Factors affecting survival in patients with oral cancer: an Australian perspective

Little is known regarding disease-specific cumulative survival and factors affecting survival in Australian populations with oral squamous cell carcinoma. Kaplan Meier and Cox proportional hazards models were used to determine survival factors in 116 consecutive patients treated surgically at a single institution. Overall 5-year disease-specific survival rate was 83.3%. Five-year disease-specific survival probability was 88.7%, 83.8%, 83.3% and 76.5% for stage I, II, III and IV, respectively. Univariate analysis revealed that local and regional recurrence, distant metastases, N stage, margin status, radiotherapy, perivascular spread and extra-capsular spread (ECS) significantly influenced survival. Significant multivariate factors included local and regional recurrence, positive margins, and ECS. Better survival rates were found than in previous, older Australian reports. Close observation for early recurrence and aggressive management of patients with recurrence, positive margins and ECS, is advised.     

Factors related to access to family dentists and regular dental checkups--results of oral health examination of an adult population

In February 2000, we examined the oral health status of 578 government employees (males 408, females 170). We also asked them to complete questionnaires on oral health. The following results were obtained. Of the total sample, 39.2% had a family dentist. There were significantly more women, and older workers, who had a family dentist. The reasons to visit family dentists were "treatment (75.9%)," "prevention (14.4%)," and "regular checkups (8.8%)." Workers who had family dentists had more filled teeth and fewer present teeth than those without family dentists, and the difference was significant. Less than half (42.7%) of the workers were receiving dental checkups regularly, more commonly at the work site (76.3%) than by family dentists (22.4%). There was no significant difference in oral health status between workers who received/did not receive regular dental checkups. Workers who repeatedly went to the clinic for treatment considered their dentist as a "family dentist." This indicated that dental professionals and ordinary people have a different concept of a "family dentist." The habit of visiting a dentist regularly seeking checkups and prevention is not yet popular. To improve this condition, it would be necessary to undertake efforts to change the concept on family dentists for both patients and dental professionals, to improve the school oral health system, to use mass dental examination at work sites effectively, and to reform the health insurance system to be prevention-oriented.     

Factors related to oral hygiene in persons with scleroderma

Objectives: The purpose of this study was to assess potential risk factors for the development of poor oral hygiene and increased dental caries in individuals with scleroderma. Methods: Twenty‐two subjects with scleroderma participated in this study. All subjects were examined with the Patient Hygiene Performance (PHP) Index, which assesses the extent of plaque and debris over a tooth surface. In addition, oral aperature, xerostomia and dominant upper extremity strength, motion, skin thickness, and dexterity were measured. Results: None of the subjects had good or excellent hygiene. Fifteen subjects had fair oral hygiene and seven subjects had poor oral hygiene as measured by the PHP Index. Significant differences were seen between these two groups for oral aperture, percentage of teeth with caries, skin thickness, dexterity and finger flexion. Dexterity and joint motion correlated significantly with the number of decayed surfaces and number of caries. Oral aperture correlated with the PHP Index and the number of dental caries. Conclusions: Subjects with poor oral hygiene required more time to complete manual dexterity task and had decreased hand strength and joint motion. Moreover, these same subjects had more contractures, scars, ulcers, and higher skin scores (more disease activity) than subjects in the fair hygiene group. In addition to frequent dental exam and routine cleaning, dental personnel may want to consider exercises to increase oral aperature and investigate toothbrush and dental floss selection used by persons with scleroderma.     

Factors related to periodontal disease in a rural population

To estimate the prevalence and related aspects of periodontitis in a rural area of the State of Bahia, Brazil, this cross-sectional study was carried out in the village of Matinha dos Pretos, Feira de Santana County, Bahia, among 172 subjects ranging from 20 to 60 years of age. During household visits, a full-mouth periodontal exam was performed on each subject, who also answered a questionnaire about socio-demographic, economic and health-related issues. The factors assessed were plaque index, bleeding on probing index, probing depth, gingival recession or hyperplasia measurements. Clinical attachment loss was also calculated. The multivariate logistic regression method was used to evaluate the relative contribution of these factors to the periodontitis condition. The prevalence of periodontitis was 24.4%. The following factors were all positively associated with the presence of periodontitis: being male (OR = 1.58; 1.00 - 2.53), being 30 years of age or older (OR = 2.80; 1.00 - 7.39), living in a house where there was more than one person per room (OR = 1.53; 0.96 - 2.45), being a cigarette or pipe smoker or ex-smoker (OR = 1.49; 0.92 - 2.39), having a plaque index of over 65% (OR = 2.97; 2.72 - 7.39) and more than four missing teeth (OR = 1.51; 0.82 - 2.78). The authors concluded that socioeconomic and biological factors, especially poor oral hygiene and older age, are positively associated with periodontitis in the rural population of a small village in the county of Feira de Santana, State of Bahia, Brazil.     

Margins and survival in oral cancer

In the surgical management of oral squamous cell carcinoma (SCC) we aim to resect the tumour with clear margins in all planes. The aim of this study was to identify and compare overall survival in a group of 591 patients who had resections, and to relate this to the clearance of margins at the tumour bed. We used life tables to calculate survival at one, two, three, five, and 10 years after diagnosis by margin (clear = 5 mm or more; close = 2–5 mm; and involved = less than 2 mm). Kaplan–Meier curves were produced for the margins alone, which were defined as clear in 480 patients (81%), close in 63 (11%), and involved in 48 (8%). Five-year survival was 81%, 75%, and 54% for clear, close, and involved margins, respectively, which highlights the importance of clear margins for survival. There is a significant prognostic implication associated with close, and particularly with involved, margins.     

Statistical analysis on oral cancer patients related to radiotherapy

Summary Sixty nine patients with carcinoma of the oral cavity, especially those treated by radiotherapy during the 5 year period from 1982 through 1987 were reviewed. Sixty three of 67 patients (94%) had received radiation therapy with curative, adjunctive or palliative intent. In the cases when external irradiation was applied, the antitumor agents were combined in most cases. As the curative therapy for tongue cancer, 23 of 33 patients were treated with radiotherapy alone, i.e., interstitial implants alone or in combination with external irradiation. The 5-year cumulative survival rate for all cases was 55.4%; for stage I and II was 84%, and for stage III and IV it was 22.7%.     

Continuing education in oral cancer prevention for dentists in Spain

Continuing education (CE) can have a large impact on dentists' oral cancer attitudes, knowledge, and behavior. Reading scientific journals is a key component of CE. The objective of this study was to assess preventive and clinical attitudes of the participants in an educational intervention on oral cancer in Spain based on scientific journals. Members of the Spanish Board of Dentists and Stomatologists participated in an online, cross-sectional study, using an anonymous, self-administered questionnaire. There were 791 general dental practitioners (GDPs) invited to participate in the study. The large majority reported that they deliver tobacco-cessation counseling (93.6 percent) as well as advice on alcohol consumption (66.6 percent), but advice on vegetable intake was less frequently provided (42.4 percent). Alcohol intake advice, routine mucosa exploration, and biopsy performance on lesions suspicious of malignancy are preventive attitudes related to training. Compared with those who did not benefit from CE courses or did so only once, the GDPs who took four or more CE courses showed a doubling in the odds of giving alcohol advice to their patients and a tenfold increased odds of performing mucosa check on a routine basis; they were 3.5 times as likely to take biopsies of suspicious lesions. A longer experience as a GDP did not increase the probability of adopting preventive attitudes. In addition to presenting the results of this study, the article also discusses the general usefulness of other preventive measures in oral cancer.     

Number of roots and canals in maxillary first premolars: study of an Andalusian population

Abstract— A study of 150 extracted maxillary first premolars from citizens of Seville, Andalusia, southern Spain, revealed 60 teeth with one root (40.0%), 85 teeth with two roots (56.7%) and five teeth with three roots (3.3%). The distribution of root canal shapes in the sample showed that all teeth with two or three roots had type I root canals (each canal had one apical foramen). Conversely, most of the single-rooted maxillary first premolars had root canal shape type II (two canals converging in the same apical foramen). Only 1.3% of the teeth had a unique orifice in the pulp chamber and only one root canal. These results emphasized the importance of good knowledge of the root canal morphology and the need for a careful radiographic examination as part of competent root canal therapy of maxillary first premolars.     

CD2 related immunoregulation in oral cancer

Sera from 93 patients with carcinoma of the buccal mucosa were analysed for its regulatory effect on CD₂ antigen expression using anti CD₂ monoclonal antibodies and sheep erythrocyte rosetting assay. The sera from 55.5% of the patients showed an inhibitory effect (blocker sera) while sera from 44.5% showed an enhancing effect (enhancer sera) on the CD₂ antigen expression. An interesting feature observed was the dominance of enhancer sera in the early stages of the cancer, well differentiated squamous cell carcinoma and verrucous carcinoma. The regulatory effect of the sera had no correlation to the concentration of circulating immune complexes (CIC), ferritin, and serum immunoglobulins on an individual basis. Taken as a whole, the concentration of CIC was higher in the enhancer sera while the concentration of IgG and IgM were higher in the blocker sera. The dominance of enhancer sera in groups with better prognosis in clinical practice suggest a correlation with the presence of serum enhancing factors to a good prognosis. The correlation of regulatory status to the prognosis of the patient is examined as the second phase of the study.     

Number of roots and canals in maxillary first premolars: study of an Andalusian population.

A study of 150 extracted maxillary first premolars from citizens of Seville, Andalusía, southern Spain, revealed 60 teeth with one root (40.0%), 85 teeth with two roots (56.7%) and five teeth with three roots (3.3%). The distribution of root canal shapes in the sample showed that all teeth with two or three roots had type I root canals (each canal had one apical foramen). Conversely, most of the single-rooted maxillary first premolars had root canal shape type II (two canals converging in the same apical foramen). Only 1.3% of the teeth had a unique orifice in the pulp chamber and only one root canal. These results emphasized the importance of good knowledge of the root canal morphology and the need for a careful radiographic examination as part of competent root canal therapy of maxillary first premolars.     

Prevalence of temporomandibular disorder pain,jaw noises and oral behaviours in an adult Italian population sample

To evaluate the prevalence of temporomandibular disorder pain (TMD‐pain), temporomandibular joint (TMJ) noises, oral behaviours in an Italian adult population sample, their possible association with gender, oral behaviours, self‐reported facial trauma and orthodontic treatment. Subjects older than 18 years were recruited from general population in public spaces during their daily life. A specific questionnaire was developed to collect data on TMD‐pain, TMJ noises, oral behaviours, orthodontic treatment and facial trauma. A total of 4299 subjects were included in the study. The most common symptom in the sample was TMJ clicking (30.7%), followed by TMD‐pain (16.3%) and TMJ crepitus (10.3%). Oral behaviours were reported in 29% of the sample; 43.6% of the sample reported a previous or ongoing orthodontic treatment. TMD‐pain and TMJ clicking were significantly associated to gender, oral behaviours and a positive history of previous facial trauma. Crepitus was significantly associated to oral behaviours, facial trauma and higher age. Ongoing orthodontic treatment was significantly associated to TMD‐pain and TMJ sounds. In a general Italian adult population sample, TMD‐pain is associated to female gender and is less prevalent than TMJ clicking. TMDs are associated to trauma and oral behaviours.     

口腔癌和癌前病变细胞中氧化应激相关基因差异表达

目的 筛选口腔鳞状细胞癌和癌前病变细胞中与氧化应激相关的差异表达基因,探讨氧化应激损伤与口腔癌发生的相关性及其作用机理.方法 采用核酸微阵列技术,对口腔鳞状细胞癌细胞株Tca8113、KB及口腔癌前病变细胞株DOK细胞的基因表达谱进行比较研究,检测、筛选口腔鳞状细胞癌中与氧化应激相关的差异表达基因.结果 与氧化应激相关的差异表达基因有28条.与氧化应激关系较密切的差异表达基因有9条,如过氧化物酶、超氧化物歧化酶、谷胱甘肽合成酶、谷胱甘肽S-转移酶、硫氧还原酶及硒蛋白等.另外,细胞角蛋白17、细胞角蛋白10及细胞角蛋白7在Tea8113和KB细胞中表达明显增高.结论 氧化应激损伤可能通过某种信号通路引起细胞角蛋白发生变化,从而导致口腔鳞状细胞癌的发生.氧化应激损伤可能与口腔鳞状细胞癌的发生密切相关.     

MicroRNAs in an oral cancer context - from basic biology to clinical utility

Oral cancer is one of the most commonly diagnosed malignancies worldwide. Its dismal five-year survival rate of ~50% has barely changed for decades. A better understanding of the molecular basis of tumorigenesis - with particular emphasis on disease initiation and progression - is needed to improve clinical outcomes, since this will facilitate the development of drugs and management strategies based on the specific genetic changes underpinning disease behaviors. MicroRNAs (miRNAs), a class of short non-coding RNAs that down-regulate gene expression, have been demonstrated to play essential roles in human cancers. miRNA deregulation has been observed in many tumor types and is implicated in oncogenic cell processes, including proliferation, survival, apoptosis, metastasis, and chemoresistance. In addition, miRNA alterations have been associated with specific clinical phenotypes such as disease progression or recurrence, development of metastases, and post-operative survival. Recent studies have explored the utility of miRNAs as diagnostic and prognostic tools and as potential therapeutic targets. Herein, we discuss miRNA biology and provide a summary of the key findings on the role of miRNAs in oral malignancies.