Evaluation of Serum Immunoglobulins (IgG, IgA, IgM) and Circulating Immune Complexes in Oral Precancer and Cancer Patients.

Objectives The aim of the present study is to evaluate the role of immunoglobulins (IgA, IgG, and IgM) and circulating immune complexes (CIC) as tumor marker in oral cancer and precancer patients. Materials and Methods The present study was performed on 45 individuals subdivided into three groups, that is, oral precancer, oral cancer and healthy individuals, and levels of immunoglobulins, and CIC was estimated by turbidometry and ELISA method. Results In the present study, the mean serum IgA levels in oral precancer were 161.00 ( ± 118.02) mg/dL, oral cancers were 270.67 ( ± 171.44) mg/dL, and controls were 133.73 ( ± 101.31) mg/dL. Mean serum levels of IgG in oral precancer were 1,430.87 ( ± 316) mg/dL, oral cancers were 1,234.27 ( ± 365.42) mg/dL, and controls were 593.87 ( ± 323.06) mg/dL. Conclusion We found that the levels of serum IgG and IgA were elevated consistently in precancer and cancer group, and Serum IgM levels were increased only in precancer. Also, significant increase in serum CIC levels were seen in oral precancer and cancer group on comparison with control.

Histo-Blood Group Antigens in Oral Cancer and Potentially Malignant Disorders.

BACKGROUND: Early detection of oral cancer is of critical importance because survival rates markedly improve when oral lesions are identified at an early stage. Aim of the present study is to investigate the expression of ABO (H) antigens in tissue specimens of oral cancer and potentially malignant disorders and to determine the role of ABO (H) antigens in tumour staging. MATERIALS AND METHODS: A prospective study was conducted on 60 cases of oral cancer and potentially malignant diseases. Specific red cell adherence test (SRCA-test) was used for studying A, B and O (H) antigens in tissue specimens and iso-antigenicity of epithelium was graded according to degree of adherence of indicator red blood cells. RESULTS: Among OSMF group, grade II adherence was seen in 53.3% cases, grade III in 33.3% cases, grade IV in 13.3% cases. In leukoplakia group, grade II adherence was seen in 26.7% cases, grade III adherence in 53.3% cases, grade IV adherence in 20% cases. Within the leukoplakia group, cases with dysplasia showed decreased adherence, compared with cases without dysplasia. Oral cancer group, negative adherence was seen in 13.3% cases, grade I adherence in 46.7% cases, grade II in 40% cases. In oral cancer group, antigen reactivity was less in poorly and moderately differentiated carcinoma, compared to well differentiated carcinoma. CONCLUSIONS: Antigen adherence and degree of loss of ABO (H) antigens in tissue specimens can be used for staging of the tumour.

Comparison of Gender Determination from Dental Pulp and Dentin after Exposure to Various Environmental Conditions: A Polymerase Chain Reaction-based SRY Gene Study.

PURPOSE: Sex determination becomes the first priority by a forensic investigator in the process of identification of bodies mutilated beyond recognition due to mass disasters. Sex-determining region Y (SRY) gene is used as a sex-typing marker as the results are said to be 100% accurate. Therefore, an experimental study was conducted to rule out the possibility of the presence of SRY gene in tooth pulp and dentin after being exposed to various environments. MATERIALS AND METHODS: Twenty extracted teeth of known gender were taken, of which ten were male and ten were female. The tooth samples were subjected to various environmental conditions for 60 days. RESULTS: Among the total twenty samples, DNA isolation was done from all the samples of pulp and dentin. Gender determination using SRY gene was correct in all the samples of the pulp, and no interpretation of SRY was possible from the dentin though the DNA was isolated. CONCLUSION: The present study has found DNA retrieval can be done from human teeth irrespective of the storage time and environmental conditions for forensic caseworks and SRY gene to be a reliable biomarker for sex determination from the pulp tissue of teeth.

Mucoepidermoid carcinoma of the minor salivary gland: Presenting as ranula.

Malignant tumors of the salivary gland are rare, clinically diverse group of neoplasms, among which mucoepidermoid carcinomas (MECs) are reported to be most frequently occurring epithelial carcinomas. MEC at times misleads the clinician because of its atypical location and innocent appearance. Here, we report a case of low-grade MEC in a 70-year-old female patient in the floor of the mouth mimicking as ranula clinically. Individuals with a history of malignancy are at risk for the development of additional malignant tumors; hence, follow-up of 2 years did not show any recurrence or additional tumors.

Identification of gender using radiomorphometric measurements of canine by discriminant function analysis.

PURPOSE: Human teeth are the most stable and durable tissues in the body. Teeth can be identified even after complete decomposition, thus making them invaluable for identification of sex and age from fragmentary adult skeleton. This study aimed to compare the morphological and radiological measurements of canine and investigate its accuracy in sex determination. MATERIALS AND METHODS: This study involved 60 males and 60 females between the age group of 20 and 30 years. Mesiodistal (MD) widths of mandibular left canines and mandibular inter-canine distance (ICD) were measured and compared both clinically and on digital intraoral periapical and occlusal radiographs. Discriminant function analysis was carried out for gender determination. Discriminant equation and cutoff point were used in determining the gender and the percentage accuracy. Kappa statistics were carried out to assess intra-observer agreement. RESULTS: A definite statistically significant difference in the MD width and ICD was found between males and females. Clinical and radiological measurements were almost equally efficacious in gender determination with an accuracy of 55-75% in both males and females. When all the variables were used, the accuracy of gender determination increased substantially to 94%. k-values suggested a high intra-observer agreement. CONCLUSION: It can be concluded that both the clinical and radiographic measurements of MD width of canine and ICD are quick and easy methods for determining sex and in identification of an unknown individual with a substantial accuracy.

Relationship of salivary cortisol and anxiety in recurrent aphthous stomatitis.

BACKGROUND AND OBJECTIVES: Recurrent aphthous stomatitis (RAS) is one of the most frequently encountered oral mucosal disorders. Despite extensive amount of research, the etiology of RAS remains unclear. Psychological-emotional factors were considered as one of the major predisposing factors. The aim of the study was to assess the levels of anxiety and salivary cortisol levels in patients with RAS and also to determine the association and relationship of salivary cortisol levels to variations of stress. MATERIALS AND METHODS: A total of 30 patients suffering with RAS, along with the same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects at 9.00 am to avoid diurnal variations of cortisol levels. Salivary cortisol levels were measured by competitive enzyme linked immunosorbent assay. Anxiety levels of both groups were measured by using Hamilton's anxiety scale. Student's t-test was used to compare the anxiety and salivary cortisol levels between both groups. RESULTS: The mean salivary cortisol level of the RAS group showed a very highly significant difference (P = 0.000) from the controls. The mean anxiety scores of the RAS group showed a very highly significant difference (P = 0.000) from the controls. The values of Pearson correlation coefficient between anxiety and salivary cortisol was 0.980 and one with a P value of 0.000 showing that there is a highly positive correlation between anxiety and salivary cortisol. CONCLUSION: Results suggest that anxiety may be involved in the pathogenesis of RAS. Thus besides traditional treatment of RAS patients, our findings suggest that psychological support is also needed.

Morphometric analysis of canine in gender determination: revisited in India.

BACKGROUND AND AIM: Teeth are excellent material for anthropological, genetic and odontologic investigations in both living and dead population. Canines are the ideal teeth for identification of sex, due to its sexual dimorphism and durability in the oral cavity. This study tests the effectiveness of the canine tooth in predicting sex of an individual. MATERIALS AND METHODS: This study involved 60 males and 60 females between the age group of 20-30 years. Mesio-distal (MD) widths of maxillary and mandibular right and left canines and inter-canine distance of both arches were measured clinically and on cast for all patients. Standard canine indices were derived from these dimensions and tested for sexual dimorphism and reliability of canine teeth in gender determination by comparison with the known gender of the population under investigation. RESULTS: All measurements showed significant sexual dimorphism. Standard mandibular canine index (CI) was found to be more reliable in gender estimation than the MD width of canine and CI values. INTERPRETATION AND CONCLUSION: Use of the standard mandibular CI in gender determination is recommended for forensic procedures as it was found to have an acceptable accuracy. MD width of canine may be used in a setup when only the single tooth or a fragment of a jaw is available for analysis, with due consideration to its relatively low accuracy.

Evaluation of salivary cortisol and anxiety levels in myofascial pain dysfunction syndrome.

BACKGROUND: Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. METHODS: Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. RESULTS: The mean serum cortisol level of the MPDS group showed a highly significant difference (p < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (p < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. CONCLUSIONS: These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.

Association of salivary cortisol and anxiety levels in lichen planus patients.

BACKGROUND: Oral lichen planus (OLP) is a frequently encountered chronic inflammatory disease of oral mucosa and skin, where the patients often relate the onset and aggravation of oral symptoms to increased levels of stress. Cortisol, also called as "stress hormone" has been used as an indicator in various stress evaluation studies. AIM: The aim of this cross-sectional study was to determine any association between anxiety and salivary cortisol levels in OLP patients. MATERIALS AND METHODS: A total of 20 OLP patients along with same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects between 9.00 to 9.15 am to avoid diurnal variations of cortisol levels. The saliva samples were analysed for cortisol levels by competitive enzyme-linked immunosorbent assay (ELISA) method. Anxiety levels of 40 patients were measured by using Hamilton's anxiety scale. Student's t-test was used to compare the anxiety and salivary cortisol levels between both groups. RESULTS: The mean salivary cortisol level of the OLP group showed highly significant difference (p<0.001) from the controls. The mean anxiety scores of the OLP group showed highly significant difference (p<0.001) from the controls. A positive correlation was found between anxiety and salivary cortisol levels in the OLP patients. CONCLUSION: These findings suggest that anxiety play a vital role in the pathogenesis of OLP, thus besides traditional treatment, psychological support is also needed.

Hereditary hypohidrotic ectodermal dysplasia: report of a rare case.

Hereditary Hypohidrotic Ectodermal Dysplasia (HHED), an X-linked, recessive, Mendelian character, is seen usually in males and it is inherited through female carriers. It is characterised by congenital dysplasia of one or more ectodermal structures and it is manifested by hypohidrosis, hypotrichosis and hypodontia. It results from abnormal morphogenesis of cutaneous and oral embryonic ectoderm. Here, we are presenting a rare case of HHED in a 19 year female with classic features of this condition.

Imaging characteristics of diffuse large cell extra nodal non-Hodgkin's lymphoma involving the palate and maxillary sinus: a case report.

Non-Hodgkin's lymphomas are a group of highly diverse malignancies and have a strong tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. Primary extra nodal lymphoma of the hard palate is rare. Here, we present a case of diffuse large B cell lymphoma in a 60-year-old male patient that manifested as slightly painful ulcerated growth on the edentulous right maxillary alveolar ridge extending onto the palate, closely resembling carcinoma of the alveolar ridge. Computed tomography images showed the involvement of the maxillary sinus and right nasal cavity, along with destruction of hard palate, superiorly extending into the orbit. This case report highlights the importance of imaging to evaluate the exact extent of such large malignant lesions, which is essential for treatment planning.

Pyoderma gangrenosum with oral involvement - case report and review of the literature.

Pyoderma gangrenosum (PG) is a rare, noninfectious neutrophilic dermatosis. Clinically, it begins with sterile pustules that rapidly progress into painful ulcers of variable depth and size with undermined violaceous borders. The diagnosis of PG is based on the history of an underlying disease, a typical clinical presentation, histopathology, and exclusion of other diseases. The peak incidence occurs between the ages of 20 to 50 years with women being more often affected than men. There have been very few reports of pyoderma gangrenosum with oral mucosal involvement. Oral lesions in previously reported cases have included ulcers of varying sizes from a few mm to several cm and have been reported to have been found on the tongue, soft and hard palate, buccal mucosa, and gingiva. Some of these oral lesions have been associated with ulcerative colitis, inflammatory bowel disease, and polycythemia rubra vera. A few cases were reported with biopsy findings, the histological picture being nonspecific, showing ulceration, and necrosis with inflammatory cell infiltrate. A peculiar case of pyoderma gangrenosum with an oral lesion is presented here, and the differential diagnosis is discussed.