Squamous cell carcinoma of the oral cavity (OSCC) is the most common head-andneck malignancy. Importantly, we are experiencing an alarming rise in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) globally. Oncogenic viruses, human papillomavirus (HPV) and Epstein-Barr virus (EBV), are known to be co-associated with OSCC and OPSCC cases. However, the reported incidence of HPV and EBV coinfection in OSCCs and OPSCCs globally is unknown. To address this, we performed a formal meta-analysis and systematic review on published studies that report the detection of both EBV and HPV in OSCCs and OPSCCs. Our analysis revealed 18 relevant studies out of a total of 1820 cases (1181 from the oral cavity and 639 from the oropharynx). Overall, HPV and EBV co-infection was found in 11.9% of OSCC and OPSCC cases combined (95% CI: 8%-14.1%). Based on anatomical subsite, dual positivity estimates were 10.5% (95% CI: 6.7%-15.1%) for OSCC and 14.2% (95% CI: 9.1%-21.3%) for OPSCC. The highest dual positivity rates described were in European countries: for OSCC 34.7% (95% CI: 25.9%-44.6%) in Sweden and for OPSCC, 23.4% (95% CI: 16.9%-31.5%) in Poland. Given these substantive prevalence rates, the value of detecting dual infection in the diagnosis and prognosis of these cancers deserves careful longitudinal studies, as do implications for cancer prevention and therapy. We further proposed molecular mechanisms that could explain how HPV and EBV could co-contribute to the aetiology of OSCCs and OPSCCs.

Background As oral cavity is the main location of Epstein-Barr virus (EBV) latency and shedding, and as EBV-encoded latent membrane protein-1 (LMP-1) has a crucial role in cell transformation, association between EBV infection, LMP-1 expression and oral malignancy is of interest. Although EBV DNA has been detected in oral squamous cell carcinoma (OSCC), studies on LMP-1 expression in OSCC and oral potentially malignant disorders are scarce and still controversial. This study aimed to evaluate the expression of LMP-1 in OSCC and oral leukoplakia (OL). Methods Biopsy specimens of 36 OSCC, 69 OL with and without dysplasia and 10 normal oral mucosa were assessed for the expression of LMP-1 using immunohistochemistry. In each case, at least 1000 cells were counted. Cells with staining were considered positive, classified by location as nuclear, cytoplasmic and nuclear plus cytoplasmic staining. Percentage of positive cells at different locations and of total positive cells were determined. For statistical analysis, SPSS version 21 was used. Statistical significance was considered at p < 0.05. Results LMP-1 was expressed in all studied specimens. In terms of percentage of total positive cells, LMP-1 expression was higher from normal mucosa (26.36%), OL without dysplasia (28.03%), OL with dysplasia (34.15%), to the significantly highest, (59.67%) in OSCC. In addition, cells with nuclear staining alone, cytoplasmic staining alone and cells with nuclear plus cytoplasmic staining were significantly higher in OSCC compared to those of normal mucosa, OL with and without dysplasia. Conclusions LMP-1 was overexpressed in OSCC. Our analysis on subcellular localization of LMP-1 in OSCC revealed prominent distinguished pattern, cytoplasmic distribution. Further studies in cell lines and animals are required to clarify the association between this EBV-encoded proteins and oral carcinogenesis.

Background: Acetylsalicylic acid (ASA) generically known as Aspirin is an analgesic, antipyretic, anti-inflammatory and also an antiplatelet drug. In order to avoid excessive bleeding and to be on the safer side, dentists have traditionally advised their patients to stop taking aspirin before extraction of teeth although this surgical procedure can be done without cessation of aspirin intake. Objective: The purpose of the study was to assess the necessity of interrupting aspirin therapy prior to dental extraction. Materials and Methods: A cross sectional study was conducted in November 2015 at outpatient department of dentistry, BIRDEM Hospital, Dhaka. Sample of 50 patients who took low dose aspirin (75mg) once daily were purposely selected for this study. The blood pressure of all the subjects was recorded preoperatively. The extractions were done atraumatically under local anesthesia using 2% lidocaine with 1:100,000 epinephrine. A gelatin sponge piece was placed in socket and closed by atraumatic silk. The subjects were instructed to apply pressure pack with sterile gauze for 30 min. Evaluation was done in every 10 minutes for 30 minutes. Results: Among 50 patients, 82.0% patients were suffering from IHD. Simple extraction was done in 92.0% of patients while the remaining extractions were done surgically. 68% was managed by pressure pack and gelatin sponge while 26.0% were managed by pressure pack only. According to Post-extraction bleeding, it was found that the bleeding time was 10 min in case of 94% patients while only 2% showed 30 minutes of bleeding time. Conclusion: The study revealed that it is not necessary to alter or stop aspirin therapy and local hemostatic measures are sufficient to control bleeding. Therefore it can be assumed that extraction can be done without cessation of low dose aspirin and avoiding the life threatening issues. Update Dent. Coll. j: 2019; 9 (1): 32-36

Though the oral cavity is anatomically proximate to the nasal cavity and acts as a key reservoir of EBV habitation and transmission, it is still unclear whether EBV plays a significant role in oral carcinogenesis. Many studies have detected EBV DNA in tissues and exfoliated cells from OSCC patients. However, very few studies have investigated the expression of functional EBV proteins implicated in its oncogenicity. The most studied are latent membrane protein 1 (LMP-1), a protein associated with the activation of signalling pathways; EBV determined nuclear antigen (EBNA)-1, a protein involved in the regulation of gene expression; and EBV-encoded small non-polyadenylated RNA (EBER)-2. LMP-1 is considered the major oncoprotein, and overexpression of LMP-1 observed in OSCC indicates that this molecule might play a significant role in oral carcinogenesis. Although numerous studies have detected EBV DNA and proteins from OSCC and oral potentially malignant disorders, heterogeneity in methodologies has led to discrepant results, hindering interpretation. Elucidating the exact functions of EBV and its proteins when expressed is vital in establishing the role of viruses in oral oncogenesis. This review summarises the current evidence on the potential role of EBV in oral oncogenesis and discusses the implications as well as recommendations for future research.

Periodontal diseases are the most commonly occurred diseases in the oral cavity with a widespread distribution around the globe. Variation in periodontal tissues associated with the aging and gender of the patient. The aim of this study was to determine relationship of age with periodontal diseases for males and females in Bangladeshi people. This study was conducted on 1837 patients visiting Department of Periodontology & Oral Medicine, Update Dental College & Hospital, from January 2017 to December 2018 (2 years) through a non-interventional cross-sectional method using descriptive and analytical statistics. Periodontal disease is the dependent variable of this study; patient age and gender serve as the independent variable. Total 37.5 % patients suffered from periodontitis and 62.5% suffered from gingivitis. Up to 48 years of age the prevalence of gingivitis was higher (70.64%) but periodontitis was more common (64.76%) in case of people over 48 years age. There is a significant (p<0.05) correlation between age and periodontal diseases exists in this study but no significant (p>0.05) correlation identified with gender. Distribution of periodontal diseases shows similar pattern between female (gingivitis=62.61%, periodontitis=37.53%) and male (gingivitis=62.47%, periodontitis=37.39%).Periodontal diseases are primarily correlating with the age but gender may not be associated. The most prevalent form of periodontal disease is gingivitis. Update Dent. Coll. j: 2019; 9 (2): 13-16