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2 DENTAL TRIBUNE Pakistan Edition March 2016 Publisher/CEO Syed Hashim A. Hasan hashim@dental-tribune.com.pk Editor Clinical Research: Dr. Inayatullah Padhiar Editors Research & Public Health Prof. Dr. Ayyaz Ali Khan Editor - Online Haseeb Uddin Designing & Layouting Sh. M. Sadiq Ali Dental Tribune Pakistan 3rd floor, Mahmood Centre, BC-11, Block-9 Clifton, Karachi, Pakistan. Tel.: +92 21 35378440-2 | Fax: +92 21 35836940 www.dental-tribune.com.pk info@dental-tribune.com.pk Dental Tribune Pakistan cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect of Dental Tribune Pakistan. Group Editor Daniel Zimmermann newsroom@dental-tribune.com Tel.:+44 161 112 1830 Clinical Editor Magda Wojtkiewicz Online Editors/Social Media Manager Claudia Duschek Editor Anne Faulmann Editorial Assistant Kristin Hübner Copy Editors Sabrina Raaff Hans Motschmann Publisher/President/CEO Torsten Oemus Chief Financial Officer Dan Wunderlich Chief Technology Officer Serban Veres Business Development Manager Claudia Salwiczek-Majonek Jr. Manager Business Development Sarah Schubert Project Manager Online Tom Carvalho Event Manager Lars Hoffmann Education Manager Christiane Ferret International PR & Project Manager Marc Chalupsky Marketing & Sales Services Nicole Andrä Event Services Esther Wodarski Accounting Services Karen Hamatschek Anja Maywald Manuela Hunger Media Sales Managers Matthias Diessner (Key Accounts) Melissa Brown (International) Antje Kahnt (International) Peter Witteczek (Asia Pacific) Weridiana Mageswki (Latin America) Maria Kaiser (North America) Hélène Carpentier (Europe) Barbora Solarova(Eastern Europe) Executive Producer Gernot Meyer Advertising Disposition Marius Mezger Dental Tribune International Holbeinstr. 29, 04229 Leipzig, Germany Tel.: +49 341 48 474 302 | Fax: +49 341 48 474 173 info@dental-tribune.com | www.dental-tribune.com Regional Offices Asia Pacific Dental Tribune Asia Pacific Limited Room A, 20/F, Harvard Commercial Building, 105–111 Thomson Road, Wanchai, Hong Kong Tel.: +852 3113 6177 | Fax: +852 3113 6199 The Americas Tribune America, LLC 116 West 23rd Street, Ste. 500, New York, N.Y. 10011, USA Tel.: +1 212 244 7181 | Fax: +1 212 244 7185 International Imprint The new model of periodontal disease n abnormal immune response or “feedback loop” could very well be the underlying cause of metastases in oral cancers, according to Dr. Marco Magalhaes, assistant professor at the University of Toronto’s Faculty of Dentistry and lead researcher in a study published in the journal Cancer Immunology Research. Magalhaes has unearthed a significant connection between the inflammatory response of a very specific form of immune cells, neutrophils, and the spread of this deadly disease. “There’s a unique inflammatory response with oral cancers,” explains Magalhaes, citing the growing body of evidence between cellular inflammation and cancer, “because the oral cavity is quite unique in the body. A great many things are happening at the same time.” Magalhaes focused attention on neutrophils, immune cells commonly found in saliva and the oral cavity but not widely researched in relation to oral cancer. Like other immune cells, neutrophils secrete a group of molecules, including TNFa, that regulates how the body responds to inflammation. The study noted that oral cancer cells secreted IL8, another inflammatory mediator, which activates neutrophils, effectively establishing a massive immune-response buildup or “feedback loop.” Ultimately, the researchers found, the immune-response loop resulted in increased invasive structures known as “invadapodia,” used by the cancer cells to invade and metastasize. “If we understand how the immune system interacts with the cancer, we can modulate the immune response to acquire an anti-cancer response instead of a pro-tumor response,” Magalhaes argues. While the study points to the possibility of one day creating targeted, personalized immunotherapies for patients with oral cancer that could effectively shut down the abnormal immune response, the team is currently expanding upon their study of inflammation and oral cancer. Approximately 3,600 cases of oral cancer are diagnosed in Canada every year, yet the survival rates — 50 to 60 percent over five years — have remained stagnant for decades while other cancer survival rates have dramatically improved. About the Faculty of Dentistry, University of Toronto Combining the rigours of biological and clinical research with a comprehensive educational experience across a full range of undergraduate and graduate programs — with and without advanced specialty training — the Faculty of Dentistry at the University of Toronto has earned international respect for its dental research and training. Whether focused on biomaterials and microbiology, next-generation nanoparticles, stem-cell therapies or ground-breaking population and access-to-care studies, the mission is to shape the future of dentistry and promote optimal health by striving for integrity and excellence in all aspects of research, education and clinical practice. You can learn more at www.dentistry.utoronto.ca. By Richard H. Nagelberg, DDS olymicrobial Synergy and Dysbiosis (PSD) is the word salad that the new model of periodontal disease is called as revealed by research. Let's consume this salad. Polymicrobial is self-explanatory; i.e., a community of different microbes. Synergy is a term used in many different settings. In business, it can be defined as the increased effectiveness that results when two or more people or businesses work together. The definition in the context of PSD is actually very similar. Synergy in this case refers to the coordinated action of oral bacteria promoting inflammation and bacterial survival. The term further explains that the coordinated action of the community of microbes is exponentially greater than it would be if the individual microbial species were working separately, and not in a good way. It's all about the increased virulence of the synergistic oral bacteria, and how damage is ramped up when they work together. Dysbiosis is an imbalance in the abundance or influence of a microbial community. A dysbiotic state promotes inflammation and periodontal disease. A homeostatic (nondysbiotic) balance of bacteria promotes healthy gums. In this current model of periodontal disease, bacteria such as Porphyromonas gingivalis are called perio pathogens. In the new model of periodontal disease development and progression, P. gingivalis is called a keystone pathogen. This is not just a matter of verbiage, as you will see. It should be borne in mind that the current model of periodontal disease also involves a polymicrobial dysbiotic bacterial community. The current model indicates that a predominance of perio pathogens is required for disease development, which is a dysbiotic state. There are, however, fundamental and critically important differences in the current and new, emerging understanding of periodontal disease. The differences are critically important in a variety of ways. DT International P Neutrophil and cancer cell ‘crosstalk’ underlies oral cancer metastasis DT International Canada A Oral squamous cell is shown invading the extracellular matrix of a healthy cell Tel.: +922135378440-2 | Fax: +922135836940 Tel.:+441611121830 Tel.: +4934148474302 | Fax: +4934148474173 Tel.: +85231136177 | Fax: +85231136199 Tel.: +12122447181 | Fax: +12122447185