Morphometric Analysis of Collagen in Different Grades of Oral Squamous Cell Carcinoma Using Picrosirius Red Stain and Spectrophotometry.

Introduction: Oral squamous cell carcinoma (OSCC) is one of the most formidable health problems for mankind. These carcinomas are characterized by invasion of epithelial tumor cells into the stroma, which get embedded in extracellular matrix and collagen producing reactive changes. Such changes in the stroma may alter the biological aggressiveness of the tumor. An attempt was made to evaluate the collagen changes in different grades of OSCC which can contribute to understanding the biologic behavior of oral cancer and predict clinical outcomes. Aims and Objectives: To assess the quantitative changes in collagen in different grades of OSCC using hematoxylin and eosin (H and E) and Picrosirius red (PSR) stain through spectrophotometry and to compare the efficacy of these stains for estimation of collagen. Materials and Methods: The study comprised a total sample size of 60, which were distributed under 4 different groups, each containing 15 samples. Group I to IV consisted of normal buccal mucosa, with well-, moderately-, and poorly-differentiated OSCC, respectively. The tissues of 10 µm thickness were stained with H and E and PSR for spectrophotometric analysis. Results: The quantity of collagen decreased with increasing grades of OSCC. Comparison between two stains showed that PSR can provide a more reliable and accurate result than H and E. Conclusion: Collagen estimation is one of the methods to assess the progression of tumor. The method used in the present study for collagen estimation in different grades of OSCC is reliable and accurate.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity.

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Peripheral ossifying fibroma: A rare case affecting maxillary region.

Focal gingival enlargements are a diverse group of lesions with almost similar clinical presentation but varied etiology and histopathology. The actual cause of peripheral ossifying fibroma (POF) has been debated over many years. POFs are usually seen in childhood and younger ages. There is a slight female predilection. It is usually localized, rarely generalized. Usually, the treatment option is only surgical excision with minimal chances of recurrence. Here, we report a case of POF of the right maxillary posterior region with a review of literature.

Assessing Difficulties Encountered by Dental Students Studying Oral Pathology and Addressing Their Concerns.

INTRODUCTION: The present scenario of Oral Pathology and Oral Histology as a subject is alarming. In spite of so many advancements in terms of books, internet and conferences there are still lacunae between the understanding and interest for the subjects in the students. It can be partly due to the fact that the students perceive it as a non-clinical subject having a lesser scope for practice. AIM: The present study was aimed at evaluating the students approach towards oral pathology department and the subject. The purpose of the study was to analyze practical hurdles encountered by students and to find out solutions to overcome them. MATERIALS AND METHODS: The cross-sectional questionnaire based study was done with BDS students of People's Dental Academy, Bhopal, India, to gauge the understanding of their knowledge in the subject of Oral Pathology and Oral Histology. Questionnaire comprised of 28 multiple choice questions under five parameters. The data recorded was subjected to statistical analysis using chi-square test. RESULTS: We found that study samples were efficient enough in terms of following instructions related to their day to day training. Although they were content with light microscope, they thought that some more interactive sessions could be beneficial for them in Oral Pathology. CONCLUSION: Through our study we found out that the students are well oriented on the whole about Oral Pathology. They certainly encounter difficulties which are easy to handle if proper measures are taken. We through our study would like the readers to be aware of the changing trends in teaching and to incorporate them routinely.

Inexplicable Co- Existence of Eccrine Spiradenoma and Lichen Planus in an old Case of Basal Cell Carcinoma.

Eccrine spiradenoma is a rare benign adnexal tumour usually seen in the head, neck or upper trunk in young adults. It is rare in the lower extremities and in the elderly. Co- existence of eccrine spiradenoma with other lesions like cylindroma, trichoepithelioma, hidradenoma and chondroid syringoma has been documented in literature. But, concomitant occurrence of eccrine spiradenoma with a non- neoplastic lesion like lichen planus in an old and treated case of basal cell carcinoma has not been documented in literature till date. We present a rare case of eccrine spiradenoma occurring on the right thigh in an elderly female along with lichen planus over the left breast. The lady had been diagnosed with basal cell carcinoma 10 years ago and treated with wide local excision. A brief review of literature is also included.

Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler: a pilot study.

BACKGROUND: The aerosol generated by an ultrasonic scaler contains microorganisms that can penetrate into the body through the respiratory system of dental surgeons and patients. The aim of this pilot study is to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine gluconate, an herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols. METHODS: This single-center, double-masked, placebo-controlled, randomized, three-group parallel design was conducted over a period of 45 days. Twenty-four patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of eight patients each to receive 0.2% chlorhexidine gluconate, herbal mouthwash, and water, respectively, as a preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at patient's chest area, doctor's chest area, and assistant's chest area on blood agar plates in all three groups. The blood agar plates were incubated at 37°C for 48 hours, and the total number of colony-forming units (CFUs) was counted and statistically analyzed. RESULTS: The results showed that CFUs in groups A and B were significantly reduced compared with group C, P <0.001 (analysis of variance). Also, CFUs in group A were significantly reduced compared with group B, P <0.05 (independent t-test). The numbers of CFUs were highest at the patient's chest area and lowest at the assistant's chest area. CONCLUSION: This study suggests that a routine preprocedural mouthrinse could eliminate the majority of bacterial aerosols generated by the use of an ultrasonic unit, and that 0.2% chlorhexidine gluconate is more effective than herbal mouthwash.

Oral hygiene-awareness and practice among patients attending OPD at Vyas Dental College and Hospital, Jodhpur.

BACKGROUND: According to World Oral Health report 2003, the prevalence of periodontitis is 86% in India. Dental care can sometimes be a forgotten part of a healthy life style. While its importance is often underestimated, the need for regular dental care cannot be overstated. Oral health has been neglected for long in India. The scarce literature on dental health awareness, attitude, oral health-related habits and behavior among the adult population in Rajasthan prompted us to assess the preventive oral health awareness and oral hygiene practices in patients attending outpatient department of Vyas Dental College and Hospital (VDCH), Jodhpur through this study. MATERIALS AND METHODS: A total of 500 patients in the age group 15-50 years were selected using random sampling technique. A self-administered structured questionnaire including 16 multiple choice questions was given to them. The results were analyzed using percentage. RESULTS: The result of this study shows an acute lack of oral hygiene awareness and limited knowledge of oral hygiene practices. In Jodhpur, few people use tooth brush. CONCLUSIONS: Hence, there is an urgent need for comprehensive educational programs to promote good oral health and impart education about correct oral hygiene practices.

Triple teeth: report of an unusual case.

Fusion or synodontia is a union of two or more than two developing teeth. Commonly fusion occurs between teeth of the same dentition, mixed dentition, or between normal and supernumerary teeth. Fused primary teeth present with several clinical problems like caries, periodontal problem, arch asymmetry, delayed eruption, ectopic eruption of succedaneous teeth, aesthetic, and other complications. This paper presents a rare and unusual case of triple teeth in mandibular primary dentition.

The role of plasma female sex hormones on gingivitis in pregnancy: a clinicobiochemical study.

OBJECTIVES: To correlate the changes in the level of female sex hormones (progesterone, estrogen) in plasma with the changes in severity of gingivitis in various trimesters of pregnancy till the postparturition. MATERIALS AND METHODS: This study comprised of 20 pregnant women with good oral hygiene who were followed up in each trimester till 3rd month of postpartum by screening their oral hygiene status following OHI-S index by Greene and Vermillion. Clinically to correlate gingivitis, gingival index by Loe and Sillness was carried out in each trimester till postpartum. For hormonal assay, blood sampling by venipuncture was done and quantative analysis of the hormones was done by ELISA test. RESULTS AND CONCLUSION: The severity of gingivitis gradually increased and reached its peak in 3rd trimester followed by sudden decline in the severity in postpartum which correlated with gradual increase in the plasma level of progesterone and estrogen levels to reach their peak in the 3rd trimester and sudden fall after the postpartum. This study shows the role of female sex hormones in aggravating gingivitis to its peak in the 3rd trimester, even though the oral hygiene remains fairly good constantly. CLINICAL SIGNIFICANCE: This study signifies the gingivitis status during different trimesters of pregnancy and postpartum indicating the general practitioner to take appropriate oral hygiene measures.

Developmental and behavioral consequences of prenatal fluoxetine.

BACKGROUND: Fluoxetine, a selective serotonin reuptake inhibitor, is the most commonly prescribed antidepressant drug for pregnant women. Studies regarding the teratogenic effect of fluoxetine on human and animal models are mainly concerned with structural malformation (congenital anomalies). AIM: Hence, the present study was planned to evaluate the postnatal behavioral effects of fluoxetine on albino rats. METHODS: Three groups of female rats received either distilled water or doses of fluoxetine 8 and 12 mg/kg orally from the 6th to the 20th day of pregnancy. Weaning of the pups was done on the 21st day followed by a battery of behavioral tests to assess for any behavioral effect. The tests included negative geotaxis, open field exploration, rota-rod test, elevated plus maze and passive avoidance test. RESULTS: In the present study there was no change in the gestational length of pregnancy, no premature birth or miscarriage during pregnancy. A high dose of in utero fluoxetine resulted in a decrease in birth weight of the offspring and also reduced weight gain during the preweaning period. No major congenital abnormalities were observed in the offspring exposed to fluoxetine. Prenatal fluoxetine exposure at high dose caused an initial transient delay in motor development and this poor motor activity was transient and not permanent. However, prenatal exposure to fluoxetine at a higher dose showed a favorable effect on learning and memory in water maze and passive avoidance tests. CONCLUSIONS: From the present study, it may be concluded that prenatal fluoxetine causes a transient delay in motor development but does not adversely affect the postnatal behavioral consequences.