non-aerosolized controls. The HPHC acrolein, reported to form DNA adducts in the buccal mucosa from e-cigarette users, was also used in similar assays. PG/G e-liquid aerosol extracts significantly enhanced cytotoxic and DNA damaging responses in NOKSI cells when compared to non-aerosolized e-liquid treatment. Acrolein treatment led to similar results. The aerosolization process of PG/G e-liquid is a critical determinant of marked cytotoxic and genotoxic stimuli in oral keratinocytes.

Effect of short-term fasting on the cisplatin activity in human oral squamous cell carcinoma cell line HN5 and chemotherapy side effects

BackgroundKetogenic interventions like short-term fasting show potential as complementary therapies to enhance the effectiveness of chemotherapy for cancer. However, the specific effects of fasting on head and neck squamous cell carcinoma (HNSCC) cells and healthy oral mucosa cells during these treatments are not well understood. This study investigates whether short-term fasting can differentially impact HNSCC cell survival and viability compared to healthy keratinocytes while undergoing standard chemotherapy regimens.MethodsThis study investigated the effects of fasting on cell viability in HN5 cell line and healthy oral keratinocyte cells. The HN5 cell line, derived from human tongue squamous cell carcinoma, and primary human keratinocytes isolated from the basal layer of gingival epithelium were divided into three groups: (1) control, (2) treated with the standard chemotherapeutic agent cisplatin, and (3) treated with cisplatin under fasting conditions achieved through 48-hour glucose restriction mimicking the blood glucose levels of fasted individuals. Cell proliferation was assessed at 48 and 72 h using the MTT assay, a colorimetric method based on mitochondrial dehydrogenase activity. Flow cytometry analysis with specific apoptosis and necrosis markers distinguished between early and late apoptotic, necrotic, and viable cells.ResultsCell viability in HN5 and healthy keratinocyte cells decreased in cisplatin with low glucose groups compared to cisplatin and control groups. The same results were observed for healthy keratinocyte cells; only a decrease in cell viability in cisplatin groups compared to control groups was observed, which was not statistically significant. Cell apoptosis in HN5 and healthy keratinocyte cells increased in cisplatin with low glucose groups compared to cisplatin and control groups. In healthy keratinocyte cells, the cisplatin with low glucose group showed an impressive increase in necrosis, late apoptosis, and early apoptosis and a significant decrease in live cells compared with other groups.ConclusionThis study revealed that short-term fasting chemotherapy significantly improved HNSCC cell line apoptosis and necrosis.

ETIOPATHOGENETIC ASPECTS OF SYNTROPY AND MUTUAL BURDEN IN THE PATHOLOGY OF THE GASTROINTESTINAL TRACT AND THE DISEASES OF THE ORAL CAVITY

The purpose of the work is to study the main etiopathogenetic mechanisms of development and peculiarities of the clinical course in the comorbidity of diseases of the oral cavity and pathology of the gastrointestinal tract by analyzing the results of scientific research published in modern scientific publications.Material and methods. Search, systematization, elaboration and analysis of scientific works of domestic and foreign authors, which present the modern results of research on etiopathogenesis and peculiarities of the clinical course in comorbidity of diseases of the oral cavity and gastrointestinal tract, with the involvement of search engines Google Scholar, PubMed and other electronic resources. The bibliosematic and analytical methods are used in the research.Results. The problem of syntropies, the basis of which is the association of etiological and pathogenetic factors of certain diseases, is an actual problem in modern medicine. The analysis of data from modern scientific literary sources proves that the development and progression of periodontal and oral mucosa diseases depends not only on the influence of local factors but also is a reaction to the influence of pathogenic factors that arise as a result of diseases of the gastrointestinal tract.Steady persistence of microflora in certain areas of the digestive tract can complicate the course of dental and gastrointestinal diseases. A gradual change in the properties of representatives of the conditionally pathogenic group of microorganisms, their association with specific diseases of the oral cavity and gastrointestinal tract indicates their role in the pathogenesis of many diseases. Mechanisms of free radical damage to cellular structures and changes in humoral and cellular immunity are important common links in the pathogenesis of periodontal and gastrointestinal tract diseases. The development of an imbalance of the endocrine system and psycho-emotional stress has a significant impact on the process of mutual burden of diseases of the gastrointestinal tract and oral cavity.Conclusion. Тoday considerable factual material has been accumulated regarding the understanding of common mechanisms of etiopathogenesis and syntropy of diseases of the oral cavity and pathology of the gastrointestinal tract. This knowledge makes it possible to develop effective comprehensive measures for the diagnosis, prevention and treatment of both diseases of the oral cavity and diseases of the gastrointestinal tract, taking into account the mutual burden of these pathologies.

B Cells Infiltration Potentially Responded Better to Systemic Corticoids in Oral Lichen Planus and Oral Lichenoid Lesions.

Oral lichen planus (OLP) and oral lichenoid lesion (OLL) are chronic inflammatory diseases involving the oral mucosa. B cells infiltration in OLP and OLL, however, little is known about these cells in OLP and OLL. To analyze the function and infiltrating features of B lymphocytes in OLP and OLL, and to preliminarily evaluate their correlation with clinical outcomes. Tissue samples were collected from OLP, OLL, and healthy mucosa. The phenotypes and amounts of B cells in tissues were analyzed by single-cell sequencing. Their proportion and infiltrating features in tissues were examined by immunohistochemistry and immunofluorescence. With the systemic medication of corticoids, the correlation between B cells infiltrating characteristics and the clinical outcomes were evaluated. A quantified proportion increase of B cells was shown in both OLP and OLL. B cells in OLP demonstrated heightened activation and enhanced regulation in immune response. A cohort of 100 patients with OLP/OLL and 13 healthy controls were examined to investigate the B cells infiltration pattern. B cells were distributed in the superficial layer of lamina propria in 92.9% and 41.9% of OLP and OLL, respectively(P < 0.01); focally distributed in 25.0% and 62.9% of OLP and OLL, respectively(P < 0.01). With the systemic medication of corticoids, the cases with B cell infiltration (B+) in OLP and OLL groups showed a statistically significant reduction in REU scores before and after treatment (P < 0.01). B cells are widely present in OLP and OLL, and B cell infiltration in OLP and OLL are related to the better therapeutic effect of oral corticoids.

Jingzhi Niuhuangjiedu Tablet Ameliorates Oral Mucositis via the AKT/NFκB/NLRP3 Signaling Pathway: A Network Pharmacology and Experimental Validation.

Oral Mucositis (OM) is a common and highly symptomatic complication of cancer therapy that affects patient function and quality of life. Jingzhi Niuhuangjiedu Tablet (JNT) is derived from the famous Chinese herbal formulas Huanglian Jiedu and Fangfeng Tongsheng decoctions, which have been widely used to treat heat toxin syndrome diseases, such as acute pharyngitis, periodontitis, oral ulcers, and oral mucositis (OM), but the underlying mechanism remains unclear. This study validated the efficacy and explored the potential mechanisms of JNT in the treatment of OM by integrating network pharmacological analyses and experimental verification. Network pharmacology and molecular docking techniques were used to predict the active components, key targets, and potential mechanisms of action of JNT against OM. The rat OM model was established by administering 5-Fluorouracil (5-FU) and acetic acid to the rat oral mucosa. Lipopolysaccharide (LPS)-treated human gingival fibroblasts (HGFs) were used as an inflammatory cell model. The GFP-NFκB HEK293T cell line was transfected to evaluate the anti-NFκB activity of JNT. A total of 236 Chinese herbal components and 201 corresponding targets were predicted for OM treatment using JNT. Bicuculine, luteolin, wogonin, and naringenin were identified as the important active compounds, while AKT1, ALB, IL6, MAPK3, and VEGFA were considered to be the major targets. Molecular docking revealed that these active compounds exhibited strong binding interactions with their targets. In vivo and in vitro experiments demonstrated that the anti-OM effect of JNT might be closely related to AKT1, NFκB, caspase-1, and NLRP3, as well as biological processes, such as inflammatory response and oxidative stress. Network pharmacological and experimental evidence indicates that JNT has a potential therapeutic effect on OM by regulating the Akt/NFκB/NLRP3 pathway.

Relationship between Oral Lichen Planus and Cardiovascular Disease of Atherosclerotic Origin: Systematic Review and Meta-Analysis.

Background/Objectives: Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral mucosa that affects between 0.5% and 2% of the general population. In the last decade, several studies have associated cardiovascular diseases (CVDs) with some inflammatory skin diseases such as oral lichen planus, demonstrating the presence of dyslipidemia in these pathologies. The objective of this work is to review whether patients with OLP show higher dyslipidemia and CRP levels compared to a healthy control population without OLP. Methods: Searches were carried out in Medline, Scopus, and Cochrane. The studies had to perform a histopathological diagnosis for OLP and the patients could not take any medication to treat this disorder. Non-lichenoid reactions were included. Results: After an initial search that provided us with 254 papers, this number was reduced to 10 articles after a detailed evaluation. All of them were case-control studies that compared the presence of analytical cardiovascular risk factors in patients affected by OLP and in healthy subjects. Conclusions: There is no scientific evidence of the possible association between OLP and CVDs. The only association we can prove is the one between OPL and CVD risk factors, especially those related to the lipid profile. More studies are needed in order to evaluate this relationship in patients diagnosed with CVDs.

The effects of carbon-ion beam irradiation on three-dimensional in vitro models of normal oral mucosa and oral cancer: development of a novel tool to evaluate cancer therapy.

Given that the original tumor microenvironment of oral cancer cannot be reproduced, predicting the therapeutic effects of irradiation using monolayer cultures and animal models of ectopic tumors is challenging. Unique properties of carbon-ion irradiation (CIR) characterized by the Bragg peak exert therapeutic effects on tumors and prevent adverse events in surrounding normal tissues. However, the underlying mechanism remains unclear. The biological effects of CIR were evaluated on three-dimensional (3D) in vitro models of normal oral mucosa (NOMM) and oral cancer (OCM3 and OCM4) consisting of HSC-3 and HSC-4 cells. A single 10- or 20-Gy dose of CIR was delivered to NOMM, OCM3, and OCM4 models. Histopathological and histomorphometric analyses and labeling indices for Ki-67, γH2AX, and TUNEL were examined after CIR. The concentrations of high mobility group box 1 (HMGB1) were measured. NOMM exhibited epithelial thinning after CIR, which could be caused by the decreased presence of Ki-67-labeled basal cells. The relative proportion of the thickness of cancer cells to the underlying stroma in cancer models decreased after CIR. This finding appeared to be supported by changes in the three labeling indices, indicating CIR-induced cancer cell death, mostly via apoptosis. Furthermore, the three indices and the HMGB1 release levels significantly differed among the OCM4 that received different doses and with different incubation times after CIR while those of the OCM3 models did not, suggesting more radiosensitivity in the OCM4. The three 3D in vitro models can be a feasible and novel tool to elucidate radiation biology.

Which Is More Harmful for the Oral Mucosa: Cigarettes or Hookah? A Cross-Sectional Study

Background: The popularity of hookah usage is on the rise in contemporary societies. Some individuals believe that using a hookah is less harmful than smoking traditional cigarettes. Objectives: The objective of this study was to examine the prevalence of oral mucosal lesions among individuals who use hookah and cigarettes. Methods: In a cross-sectional study conducted at Ahvaz Dental School, 102 individuals seeking examination and treatment for dental problems were recruited from spring 2022 to winter 2023 and categorized into three groups: Cigarette users (A), hookah users (B), and non-users of both (C). A thorough oral examination was performed on each patient to identify any oral mucosal lesions. If necessary, a biopsy was performed to confirm the diagnosis. The information for each patient was recorded on individual sheets and subsequently analyzed. To examine the relationship between qualitative variables, a chi-square test or Fisher's exact test was employed. Results: The most prevalent oral mucosal lesion observed in both group A (42%) and group B (27%) was hyperpigmentation of the oral mucosa. Notably, a premalignant lesion was exclusively observed in individuals belonging to group A (7%). Complaints of bad taste in the mouth were more common in tobacco users (in any form) than in non-users (P = 0.004). Conclusions: Tobacco users (of any kind) have more oral lesions than non-smokers, although most of these lesions are harmless.

Mucin incorporated electrospun fibrous matrix of zein and PVP: Towards transmucosal propranolol hydrochloride delivery

Mucoadhesive drug delivery systems are being widely explored as a substitute for conventional drug delivery devices. Several polymers and their functional modifications are under investigations. In that scenario, the cohesive influence of mucin in the polymer system itself to the biologically available mucin in the mucosa is a novel approach. The added advantage of mucin in augmenting mucoadhesion was explored. A two-fold increase in the force of adhesion and an eight-fold increase in the work of adhesion were intriguing observations to be noted. Mucin incorporation in the matrix was done via EDC crosslinker. The results of the TNBS assay confirmed 39 % of mucin binding. A three-fold decrease of elongation at break (%) after mucin binding is a piece of quantitative information to corroborate the same. This work also investigates the efficiency of the mucoadhesive matrix towards the release of Propranolol Hydrochloride (PL). Low oral bioavailability of PL demands its administration via mucosal route to avoid hepatic first-pass metabolism. The release study of PL in PBS and permeation through RPMI 2650 cells revealed a burst release followed by a sustained release profile and best fitted with Korsmeyer Peppas model. PL permeation through the cell monolayer without a cell junction opening pursued a transcellular transport mechanism. Drug permeation through porcine buccal mucosa also assured adequate permeation in ex-vivo conditions. The sustained release of PL from MUZPVP and prolonged residence time of the matrix over mucosa due to increased mucoadhesion guarantees an optimistic drug delivery device to the biomedical discipline.

Oral health-related quality of life in Fanconi anemia: a cross-sectional study.

To evaluate the oral health-related quality of life (OHRQoL) of individuals diagnosed with Fanconi anemia (FA). A cross-sectional study was conducted with FA patients from two Brazilian referral centers. Participants underwent a complete dental, periodontal, and oral mucosa examination, as well as assessment of resting salivary flow. The short version of the Oral Health Impact Profile (OHIP-14) questionnaire was administered. Descriptive and bivariate analyses were performed, followed by multivariate analysis to examine the impact of independent variables on OHRQoL. The study included 20 (57.1%) males and 15 (42.9%) females, with a mean age of 18.9years. Oral leukoplakia (OL) was found in 18 individuals. The overall OHIP-14 score was 9.9 ± 10.5. Individuals aged ≥ 16years had higher OHIP-14 scores, indicating worse OHRQoL for physical pain (p = 0.007), psychological discomfort (p = 0.001), physical disability (p = 0.03), psychological disability (p = 0.001), handicap (p = 0.004), and overall score (p = 0.007). Females reported more negative OHRQoL than males for physical pain (p = 0.02), psychological discomfort (p = 0.03), psychological disability (p = 0.009), and overall score (p = 0.02). Individuals with OL had an overall OHIP-14 score 1.83 times higher than those without OL (95% CI: 1.02-3.28; p = 0.04). Lower salivary flow correlated with higher overall OHIP-14 scores (95% CI: 0.14-0.84; p = 0.01). This study represents the first attempt to evaluate OHRQoL in individuals with FA. The presence of OL and reduced salivary flow were identified as predictors of a negative impact on OHRQoL. It is imperative to integrate patients' quality of life in the clinical treatment protocols for the FA population.

Evaluation of therapeutic response to algorithm assisted improvement of oral mucosa damage in male AIDS patients

HIV/AIDS is now the biggest cause of mortality in Africa and the fourth highest cause of death globally. Half or more of HIV-infected individuals and as many as 80% of AIDS patients develop oral lesions. People living with HIV/AIDS may benefit from early testing, diagnosis, and treatment if oral lesions are detected, as they are the initial clinical characteristics of the infection and strong indicators of immunodeficiency. Oral candidiasis (OPC), oral hairy leukoplakia (OHL), oral Kaposi’s sarcoma (OKS), and HIV-associated periodontal diseases were the subjects of this comprehensive review designed to assess the available data for the management of these and other common oral mucosa damage that are linked to HIV. Further exacerbating the condition are host variables such as xerostomia, smoking, dental caries, oral prosthesis, diabetes, and cancer treatments. A separate portion of this Worldwide Workshop discusses the treatment of salivary gland illness linked with HIV. Oral mucosa injury in AIDS patients does not have a reliable diagnostic approach. Improving the early diagnosis of Oral Mucosa damage in male AIDS patients was the primary goal of this work, which sought to construct an Artificial Intelligence (AI) diagnostic model with high sensitivity. To demonstrate a Gradient Boosting Regression (GBR) based method for assessing the efficacy of treatments for oral mucosa damage in AIDS patients. Both investigation and diagnostic applications may benefit from this predictor. Results show that, compared to existing models, the suggested AI and GBR methods can accurately predict oral mucosa deterioration in AIDS patients. This study significantly contributes to the profession by improving the accuracy of diagnoses and providing useful information for treatment options.