Prevention Of Oral Cancer Research Articles

IARC Perspective on Oral Cancer Prevention

In a review of strategies for preventing oral cancer, an expert panel reports that the use of tobacco (both smoking and smokeless), areca nut exposure, and heavy alcohol consumption are major contributors to this illness.

Tobacco cessation center in a dental college: An 8 year institution-based study.

Oral cancer is a major health concern in the Indian subcontinent, where it ranks among the top three types of cancer in the country. Tobacco and its products have been implicated as a major etiologic factor behind cancers. It is believed that tobacco is an epidemic in itself taking the death toll to 7 million globally. In India alone, mortality because of tobacco is more than 1.3 million. Dentists are the first to notice any change in the oral cavity or come across any suspicious looking oral lesion and therefore are instrumental in primary prevention and care. The present study data are of the patients enrolled in a Tobacco Cessation Center(TCC) at a Dental College in Meerut in Meerut from May 2012 (since its inception) to March 2020. The following methods of counseling were carried out: group counseling, interactive sessions, audio-visual aids, and individual counseling sessions. Self-training for oral cavity examination was also given after every group counseling session. Behavioral counseling and pharmacological intervention were given as per Fagerström Test for Nicotine Dependence (FTND) score. At the end of 1 year, patients who quit were graded into 0, 1, and 2, with 0 for those who failed to quit, 1 for those who did completely quit, and 2 for those who reduced their habit by more than 50%. The quit rate achieved was 57.6% (complete responders -43.2% and partial responders 14.4%). The relapse reported was 1.8%. A Tobacco cessation Center set up in a Dental College could be of great help in the primary prevention of oral cancer and can bring a drastic increase in quit rates. Proper counseling skills once nurtured in young under-graduates can boost the tobacco-free India campaign.

Knowledge, attitudes, and practices of oral cancer prevention among dental students and interns: an online cross‑sectional questionnaire in Palestine

BackgroundOral cancer is frequently characterized with an aggressive behavior and an unfavorable prognosis; however, it is generally associated with promising prognosis if detected early. Therefore, this study aimed to assess knowledge, practices, and attitudes toward oral cancer prevention among dental students and interns; and to investigate the factors that influence their practices of oral cancer screening or prevention.Material and methodsA cross-sectional questionnaire-based survey was conducted between March and April of 2022 on the fourth- and fifth-year undergraduate dental students and interns in the College of Dentistry at Arab American University in Palestine. A 48-item questionnaire which has 4 sections: demographics, knowledge, practices, and attitudes toward oral cancer prevention and early detection was sent to all eligible participants (N = 570).ResultsThe response rate was 68.7% (N = 351). About 66.8% of the respondents had poor knowledge about oral cancer and its risk factors, and 85.5% had a poor practice of oral cancer early detection and prevention; however, the majority of the respondents (81.1%) had shown favorable attitudes toward oral cancer prevention. Interns had significantly better knowledge and attitude scores compared to the undergraduate dental students (P < 0.05). Lack of training, time, confidence, and effectiveness were stated among the barriers to oral cancer screening.ConclusionsMost of the participants surveyed in this study appeared to lack adequate knowledge and skills in oral cancer prevention and early detection; however, they seemed to have good motivation and a good attitude toward oral cancer prevention training.

Prevention of carcinogen-induced oral cancers by polymeric black tea polyphenols via modulation of EGFR-Akt-mTOR pathway

The overexpression of Epidermal Growth Factor Receptor (EGFR) and dysregulation of its downstream effector pathways are important molecular hallmarks of oral cancers. Present study investigates the chemopreventive potential of polymeric black tea polyphenols (PBPs)/thearubigins (TRs) in the hamster model of oral carcinogenesis as well as determine the effect of PBPs on EGFR and the molecular players in the EGFR pathway. In dose-dependent manner, pre and concurrent treatment with PBPs (1.5%, 5%, 10%) decreased the number and volume of macroscopic tumors as well as the number and area of microscopic lesions. Interestingly, at 10% dose of PBPs, no macroscopic or microscopic tumors were observed. We observed PBPs mediated dose-dependent decrease in oxidative DNA damage (8OHdG); inflammation (COX-2); proliferation (PCNA, Cyclin D1); expression of EGFR, and its downstream signaling kinases (pAkt, Akt, and mTOR); hypoxia (HIF1α) and angiogenesis (VEGF). There was also a PBPs mediated dose-dependent increase in apoptosis (Bax). Thus, our data clearly indicate that the observed chemopreventive potential of PBPs was due to modulation in the EGFR pathway associated with cell proliferation, hypoxia, and angiogenesis. Taken together, our results demonstrate preclinical chemopreventive efficacy of PBPs and give an insight into its mechanistic role in the chemoprevention of experimental oral cancer.

POPULATION PROFILE IN ORAL CANCER PREVENTION CAMPAIGNS IN THE STATE OF PARANÁ-BRAZIL BETWEEN 2014-2018

<h3>Objectives</h3> To assess the profile of the population examined in oral cancer preventive actions. <h3>Study Design</h3> Between 1989 and 2018, health actions were taken in different cities of Paraná, Brazil. Clinical exams of individuals over 30 years of age were performed. A questionnaire was used for demographic, socioeconomic, and habits information. <h3>Results</h3> During the period, 1261 oral lesions were identified in 6314 individuals examined; 56.9% were female and 76.5% were White. Of these, 63.7% received less than 2 minimum wages, 17.4% did not go to the dentist, and 24.7% reported that only go with pain. Edentulism was observed in 37.5% of individuals. In relation to harmful habits, 76.5% reported being nondrinkers and 65.3% nonsmokers, and 10.6% were ex-smokers. In addition, 3.1% never heard of oral cancer prevention. A total of 1261 lesions were found; 31.8% were inflammatory and 31.2% traumatic. In relation to premalignant lesions, we found 12.8% of actinic cheilitis, 6.9% of leukoplakia, and 1.3% of lichen planus. We observed 6.4% of lesions suspicious for malignancy. All patients with lesion were referred for treatment. <h3>Conclusions</h3> Oral cancer preventive actions are important not only to help in early diagnosis of oral cancer but also to make the population aware of the disease and provide information about prevention measures.

Use of DNA image cytometry in conducting oral cancer screening in rural India

Oral cancer screening can assist in the early detection of oral potentially malignant lesions (OPMLs) and prevention of oral cancers. It can be challenging for clinicians to differentiate OPMLs from benign conditions. Adjunct screening tools such as fluorescence visualisation (FV) and DNA image cytometry (DNA-ICM) have shown success in identifying OPMLs in high-risk clinics. For the first time we aimed to assess these technologies in Indian rural settings and evaluate if these tools helped clinicians identify high-risk lesions during screening. Dental students and residents screened participants in five screening camps held in villages outside of Hyderabad, India, using extraoral, intraoral, and FV examinations. Lesion and normal tissue brushings were collected for DNA-ICM analysis and cytology. Of the 1116 participants screened, 184 lesions were observed in 152 participants. Based on white light examination (WLE), 45 lesions were recommended for biopsy. Thirty-five were completed on site; 25 (71%) were diagnosed with low-grade dysplasias (17 mild, 8 moderate) and the remaining 10 showed no signs of dysplasia. FV loss was noted in all but one dysplastic lesion and showed a sensitivity of 96% and specificity of 17%. Cytology combined with DNA-ICM had a sensitivity of 64% and specificity of 86% in detecting dysplasia. DNA-ICM combined with cytology identified the majority of dysplastic lesions and identified additional lesions, which were not considered high-risk during WLE and biopsy on site. Efforts to follow-up with these participants are ongoing. FV identified most high-risk lesions but added limited value over WLE.

Knowledge about oral cancer among dental students and Primary Health Care dentists: A Brazilian study.

The present study aims to evaluate the knowledge of dental students and dentists who work in Primary Health Care (PHC). These are professionals who work in the public basic health units regarding oral cancer prevention, diagnosis, and treatment. A cross-sectional and observational Brazilian study was conducted. A survey with 27 questions was carried out regarding the (i) demographic, academic, and professional data of the participants, (ii) attitudes, practices, and self-perception about their training, and (iii) knowledge about oral cancer. With the exception of one question regarding the clinical characteristics of oral cancer, all knowledge answers were graded as correct or incorrect. Grades were assigned to each participant according to their level of knowledge, and scores for each participant were calculated ranging from 1 to 10. Mann-Whitney and Kruskal-Wallis tests were used to examine the difference in the knowledge score of oral cancer according to explanatory variables. The level of significance adopted was 5%. The sample comprised 541 dental students and 82 PHC dentists. Most participants did not consider it appropriate or had not received training for palpation of lymph nodes or for identifying lymphadenopathies associated with oral cancer. Less than 20% of the participants had some kind of practice before and felt safe performing biopsy surgery. The average student score was 7.01±2.15, and the average dentist score was 7.81±1.467. Although the scores were satisfactory, most of the participants did not show adequate knowledge about biopsy and palpation of cervical lymph nodes.

The New Era of Salivaomics in Dentistry: Frontiers and Facts in the Early Diagnosis and Prevention of Oral Diseases and Cancer.

Nowadays, with the development of new and highly sensitive, blood is not the only medium of choice for the diagnosis of several diseases and pathological conditions. Saliva is now considered a safe and non-invasive sample to study oral and systemic diseases, showing great diagnostic potential. According to several recent studies, saliva has emerged as an emerging biofluid for the early diagnosis of several diseases, indicated as a mirror of oral and systemic health and a valuable source of clinically relevant information. Indeed, several studies have observed that saliva is useful for detecting and diagnosing malignant tumours, human immunodeficiency virus, heart disease, and autoimmune diseases. The growing realisation that saliva is an inexhaustible source of information has led to the coining of the term ‘Salivaomics’, which includes five “omics” in connection with the main constituents of saliva: genome and epigenome, transcriptomics, metabolomics, lipidomics, proteomics and microbiota. All those may be changed by disease state, so they offer significant advantages in the early diagnosis and prognosis of oral diseases. The aim of the present review isto update and highlight the new frontiers of salivaomics in diagnosing and managing oral disorders, such as periodontitis, premalignant disorders, and oral squamous cell carcinoma (OSCC).

Knowledge, Practice, and Awareness of Oral Cancer and HPV Infection among Dental Students and Residents: A Cross-Sectional Study.

Background and Objectives: Dentists play a very important part in the early identification of oral cancer lesions. This aspect of dental practice depends on the knowledge acquired during the faculty years. The aim of this study was to assess dental students’ and residents’ levels of awareness in terms of oral cancer. Materials and Methods: The cross-sectional study was conducted at the Faculty of Dental Medicine within the “Grigore T. Popa” University of Medicine and Pharmacy in Iasi, on a sample of 197 students in the fourth and the fifth years and first year residents in general dentistry. To assess their knowledge, a questionnaire was created containing 22 questions about the risk factors for oral cancer, with a focus on HPV infection. Results: Most participants correctly identified smoking, alcohol, and the HPV infection as risk factors and leukoplakia and erythroplasia as potentially malignant lesions. At the opposite site, aspects considered as unsatisfactory focused on the palpation of lymphatic nodules, a procedure largely carried out by 41.6% of the fourth year students, the counseling only of the patients at risk performed by 59.7% of residents, the lack of knowledge about the prevention of oral cancer through anti-HPV immunization found in 39.7% of the fifth year students. Other incorrect answers focused on other types of suspicious lesions, such as actinic cheilitis, as well as certain areas in the oral cavity subject to the frequent onset of oral cancer, such as buccal mucosa. Conclusions: Although the fifth year students and residents have better knowledge than the fourth year students, the gaps in terms of knowledge and practice encountered in all three categories of participants require a reevaluation of the academic curriculum and the focus on the building of the skills necessary for the correct screening of oral cancer.

Process Evaluation of a Comprehensive Intervention for the Early Detection and Prevention of Oral Cancer: A Mixed Methods Study.

Process evaluations help to understand and refine health interventions. The “ISAC” intervention targeted the enhancement of early detection and prevention of oral cancer (OC) through tobacco-cessation counseling, patient communications, and ISAC role-modeling. Over six months, throughout ISAC implementation in the Jazan region of Saudi Arabia, Linnan and Steckler’s process evaluation framework’s specified indicators were assessed, by mixed methods, on context, reach, dose delivered, dose received, fidelity, recruitment, and participant’s satisfaction. Findings showed that 47 of 80 (58.75%) eligible dentists were reached and received all components. Thirty-six (76.6%) participants reported reading all intervention materials, visited the ISAC website, scored high on the perceived quality of provided information (M = 4.62 ± 0.63), and provided support (M = 4.67 ± 0.57). The fidelity was scored high across all intervention components. Role-modeling of the ISAC had the highest satisfaction score (M = 9.77 ± 0.58 out of 10). High perceived-effects were reported in relation to feeling confident in performing OC examination and training patients on OC self-examination (3.95 ± 0.22). The intervention attained high implementation levels for dose delivered, dose received, and fidelity. The intervention delivery was associated with high satisfaction and perceived effects. Using multiple data sources enhanced the understanding of the implementation process and strengthened the validity of the study’s findings.

Sulforaphane inhibits histone deacetylase causing cell cycle arrest and apoptosis in oral squamous carcinoma cells

BackgroundBiologic compounds have recently generated interest in cancer chemoprevention. Sulforaphane (SFN), an isothiocyanate from cruciferous vegetables, has profound epigenetic actions. Since epigenetic aetiology is crucial for oral cancer, this study evaluated the role of SFN in oral cancer prevention. MethodsOral squamous cell carcinoma cells (UPCI-SCC-172) were treated with SFN in three concentrations: 10 μM, 20 μM and 30 μM for two time periods: 24 h and 48 h. MTT assay assessed cell proliferation. Histone deacetylase (HDAC) enzyme activity was colorimetrically estimated in the nuclear extracts. Flow cytometry determined cell cycle stages, reactive oxygen species (ROS) generation and mitochondrial membrane potential (MMP) changes. Extrinsic and intrinsic apoptotic pathways were evaluated from caspase enzyme assays. ResultsCell proliferation and HDAC activity (44% in 24 h and 40% in 48 h) were significantly inhibited (p < 0.01). For 10 μM concentration, G2/M cell cycle arrest was found with a reduction in G1 phase cell population at 24 h and 48 h. Concentrations of 20 μM and 30 μM SFN presented cells in apoptosis marked by increased sub G1 cells at 48 h. Concentrations of 10 μM and 20 μM SFN showed a 1.3 to 2.8-fold increase in ROS generation at 24 h and 48 h. The concentration of 30 μM SFN showed a drop in ROS production, denoting cells already in apoptosis. Fall in MMP was also dose- and time-dependent. Caspase enzyme assays (p < 0.001) demonstrated activation of both extrinsic and intrinsic apoptotic pathways. ConclusionInhibitory action of SFN on oral cancer cell proliferation and HDAC activity led to cell cycle arrest and apoptosis. These effects marked by increase in ROS, a decrease in MMP and activation of apoptotic pathways offer exciting therapeutic options.

Machine-Learning Applications in Oral Cancer: A Systematic Review

Over the years, several machine-learning applications have been suggested to assist in various clinical scenarios relevant to oral cancer. We offer a systematic review to identify, assess, and summarize the evidence for reported uses in the areas of oral cancer detection and prevention, prognosis, pre-cancer, treatment, and quality of life. The main algorithms applied in the context of oral cancer applications corresponded to SVM, ANN, and LR, comprising 87.71% of the total published articles in the field. Genomic, histopathological, image, medical/clinical, spectral, and speech data were used most often to predict the four areas of application found in this review. In conclusion, our study has shown that machine-learning applications are useful for prognosis, diagnosis, and prevention of potentially malignant oral lesions (pre-cancer) and therapy. Nevertheless, we strongly recommended the application of these methods in daily clinical practice.

Review of the Literature on Oral Cancer: Epidemiology, Management and Evidence-based Traditional Medicine Treatment

Oral cavity cancers are part of the upper aerodigestive tract cancers and represent a significant burden worldwide. Its epidemiology varies from country to country with high frequencies in South East Asian countries. Tobacco and alcohol are the main risk factors. Survival of oral cancer is low i.e., less than 40% in the advanced stage (stage III and IV), diagnosis of oral cavity cancer is based on a complete clinical examination of the oral cavity complete with biopsy, bio-markers are an adjunct to screening and diagnosis of oral cavity cancers, surgery, radiotherapy, chemotherapy and immunotherapy are part of the therapeutic armamentarium of oral cancer but also have limitations. Traditional medicine is an important and proven alternative in the treatment and support of patients with oral cavity cancer. Prevention of oral cavity cancers includes not only early detection of precancerous and cancerous lesions but also control of risk factors and education of the population. Surgery, radiotherapy, chemotherapy and immunotherapy are part of the therapeutic strategy of oral cancer treatment but also have limitations. Traditional Medicine is an important and proven alternative in the treatment and support of patients with oral cavity cancer. It is thus desirable to scientifically validate phytochemicals in order to integrate alternative medicine as part of national cancer management strategy. In silico advanced studies on secondary metabolites of medicinal plants traditionally used to treat oral cancer are in progress.

Major considerations of the dentist in the diagnosis and treatment of oral cancer in hospitals: a systematic review

Introduction: Contemporary dental care must be comprehensive, aimed not only at dental treatment but also at assessing the patient's health status. Dentistry is of paramount importance in preventive actions against cancer in hospitals, given that oral cancers (OC) have a frequency of approximately 90% of cases in hospitals. Objective: It was to present, through a systematic review, the importance of the dental surgeon in the early diagnosis and prevention of oral cancer in the hospital environment. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 118 articles were found. A total of 67 articles were fully evaluated and 38 were included in this study. Based on the objective of the present study and on the literary findings, it became evident that the elaboration of the work by dentists in hospitals can enable early and effective treatment of patients with oral cancer. It also made it possible to discuss dentistry in general, address dental care in the hospital environment, and highlight the difficulties faced in its insertion in hospitals. It is necessary to train and train the entire hospital team and the dental surgeon so that oral health is offered to patients, as well as to know the impact caused by oral problems on the systemic health of patients and implement specific protocols on the subject in all hospital aspects. The dentist must promote the general health of the hospitalized individual, based on interdisciplinary planning developed together with other health professionals, as well as assess the main needs of the patient and contribute to the quality of life of these individuals.

Evidence of areca nut consumption in the United States mainland: a cross-sectional study

BackgroundAreca nut (AN) is an addictive substance consumed in the Southeast region and is highly associated with oral premalignant lesions and oral cancer. The impact of AN use in the United States (US) is largely unknown, but the products are readily available and probably used by a significant fraction of Asian immigrants or descendants living in the US. We aimed at assessing AN use prevalence among the Asian community in Houston, Texas.MethodsA cross-sectional questionnaire was used to interview adult individuals (≥ 18 years of age) who self-identified as Asian immigrants or descendants residing in Houston. Means, frequencies, and proportions were reported. Factors associated with AN use were evaluated using logistic regression.ResultsWe surveyed 275 individuals (58% women, 43% between 35–54 years old, 67% born outside of the US, and 6% concurrent smokers). Among respondents, 91% were familiar with AN products, 17% self-reported ever use of AN products in the US, and 31% had friends/family members who were AN ever users. AN use was significantly associated with being Indian Subcontinent immigrants or descendants (ISID) (OR = 3·9; CI: 1·10,13·81; p = 0·035) and having friends/family members using AN products (OR = 6·2; CI: 1·69, 22·69; p = 0·006).ConclusionsOur findings provide quantitative data on the prevalence of AN ever use and context for future AN prevention and cessation interventions specific to the Southeast Asian groups living in the US mainland. This is crucial for the prevention and control of oral cancer and other detrimental conditions related to AN consumption.

Oral cancer awareness and knowledge: Survey of dentists in Democratic Republic of the Congo

Oral cancer (OC) is one of the global diseases that is the eighth rank among different others. Early intervention therapy had a positive impact on increasing the prognosis and the survival rate up to 5 years. The aim of the current study was to evaluate the knowledge, attitude, and practice of dentists about OC in the Democratic Republic of the Congo (DRC). Materiel and MethodsIt was a cross-sectional analytical survey conducted in the primary oral health care centers in DR. Congo from February to April 2021. Only dentists working at any of the primary oral health care centers, public or private was included. Data were collected by using a survey of a 33-item questionnaire. The practice level, knowledge, risk factors, diagnosis for OC, attitude, and opinions of the dentists were recorded and evaluated. The SPSS 20 was used for data analysis and P < 0.05 was considered significant. ResultsOut of 162 dentists recorded, 65.4% were male and 34.6% were females. Half of the dentists (50.6%) had more than 5–15 years of practical experience, and 81.5% of the participants were general practice dentists. A majority of dentists were not familiar with the proper physical oral examination steps (80.2%). The practice level of the dentists was highly poor. The knowledge level about clinical features and diagnostic procedures (frequent anatomical region, common type of OC, associated factor with OC, frequent stage diagnosis of OC, and condition associated with OC) was very low. The dentists’ gender was associated with a poor level of practice (P = 0.009). However, the age experience of work was associated with the high knowledge of the clinical presentation of oral cancer (P = 0.040). ConclusionThe dentists in DRC have obvious problems in the knowledge of OC diagnosis. More continued education and training programs for dentists would serve to address the knowledge deficits and practice shortcomings about oral cancer screening, prevention, and early detection

Forecast of peak attainment and imminent decline after 2017 of oral cancer incidence in men in Taiwan

Oral cancer is the fourth most common cancer among men in Taiwan. The age-standardized incidence rate of oral cancer among men in Taiwan has increased since 1980 and became six times greater in 2014. To enable effective public health planning for oral cancer, research on the projection of oral cancer burden is essential. We conducted an age-period-cohort analysis on the incidence of oral cancer among men in Taiwan from 1997 to 2017 and extrapolated the trend to 2025. We found that the period trends for young adults aged between 25 and 44 have already peaked before 2017; the younger, the earlier, and then the trends declined. The cohort trends have peaked roughly at the 1972 birth cohort and then declined for all ages. Despite the increasing trend in the age-standardized incidence rate for oral cancer among men in Taiwan from 1997 to 2017, we forecast a peak attained, an imminent decline after 2017, and a decrease of 8.4% in age-standardized incidence rate from 2017 to 2025. The findings of this study contribute to developing efficient and comprehensive strategies for oral cancer prevention and control.

Unmet Needs and Perspectives in Oral Cancer Prevention

Simple SummaryOral cavity is the most common site of head and neck cancer which is ranked as the eighth most common cancer worldwide. Oral cancer treatment is often associated with significant morbidity and is sometimes ineffective. These cancers, mainly due to tobacco and alcohol consumption, can develop from oral potentially malignant disorders, the most common of which is oral leukoplakia. Some of these oral potentially malignant disorders disappear, while others will transform to oral cancer. Patients may also develop cancer in the field of cancerization. Unfortunately, except for the surgical excision of lesions with dysplasia, there is no effective intervention to effectively prevent transformation or cancer development in the field of cancerization. Moreover, no standardized biomarker has been clearly identified as sufficient to predict malignant transformation. In this article, several experts discuss the main challenges in oral cancer prevention, in particular the need (i) to define new a new classification system integrating cellular and molecular features aiming (ii) at better identifying patients at high risk of malignant transformation, and (iii) at developing treatment strategies to prevent their malignant transformation of oral potentially malignant disorders.Oral potentially malignant disorders (OPMD) may precede oral squamous cell carcinoma (OSCC). Reported rates of malignant transformation of OPMD range from 3 to 50%. While some clinical, histological, and molecular factors have been associated with a high-risk OPMD, they are, to date, insufficiently accurate for treatment decision-making. Moreover, this range highlights differences in the clinical definition of OPMD, variation in follow-up periods, and molecular and biological heterogeneity of OPMD. Finally, while treatment of OPMD may improve outcome, standard therapy has been shown to be ineffective to prevent OSCC development in patients with OPMD. In this perspective paper, several experts discuss the main challenges in oral cancer prevention, in particular the need to (i) to define an OPMD classification system by integrating new pathological and molecular characteristics, aiming (ii) to better identify OPMD at high risk of malignant transformation, and (iii) to develop treatment strategies to eradicate OPMD or prevent malignant transformation.

ROLE OF POLYPHENOL IN DENTISTRY AND GENERAL HEALTH

Polyphenols have gained much interest recently due to its anti-oxidant capacity and possible benets to human health such as anti-carcinogenic, anti-atherogenic, anti-ulcer, anti-thrombotic, anti-inammatory, immune modulating, anti-microbial, vasodilator and analgesic effects. Polyphenols constitute one of the most common groups of substance in plants. Polyphenol compounds have been reported to have wide range of biological activities, many of which are related to their conventional antioxidant action; however increasing scientic knowledge has highlighted their potential activity in preventing oral disease, including the prevention of tooth decay, oral ulcers, oral cancers, gingivitis, periodontitis and halitosis.

Determining the Probability of Malignant Transformation of Tobacco-Induced Oral Leukoplakia using Tissue p53 as a Prognostic Marker – A Cross-Sectional Study

Context: The concept of field cancerization necessitates substantiation of clinical assessment and histopathological examination by molecular markers. Molecular tumor biomarkers such as p53 protein overexpression aid in assessing the malignant transformation of such potentially malignant oral lesions. Aim: To identify the molecular changes in oral leukoplakia by studying the immunoexpression of tissue p53 and correlating it with the clinical and histological findings to establish an appropriate treatment plan. Methods and Material: Biopsy samples taken from 25 oral leukoplakia cases were subjected to histopathological and immunohistochemical analysis to determine the percentage positivity of p53 expression. Histopathological grading was based on dysplastic features and level of epithelial involvement. Dysplasia grading in IHC sections was estimated by p53% positivity in the cells. The obtained data were subjected to statistical analysis. Results: 24 samples were considered for statistical analysis due to the loss of epithelium in the IHC section of one sample. The results showed a statistically significant association between histopathological and IHC grading of dysplasia with a P value less than 0.05 in Fisher Exact test. Conclusion: Increased expressions of p53 in potentially malignant oral lesions are proportional to the risk of malignancy. The gold standard histopathological result does not reveal the molecular abnormality associated with a potentially malignant oral lesion. Therefore molecular analysis of such lesions will aid in the effective prevention of oral cancer.