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PURPOSE: To report on the clinicopathological aspects of odontogenic keratocysts (OKC)/keratocystic odontogenic tumours (KCOT) presenting in a New Zealand population. METHODS: Information on defined areas--including age at presentation, gender, anatomical sub-location, presenting features, histological subtype and the recurrence pattern--were extracted from the histopathological data available in the Oral Pathology database of the University of Otago School of Dentistry. RESULTS: Two hundred and twenty three cases of OKC/ KCOT were identified over the period ranging from 1987 to 2008. Mean age at presentation was 37.0 years (males 38.6 years, females 34.4 years), with 61.0% of cases being male. The mandible was the dominant jaw affected, with 65.9% of lesions, with the angle of mandible being the commonest anatomical sub-location (with 32.4% of lesions). One-fifth of the cases were asymptomatic incidental findings, while the majority of problems were related to the third molar tooth and/or pain and swelling. The overall recurrence rate was 18.3%, with the majority (62.2%) in the mandible and more males (67.5%) affected. Recurrence was highest in the first 5 years of follow-up, and decreased sharply thereafter. CONCLUSION: This study is the first to describe the frequency, distribution, presentation and recurrence rates of OKC/KCOT in New Zealand and shows that these are similar to those reported from other populations. [ABSTRACT FROM AUTHOR]

Dental education is a unique form of health professional education. This is because the clinical training component largely occurs within the dental school and involves students carrying out irreversible patient interventions early in their education. Perhaps not surprisingly, previous research indicates that dental education (and particularly the clinical component) is stressful for many students. In their responses to an annual clinical learning environment survey, final-year Bachelor of Dental Surgery (BDS) students at the University of Otago have suggested that teaching staff play a key role in mitigating or compounding stressors associated with students' clinical work. In 2007-2009 questionnaire responses, students identified the kinds of staff feedback which they found constructive or unhelpful while working in patient clinic settings, described their responses to feedback received, and identified ways in which students' clinical learning experiences might be improved. This paper outlines 2007-2009 University of Otago Faculty of Dentistry clinical learning environment survey findings, and relates these to the literature on effective teaching and clinical teaching. It then describes programmatic changes and research initiatives developed in response to student feedback. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study's primary objective was to review (for the years 2003 to 2006) the outcomes of using prophylactic hyperbaric oxygen therapy (HBOT) to prevent osteoradionecrosis (ORN) in a group of patients previously exposed to radiotherapy of the head and neck. A secondary objective was to evaluate any HBOT-associated vision changes. DESIGN: The study was a retrospective audit of the clinical outcomes of HBOT for the prevention of ORN following dental extractions in previously irradiated jaws. METHODS: Information was obtained from dental records held at Green Lane Clinical Centre (Auckland) and Oxygen Therapies Ltd (Quay Park Health, Auckland). Data included patient age, gender, site of tumour, radiation dose, time lapse between radiotherapy and tooth/teeth extracted, extraction procedures and the HBOTprotocol used. Follow-up data were obtained through a telephone interview using a standardised questionnaire. RESULTS: Of the 29 treated patients, 26 (90%) were available for follow-up. Of these, one failed to heal after dental extractions following the use of prophylactic HBOT, and only nine (34%) developed temporary vision changes. CONCLUSION: The outcome of this audit suggests that it is appropriate to use prophylactic HBOT in association with dental extractions in patients who have previously had radiotherapy to the head and neck. Acute vision changes following the 30th HBOT were transient. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to investigate the use of field emission scanning electron microscopy and electron dispersive spectrography (SEM-EDS) to identify silver solder 'tattoo.' STUDY DESIGN: SEM-EDS was used to analyze material present in the connective tissue of a patient who presented with bilateral pigmentation of the mandibular lingual gingiva adjacent to the first molars. No dental restorations were present. RESULTS: SEM-EDS analysis identified silver, with no evidence of tin, copper, or mercury. The patient was wearing an orthodontic appliance where brackets had been soldered to the archwire with silver solder. It is hypothesed that the solder underwent electrolytic corrosion with subsequent regrouping of silver ions in the submucosa leading to blue-gray discoloration. CONCLUSION: Spectrography proved to be a powerful diagnostic tool in identifying the metal within the oral mucosa. Attention is drawn to this newly described lesion, which should be included as a differential diagnosis for pigmented oral mucosal lesions. [ABSTRACT FROM AUTHOR]

Magnesium alloys present a compelling prospect for absorbable implant materials in orthopedic and trauma surgery. This study evaluates an ultra-high purity, lean magnesium-calcium alloy (X0), both with and without plasma electrolytic oxidation (PEO) surface modification, in comparison to a clinically utilized WE43 magnesium alloy. It is shown that the mechanical properties of X0 can be tuned to yield a high-strength material suitable for bone screws (with an ultimate tensile strength of 336 MPa) or a ductile material appropriate for intraoperatively deformable plates (with an elongation at fracture of 24 %). Four plate-screw combinations were implanted onto the pelvic bones of six sheep without osteotomy for 8 weeks. Subsequent analysis utilized histology, micro-computed tomography, and light and electron microscopy. All implants exhibited signs of degradation and hydrogen-gas evolution, with PEO-coated X0 implants demonstrating the least volume loss and the most substantial new-bone formation on the implant surface and surrounding cancellous bone. Furthermore, the osteoconductive properties of the X0 implants, when uncoated, exceeded those of the uncoated WE43 implants, as evidenced by greater new-bone formation on the surface. This osteoconductivity was amplified with PEO surface modification, which mitigated gas evolution and enhanced osseointegration, encouraging bone apposition in the cancellous bone vicinity. These findings thus indicate that PEO-coated X0 implants hold substantial promise as a biocompatible and absorbable implant material., Competing Interests: LB and JFL are shareholders of Kairos Medical AG, an ETH Zurich spin-off working on absorbable magnesium-based implants. LB is currently employed by the company. This study and analysis was performed before its foundation., (© 2024 The Authors.)

Biodegradable magnesium is a highly desired material for fracture fixation implants because of its good mechanical properties and ability to completely dissolve in the body over time, eliminating the need for a secondary surgery to remove the implant. Despite extensive research on these materials, there remains a dearth of information regarding critical factors that affect implant performance in clinical applications, such as the in vivo pH and mechanical loading conditions. We developed a measurement system with implantable strain, temperature, pH and motion sensors to characterize magnesium and titanium plates, fixating bilateral zygomatic arch osteotomies in three Swiss alpine sheep for eight weeks. pH 1-2 mm above titanium plates was 6.6 ± 0.4, while for magnesium plates it was slightly elevated to 7.4 ± 0.8. Strains on magnesium plates were higher than on titanium plates, possibly due to the lower Young's modulus of magnesium. One magnesium plate experienced excessive loading, which led to plate failure within 31 h. This is, to our knowledge, the first in vivo strain, temperature, and pH data recorded for magnesium implants used for fracture fixation. These results provide insight into magnesium degradation and its influence on the in vivo environment, and may help to improve material and implant design for future clinical applications., Competing Interests: None., (© 2024 The Authors.)

Purpose: This research aimed to investigate the relative frequency of odontogenic tumours (OT) and selected odontogenic cysts in a single oral pathology center in New Zealand from 2008 to 2023., Methods: Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OT. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst (COC), previously classified as OT were also included. Patient demographics, clinical details and histopathologic diagnoses were recorded. Data were analyzed using SPSS., Results: Of the 34,225 biopsies over the 15-year period, 1.8% were identified as OTs, COC and OKCs and accounted for 47%, 1.5% and 51.5% respectively. The most prevalent OT types were odontoma (43.7%), ameloblastoma (27%) and cemento-ossifying fibroma (7.5%). Malignant OT, ameloblastic carcinoma, constituted 1.4% of OT. The average age at diagnosis for OKC, COC and OT patients were 48.2 ± 20.9, 33.7 ± 23.3 and 28.9 ± 19.3 years. Overall, male and mandibular site predilections were observed. Recurrence of OKC and ameloblastoma occurred in 15.2% and 13.7% of patients. The time for recurrence for OKC and Ameloblastoma were 61.7 ± 56.5 months and 122 ± 152 months respectively., Conclusion: The demographic features and range of OT, COC and OKC in New Zealand align with those of other western countries. The study also confirms need for long term follow up for patient with OKC and ameloblastoma., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: This ex vivo study aimed to compare protein expression of advanced glycation end-products (AGE) and receptor (RAGE), and the levels of selected genes associated with inflammation and collagen within dental pulp tissue from patients with type 2 (T2D) diabetes and non-T2D., Methodology: Noncarious extracted permanent molar teeth from patients with well-controlled T2D (n = 19) and non-T2D (controls) (n = 19) were collected and compared. The coronal pulp was examined using immunohistochemistry (IHC) (n = 10 per group) for anti-AGE and anti-RAGE. Quantitative PCR (n = 9 per group) was used to analyse the gene expression levels of NFKB, S100A12 and COLIA1. Data analyses were performed between the groups using GraphPad Prism using Pearson correlation, Shapiro-Wilk and Mann-Whitney U-tests, and multiple regression using SPSS., Results: AGEs were distributed diffusely throughout the pulp extracellular matrix associated with collagen fibres and were present on several cell types. RAGE was expressed at the pulp-dentine interface and was observed on odontoblasts, immune cells, endothelial cells and fibroblasts. Semi-quantitative analysis of IHC samples showed significantly increased expression of AGE (p < .0001) and RAGE (p = .02) in T2D samples compared with controls. The expression of NFKB (p < .0001), S100A12 (p < .0001) and COLIA1 (p = .01) genes were significantly higher in the T2D pulp, and multivariate logistic regression analysis showed that these findings were not affected by age., Conclusion: T2D may exert a similar glycation response in the dental pulp to other body sites. This could occur through activation of NF-κB pathways with a concomitant increase in genes associated with inflammation and collagen., (© 2023 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

Competing Interests: Conflicts of interest None disclosed.

Duloxetine hydro-chloride (trade name Cymbalta) is marketed as a single enanti-omer ( S )- N -methyl-3-(naphthalen-1-yl-oxy)-3-(thio-phen-2-yl)propyl-am-in-ium chloride, C 18 H 20 NOS + ·Cl - , which is twice as effective as the ( R )-enanti-omer in serotonin uptake. Here, we report the crystal structure of duloxetine hydro-chloride in its racemic form (space group Pna 2 1 ), where it shows significant differences in the mol-ecular conformation and packing in its extended structure compared to the previously reported ( S )-enanti-omer crystal structure. Mol-ecules of this type, comprising aromatic groups with a single side chain terminated in a protonated secondary amine, are commonly found in active anti-depressants. A Cambridge Structural Database survey of mol-ecules with these features reveals a strong correlation between side-chain conformation and the crystal packing: an extended side chain leads to mol-ecules packed into separated layers of hydro-phobic and ionic hydro-philic phases. By comparison, mol-ecules with bent side chains, such as racemic duloxetine hydro-chloride, lead to crystal-packing motifs where an ionic hydro-philic phase is encapsulated within a hydro-phobic shell., (© Bhadbhade et al. 2023.)

The diagnosis and management of oral potentially malignant disorders (OPMD) should be the same the world over, but there are important nuances in incidence, aetiological factors, and management opportunities that may lead to differences based on ethnogeography. In this review, we update and discuss current international trends in the classification and diagnosis of OPMD with reference to our experience in various regions in Oceania. Oceania includes the islands of Australia, Melanesia (including Papua New Guinea, Fiji, Solomon Islands, Micronesia and Polynesia (including New Zealand, Samoa, Tonga) and hence has diverse populations with very different cultures and a range from well-resourced high-population density cities to remote villages., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Rich, Hussaini, Nizar, Gavidi, Tauati-Williams, Yakin and Seo.)

Background: The incidence of oral squamous cell carcinoma (OSCC) is very high in South Asia and Vascular endothelial growth factor (VEGF) is one of the key factors essential for cancer growth. The importance of VEGF-A and VEGF Receptor 2(VEGFR-2) in oral cancer pathophysiology is yet to be decided. Vascular Endothelial Growth Factor A (VEGF-A) is the main factor concerned in angiogenesis in tumors, but its role in Oral Squamous Cell Carcinoma (OSCC) is still debatable. Our study aimed to determine the role of VEGF-A and VEGFR-2 in OSCC., Methods: Blood from 30 patients with primary OSCC and 1:1 age-sex-matched controls was subjected to qPCR and ELISA to detect VEGF-A gene expression and serum level. Tumors of the 30 patients were investigated for VEGF Receptor-2 (VEGFR-2) expression and were analyzed using Image J software version 1.52 for DAB percentage (DAB-P) area and optical density (OD)., Results: VEGF-A relative gene expression among patients was 2.43-fold higher compared to the healthy control group. Well-differentiated had a 1.98-fold increment, while poorly differentiated had a 3.58-fold increment. Serum VEGF-A was significantly elevated among the patients compared to controls (458.7 vs 253.2, p=0.0225). Poorly differentiated had a higher serum VEGF concentration (1262.0±354.7pg/ml) compared with other two. Mean VEGFR-2 DAB-P level in OSCC was 42.41±5.61(p=0.15). Well-differentiated had a DAB-P of 41.20±5.32 while poorly differentiated had DAB-P 46.21±3.78. The mean OD in OSCC was 0.54±0.16. VEGFR-2 OD in well and poorly differentiated OSCC were 0.48±0.12 and 0.68±0.17, respectively., Conclusions: VEGF-A gene expression, serum levels, and tissue VEGFR-2 levels correlated linearly with the stage and grade of the tumor. This study justifies the value of VEGF-A as a potential biomarker in OSCC in early detection of OSCC. More studies are needed to accept the use of VEGF-A.

Immunohistochemistry (IHC) is one of the most widely used protein detection techniques. The principle of this technique is based on the binding of a specific antibody to a matching specific antigen in tissue. The bound antigen-antibody complex then is visualized using a range of detection techniques. IHC uses a number of different enzymatic labels, such as peroxidase and alkaline phosphatase, for the detection of the antigens of interest whereas immunofluorescence (IF) uses a fluorescent signal. In this chapter, IHC will be described using the peroxidase label. Both IHC and IF can be used on formalin-fixed paraffin-embedded (FFPE) or appropriately processed fresh tissues. IHC/IF can be multiplexed to detect more than one antigen at a time, or may be sequentially stained to detect multiple targets. These techniques are routinely used in diagnostic pathology laboratories, not just for diagnostic purposes but many biomarkers are used for patient staging, treatment allocation, and prognostication. Immunofluorescence is routinely used for the detection of antibodies and antigens in freshly biopsied tissues, particularly for immune-mediated and vesiculobullous lesions. In this chapter, the principles of IHC are reviewed followed by examples of IHC and IF staining using readily available antibodies. Steps and processes involved in IHC/IF double staining are also described., (© 2023. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Adverse cardiac events after laparoscopic bariatric surgery are rare, yet preoperative cardiology evaluation and testing remain common, resulting in the overuse of cardiac testing in low-risk patients. Our objective was to assess the frequency of, and factors associated with, overuse of preoperative cardiac testing in patients at low cardiac risk before laparoscopic bariatric surgery. We retrospectively reviewed data from 1,094 adult patients who underwent laparoscopic bariatric surgery at our institution from January 1, 2015, through December 31, 2019. The cardiac risk was determined using the Revised Cardiac Risk Index (RCRI) and the National Surgical Quality Improvement Program Myocardial Infarction and Cardiac Arrest (NSQIP MICA) risk model. Multivariate logistic regression was used to evaluate risk factors associated with the overuse of cardiac testing in low-risk patients. Overall, 1,059 patients (96.8%) were estimated to be at low cardiac risk by the RCRI, and 1,094 (100%) were at low cardiac risk by NSQIP MICA. A total of 587 patients (51.8%) were referred to cardiology for preoperative evaluation, and 643 patients (56.7%) underwent one or more preoperative cardiac tests. Factors associated with overuse of preoperative cardiac testing in low-risk patients included preoperative cardiology referral (adjusted odds ratio 37.2, 95% confidence interval 25.3 to 54.7) and patient age (adjusted odds ratio 1.05, 95% confidence interval 1.03 to 1.07). Overuse of preoperative cardiac testing was common in patients at low cardiac risk before laparoscopic bariatric surgery. Preoperative referral to cardiology was the most significant risk factor associated with the overuse of preoperative cardiac testing. Application of risk models such as the RCRI or NSQIP MICA at the time of bariatric program enrollment may reduce unnecessary preoperative cardiac testing in low-risk patients., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Endoplasmic reticulum (ER) stress and unfolded protein response (UPR) have been shown to be crucial in the pathogenesis and response to treatment in various cancers. However, such response has not been profiled in oral squamous cell carcinoma (OSCC), the most frequent form of cancer in the head and neck region. Cell lines derived from OSCC (SCC4, SCC15 and SCC25) and normal oral mucosa (OKF4, OKF6 and OKP7) were subjected to tunicamycin-induced ER stress (2.5 μg/mL for 24 h) after which the differential regulation of 84 key UPR/ER stress genes were assessed using Quantitative real-time reverse transcription polymerase chain reaction. The expression of the transcription factors SREBP1 and CREB3L3, and the activation of SREBP1, were examined using ELISA and a transcription factor assay. The expression of DDIT3 was immunohistochemically verified in OSCC tissue samples. SREBP1 and CREB3L3 were significantly up-regulated in OSCC with and without tunicamycin-induced ER stress. A significantly higher level of SREBP1 transcriptional activation was observed in OSCC. Apoptosis-associated genes (DDIT3, HTRA4 and HSPA1L) were also significantly up-regulated in OSCC upon ER stress induction. The findings demonstrated the involvement of UPR and ER stress in the pathogenesis of OSCC through the identification of apoptosis-associated genes (DDIT3, HSPA1L and HTRA4) and regulators of metabolism (SREBP1 and CREB3L3) as the key factors differentiating between normal and malignant oral keratinocytes., (Copyright © 2022 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.)

Exosomes are membrane-bound nanovesicles released by cells into their extracellular environment. They carry different types of RNA including mRNA which may be useful in the diagnosis of various diseases. Exosome isolation has been a challenge because of their small size; therefore, two exosome isolation methods were compared in this study. The Exoquick-TC PLUS™ exosome isolation kit (kit) was compared with the classic ultracentrifugation (UC) method for exosome isolation. In samples obtained using both methods, cryo-electron microscopy showed round or slightly elongated vesicles with diameters ranging from 50 to 150 nm and delimited by a bilayered membrane. Dynamic light scattering resulted in multiple peaks for kit exosomes, whereas a single peak was observed for UC exosomes. Significantly, more total RNA was present in UC exosomes in contrast to kit exosomes ( P < 0.0001). This was reflected in subsequent mRNA analysis using qPCR, where UC exosomes had lower Ct values compared to kit exosomes. In conclusion, exosome characterization revealed the presence of exosomes in both UC and the kit samples. The kit samples presented additional peaks from DLS which might be due to impurities. Overall, due to a higher total RNA and mRNA content, UC is a better option for subsequent mRNA analysis; nevertheless, the kit can still be used if an ultracentrifuge is not available as four out of the five genes selected were detected and quantified using the kit., Competing Interests: The authors declare they have no competing interests., (Copyright © 2022 Mohammad A. Aziz et al.)

Background: The global incidence of oral squamous cell carcinoma (OSCC) is on the rise with no improvement seen in survival rates. Tobacco consumption varies depending on geographic location, ethnicity and culture. The present case-controlled study aimed to determine the relative risk of OSCC for different tobacco consumption patterns in a selected Sri Lankan population. Methods: One hundred and five patients with histopathologically confirmed OSCC attending the National Cancer Institute (Apeksha Hospital) of Sri Lanka and 210 age and gender-matched controls from the community responded to an interviewer-administered questionnaire regarding their smoking and betel-quid chewing (with/ without smokeless tobacco) habits were included in the study. The odds ratios (OR) and 95% confidence intervals (CI) were calculated. p<0.05 was considered as statistically significant. Results: The overall risk of OSCC increased 2.93-fold for smokers. Those smoking two packets of cigarettes or more per day (OR=5.56; 95% CI-2.822- 10.984; p=0.000) had more than double the risk of OSCC than those smoking 1-2 packets per day. Smoking for more than 20 years had a 3.4-fold risk of OSCC. Consumption of betel quid containing tobacco (smokeless tobacco) had a 4.26-fold higher risk for OSCC (OR=4.26; 95% CI-2.21-8.21; p=0.000), and the risk increased when all four ingredients (betel leaf, slaked lime, areca nut, and tobacco) were consumed together (OR=4.26; 95% CI-2.34-7.74; p=0.000). The combined effect from concurrent smoking and betel chewing emerged as the highest risk for OSCC (OR=15.34) which significantly exceeded the risks evident for the two habits practised in isolation from each other. Conclusions: Use of smokeless tobacco, consumption of all four ingredients together, duration of smoking, the number of cigarettes smoked per day and combined consumption of betel quid and smoking are significant risk factors in the development of OSCC among Sri Lankans.

Objectives: This investigation aimed to isolate and culture human dental pulp cells from carious teeth (cHDPCs) and compare their growth characteristics, colony-forming efficiency, mineralization potential and gene expression of Toll-like receptors (TLR)-2, TLR-4, TLR-9, tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, IL-17A, 1L-17R, IL-23A, nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK1), dentin matrix protein (DMP)-1, dentin sialophospho protein (DSPP), sex determining region Y-box 2 (SOX2) and marker of proliferation Ki-67 (MKi67) with cells isolated from healthy or non-carious teeth (ncHDPCs)., Methods: Pulp tissues were obtained from both healthy and carious teeth (n = 5, each) to generate primary cell lines using the explant culture technique. Cell cultures studies were undertaken by generating growth curves, a colony forming unit and a mineralization assay analysis. The expression of vimentin was assessed using immunocytochemistry (ICC), and the gene expression of above-mentioned genes was determined using quantitative real-time reverse-transcription polymerase chain reaction., Results: ncHDPCs and cHDPCs were successfully isolated and cultured from healthy and inflamed human dental pulp tissue. At passage 4, both HDPC types demonstrated a typical spindle morphology with positive vimentin expression. No statistical difference was observed between ncHDPCs and cHDPCs in their growth characteristics or ability to differentiate into a mineralizing phenotype. ncHDPCs showed a statistically significant higher colony forming efficiency than cHDPCs. The gene expression levels of TLR-2, TLR-4, TLR-9, TNF-α, IL-6, IL-8, IL-17R, IL-23A, NF-κB, MAPK1, DMP1, DSPP and SOX2 were significantly higher in cHDPCs compared with ncHDPC cultures., Conclusion: cHDPCs retain their differentiation potential and inflammatory phenotype in vitro. The inflamed tooth pulp contains viable stem/progenitor cell populations which have the potential for expansion, proliferation and differentiation into a mineralizing lineage, similar to cells obtained from healthy pulp tissue. These findings have positive implications for regenerative endodontic procedures.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic that has become a significant global public health concern. The virus gains entry to cells via angiotensin-converting enzyme-2 (ACE2) receptors, which have been found to be the functional receptor for SARS-CoV-2 infection. High expression of ACE2 is found in type II alveolar cells, macrophages, bronchial and tracheal epithelial cells and in the oral cavity, particularly on the tongue. Taste disturbance is one of the early symptoms of COVID-19, suggesting that taste cells in taste buds are vulnerable to SARS-CoV-2 infection. Taste is modulated by hormones that are regulated in the renin-angiotensin-aldosterone system. Hypothetical causes of taste disturbance by SARS-CoV-2 may be due to direct cell and/or neuronal injuries, inflammatory responses and dysregulation of ACE2., Competing Interests: Nil.

Lymphangiogenesis makes an important contribution to the tumour microenvironment (TME), but little is known about this in oral squamous cell carcinoma (OSCC). Archival formalin-fixed paraffin-embedded specimens (28 OSCC, 10 inflamed and 6 normal oral mucosa controls) were processed using immunohistochemistry (IHC) with antibodies against lymphatic markers D2-40 (podoplanin), LYVE-1, VEGFR3 and Prox1. After the endothelial cells had been highlighted by the various markers for lymphatic endothelium, the positive stained cells and vessels were identified and counted in a systematic manner to determine microvessel density. Double-labelling immunofluorescence (DLIF) was used to investigate the specificity of D2-40 and LYVE-1 to lymphatic endothelial cells (LECs) as opposed to blood ECs. There was higher D2-40 and Prox1 lymphatic vessel density (P = .001) in the OSCC group when compared with both control groups. Some malignant keratinocytes expressed lymphatic markers, as did a much smaller number of epithelial cells in the control groups. DLIF showed that no vessels co-expressed D2-40/CD34 or LYVE/CD34. Some D2/40 + LVs were LYVE - . D2-40 was the most specific LEC marker in OSCC tissues. These results establish that the OSCC TME contains significantly more lymphatic vessels expressing D2-40 and Prox1 than the control groups, which may play a role in facilitating lymphatic invasion and metastases., (© 2021 Company of the International Journal of Experimental Pathology (CIJEP).)

This review outlines the important oral implications of tobacco use. The lining of the mouth (oral mucosa), if exposed to tobacco and its products in a susceptible individual, can develop benign, potentially malignant, and malignant tumours. Treatment and prognosis depend on tumour type, how early it is detected, its size and site in the oral cavity and whether it has spread. Advanced oral squamous cell carcinoma (OSCC) has a 20% 5-year survival rate. Tobacco use also increases the risk of periodontitis, peri-implantitis, caries, alveolar osteitis and halitosis. Although less life threatening than OSCC, these tobacco related conditions create a substantial financial and health burden for individuals and society. Dental practitioners routinely examine the oral cavity for signs of mucosal and tooth changes, are experienced in recognising variations from normal and have established management and referral pathways. They are also ideally positioned to provide brief interventions to assist their patients to quit smoking., (© 2021 Society for the Study of Addiction.)

Caries results in the demineralization and destruction of enamel and dentine, and as the disease progresses, irreversible pulpitis can occur. Vital pulp therapy (VPT) is directed towards pulp preservation and the prevention of the progression of inflammation. The outcomes of VPT are not always predictable, and there is often a poor correlation between clinical signs and symptoms, and the events occurring at a molecular level. The inflamed pulp expresses increased levels of cytokines, including tumour necrosis factor (TNF)-α, interleukin (IL)-1α, IL-1β, IL-4, IL-6, IL-8, IL-17 and IL-23, which recruit and drive a complex cellular immune response. Chronic inflammation and sustained cytokine release can result in irreversible pulp damage and a decreased capacity for tissue healing. Other chronic inflammatory diseases, such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis, are also characterized by an dysregulated immune response composed of relatively high cytokine levels and increased numbers of immune cells along with microbial and hard-soft tissue destructive pathologies. Whilst anti-cytokine therapies have been successfully applied in the treatment of these diseases, this approach is yet to be attempted in cases of pulp inflammation. This review therefore focuses on the similarities in the aetiology between chronic inflammatory diseases and pulpitis, and explores how anti-cytokine therapies could be applied to manage an inflamed pulp and facilitate healing. Further proof-of-concept studies and clinical trials are justified to determine the effectiveness of these treatments to enable more predictable outcomes in VPT., (© 2021 International Endodontic Journal. Published by John Wiley & Sons Ltd.)

Application of iron (Fe)- and silica (Si)-enhanced biochar compound fertilisers (BCF) stimulates rice yield by increasing plant uptake of mineral nutrients. With alterations of the nutrient status in roots, element homeostasis (e.g., Fe) in the biochar-treated rice root was related to the formation of biominerals on the plaque layer and in the cortex of roots. However, the in situ characteristics of formed biominerals at the micron and sub-micron scale remain unknown. In this study, rice seedlings (Oryza sativa L.) were grown in paddy soil treated with BCF and conventional fertilizer, respectively, for 30 days. The biochar-induced changes in nutrient accumulation in roots, and the elemental composition, distribution and speciation of the biomineral composites formed in the biochar-treated roots at the micron and sub-micron scale, were investigated by a range of techniques. Results of laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) showed that biochar treatment significantly increased concentrations of nutrients (e.g., Fe, Si, and P) inside the root. Raman mapping and vibrating sample magnetometry identified biochar particles and magnetic Fe nanoparticles associated with the roots. With Fe plaque formation, higher concentrations of FeO x - and FeO x anions on the root surface than the interior were detected by time-of-flight secondary ionization mass spectrometry (ToF-SIMS). Analysis of data from scanning electron microscopy energy-dispersive spectroscopy (SEM-EDS), and from scanning transmission electron microscopy (STEM) coupled with EDS or energy electron loss spectroscopy (EELS), determined that Fe(III) oxide nanoparticles were accumulated in the crystalline fraction of the plaque and were co-localized with Si and P on the root surface. Iron-rich nanoparticles (Fe-Si nanocomposites with mixed oxidation states of Fe and ferritin) in the root cortex were identified by using aberration-corrected STEM and in situ EELS analysis, confirming the biomineralization and storage of Fe in the rice root. The findings from this study highlight that the deposition of Fe-rich nanocomposites occurs with contrasting chemical speciation in the Fe plaque and cortex of the rice root. This provides an improved understanding of the element homeostasis in rice with biochar-mineral fertilization.- anions on the root surface than the interior were detected by time-of-flight secondary ionization mass spectrometry (ToF-SIMS). Analysis of data from scanning electron microscopy energy-dispersive spectroscopy (SEM-EDS), and from scanning transmission electron microscopy (STEM) coupled with EDS or energy electron loss spectroscopy (EELS), determined that Fe(III) oxide nanoparticles were accumulated in the crystalline fraction of the plaque and were co-localized with Si and P on the root surface. Iron-rich nanoparticles (Fe-Si nanocomposites with mixed oxidation states of Fe and ferritin) in the root cortex were identified by using aberration-corrected STEM and in situ EELS analysis, confirming the biomineralization and storage of Fe in the rice root. The findings from this study highlight that the deposition of Fe-rich nanocomposites occurs with contrasting chemical speciation in the Fe plaque and cortex of the rice root. This provides an improved understanding of the element homeostasis in rice with biochar-mineral fertilization.

This study describes organic thin films prepared under a range of conditions from a model series of bis- N -alkyl chloro-triazines functionalized with short alkyl chains from ethyl to hexyl. The pure films were characterized using atomic force microscopy (AFM), X-ray diffraction (XRD), Raman spectroscopy, and X-ray photoelectron spectroscopy (XPS). When cast on mica, these compounds assemble as crystalline sheets made up of a synthetic bilayer along the crystallographic ab -plane with an internal hydrogen-bonded domain between external alkyl chains. These micron-scale surfaces stack along the c -axis, and increasing the alkyl chain length results in changes to the crystal morphology from needles to nanoscale plates. Thicker films produce nanoscale, pyramidal stacks of bilayers. Compared to atomically flat mica, a rougher, unetched silicon substrate produced irregular domains in the secondary bilayer. Films of mixtures comprising the ethyl derivative with butyl, pentyl, or hexyl derivative were imaged using time-of-flight secondary-ion mass spectrometry (ToF-SIMS) that indicated a trend toward a constant stoichiometry with increasing alkyl chain length. AFM of mixed films on mica showed single bilayers of height <2 nm, with an acceptable correlation to the XRD measurements, supporting a constant stoichiometry. These materials permit easy modification of mica to a micron-scale, atomically flat hydrophobic surface, and the use of mixtures with different alkyl chain lengths suggests a method to improve the quality of functional organic thin films.

Objective: The aim of this study was to identify the rate of malignant transformation in a longitudinal cohort of patients with oral lichen planus and oral lichenoid lesion (OLP/OLL) and to assess the associations between clinicopathologic aspects and malignant transformation., Study Design: Data were taken from the records of 829 patients histologically diagnosed with OLP/OLL in the years 2005 to 2018., Results: Of the study patients, 548 (66.1%) were females and 281 (33.9%) were males. The average age at diagnosis was 57.3 years. The hyperplastic type was the most frequent (58.5%). Most patients had multiple sites of involvement, with the buccal mucosa being the most frequent site of biopsy. Oral epithelial dysplasia developed in 5 (0.6%) patients with a previous histologic diagnosis of OLP/OLL and developed oral squamous cell carcinoma (OSCC) in 23 patients (2.8%) during the follow-up period. The atrophic/ulcerative forms are 25.8 times more likely to progress to OSCC compared with the hyperplastic types (hazard ratio [HR] 25.8; P < .05). The HR increases by 5% with every year of age (HR 1.05; 95% confidence interval; P < .05)., Conclusions: In our study, oral epithelial dysplasia developed in less than 1% of patients with OLP/OLL, and OSCC in 2.8%during the follow-up period. The atrophic/ulcerative forms are 25.8 times more likely to progress to OSCC compared with the hyperplastic types. The HR increases by 5% with every year of age., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To investigate the presence of titanium particles in peri-implant tissues in cases diagnosed with peri-implantitis, and to identify immunological reactions that these particles may elicit., Methods: Ten peri-implant tissue biopsies of patients diagnosed clinically and radiographically with peri-implantitis were obtained from the archives of Oral Pathology Centre, University of Otago. The inclusion criteria involves: bleeding on probing, ≥6 mm probing depth and ≥3 mm radiographic bone loss around the dental implant. Peri-implant tissue samples were evaluated using scanning electron microscopy-energy dispersive x-ray spectroscopy (SEM-EDS) to identify of sites with/without titanium particles. Antibodies against human transforming growth factor beta 1 (TGF-β1), receptor activator of nuclear factor kappa-B ligand (RANKL), interleukin 33 (IL-33) and cluster of differentiation 68 (CD68) were used to stain the specimens. ImageJ software was used to standardise the sampling area, compare and characterise the inflammatory infiltrate in tissues with/without titanium particles. Inflammatory cytokines positivity was assessed using the immunoreactive scores (IRSs)., Results: Light microscopy and SEM-EDS analysis identified titanium wear particles in 90% of the tissue samples, associated with a mixed chronic inflammatory infiltrate. Quantification analysis of RANKL revealed significantly higher IRS and intensity scores (p < 0.05) in areas containing titanium. High intensity, proportion and IRSs of TGF-β1 and IL-33 were observed in areas with titanium. CD68 had higher IRSs in the absence of titanium particles., Conclusions: Significant overexpression of the cytokine RANKL was observed, with a trend for over-expression of IL-33 and TGF-B1 in areas with titanium. Further studies with large sample size and appropriate control group for quantification analysis is needed to confirm the role of titanium particles in initiating bone loss., Competing Interests: None., (© 2019 The Authors.)

Background: There has been no previous report of the prevalence of paediatric oral and maxillofacial pathology in a New Zealand oral pathology diagnostic service., Aim: The aim of this study was to review cases of paediatric oral pathology to determine relative frequencies of oral lesions in this age group., Design: Paediatric oral pathology cases (≤15 years of age) received between 2007 and 2016 were retrieved from the electronic database of the Oral Pathology Centre, University of Otago. Data collected included diagnoses (categorised into 12 groups), age at diagnosis, and gender. The prevalence of each diagnosis was calculated in terms of percentage of all diagnoses made. Male-to-female ratio and mean age at diagnosis were also determined., Results: A total of 1139 paediatric cases were identified representing 5.2% of all cases. The most common diagnostic group was salivary gland pathology (25.4%), followed by dental (24.8%) pathology. The most prevalent lesion was mucocoele (23%), followed by dental follicle (14.1%). Malignancies were rare with only two cases identified., Conclusion: The findings provide an insight into the prevalence of paediatric oral pathology for clinicians. Mucocoele was the most common diagnosis made, suggesting a high prevalence of soft tissue injury as a main presenting concern warranting diagnosis and management through biopsy., (© 2019 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

In this study, we describe the synthesis and molecular properties of anthranilamide-based short peptides which were synthesised via ring opening of isatoic anhydride in excellent yields. These short peptides were incorporated as low molecular weight gelators (LMWG), bola amphiphile, and C 3 -symmetric molecules to form hydrogels in low concentrations (0.07-0.30% (w/v)). The critical gel concentration (CGC), viscoelastic properties, secondary structure, and fibre morphology of these short peptides were influenced by the aromaticity of the capping group or by the presence of electronegative substituent (namely fluoro) and hydrophobic substituent (such as methyl) in the short peptides. In addition, the hydrogels showed antibacterial activity against S. aureus 38 and moderate toxicity against HEK cells in vitro.

We used mitochondrial DNA to examine gene flow in a region of western Uganda that has received little attention regarding chimpanzee population dynamics. The area is critical to gene flow between isolated Democratic Republic of Congo populations and the rest of East Africa. None of the chimpanzees in each of the 4 protected areas under consideration (Toro-Semliki Wildlife Reserve, Semuliki National Park, Rwenzori Mountains National Park and Itwara Central Forest Reserve) are fully habituated. Therefore, it is not clear whether one or more populations have historically used this fragmented landscape for (1) regular ranging and/or (2) infrequent dispersal. We incorporated the published sequences of the first hypervariable region of the D-loop of the mitochondrial genome from 3 previously sampled sites (n = 39) while also contributing the first extensive genetic sampling of chimpanzees in Toro-Semliki (n = 80). Our goal was to generate a historical baseline model of metapopulation dynamics in this region and determine which, if any, of these protected areas forms a fragmented landscape for a single chimpanzee population. According to a discriminant analysis of principal components, the haplotypes at Toro-Semliki form a central cluster, and Itwara is its nearest genetic neighbor. Rwenzori Mountains National Park is the most distant neighbor of all protected areas. We performed an analysis of molecular variance for 14 different population models that divided the samples from the 4 protected areas into 2, 3 or 4 populations. The best fit model included 3 populations: Toro-Semliki Wildlife Reserve and Itwara Forest Reserve comprised a single population; Semuliki National Park and Rwenzori Mountains National Park formed 2 additional separate populations (variance among = 9%, p = 0.014). The results indicated that some protected areas comprised distinctive populations, while others formed a fragmented landscape for a population's ranging for foraging purposes. Therefore, the edges of a protected area do not always define a chimpanzee population. We propose a closer examination of those dynamics through renewed sampling. Advances in DNA extraction and next-generation sequencing will allow us to compare thousands of single nucleotide polymorphisms in the genomes of unhabituated chimpanzees living in each of these protected areas., (© 2020 S. Karger AG, Basel.)

Background: Accurate prediction of the behaviour of oral squamous cell carcinoma (OSCC) is necessary to determine prognosis and provide appropriate treatment. Therefore, it is important to investigate potential prognostic markers to determine their predictive ability. Histological assessment of specific features at the invading front of oral squamous cell carcinomas has shown to provide accurate and reproducible prognostic information. Proliferating cell nuclear antigen (PCNA) is a nuclear marker known to reflect cell turnover and may be used as a marker for tumour aggressiveness., Methods: Twenty cases of OSCC were histologically assessed to evaluate the correlation between proliferating cell nuclear antigen expression and invasive front grading. Each case was first assessed on a haematoxylin and eosin stained slide and an invading front grading (IFG) score was determined. In order to obtain a PCNA score, immunohistological staining was carried out using the peroxidase-labelled streptavidin-biotin technique with the monoclonal antibody PC10., Results: In all cases, tumour islands had a periphery of intensely stained proliferating cell nuclear antigen-positive epithelial cells. The average IFG score was 8 ± 1.8, and the average PCNA score was 75% ± 11.2. Regression analysis was done using data from the IFG score and PCNA score and taking the latter as the predictor variable. The Pearson correlation coefficient was 0.134, with a p-value of 0.572., Conclusion: Since the correlation between PCNA score and IFG score was not significant (p > 0.05), we conclude that there is no association between cell proliferation at the invading tumour front and the histological grading of OSCC.

The objective of this study was to develop a mouthpiece sensor with improved head kinematic measurement for use in non-helmeted and helmeted sports through laboratory validation and pilot field deployment in female youth soccer. For laboratory validation, data from the mouthpiece sensor was compared to standard sensors mounted in a headform at the center of gravity as the headform was struck with a swinging pendulum. Linear regression between peak kinematics measured from the mouthpiece and headform showed strong correlation, with r 2 values of 0.95 (slope = 1.02) for linear acceleration, 1.00 (slope = 1.00) for angular velocity, and 0.97 (slope = 0.96) for angular acceleration. In field deployment, mouthpiece data were collected from four female youth soccer players and time-synchronized with film. Film-verified events (n = 915) were observed over 9 practices and 5 games, and 632 were matched to a corresponding mouthpiece event. This resulted in an overall sensitivity of 69.2% and a positive predictive value of 80.3%. This validation and pilot field deployment data demonstrates that the mouthpiece provides highly accurate measurement of on-field head impact data that can be used to further study the effects of impact exposure in both helmeted and non-helmeted sports.

Oral candidiasis is prevalent among older people due to predisposing factors such as impaired immune defenses, medications and denture use. An increasing number of older people live in rest home facilities and it is unclear how this institutionalized living affects the quantity and type of fungi colonizing these people's oral cavities. Smears and swabs of the palate and tongue and saliva samples were taken from participants residing in rest homes (RH; n = 20) and older people living in their own homes (OH; n = 20). Yeast in samples were quantified and identified by culturing on CHROMagar Candida and sequencing the ITS2 region of rDNA. A higher proportion of RH residents had Candida hyphae present in smears compared to OH participants (35% vs. 30%) although this difference was not statistically significant ( p = 0.74). RH residents had, on average, 23 times as many yeast per mL saliva as OH participants ( p = 0.01). Seven yeast species were identified in OH samples and only five in RH samples, with Candida albicans and Candida glabrata being the most common species isolated from both participant groups. The results indicate that older people living in aged-care facilities were more likely to have candidiasis and have a higher yeast carriage rate than similarly aged people living at home. This may be due to morbidities which led to the need for residential care and/or related to the rest home environment.

ABSTRACT., Objective: This study aimed to examine the protein and gene expression of vascular endothelial growth factor (VEGF) and angiopoietins-1 and 2 in tissue from healthy and inflamed dental pulps., Methods: Permanent teeth with pulps diagnosed as healthy or reversible pulpitis were used for immunohistochemistry (IHC) and gene expression experiments. For IHC, a whole pulp tissue was excavated from the pulp chamber, and it was formalin-fixed and processed for routine IHC with angiogenic markers anti-VEGF, anti-Ang1, and anti-Ang2. Staining was visualized with diaminobenzidine (DAB), and examined using light microscopy. The distribution of markers in healthy and inflamed pulps was qualitatively and quantitatively analyzed. Real-time quantitative polymerase chain reaction (RT qPCR) was used to ascertain the gene expression levels of ANGPT1 , ANGPT2 , and TEK in the presence of inflammation. Statistical analysis was performed using the Mann-Whitney test with the statistical significance level set at 0.05., Results: There was increased protein and mRNA expression of VEGF and Ang-1 markers in inflamed pulp samples as compared with that in the healthy pulp tissue. IHC demonstrated intense expression of the VEGF protein on endothelial cells (EC) and some non-ECs, and there was significantly more staining on ECs associated with inflamed tissue (P<0.001). Ang-1 and Ang-2 were significantly expressed on ECs and non-ECs (P<0.05). RT qPCR did not show significant differences in gene expression between healthy and inflamed samples although similar trends were observed to IHC., Conclusion: The presence of Ang-1, Ang-2, VEGF, and TEK gene in healthy and mildly inflamed pulp tissue associated with reversible pulpitis indicates that these angiogenic factors may participate in physiological and pathological angiogenesis and healing. The inflammatory process may regulate Ang-1/Ang2/Tie2 signaling; and together with VEGF, these growth factors have an important role in modulating pulp angiogenesis., Competing Interests: Disclosures Conflict of interest: The Authors declare no conflict of interest., (Copyright: © 2019 European Endodontic Journal.)

Objective: To examine the microvessel density (MVD) and spatial distribution of endothelial cells and angiogenic activity in immature and mature permanent teeth using immunohistochemistry., Methods: Healthy third molars with immature and mature root development were formalin-fixed, decalcified in 10% ethylenediaminetetraacetic acid, and processed for routine immunohistochemistry with endothelial cell markers anti-CD34 and anti-CD146 and angiogenic markers anti-vascular endothelial growth factor (VEGF) and anti-VEGF receptor-2 (VEGFR2). Staining was visualized with diaminobenzidine and examined using light microscopy. The distribution of markers was analyzed qualitatively and quantitatively in the coronal, middle, and apical regions of the dentine-pulp complex., Results: There were spatial differences in protein expression for immature and mature teeth. The pulps of immature teeth were more vascular, had a greater number of CD34+ and CD146+ cells, and a significantly higher MVD in the coronal region than those of mature teeth (P=0.03). The apical papilla contained few blood vessels. VEGF/VEGFR2 activity was significantly greater for immature teeth (P=0.001). VEGF was expressed throughout the pulp-dentine complex, but there was significantly more growth factor coronally (immature P=0.04 and mature P=0.02). VEGFR2 was expressed less than VEGF but was seen on the endothelial cells and single cells unrelated to a vessel lumen., Conclusion: The spatial distribution of vascular and angiogenic (VEGF/VEGFR2) markers indicates the potential for altered healing responses in the pulps of immature and mature teeth. Immature teeth have a greater MVD and VEGF/VEGFR2 expression than mature teeth, and the increased expression of these markers in the coronal region of both tooth types is important for pulp healing., Competing Interests: Disclosures Conflict of interest: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright: © 2018 European Endodontic Journal.)

In this study, we report the synthesis of glyoxylamide peptide-mimics as self-assembled gels with well-defined molecular structures for topical delivery of ciprofloxacin (CIP). The glyoxylamide peptide mimics successfully formed hydrogels with critical gel concentrations of 0.02-0.08% (w/v). The mechanical strength, secondary structure, and fiber morphology of these hydrogels can be modulated by varying the N-substituent of the ring-opened isatins. The synthesised hydrogel exhibited a high loading capacity of CIP (40% (w/w)) and a sustained release profile. The CIP-loaded hydrogels were able to release CIP for more than 15 days and the released solution was shown to retain activity against Gram-positive and Gram-negative bacteria. In addition, the hydrogels formed showed low toxicity against Cos7 cells.