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Objective: Oral potentially malignant disorders (OPMDs) with epithelial dysplasia can progress to oral squamous cell carcinoma (OSCC). Toluidine blue (TB) has been used in oral screening with various methods. This study aimed to evaluate the sensitivity and specificity of TB-containing electrospun fibers in detecting OPMDs with epithelial dysplasia compared to histopathology., Methods: The concentrations of polyvinylpyrrolidone (PVP) and TB were optimized for fiber diameter and puncture strength using the design of experiments method with a central composite design. These optimized fibers were tested on 36 suspected OPMD lesions in 30 patients, followed by a biopsy for histopathological examination., Results: The quadratic and two-factor interaction models described the relationship between TB and PVP concentrations and fiber characteristics. The TB-containing electrospun fibers had 77.3% sensitivity and 35.7% specificity in detecting OPMDs with epithelial dysplasia., Conclusion: The TB-containing electrospun fibers offer advantages such as easy application, cost-effectiveness, and enhanced sensitivity in identifying OPMDs with epithelial dysplasia. However, their diagnostic accuracy is insufficient as a standalone diagnostic method, and they should be considered an adjunctive tool for detecting dysplastic changes in the oral epithelium., Trial Registration: Thailand Clinical Trials Registry: TCTR20240429002., (© 2024 Wiley Periodicals LLC.)

Dentists, especially those who are not oral lesion specialists and live in rural areas, need an artificial intelligence (AI) system for accurately assisting them in screening for oral cancer that may appear in smartphone images. Not many literatures present a viable model that addresses the needs, especially in the context of oral lesion segmentation in smartphone images. This study demonstrates the use of a deep learning-based AI for simultaneously identifying types of oral cancer lesions as well as precisely outlining the boundary of the lesions in the images for the first time. The lesions of interest were oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) lesions. The model could successfully (1) detect if the images contained the oral lesions, (2) determine types of the lesions, and (3) precisely outline the boundary of the lesions. With future success of our project, patients will be diagnosed and treated early before the pre-cancer lesions can progress into deadly cancerous ones.

There is limited documentation of using fluorescence images in oral potentially malignant disorders (OPMDs) and oral cancer screening through the field of teledentistry. This study aims to develop and evaluate the validity and reliability of the intraoral camera with the combination method of autofluorescence and LED white light used for OPMDs and oral cancer screening in teledentistry. The intraoral camera with fluorescent aids, which uses a combined method of both autofluorescence and LED white light, was developed before the device was evaluated for validity and reliability as a OPMDs screening tool for teledentistry. All lesions of thirty-four OPMD patients underwent biopsy for definitive diagnosis and were examined by an oral medicine specialist. Both images under autofluorescent and LED white light mode captured from the device were sent online and interpreted for the initial diagnosis and dysplastic features in addition to being compared to the direct clinical examination and histopathological findings. The combination method was also compared with autofluorescence method alone. The device provided good image quality, which was enough for initial diagnosis. Using the combination method, sensitivity, specificity, PPV, and NPV of the device via teledentistry were 87.5%, 84.6%, 63.6%, and 95.7%, respectively, which were higher than autofluorescence method alone in every parameter. The concordance of dysplastic lesion was 85.29% and 79.41% for category of lesion. The validity and reliability results of the combination method for the screening of dysplasia in OPMDs were higher than autofluorescent method alone. The intraoral camera with fluorescent aids for the OPMDs screening can be utilized for screening via teledentistry., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Sirikanlaya Vetchaporn et al.)

Objectives: N-Acetyl cysteine (NAC), a well-known antioxidant molecule, has been used to modulate oxidative stress and inflammation. However, no studies have examined the effect of NAC in regenerative endodontic procedures (REPs). Therefore, the aim of this study was to investigate the effects of NAC on cell survival, mitochondrial reactive oxygen species (mtROS) production, and inflammatory and mitochondria-related gene expression on lipopolysaccharide (LPS)-treated apical papilla cells (APCs)., Materials and Methods: To assess the NAC concentration, 5 and 10 mM NAC were administered to LPS-treated APCs. Cell proliferation was measured at 24, 48, and 72 h by using AlamarBlue® assay. The 5-mM concentration was further analyzed using different treatment durations: 10 min, 24 h, and the entire study period. The mtROS production was quantified using MitoSOX™ Red and MitoTracker™ Green. RT-PCR was used to detect the expression of IL-6 and TNF-α inflammatory genes and mitochondrial morphology-related genes (Mfn-2/Drp-1 and Bcl-2/Bax) at 6 and 24 h. The statistical significance level was set at 0.05., Results: Five-millimolar NAC promoted the highest LPS-treated APC proliferation. The use of 24-h NAC stimulated cell proliferation, whereas the entire-period NAC application (> 48 h) significantly reduced the cell number. The mtROS levels were slightly altered after NAC induction. Ten-minute NAC treatment downregulated the IL-6 and TNF-α expression, whereas the expression of Bcl-2/Bax and Mfn-2/Drp-1 ratios was upregulated at 6 h., Conclusions: Under the LPS-induced inflammatory condition, NAC stimulated APC survival and decreased inflammation. Ten-minute NAC treatment was sufficient to reduce the level of inflammation and maintain the mitochondrial dynamics., Clinical Relevance: Ten-minute NAC application is sufficient to reduce the level of inflammation and maintain the mitochondrial dynamics. Therefore, NAC may be considered as a potential adjunctive irrigation solution in REPs.

Objectives: The present study is to investigate the salivary gland function of metabolic syndrome (MetS) patients, as indicated by salivary flow rate, amylase activity, and salivary oxidative stress, by measuring MDA level., Materials and Methods: One hundred and eighty-one MetS patients from Maharaj Nakorn Chiang Mai Hospital were enrolled onto this study. The metabolic parameters of each patient were collected and evaluated. Unstimulated saliva was also collected for 5 min. Salivary gland functions, including salivary flow rate, amylase activity, and salivary MDA levels, were investigated., Results: High levels of triglycerides, high-density lipoprotein, blood pressure, and waist circumference in MetS patients did not show a correlation with altered salivary gland function. However, a decrease in salivary flow rate was observed in MetS patients with hyperglycemia. In addition, decreased amylase activity was found in MetS patients with obesity (BMI ≥ 23 kg/m 2 ). Salivary amylase activity of MetS patients treated with dipeptidyl peptidase IV (DPP-IV) inhibitor was significantly greater than that observed in MetS patients without a DPP-IV inhibitor. Moreover, the salivary amylase activity in MetS patients was found to be independently positively correlated with DPP-IV inhibitor therapy (r = 0.708, p < 0.01)., Conclusion: These findings suggest that obesity and hyperglycemia in MetS patients were associated with the impairment of salivary glands. Treatment with a DPP-IV inhibitor was found to exert beneficial effects on the salivary gland., Clinical Relevance: This study demonstrated the impairment of salivary glands of MetS patients and the beneficial effect of DPP-IV inhibitor treatment in the salivary glands.

Objective: Chronic high-fat diet consumption causes not only obese- insulin resistance, but also leads to pathological changes in salivary glands, including increased mitochondrial dysfunction, apoptosis, oxidative stress, and inflammation. Dipeptidyl peptidase-4 inhibitor (vildagliptin) is an oral anti-diabetic drug, using for treatment of type 2 diabetes. Vildagliptin has been shown to exert beneficial effects on several organs in cases of obese-insulin resistant condition. However, the effect of vildagliptin on salivary glands impaired by obese-insulin resistance has not been investigated. The hypothesis in this study is that vildagliptin confers beneficial effects on the salivary gland impaired by obese-insulin resistance via decreasing mitochondrial dysfunction, apoptosis, oxidative stress, and inflammation., Design: Twenty-four male Wistar rats were divided into two groups. Each group was fed with either a normal (ND; n=8) or a high fat diet (HFD; n=16) for 16 weeks. At week 13, the HFD-fed rats were subdivided into 2 subgroups to receive either a vehicle or vildagliptin (3mg/kg/day) for 28days via gavage feeding. ND-fed rats were treated with the vehicle. At the end of treatment, metabolic parameters were examined, and rats were killed. Submandibular glands were removed to appraise inflammatory markers, apoptosis and mitochondrial function., Results: Vehicle-treated HFD-fed rats developed obese-insulin resistance with an increase in oxidative stress, inflammation, apoptosis, and mitochondrial dysfunction in the salivary glands. Vildagliptin therapy reduced oxidative stress, inflammation, apoptosis and mitochondrial dysfunction in salivary gland of HFD-fed rats., Conclusion: Vildagliptin prevented salivary gland injury occurring due to obese-insulin resistance., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Long-term consumption of a high-fat diet (HFD) causes not only obese-insulin resistance, but is also associated with mitochondrial dysfunction in several organs. However, the effect of obese-insulin resistance on salivary glands has not been investigated. We hypothesized that obese-insulin resistance induced by HFD impaired salivary gland function by reducing salivation, increasing inflammation, and fibrosis, as well as impairing mitochondrial function and calcium transient signaling. Male Wistar rats (200-220 g) were fed either a ND or an HFD (n = 8/group) for 16 weeks. At the end of week 16, salivary flow rates, metabolic parameters, and plasma oxidative stress were determined. Rats were then sacrificed and submandibular glands were removed to determine inflammation, fibrosis, apoptosis, mitochondrial function and dynamics, and intracellular calcium transient signaling. Long-term consumption of an HFD caused obese-insulin resistance and increased oxidative stress, fibrosis, inflammation, and apoptosis in the salivary glands. In addition, impaired mitochondrial function, as indicated by increased mitochondrial reactive oxygen species, mitochondrial membrane depolarization, and mitochondrial swelling in salivary glands and impaired intracellular calcium regulation, as indicated by a reduced intracellular calcium transient rising rate, decay rates, and amplitude of salivary acinar cells, were observed in HFD-fed rats. However, salivary flow rate and level of aquaporin 5 protein were not different between both groups. Although HFD consumption did not affect salivation, it caused obese-insulin resistance, leading to pathophysiological alteration of salivary glands, including impaired intracellular calcium transients, increased oxidative stress and inflammation, and salivary mitochondrial dysfunction.

Salivary gland dysfunction in several systemic diseases has been shown to decrease the quality of life in patients. In non-insulin dependent diabetes mellitus (NIDDM), inadequate salivary gland function has been evidenced to closely associate with this abnormal glycemic control condition. Although several studies demonstrated that NIDDM has a positive correlation with impaired salivary gland function, including decreased salivary flow rate, some studies demonstrated contradictory findings. Moreover, the changes of the salivary gland function in pre-diabetic stage known as insulin resistance are still unclear. The aim of this review is to comprehensively summarize the current evidence from in vitro, in vivo and clinical studies regarding the relationship between NIDDM and salivary gland function, as well as the correlation between obesity and salivary gland function. Consistent findings as well as controversial reports and the mechanistic insights regarding the effect of NIDDM and obesity-insulin resistance on salivary gland function are also presented and discussed., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Oral lichen planus (OLP) is a chronic inflammatory lesion in oral mucosa. Reticular (OLP-R) and erosive (OLP-E) types of OLP are the common forms that have been found in dental clinics. The aim of this investigation is to determine the correlation between neurogenic inflammation and nociception associated with OLP-R and OLP-E., Materials and Methods: The oral mucosal lesions from six patients with OLP-E, four with OLP-R and three with noninflamed oral mucosa, which represent normal mucosa, were identified by morphometric analysis of nerve fibers containing immunoreactive protein gene product (PGP) 9.5. The level of inflammation was measured with hematoxylin and eosin staining and the level of nociception was analyzed with visual analog scale measurement., Results: We found that 1) an increase in peripheral innervation was related to the size of the area of inflammatory cell infiltration from both OLP-R and OLP-E; 2) the pattern of PGP 9.5-immunoreactivity among OLP-R and OLP-E was not significantly different (P=0.23); and 3) the correlation between nociception and an increase in PGP 9.5-immunoreactivity was not found in OLP-E and in OLP-R., Conclusions: Our findings suggest that an increase in peripheral innervation may lead to increased inflammation, which is part of the immunopathogenesis of OLP. Differences in nociception between OLP-R and OLP-E arise from the pathogenesis of each lesion, not from the differences in peripheral innervation.