EXPRESSION OF ALPHA-SMOOTH MUSCLE ACTIN IN ODONTOGENIC CYSTS AND TUMORS.

BACKGROUND: Odontogenic cysts and tumors exhibit different degrees of aggressiveness in their biological behavior. There has been evidence that the presence of myofibroblasts (MFs) at the invasion front promotes tumor invasion. Our study is based on the fact that MFs are important in the biological behavior of odontogenic cysts and tumors. AIM: To assess immunohistochemically expression of alpha-smooth muscle actin (α-SMA) of MFs in odontogenic cysts and tumors and correlate this expression to their biological behavior. MATERIALS AND METHODS: The archival tissues collected for 1.5 years were obtained from the Department of Oral Pathology & Microbiology, People's Dental Academy, Bhopal (India). A total of 40 cases consisting of 10 cases each of odontogenic keratocysts, radicular cysts, dentigerous cysts and ameloblastomas formed the study group. An immunohistochemical analysis of α-SMA expression and localization was carried out. RESULTS: Mean MF counts were the highest in odontogenic keratocysts which was followed by ameloblastomas, entigerous cysts and radicular cysts. Weak α-SMA-expression was found in 50% of cases, moderate in 22.5% of cases, and intense - in 10% cases. MFs were arranged in the spindle, focal, or network patterns in 35; 27.5 and 20% of cases, respectively. CONCLUSION: The analysis revealed that the MFs were distinctly heterogeneous in distribution and pattern of arrangement. This provided persuasive evidence that stroma of these lesions harbor MFs as reflected by α-SMA immunopositive cells.

Assessment of Tumor Cell Cannibalism as a Predictor of Oral Squamous Cell Carcinoma - A Histopathologic Correlation.

AIM: Cellular cannibalism is defined as the ability of a cell to engulf another cell of its own type or any other. It has been recognized in various malignancies and is linked well with the aggressiveness, degree of anaplasia, invasiveness and metastatic potential. Literature search fetched up very few studies related to the presence and significance of cannibalism with respect to Oral squamous cell carcinoma [OSCC]. The present study was aimed to detect tumor cell cannibalism in OSCC and to validate its role as a prognosticator of OSCC in relation to metastasis and degree of differentiation. METHOD: 30 histopathologically proven cases, 15 cases each of metastatic OSCC (7 well differentiated OSCC and 8 moderately differentiated OSCC) and non-metastatic OSCC (8 well differentiated OSCC and 7 moderately differentiated OSCC) were included in the study. Quantitative assessment of tumor cell cannibalism was done. The data was analyzed using Mann Whitney test. RESULT: Metastatic OSCC showed higher frequency of cannibalistic cells compared to non-metastatic OSCC. More number of cannibalistic cells were found in moderately differentiated OSCC than well differentiated OSCC in both groups. Moreover, Grade III cannibalism and complex cannibalism was also found to be associated with metastatic, moderately differentiated OSCC exclusively. CONCLUSION: It has been found that higher number of cannibalistic cells were associated with OSCC showing metastasis indicating their aggressive behavior. So, we recommend that quantitative assessment of tumor cell cannibalism should become a part of the routine histopathological examination of OSCC to screen its hostile behavior.

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.

Quick response code in acrylic denture: will it respond when needed?

Use of acids and other caustic substances in destroying the human body to avoid personal identification is drawing great deal of attention in recent times. With rapid industrial growth, incidence of industrial disasters has increased. In an event of chemical industry disaster, human identification can become a challenge. Embedding bar codes and other electronic means for identification in denture have proved to be a novel innovation in identification of edentulous patients. However, the validity of this method in events of chemical extremes has not been assessed. Hence, the study was undertaken to know the effect of different acids on dentures embedded with quick response codes. Results of this study indicate that simple bar code can be readable up to 33 h after acid treatment. With minimal armamentarium, bar code can be generated incorporating large data into it, providing it to be a cheap and reliable means of denture identification.

Total sialic acid, total protein and total sugar levels in serum and saliva of oral squamous cell carcinoma patients: A case control study.

BACKGROUND: Detection of cancer at an early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, non-invasive methods like analysis of serum and saliva may provide cost-effective approach for screening a large population. Tumor markers are a major part of secondary prevention and thus, the detection of malignancies. The aim of this study was to evaluate total sialic acid (TSA), total protein and total sugar (TS) in serum and saliva of oral squamous cell carcinoma (OSCC) and controls to assess their role as a diagnostic marker. MATERIALS AND METHODS: Unstimulated whole saliva and sera were collected from 40 squamous cell carcinoma patients and 20 controls. Serum and salivary TSA, total protein and TS estimation was carried out. This was correlated with clinical stages and histopathological grades of OSCC. The data obtained was analyzed statistically using Chi-square test, ANOVA and Student's t-test with SPSS statistical software. RESULTS: A highly significant rise in the salivary sialic acid, serum sialic acid and serum protein was noted in OSCC subjects compared to controls. Salivary protein, serum and salivary sugar did not show any significance. Furthermore, serum and salivary sialic acid levels were found to be significantly increased with increasing level of histopathological grading. CONCLUSION: The present study showed a significant increase in serum sialic acid, salivary sialic acid and serum protein from control to OSCC and suggests that these markers may be reliable in diagnosis and predicting prognosis.

Natal and neonatal teeth: an overview of the literature.

The occurrence of natal and neonatal teeth is an uncommon anomaly, which for centuries has been associated with diverse superstitions among different ethnic groups. Natal teeth are more frequent than neonatal teeth, with the ratio being approximately 3 : 1. It must be considered that natal and neonatal teeth are conditions of fundamental importance not only for a dental surgeon but also for a paediatrician since their presence may lead to numerous complications. Early detection and treatment of these teeth are recommended because they may induce deformity or mutilation of tongue, dehydration, inadequate nutrients intake by the infant, and growth retardation, the pattern and time of eruption of teeth and its morphology. This paper presents a concise review of the literature about neonatal teeth.

Cyclin d1 expression and its correlation with histopathological differentiation in oral squamous cell carcinoma.

BACKGROUND: Cyclin D1 regulates the G1 to S transition of cell cycle. Its deregulation or overexpression may lead to disturbance in the normal cell cycle control and tumour formation. Overexpression of cyclin D1 has been reported in various tumors of diverse histogenesis. This case control retrospective study was carried out to study the immunohistochemical reactivity and expression of cyclin D1 and its association with site, clinical staging, and histopathological differentiation of oral squamous cell carcinoma (OSCC). METHODS: Forty formalin-fixed paraffin-embedded tissue blocks of biopsy specimens of oral squamous cell carcinoma were immunohistochemically evaluated for expression of cyclin D1. RESULTS: Cyclin D1 expression was seen in 45% cases of OSCC. It did not correlate with site and clinical staging. Highest expression was seen in well-differentiated, followed by moderately differentiated, and poorly differentiated squamous cell carcinomas, with a statistically significant correlation. CONCLUSION: Cyclin D1 expression significantly increases with increase in differentiation.

Lycopene in the management of oral lichen planus: a placebo-controlled study.

CONTEXT: Oxidative stress has been implicated in the pathogenesis of lichen planus, and a lower level of lycopene has been reported in erosive and atrophic oral lichen planus (OLP) patients. However, its efficacy in the management of OLP has not been reported. AIM: This study was designed to assess the efficacy of systemic lycopene in the management of OLP. SETTINGS AND DESIGN: This prospective, randomized, double-blind, placebo-controlled study was done in the Oral Medicine Department of a postgraduate teaching dental hospital in India. MATERIALS AND METHODS: Thirty symptomatic OLP patients, randomly divided into two groups of 15 each, were administered lycopene 8 mg/day and an identical placebo, respectively, for 8 consecutive weeks. Burning sensation using visual analogue scale and overall treatment response using Tel Aviv-San Francisco scale were recorded at every visit. The data obtained were analyzed statistically using Wilcoxon Rank test, Mann-Whitney and Fischer's Exact test. RESULTS: A higher (84%) reduction in burning sensation was seen in lycopene than in the placebo group (67%). All 15 (100%) patients in the lycopene group showed 50% or more benefit and 11 (73.3%) patients showed 70-100% benefit, while this number was only 10 and 4 (26.7%), respectively, in the placebo group. CONCLUSION: Lycopene was very effective in the management of OLP, and oxidative stress may have a role in disease pathogenesis.

Maintaining dental records: Are we ready for forensic needs?

CONTEXT: Dental remains are usually the last to get destroyed among body parts after death. They may be useful for personal identification in cases of mass disasters and decomposed unidentified bodies. Dental records may help in the identification of suspects in criminal investigations and in medicolegal cases. Maintenance of dental records is legally mandatory in most of the European and American countries. Unfortunately, the law is not very clear in India, and the awareness is very poor. AIMS: To assess the awareness regarding the dental record maintenance among dentists in Rajasthan, to deduce the quality of average dental records kept by them and to evaluate the potential use of their maintained records, in any of forensic or medicolegal cases. SETTINGS AND DESIGN: A cross-sectional survey was conducted among 100 dental practitioners of different cities in Rajasthan, India. MATERIALS AND METHODS: Data were collected through a structured questionnaire, which was responded by the study population in the course of a telephonic interview. The questionnaire addressed on the mode of maintaining dental records in their regular practice. STATISTICAL ANALYSIS USED: The data so gathered were subjected for descriptive analysis. RESULTS: As for knowledge or awareness about maintaining dental records, surprisingly a very low percentile (about 38%) of surveyed dentists maintained records. Sixty-two percent of the dentists were maintaining no records at all. CONCLUSION: Nonmaintenance or poor quality of records maintained indicates that the dentists in Rajasthan are not prepared for any kind of forensic and medicolegal need if it arises.

Oral focal mucinosis: report of two cases / Mucinose oral focal: relato de dois casos

Purpose: Oral focal mucinosis (OFM), an oral counterpart of cutaneous focal mucinosis, is a rare disease of unknown etiology. Its pathogenesis may be due to overproduction of hyaluronic acid by fibroblast at the expense of collagen production, resulting in focal myxoid degeneration of connective tissue primarily affecting the mucosa overlying bone. It has no distinctive clinical features, since the diagnosis is solely based on histopathological features. This paper reports two cases and discusses clinicopathological, immunohistochemical features and differential diagnosis of myxomatous lesions of the oral cavity. Case description: The two cases of OFM lesions were present in a 50 year-old patient on the hard palate and in a 26 year-old female patient in the mandible, which seem to be the first report in the Indian population. Conclusion: The histopathological and immunohistochemical analysis of Vimentin and S-100 protein may play a vital role in the correct diagnosis of OFM.

Objetivo: Mucinose oral focal (MOF), uma lesão equivalente à mucinose cutânea focal, é uma doença rara de etiologia desconhecida. Sua patogênese pode ser devido a superprodução de ácido hialurônico pelo fibroblasto às expensas de produção de colágeno, resultando em degeneração mixoide focal de tecido conjuntivo primariamente afetando a mucosa sobre o osso. Não tem características clínicas distintas e o diagnóstico é baseado somente em características histopatológicas. Este artigo relata dois casos e discute as características clinico-patológicas e imuno-histoquímicas, bem como o diagnóstico diferencial de lesões mixomatosas da cavidade bucal. Descrição dos casos: Os dois casos de lesões de MOF estavam presentes no palato duro de um paciente do sexo masculino, de 50 anos de idade, e na mandíbula de uma paciente do sexo feminino, de 26 anos. Estes parecem ser os primeiros casos relatados na população da India. Conclusão: A análise histopatológica e imuno-histoquímica de Vimentin e proteína S-100 podem ter um papel importante no correto diagnóstico de MOF.