Shankargouda Patil

Dr. Shankargouda Patil is an Associate Professor Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia. He is an acclaimed professional who has devoted majority of his skilled term to the field of research and publications. This noteworthy mark can be easily noticed through his contributions for many National and International Peer Reviewed Journals as an Editor-in-Chief and Reviewer for the scientific excerpts. As a Good Samaritan of his specialty, Dr. Patil to his credit has more than 200 research publications and 4 reference books with his research interests being oral potentially malignant disorders, oral cancer and forensic odontology. Dental fraternity has been conspicuously benefitted by Dr. Patil’s guest lectures presented in various National and International fora. He has filed 2 patents on tissue processing systems and associated apparatus. His services to the field of dentistry are nowhere less on a social desk. He is the Founder Member and Secretary General of International Association of General Dentistry (IAGD). Being a Founder Member and Secretariat of Dental Institute of Continuing Education (DICE) his beneficence is exceptional in the field of Dental Education. He has organized more than 40 CDE Programs and Annual Conferences under the aegis of IAGD and DICE. He is also an active member of various National and International Professional Societies and Organizations viz., International Association of Oral Pathology (IAOP) and International Association of Dental Research (IADR) to name a few.

Title 1: Oral Potentially Malignant Disorders

Abstract 1: The term precancerous lesions and conditions were replaced by the term oral potentially malignant disorders (OPMDs) by WHO. The reason for the change in terminology was that precancer denotes that the lesion would eventually transform into cancer with utmost certainty, but, not all cases designated as precancer show malignant transformation. Many precancer cases have been reported to remain the same or even regress. Thus, the use of the term potentially malignant was a more precise indicator of its behavior. Despite implementing strict definition and diagnostic criteria for OPMDs, there are certain entities which are not well defined clinically or histopathologically. Oral lichenoid dysplasia and exophytic verrucous hyperplasia are two such entities wherein even their existence is not universally accepted. Our research team has conducted multi-institute retrospective studies analyzing these two entities and their related lesions. The results of the study have provided significant insight into the true nature of these enigmatic entities which will be discussed in the presentation. Another critical issue concerning OPMDs is the lack of accuracy of our grading system to predict their malignant potential. The major limitation of all the major epithelial dysplasia grading system is the significant inter and intraobserver subjectivity. Our research team has explored the possibility of overcoming the subjectivity by formulating a customized grading system for each OPMDs. Each of the OPMDs and their respective malignant counterparts would be histopathologically assessed for dysplastic features. All the dysplastic features which were common for the OPMD and the malignant counterpart will be considered as the sole features to be considered in the grading system. Such a customised grading system would reduce the subjectivity of the grading and increase the accuracy of predicting the malignant risk. Thus, my presentation would cover the natural history of the controversial OPMDs-oral lichenoid dysplasia and exophytic oral verrucous hyperplasia and emphasize the importance of formulating customised epithelial dysplasia grading system for OPMDs.

Title 2: Oral Cancer

Abstract 2: The past decade has seen significant progress being made in the development of molecular diagnostic and treatment tools against oral cancer.  Despite the advent of novel diagnostics and therapeutics, cancer control has largely been ineffective. The primary cause being the growing resistance in cancer and the inability of current treatment modalities to prevent loco-regional recurrence and distant metastasis. Although current treatment modalities effectively counter the primary tumor, they largely fail to diagnose and treat any potential minimal residual disease. Due to the lack of active therapeutic intervention post-primary therapy, the minimal residual disease has an increased risk of proliferation resulting in recurrences.  It is also imperative to note that certain molecular treatment modalities have unintended effects which in turn can lead to the development of therapeutic resistance. For example, a recent study used inactivation of the DNA mismatch repair gene as a therapeutic modality. The basis for the study was that when the DNA mismatch repair genes are inactivated, they would result in additional mutations which would be interpreted by the immune system as a neoantigen generating sustained immune response against cancer. Although the studies have shown promising results, it is vital to acknowledge the potential complication of such endeavors. One such complication in this scenario is that if normal cells surrounding the cancer cells are exposed to DNA repair inhibition, they would develop mutation leading to neoplastic transformation. In addition, if the new mutation in the cancer cells does not elicit an immune response, it would just result in the accumulation of new mutation which in turn could increase the aggressiveness of cancer. Lack of progress in cancer control could also be explained by the lack of awareness as to several unknown potential risk factors in oral cancer. One such potential risk factor is the household air pollution (HAP). Despite HAP being closely associated with lung cancer and that HAP and oral cancer have an epidemiological association, there has been a lack of studies examining the role of HAP as a potential risk for oral cancer. Thus, until we are able to uncover all the potential causes of oral cancer and effectively counter these etiologic factors, it is not possible to curb the growing prevalence of oral cancer. Thus, my lecture would cover the current challenges in oral cancer control and future directions in oral cancer research.