Matrix metalloproteinases-2 (MMP-2) and the tissue inhibitor of metalloproteinase-2 (TIMP-2), may presumably have an important role on the invasion and metastatic spread of malignancies attributed to an uncontrolled degradation of the extracellular matrix (ECM). A retrospective chart analysis was carried out to study the expression of MMP-2 and TIMP-2 on the archival samples of oral squamous cell carcinoma (OSCC) (n = 30) and normal mucosa (n = 10) by immunohistochemistry and compared with the clinicopathologic parameters of cases. Both MMP-2 and TIMP-2 expressions showed a positive correlation with the grades, stages and metastatic capacities of tumors (Spearman's correlation, p < 0.05). Concomitant increase in the expression of TIMP-2 and MMP-2 suggested that the rate of MMP-2/TIMP-2 expression is a better marker for characterization of MMP-2 concentration. High expression and/or activity of MMP-2 were linked with poorer survival in OSCC cases, while TIMPs have been shown to apparently act as either growth-stimulating or suppressor factors for tumors. It was also revealed that MMP-2 and TIMP-2 were secreted by both tumor cells and stromal cells. A new concept, supposing the dynamic, anticancer partnership between the residual genome stabilizer machinery of tumor cells and defensive cells adjacent to tumors, may illuminate the controversial results. In conclusion, the stronger the infiltrative and metastatic capacity of cancers, the higher is the rate of MMP-2/TIMP-2 expression helping the arrival of humoral and cellular anticancer forces.

Objective: To determine the number and pattern of palatal rugae in Nepalese subjects and to find the association of gender with the number and pattern of palatal rugae. Materials & Method: 200 Nepalese subjects comprising of 100 male and 100 female were randomly selected and their maxillary casts were examined for the palatal rugae length applying the classification proposed by Thomas and Kotze and palatal rugae pattern was recorded using the classification given by Kapali. Statistical analysis using Student t-test was applied for comparing the number of palatal rugae between right and left sides. Chi square test was used to find the association between gender and number of rugae as well as the pattern. Result: The study demonstrated that the mean number of primary palatal rugae on left side was predominant, similarly wavy pattern was the most predominant in Nepalese subjects. No statistical significant difference was noticed in the palatal rugae number and pattern between the gender groups. Conclusion: The study found predominant palatal form in Nepalese subjects which might have superior effectiveness in population differentiation and may be used as an effective tool in forensic odontology identification.

Aim. To study the immunohistochemical expression of matrix metalloproteinase and tissue inhibitors of matrix metalloproteinase-2 in different histological grades of tobacco associated epithelial dysplasia and correlate the association between these proteases. Potentially malignant oral disorders (PMODs) progressing to oral cancer are related to the severity of epithelial dysplasia. Methods. A retrospective immunohistochemical study was carried out on 30 clinically and histologically proven cases of leukoplakia with dysplasia and 10 cases of normal buccal mucosa using anti-MMP-2 and anti-TIMP-2 monoclonal antibodies. Results. Mann Whitney U test, for comparing the expression of both MMP-2 and TIMP-2 in normal mucosa with dysplasia, was highly significant (P < 0.001). Kruskal-Wallis test to compare the median score of MMP-2 and TIMP-2 in different grades of dysplasia showed statistical significance (P < 0.001), and a Spearman's correlation between MMP-2 and TIMP-2 through different grades of dysplasia and cells observed showed positive correlation. Conclusion. Concomitant increase in the expression of both MMP-2 and TIMP-2 suggested that the activation of MMP-2 is dependent on TIMP-2 acting as a cofactor. Changes in TIMP-2 levels are considered important because they directly affect the level of MMP-2 activity.

Neoplasms of diverse cellular origin arise in the oral cavity and among these oral squamous cell carcinoma (OSCC) arising from the mucosa of the oral cavity constitutes to over 90% 1, 2. Oral cancer encompasses all the malignancies originating in the oral tissues, including cancers of the lip, tongue, gingiva, floor of the mouth, buccal mucosa, palate and the retromolar trigone. It is the 6 th most common cancer worldwide 3. Oral squamous cell carcinoma is described as an invasive epithelial neoplasm with varying degrees of squamous differentiation and a propensity to early and extensive lymph node metastases, occurring predominantly in alcohol and tobacco using adults generally in the 5 th and 6 th decades of life. Globally about 5, 00,000 new cases of oral and oropharyngeal cancers are diagnosed and three quarters of these are from the developing world 7, 8, 9. Approximately 3, 89,650 cases occurred in the year 2000 out of which 2, 66,672 were in the oral cavity (ICD-9 140-5) and 1, 22,978 for the cancer of oropharynx (ICD-9 146, 8-9). This represented about 5% of all cancers for men and 2% for women 10. Oral and oropharyngeal cancers remain one of the more common cancers in the South and South East Asian countries, as opposed to Western society, where it accounts for only about 1-4% of the of reported cancers incidence 4. For example, the incidence of oral cancer in India is high, constituting about 12% of all cancer in men and 8% in women 5 ; mortality rate is equally high in this population, ranking number one in men and number three in women 6. Oral and oropharyngeal cancers therefore qualify as major public health problem, not only in India, but also globally. Worldwide, oral cancer incidence rates appear to have been stabilizing over the last decade 12 , but the greater frequency of oral cancer in certain regions and among specific populations is a cause for concern since their overall 5-year survival rate is 53% and it has not changed in the last two decades 13. With this heightened awareness, research to further investigate the detection, diagnosis and prevention or oral cancer has recently been included as one of the targeted priorities supported by the National Institute of Dental and Craniofacial Research (NIDR) in the United States 14. The overall 5-year survival rate for patients without clinically evident cervical lymph node metastases is 85%. However, patients with microscopic lymph node metastases have a survival rate of 54%. It has been estimated that 20-50% of patients without clinically evident cervical lymph node metastases do in fact have microscopic metastases and therefore poorer www.intechopen.com Oral Cancer 48 prognosis 87. Among the Indian population, the overall 5-year observed and relative survival rates were 30.5% and 39.7%, respectively. Survival steadily declined with advancing age and advanced clinical stages. 5-year observed survival was 59.1% for localized cancer, 15.7% for cancers with regional extension and 1.6% for those with distant metastasis. Those with tongue, buccal mu...

Background: Lack of knowledge and awareness about oral cancer, its risk factors and negligence of the early warning signs play crucial role in raising the incidence of the disease. The present study was carried out to evaluate the awareness of oral cancer among patients visiting Kantipur Dental College, Kathmandu, Nepal. Methods:The cross-sectional study was done in 471 patients from 15-85 years. Self administered questionnaire was prepared which comprised of knowledge of oral cancer, source of information, its early signs and symptoms along with the awareness of its risk factors.Results: Most of the participants (41.80%) had not heard of oral cancer. 31.60% recognized tobacco smoking and tobacco chewing as the chief risk factor with 15.50% and 10.80% of participants who identified white patch and red patch as early sign of oral cancer respectively. Pearson's chi square test was used which showed statistically significant association of total mean knowledge score and awareness score with age, education level and occupation (p<0.05).Conclusions: This study done in dental patients showed lack of knowledge and awareness in general public about oral cancer. There seem to be a need for more planned awareness programs through newspapers, radio, television and health campaigns regarding the association of habits in the development of oral cancer and benefits of detecting oral cancer at early stage for better prognosis.

The progression from normal to dysplasia to carcinoma involves series of molecular events. Matrix metalloproteinase-2 (MMP-2), proteolytic enzyme causes the degradation of the basement membrane, which is a primary step in cancer invasion and progression. The aim of this study was to compare the expression of MMP-2 in normal mucosa (NOM), oral epithelial dysplasia (OED) and Oral Squamous cell Carcinoma (OSCC).MMP-2 expression was evaluated immunohistochemically in NOM (n = 10), OED in each of its histological grades (n = 26) and OSCC of the lining mucosa (n = 19). A semi quantitative retrospective analysis was carried out in 100 cells in each of 5 different fields at 40x magnification in each case and the proportion of cells expressing MMP-2 were estimated. Suitable positive and negative controls were used for all our analysis. Expression scores of basal cells as well as adjacent stromal cells of OED and tumor cells as well as adjacent stromal cells of OSCC were analyzed. Expression of MMP-2 increased from NOM to OED through different grades to OSCC. Mann Whitney U test for comparison of expression for MMP-2 was statistically significant. However, the comparison for the expression of MMP-2 in mild and moderate dysplasia (p=0.018) as well as moderate and severe dysplasia (p=0.026) was not statistically significant.Increase in the expression of MMP-2 from normal oral mucosa to dysplasia to oral cancer suggests it as an early event in oral carcinogenesis.

Background: Personal identification is one of the key areas in the forensic sciences. A combination of different simple and easily available methods such as lip prints and fingerprints can be used for human identification. Our objective was to analyze the types of lip print and fingerprint patterns in dental students and to identify if they were associated with gender. Methods: This was a cross-sectional comparative study conducted in 150 students (male: female 1:1), aged between 17 to 34 years, from Kantipur Dental College. The lip print and fingerprint patterns were recorded and interpreted based on the Tsuchihashi and Michael Kucken classification respectively. Results: The most common lip print pattern was intersected type (44, 29.3%), while the least common was undetermined type (7, 4.7%). The intersected lip pattern (23, 30.7%) was most prevalent in males and the vertical pattern (28, 37.3%) was most prevalent in females (p < 0.05). The loop-type (82, 54.7%) fingerprint pattern was the most common while the arch-type (19, 12.7%) was the least common.  The most common fingerprint pattern in both sexes was loop pattern (38, 50.7%). Conclusions: The type of lip print pattern holds potential promise as a supplementary tool for gender identification. However, fingerprint pattern was not associated with gender.

Background Mandible is the largest and strongest bone of the face, is very durable, and hence remains well preserved than many other bones. In cases of mass disasters where an intact skull is not found, the mandible may play a vital role in sex determination as it is the most dimorphic bone of the skull. Morphometric analysis of mandibular ramus provides highly accurate data to discriminate sex. This can be accomplished by the use of panoramic radiography which is widely available and is used routinely to assess the mandibular structures. Objective To evaluate and compare the various parameters of the mandibular ramus and to determine the usefulness of the mandibular ramus as an aid in sex determination. Method Orthopantomograms of 140 samples (70 males and 70 females) were collected from the archives and traced manually on matte acetate tracing paper. Various parameters of mandibular ramus were measured on the right and left sides. The obtained measurements were subjected to discriminant function analysis. Result Mandibular measurements on the right side were greater than on the left side. However, only the ramus breath (minimum and maximum) and projective height of ramus were statistically significant (p < 0.05). All the measurements were higher for males than females. F-statistic values indicated that the highest sexual dimorphism was seen with the projective height of ramus and least with minimum ramus breath. Conclusion Mandibular ramus measurements can be a useful tool for gender determination and can be an essential tool in forensic science especially when there is damaged or partially preserved mandibles and may be helpful for medico-legal purpose in Nepal.