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Context: Early diagnosis of head and neck squamous cell carcinomas (HNSCC) is critical for preventing further disease progression. This study aimed to compare the serum folate and homocysteine levels in patients with HNSCC and healthy controls through a systematic review and subsequent meta-analyses. Evidence Acquisition: The research question was: Is there a difference between serum folate and homocysteine levels (O) of patients with HNSCC (E) compared to healthy controls (C)? To conduct a systematic review, keywords were first identified and then searched in Medline/PubMed, Web of Science, ProQuest, EMBASE, Scopus, and Google Scholar databases within the period from January 2000 to November 2023. The searched studies were screened based on inclusion and exclusion criteria, and after assessing the quality of the selected articles using the Joanna Briggs Institute assessment checklist, 10 articles were finally included in the meta-analysis (nine articles for serum folate and eight for homocysteine). Due to the heterogeneity of studies, meta-analyses were conducted according to the random-effects model. Several meta-analyses were carried out because the selected articles were not uniform regarding smoking habits. Results: Regardless of smoking conditions, the serum folate levels of the HNSCC patients were significantly lower than those of the control groups. Similarly, the serum homocysteine levels were significantly higher in the patient groups compared to the control groups. Conclusions: The meta-analyses in this study showed an association between serum folate and homocysteine levels with HNSCC, indicating their possible use as biomarkers for the early detection of HNSCC. [ABSTRACT FROM AUTHOR]

Background: Radiation-induced hyposalivation is a common complication of radiotherapy for head and neck cancers. The most commonly prescribed medication for hyposalivation is pilocarpine. However, due to the numerous systemic side-effects associated with pilocarpine, there has been a proposal to use it as a mouthwash. This study aimed to evaluate the impact of 1% pilocarpine mouthwash on salivary flow in patients with radiation-induced xerostomia. Method: This double-blind, randomized clinical trial involved 63 patients with radiation-induced xerostomia. The patients were randomly allocated into the pilocarpine hydrochloride 1% mouthwash group and the placebo one. Patients were instructed to use these mouthwashes four times a day, with 30 drops each time, for two minutes. Unstimulated saliva production in patients was measured using the spitting method at three stages: two weeks before the commencement of radiotherapy, two weeks after, and four weeks after the completion of radiotherapy. These measurements were then compared between the two groups. Statistical analysis included chi-square, independent t-test, and Analysis of Variance (ANOVA) with repeated measures and the Sidak post hoc test. Statistical analysis was conducted using SPSS 17, and a significance level of P < 0.05 was applied. Results: A comparison of saliva secretion between the pilocarpine mouthwash group and the control group at various time points after radiotherapy revealed that saliva secretion in the control group significantly decreased compared with the pilocarpine mouthwash group (P < 0.001). Conclusion: 1% pilocarpine mouthwash is recommended for managing radiation-induced xerostomia. [ABSTRACT FROM AUTHOR]

Context: Salivary cortisol could be a good marker for temporomandibular joint disorders. This article aimed to study the association between salivary cortisol and temporomandibular joint disorders (TMD). Methods: PubMed, Web of Science, Scopus, and Embase were searched according to the PRISMA guidelines without restricting the publication start date until October 2022. Only case-control studies were included in the study. The critical appraisal checklist of the Joanna Briggs Institute was utilized to appraise the selected articles. Results: Of 1173 articles found, 23 studies were eligible, and 18 were meta-analyzed. A total of 696 TMD patients and 785 controls were included. Meta-analysis showed that salivary cortisol was significantly higher in patients with TMD than the controls. Meta-regression showed that the difference in mean salivary cortisol decreased significantly between the two groups with increasing age. Conclusions: The salivary cortisol in patients with TMD is significantly higher than in the controls. As the heterogeneity among the studies was high, more studies are required to verify this association. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the antibacterial effects of calcium hydroxide, curcumin, and Aloe vera as an intracanal medicament on 6-week-old Enterococcus faecalis biofilm. Materials and Methods: In this in vitro study, the solution containing E. faecalis ATCC® 29212™ was inserted into the canals of 72 single-rooted teeth to produce biofilm. The samples were divided into four groups, and the antibacterial agent as an intracanal drug was used for 1 week. Calcium hydroxide, curcumin, and A. vera were used as intracanal medicaments in three groups, respectively, and the fourth group was irrigated with normal saline. The collected debris was cultured by spread plate method for the bacterial count by colony count machine, and the number of bacteria in each sample per ml was reported in colony-forming unit per ml (CFU/ml). The data were analyzed using SPSS software. KruskalWallis and MannWhitney U-tests were used for comparison of CFU/ml between the study groups. P <0.05 was considered significant. Results: The mean CFU/ml in the groups of calcium hydroxide, curcumin, and A. vera were 749.44, 630.55, and 1529.16, respectively. Compared with the control group, curcumin, calcium hydroxide, and A. vera showed 99.5%, 99.41%, and 98.79% antimicrobial effects, respectively. All three groups were significantly effective than the control group (P = 0.023, P = 0.023, and P = 0.024, respectively) but were not significantly different from each other (P = 0.057). Conclusion: All three groups showed significant antibacterial activity compared to the control group, curcumin had the most significant effect, followed by calcium hydroxide and A. vera. Therefore, herbal materials can be considered safe alternatives to synthetic medicaments for intracanal usage. [ABSTRACT FROM AUTHOR]