ObjectiveTo assess the feasibility of using a remote sensing model as a free messaging application tool in the preventive screening of oral potentially malignant disorders in a rural area of India.DesignAn observational cross‐sectional study.SettingPrimary care setting in Udupi District, Karnataka, South India.ParticipantsOne‐hundred and thirty‐one individuals with a mean (SD) age of 37.34 (11.31) years, of whom 64.1% and 35.9% were men and women, respectively.InterventionsClinical oral examination followed by photo capture of five areas of the patients' mouth.Main outcome measuresReliability measures for the use of a photo messaging service in diagnosing oral potentially malignant disorders, as compared to the clinical examination.ResultsWhen lesions were categorised as normal and abnormal, the reliability (kappa) between the diagnoses, based on photo messaging and clinical oral examination, was 0.68 and 0.67 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.5% and 99.04%, respectively, whereas the specificity was 72% and 64%, respectively. When the agreement between photo messaging and clinical oral examination for an exact diagnostic match was assessed, the reliability (kappa) was 0.59 and 0.55 for Examiners 1 and 2, respectively. The sensitivity values for Examiners 1 and 2 were 98.1% and 98.7%, respectively, whereas the specificity was 64% and 52% respectively.ConclusionThere was a substantial agreement between the diagnosis based on clinical examination and WhatsApp image for both the examiners, when the lesions were dichotomised as normal and abnormal, but slightly reduced when assessed for the exact diagnostic match. Screening for oral potentially malignant disorders using photo messaging can serve as an effective adjunct and a potential cost‐effective tool in a low‐resource setting.

There was a discernible change in oral mucosal, salivary, and candidal status during the course of the study.

Objectives. To identify the potential risk factors for the occurrence of osteoradionecrosis (ORN) of the jaws among patients who have been treated with radiotherapy for head and neck malignancy. Methods. The study comprised of 231 patients treated with radiotherapy for head and neck malignancy at a tertiary referral center. The following details were recorded for each patient: age, gender, histopathological diagnosis, clinical staging, tumor site, treatment modality, radiation dose, radiation field, number of fractions, type of accelerator used, radiation area and duration of follow-up . Patient’s tobacco, alcohol habit history, and history of extraction of teeth before/during/after radiotherapy were also noted. Results. Thirteen patients had osteoradionecrosis (frequency 5.62%). Among the radiotherapy variables assessed, increased radiation area was found to be significantly associated with the occurrence of osteoradionecrosis. Among the 13 ORN cases, 10 (76.9%) had a history of tobacco consumption, 8 (61.5%) had a time interval between radiotherapy and occurrence of ORN of less than 1-year duration. Discussion and conclusion. We found a low cumulative incidence of osteoradionecrosis and a tendency to occur within a year of starting radiotherapy. Patients of older age, those with a prior tobacco habit may be considered more liable to develop osteoradionecrosis. A larger radiation field may also put patients at hazard for developing osteoradionecrosis.

Oral submucous fibrosis (OSF) is a chronic, progressive, and precancerous condition mainly caused by chewing areca nut. Currently, OSF therapy includes intralesional injection of corticosteroids with limited therapeutic success in disease management. Therefore, a combined approach of in silico, in vitro and in vivo drug development can be helpful. Polyphenols are relatively safer than other synthetic counterparts. We used selected polyphenols to shortlist the most suitable compound by in silico tools. Based on the in silico results, epigallocatechin-3-gallate (EGCG), quercetin (QUR), resveratrol, and curcumin had higher affinity and stability with the selected protein targets, transforming growth factor beta-1 (TGF-β1), and lysyl oxidase (LOX). The efficacy of selected polyphenols was studied in primary buccal mucosal fibroblasts followed by in vivo areca nut extract induced rat OSF model. In in vitro studies, the induced fibroblast cells were treated with EGCG and QUR. EGCG was safer at higher concentrations and more efficient in reducing TGF-β1, collagen type-1A2 and type-3A1 mRNA expression than QUR. In vivo studies confirmed that the EGCG hydrogel was efficient in improving the disease conditions compared to the standard treatment betamethasone injection with significant reduction in TGF-β1 and collagen concentrations with increase in mouth opening. EGCG can be considered as a potential, safer and efficient phytomolecule for OSF therapy and its mucoadhesive topical formulation help in the improvement of patient compliance without any side effects. Graphical abstract Highlights Potential polyphenols were shortlisted to treat oral submucous fibrosis (OSF) using in silico tools Epigallocatechin 3-gallate (EGCG) significantly reduced TGF-β1 and collagen both in vitro and in vivo EGCG hydrogel enhanced antioxidant defense, modulated inflammation by reducing TGF-β1 and improved mouth opening in OSF rat model.

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