Background This study aims to qualitatively and quantitatively review the association between Epstein-Barr virus (EBV) and oral squamous cell carcinoma (OSCC). Methods PubMed, Scopus, and Web of Science databases were searched using the keywords “EBV or Epstein Barr virus and Oral cancer or Oral squamous cell carcinoma” for published case-control studies in the English language upto August 2019. Results The search yielded 985 articles out of which 966 articles were excluded by screening their titles and abstracts as they were irrelevant or duplicates. Based on the full-text assessment of the remaining 19 articles, only 7 satisfied the inclusion criteria and were included in the qualitative analysis, out of which only 4 were compatible to be included in the meta-analysis. The diagnostic modalities used included immunohistochemistry, in situ hybridization and polymerase chain reaction. The diagnostic targets included latent membrane protein (LMP)-1, EBV determined nuclear antigen-1, EBV-encoded small non-polyadenylated RNA-2. The meta-analysis showed that there is an association between the EBV and OSCC. Conclusions Determining the association of EBV with OSCC is highly tedious due to the contrasting data obtained from individuals’ studies which in turn is due to the wide variations in the sensitivity and specificity of the diagnostic modalities used and diagnostic targets selected. Although the meta-analysis revealed an association between EBV and OSCC, the number and the quality of the studies included in the meta-analysis are limited, thus the association requires further validation for any conclusive inference.
Head and neck lymphadenopathy may represent a localized infection or a tumor or may be part of a systemic disease. A thorough knowledge of the varied clinical presentation exhibited by the lymph nodes under physiological and pathological states is vital in arriving at a provisional diagnosis. Despite the availability of advanced diagnostic aids, a precise clinical examination remains to be the most ideal tool for assessing head and neck lymph nodes. The present manuscript summarizes the varied clinical presentations of head and neck lymphadenopathy.
Background: Periodontitis is a chronic inflammation that destroys tissues and attachment apparatus, leading to loss of teeth. Porphyromonas gingivalis is essentially absent in healthy periodontal tissues while it is isolated at a significant amount in periodontitis. Thus, P. gingivalis is considered as a major microbial etiologic factor for periodontitis. Several therapeutic regimens including a combination of surgical and non-surgical techniques are available to control the spread of pathogenic microbes in the periodontal tissues. Most of these treatment options although effective have fallen short on establishing as the therapeutic gold standards. Thus, it is vital to explore novel therapeutic modalities for treating periodontitis effectively. Given the recent success of the use of ozone therapy as an antimicrobial, the present study explores its potential role in effectively controlling the P. gingivalis count in cases of chronic periodontitis. Materials and Methods: A total of 30 adult patients diagnosed clinically as chronic periodontitis with gingival inflammation and pocket depth ≥5 mm were included in the study. Patients with systemic conditions and/or other oral lesions/diseases were excluded from the study. The gingival crevicular fluid of patients was collected using paper points. The collected samples were assessed for colony-forming units of P. gingivalis. All patients positive for the microbe were subjected to oral scaling followed by the first set of ozone therapy following which they were immediately evaluated for a microbial count. Cases which were positive post first set of ozone therapy were subjected to a second set of ozone therapy following which they were immediately assessed for the microbial count. Results: Of the 30 chronic periodontitis cases, only 12 (40%) showed the presence of P. gingivalis. These 12 patients were treated to a round of ozone therapy. The follow-up showed that of the 12 patients, six patients were negative for P. gingivalis and six patients were positive but had significantly reduced the count. Following a second round of ozone therapy for the six positive cases, five cases were negative and one case was positive but with a significantly reduced count. Conclusion:The results show that a single round of ozone therapy led to a substantial reduction in all the chronic periodontitis cases positive for P. gingivalis. The second round led to effectively inhibiting all but one case of the study sample. The sample which remained positive despite two rounds of ozone therapy had a relatively higher microbial count, to begin with. Thus, to conclude in the limited sample size of the present study, ozone therapy has shown to effectively control P. gingivalis count and could indeed be used as an adjunct to conventional treatment modalities for chronic periodontitis. Further, multicenter prospective studies are needed to confirm the effectiveness of ozone therapy on a larger scale.
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