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Efficacy of surgical laser therapy in the management of oral pigmented lesions: A systematic review

Abduljabbar T, Vohra F, Akram Z, Ghani SMA, Al-Hamoudi N, Javed F

J. Photochem. Photobiol. B, Biol., 2017 Aug;173:353-359.
PMID: 28641206 DOI: 10.1016/j.jphotobiol.2017.06.016

BACKGROUND: Oral pigmentation, especially in the gingiva poses esthetic problems. Laser therapy has been widely used for cosmetic therapy in dentistry. The aim of the present study was to systematically review the efficacy of surgical laser therapy (SLT) in the management of oral pigmented lesions (OPL).
MATERIALS AND METHODS: The addressed focused question was "Is SLT effective in the management of OPL?" Databases (MEDLINE via PubMed; EMBASE; Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched from 1970 up to and including February 2017.
RESULTS: Ten studies were included. The reported number of OPL ranged between 8 and 140. Oral pigmented sites included, gingiva, buccal and labial mucosa, alveolar mucosa and lips. Lasers used in the studies included Q-switched alexandrite, Neodymium-doped yttrium aluminium garnet, diode, Erbium: yttrium aluminium garnet and carbon dioxide laser. Laser wavelength, power output and number of irradiations were 635-10,600nm, 1-10W and 1 to 9 times, respectively. The follow up period ranged from 6 to 24months. All studies reported SLT to be effective in the treatment of OPL. In five studies, recurrence of OPL occurred which ranged from 21.4% to 45%.
CONCLUSIONS: Lasers are effective in the management of OPL including physiologic gingival pigmentation, smokers' melanosis and pigmentation in Laugier-Hunziker syndrome. Different laser types (CO2, Er:YAG and Diode) showed comparable outcomes in the treatment of OPL.

Matched MeSH terms: Gingiva/metabolism
Cellular crosstalk mechanism of Toll-like receptors in gingival overgrowth (review)

Subramani T, Rathnavelu V, Alitheen NB, Padmanabhan P

Int J Mol Med, 2015 May;35(5):1151-8.
PMID: 25812632 DOI: 10.3892/ijmm.2015.2144

Gingival overgrowth is an undesirable outcome of systemic medication and is evidenced by the accretion of collagenous components in gingival connective tissues along with diverse degrees of inflammation. Phenytoin therapy has been found to induce the most fibrotic lesions in gingiva, cyclosporine caused the least fibrotic lesions, and nifedipine induced intermediate fibrosis in drug‑induced gingival overgrowth. In drug‑induced gingival overgrowth, efficient oral hygiene is compromised and has negative consequences for the systemic health of the patients. Toll‑like receptors (TLRs) are involved in the effective recognition of microbial agents and play a vital role in innate immunity and inflammatory signaling responses. TLRs stimulate fibrosis and tissue repairs in several settings, although with evident differences between organs. In particular, TLRs exert a distinct effect on fibrosis in organs with greater exposure to TLR ligands, such as the gingiva. Cumulative evidence from diverse sources suggested that TLRs can affect gingival overgrowth in several ways. Numerous studies have demonstrated the expression of TLRs in gingival tissues and suggested its potential role in gingival inflammation, cell proliferation and synthesis of the extracellular matrix which is crucial to the development of gingival overgrowth. In the present review, we assessed the role of TLRs on individual cell populations in gingival tissues that contribute to the progression of gingival inflammation, and the involvement of TLRs in the development of gingival overgrowth. These observations suggest that TLRs provide new insight into the connection among infection, inflammation, drugs and gingival fibrosis, and are therefore efficient therapeutic target molecules. We hypothesize that TLRs are critical for the development and progression of gingival overgrowth, and thus blocking TLR expression may serve as a novel target for antifibrotic therapy.

Matched MeSH terms: Gingiva/metabolism
Clinical and radiographic periodontal parameters and release of collagen degradation biomarkers in naswar dippers

Daood U, Abduljabbar T, Al-Hamoudi N, Akram Z

J Periodontal Res, 2018 Feb;53(1):123-130.
PMID: 28940417 DOI: 10.1111/jre.12496

BACKGROUND AND OBJECTIVE: The aim of the present study was to compare clinical periodontal parameters and to assess the release of C-telopeptides pyridinoline cross-links (ICTP) and C-terminal crosslinked telopeptide (CTX) from gingival collagen of naswar (NW) and non-naswar (control) dippers.
MATERIAL AND METHODS: Eighty-seven individuals (42 individuals consuming NW and 45 controls) were included. Clinical (plaque index, bleeding on probing, probing depth and clinical attachment loss) and radiographic (marginal bone loss) periodontal parameters were compared among NW and control groups. Gingival specimens were taken from subjects in NW and control groups, assessed for ICTP and CTX levels (using ELISA) and analyzed using micro-Raman spectroscopy. The significance of differences in periodontal parameters between the groups was determined using Kruskal-Wallis and Mann-Whitney U tests. The percent loss of dry mass over exposure time and the rate of release of ICTP and CTX from all groups were compared using the paired t-test to examine the effects of exposure time.
RESULTS: Clinical and radiographic periodontal parameters were significantly higher in the NW group than the control group (P

Matched MeSH terms: Gingiva/metabolism
Eldecalcitol (ED-71), an analog of 1α,25-dihydroxyvitamin D3 as a potential anti-cancer agent for oral squamous cell carcinomas

Shintani T, Rosli SNZ, Takatsu F, Choon YF, Hayashido Y, Toratani S, et al.

J Steroid Biochem Mol Biol, 2016 11;164:79-84.
PMID: 26444325 DOI: 10.1016/j.jsbmb.2015.09.043

We have previously reported that 1,25(OH)2D3 inhibits NF-κB activity and thus inhibits growth of OSCC cells in serum-free culture and down-regulates HBp17/FGFBP-1 expression, which is important for cancer cell growth and angiogenesis. Here, we have investigated the effects of ED-71, an analog of vitamin D3 (VD) on OSCC cell lines in serum-free culture. It is known that ED-71 has a stronger inhibitory effect on bone resorption compared to VD and other VD analogs. To the best of our knowledge, there was no report examining the potential of ED-71 as an anti-cancer agent for OSCC. We found that ED-71 is able to inhibit the growth of cancer cell lines at a concentration of hundred times lower than calcitriol. As Cyp24A1 was reportedly induced in cancer cells, we measured the expression of CYP24A1 in OSCC cell lines (NA and UE), A431 epidermoid carcinoma and normal fibroblast cell (gfi) in serum-free culture. As a result, CYP24A1 mRNA and the protein expression in the OSCC cells treated with ED-71 increased in a dose-dependent manner. However, in vivo experiment, in which the A431 cells were implanted in mice, tumor formation was reduced by the ED-71 treatment with no significant difference between Cyp24A1 expression in the tumors of ED-71-treated and control group, as analyzed by western blotting and immunohistochemistry. These results suggest that ED-71 is a potential anti-cancer agent for OSCC.

Matched MeSH terms: Gingiva/metabolism