A Retrospective Study of Re-excised Skin Cancers in a Pathology Center.

Surgical re-excision is the recommended treatment for the complete removal of incompletely excised skin cancers (SCs), but it may not always lead to this goal. In the present study, the re-excision rate and the presence of residual tumors in re-excised SCs were evaluated. In this retrospective descriptive study, the pathological archives of a hospital center were examined for incompletely excised tumors. Out of the 96 incompletely excised tumors, 19 cases (19.8%) underwent re-excision, of which residual tumors were observed again in 7 cases (36.8%). The highest rate of residual tumor was found in the cheek (66.66%), and the involvement with tumor remnants of both margins combined was greater than the involvement of each of the lateral and deep margins alone. Collecting and reporting of surgical results of re-excised tumors may assist clinicians in determining the patient's condition and making appropriate decisions to increase the success rate of reoperations.

Suggested risk factor for oral lichen planus arising after mRNA COVID-19 vaccination.

A single dose of BNT162b2 vaccine is suggested for COVID-19-infected individuals to reduce side effects due to release of inflammatory mediators such as oral lichen planus (OLP).

Investigation of the Relationship between Oral Human Papillomavirus Infection and Oral Health.

Statement of the Problem: Oral health status has been suggested as one of the possible risk factors for oral human papillomavirus (OHPV) infection. There is inconsistent evidence concerning its relationship with the presence of OHPV. Purpose: This study aimed to compare oral health status between two groups of patients with and without OHPV infection. Materials and Method: This cross-sectional study was performed on 272 oral rinse samples, collected from our previous study population. After signing the written informed consents, the oral examination was performed to determine some clinical parameters of oral health status including periodontal disease status, oral hygiene status, decayed, missing, and filled teeth (DMFT) of participants. Next, viral deoxyribonucleic acid (DNA) extraction, polymerase chain reaction (PCR), and HPV genotyping tests were performed on the samples. Results: OHPV DNA was detected in a total 31 (11.40%) samples that were considered as OHPV+ group. None of the determined clinical parameters of oral health status was significantly different between OHPV+ and OHPV DNA negative (OHPV-) groups (p> 0.05). Conclusion: The findings of the current study did not indicate a significant association between oral health status and OHPV. Further studies with larger sample size are recommended to reach a definite conclusion.

Frequency of and risk factors for incomplete surgical margins of cutaneous cancers: a retrospective study.

BACKGROUND: Incomplete resection is a problem in the management of malignancies. This study is aimed to determine frequency of and risk factors for incomplete surgical margins in skin cancers. METHODS: In this retrospective study, resected skin cancers of a hospital from 2009 to 2020 were reviewed and, based on histopathology reports, categorized as incomplete/positive or complete/negative margins. The demographics and tumor characteristics were extracted from patients' medical files and compared between two groups. RESULTS: Three hundred and sixty-four skin cancers were resected from 304 patients; incomplete margins occurred in 26.3%. There were no significant differences in gender, age, and site of tumors on the body parts (including head, neck, trunk, and limbs) between the positive and negative margin groups. Incomplete resections were significantly associated with size, site of tumors on various parts of the head (such as scalp, ear, nose, etc.), number of lesions excised in one session, and physician specialty. CONCLUSIONS: Size, site of tumors on various parts of the head (such as scalp, ear, nose, etc.), number of lesions excised in one session, and physician specialty are risk factors for positive surgical margin. These characteristics may help clinicians to identify high-risk tumors and reduce the chance of incomplete cancer resection.

Comparative study of laminin332-γ2 chain expression in oral lichen planus and squamous cell carcinoma by immunohistochemistry.

BACKGROUND: Classification of oral lichen planus (OLP) as a condition with malignant potential is still controversial. One of the major properties of malignancy is invasion. Ln332-γ2 chain plays a critical role in invasive activity of cancer cells. This study aims to compare Ln332-γ2 chain expression in OLP, oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). METHODS: Ln332-γ2 expression was evaluated in 16 epithelial hyperplasia with no dysplasia (group A), 16 OLP (group B), 18 OED (group C) and 18 OSCC (group D) by immunohistochemistry. RESULTS: Except in A group, Ln332-γ2 expression was detected in other groups. There was a significant difference in Ln332-γ2 expression among B, C and D groups as well as between B and D, C and D groups (P<0.001). However, there was no significant difference between B and C groups (P=0.999). CONCLUSIONS: According to the findings of this study, the likelihood of similarity of OLP with premalignant dysplastic lesion can be suggested. This is not corroborating OLP definitive transformation to an OSCC. But it might be advisable that OLPs with >10% Ln332- γ2 expression may have a higher risk of cellular invasion occurrence and malignant transformation.

Special care for oral tissue samples after biopsy: proper storage and transport ­ a comparative study / Cuidado especial para las muestras de tejido bucal después de la biopsia: almacenamiento y transporte adecuados ­ un estudio comparativo

Objective: Biopsy is the gold standard for the diagnosis of oral lesions. Correct management and care of biopsy at all steps (before, during and after obtaining a biopsy) is highly important to provide proper tissue samples for microscopic assessment by pathologists. This study aimed to assess and compare the knowledge of dental students (DSs) and general dentists (GDs) on post-oral biopsy instructions. Material and Methods: A questionnaire including two parts was used: 1) Demographic data and self-evaluation of biopsy knowledge by the participants and 2) 11 items about the correct oral biopsy storage and transport to a histopathology laboratory. The data collected from the questionnaires were analyzed by STATA. Results: 48 GDs and 131 DSs participated in this study. The knowledge score of the DSs (5.43±2.01) was significantly lower than GDs (8.33±1.78) (p<0.05). Moreover, there was no significant relationship between GDs' knowledge and their working experience, age, gender and the university they graduated from. However, there was a significant relationship between DSs' school year and their knowledge. Conclusion: The findings showed that the knowledge of DSs was lower than GDs. Since, these students will care for the oral and dental health of the community in the future, upgrading their training (by improving the quantity and quality of theoretical and practical training) is necessary to both understand the different aspects of biopsy, and to be familiar enough with proper oral biopsy storage and transport processes.

Objetivo: La biopsia es el estándar de oro para el diagnóstico de lesiones bucales. El manejo y cuidado correctos de la biopsia durante todos los pasos (antes, durante y después de obtener una biopsia) es muy importante para proporcionar muestras de tejido adecuadas para la evaluación microscópica por parte de los patólogos. Este estudio tuvo como objetivo evaluar y comparar los conocimientos de estudiantes de odontología (SD) y dentistas generales (GD) sobre las instrucciones posteriores a la biopsia oral. Material y Métodos: Se utilizó un cuestionario que constaba de dos partes: 1) Datos demográficos y autoevaluación del conocimiento de la biopsia por parte de los participantes y 2) 11 ítems sobre el correcto almacenamiento y transporte de la biopsia oral a un laboratorio de histopatología. STATA analizó los datos recopilados de los cuestionarios. Resultados: 48 GD y 131 SD participaron en este estudio. La puntuación de conocimiento de los DS (5,43 ± 2,01) fue significativamente menor que la de los GD (8,33 ± 1,78) (p <0,05). Además, no hubo una relación significativa entre los conocimientos de los GD y su experiencia laboral, edad, género y la universidad de la que se graduaron. Sin embargo, hubo una relación significativa entre el año escolar de los DS y sus conocimientos. Conclusión: Los hallazgos mostraron que el conocimiento de los SD era menor que el de los GD. Dado que estos estudiantes se ocuparán de la salud bucodental de la comunidad en el futuro, es necesario mejorar su formación (mejorando la cantidad y calidad de la formación teórica y práctica) tanto para comprender los diferentes aspectos de la biopsia como para estar familiarizados suficientemente con los procesos adecuados de almacenamiento y transporte de biopsias orales.

Prevalence and risk factors of oral HPV infection among a healthy Iranian population; Kurdistan, West of Iran.

Human papillomavirus (HPV) infection has implicated in the development of some of the oral/oropharyngeal cancers. However, controversy still exists regarding the prevalence of oral HPV (OHPV) and its risk factors. This study aimed to determine the prevalence and variables of OHPV infection in a healthy Iranian population. This study evaluated 300 oral rinse samples. Following the oral and dental examination of participants and filling out a self-administered questionnaire; samples collected by swishing and gargling 0.09% saline. The viral DNA extraction, polymerase chain reaction and HPV genotyping then performed. Prevalence of OHPV DNA/OHPV+ infection and OHPV genotypes was 12% and 1% (two cases of HPV6 and one case of HPV53), respectively. Comparison of variables between OHPV+ and OHPV- groups revealed that only income (P = .045), number of cigarettes smoked per day (P = .002), and number of teeth in the mouth (P = .005) were significantly different between the two groups. In conclusion, prevalence of OHPV+ infection and its genotypes were very low in our healthy Iranian population, and its association was not significant with the majority of suggested risk factors. Further studies with a larger sample size are recommended to determine OHPV infection risk factors.

Survey of pathology reports with no definitive diagnosis in oral lesions: the necessary skills for the clinicians.

PURPOSE: Biopsy plays a crucial role in definitive diagnosis of lesions and consequently, appropriate treatment of them. Clinicians should correctly do the biopsy in accordance to the existing principles and guidelines to prevent adverse effects on the pathologist's diagnosis. This study aimed to determine the frequency and reasons for not providing definitive histopathological diagnosis of the biopsy samples belong to the laboratory of the Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Hamadan University of Medical Sciences. METHODS: Archival reports belong to 2006-2016 period of the related laboratory were studied to determine the reports with no definitive histopathological diagnosis. RESULTS: Out of 1018 archived reports; 90 reports (8.84%) had no definitive diagnosis. The most common reasons found were incompatibility between the clinical/radiographical diagnosis and histopathological findings for 42 cases (46.66%), absence of adequate information about the clinical/radiographical findings for 17 cases (18.88%) and inappropriate quality of samples for 13 cases (14.44%), respectively. CONCLUSION: The reasons for not providing definitive histopathological diagnosis of the biopsy samples in present study indicated that preparation, assessment and diagnosis of microscopic slide by pathologists do not separate from the clinician performance.

Alternation of ß-catenin and CD44s Immunoexpression in Different Histopathological Grades of Oral Squamous Cell Carcinoma.

OBJECTIVE: Cell-cell adhesion molecules play an essential role in cell growth and differentiation. ß-catenin and CD44s are two adhesion molecules which their expression changes are correlated to loss of differentiation and gain of an invasive epithelial phenotype. Oral squamous cell carcinoma (OSCC) is the most common malignancy of oral cavity. Aim of this study was to compare ß-catenin and CD44s expression in different histopathological grades of OSCC. METHODS: ß-catenin and CD44s expression were evaluated in 10 well differentiated OSCC (group A) and 10 moderately/poorly differentiated OSCC (group B) using immunohistochemistry. RESULTS: ß-catenin membranous and nuclear/cytoplasmic expression were significantly different between groups A and B. CD44s membranous expression was insignificant amongst the two groups. CONCLUSION: Expression of ß-catenin and CD44s alter in different histopathological grades of OSCC. It seems that more rate of aberrant cytoplasmic and/nuclear expression and less membranous expression of ß-catenin can lead to significantly lower degree of cell differentiation in OSCC. 
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A Clinicopathological Report of Four Cases of Squamous Odontogenic Tumor-Like Proliferations in Odontogenic Cysts: Suggested Opinions regarding This Unusual Nature.

Distinguishing squamous odontogenic tumor-like proliferations (SOTLPs) is important in odontogenic cysts to avoid misinterpretation such as a squamous odontogenic tumor, well-differentiated squamous cell carcinoma, and acanthomatous type of ameloblastoma. This study is aimed at reporting 4 cases of these clinicopathological proliferations in order to shed more light on the importance of distinguishing them from other similar types. 150 odontogenic cysts were studied in which four cases (2.66%) with SOTLPs were identified including 2 radicular cysts, 1 dentigerous cyst, and 1 odontogenic keratocyst. These proliferations were observed in the cysts' wall particularly adjacent to the epithelial lining. All cysts had inflammation while 3 cases showed budding from the epithelial cyst lining. The findings suggested that lining of odontogenic cysts could be a source of SOTLPs, and inflammation probably played an effective role in their development. Its incidence was 2.66% in the present study. Although SOTLPs are not frequent in odontogenic cysts, their identification is important to prevent wrong histopathologic interpretation and treatment.

Clinicians' role in the occurrence of oral biopsy artifacts as a potential diagnostic dilemma.

A lack of knowledge about biopsy techniques and the management of biopsy specimens can cause artifacts. Artifacts are false structures that change the normal morphological and cytological features of tissues. This review article aimed to familiarize clinicians / dentists / surgeons with the factors causing artifacts and with the efficient strategies to prevent or minimize their occurrence. Non-adherence to several rules can result in the formation of artifacts. The clinician's performance during and after the surgical procedure (until the sample is received by the laboratory) may damage the biopsy specimen or make it susceptible to damage. Artifacts may not be clinically considered noteworthy. However, by modifying the histopathological features of the specimen, they can lead to serious errors in the interpretation of lesions. Knowledge on the part of clinicians / dentists / surgeons regarding the factors and potential conditions that can lead to artifacts can decrease the risk of their occurrence, and considerably help pathologists and patients by paving the way for a correct diagnosis, and consequently an appropriate treatment plan.

Explanation for different behavior of peripheral and central giant cell granuloma by CD44 and CD34 immunostaining.

AIM: Despite their histopathological similarity, unlike peripheral giant cell granuloma (PGCG), central giant cell granuloma (CGCG) is an osteolytic lesion. Low motility of osteoclasts as bone-resorbing agents decreases osteolysis where CD44 plays a role. The lesion requires angiogenesis to grow which in turn may cause bone resorption. This study aims to compare CD44 and CD34 expression in PGCG and CGCG. METHODS: 30 PGCG (group A) and 30 CGCG (group B) including non-aggressive (B1, N = 14) and aggressive (B2, N = 16) subgroups were evaluated for CD44 and CD34 expression through immunohistochemistry. RESULTS: CD44 staining intensity distribution (SID) score and CD44 labelling index (LI) in PGCG were significantly higher than those in CGCG, while microvessel density assessed by CD34 (MVD-CD34) was significantly higher in CGCG compared with PGCG. CD44-SID score and CD44-LI were higher for B1 whereas MVD-CD34 was higher for B2 (P < .05). CONCLUSION: Different CD44 expression among the studied groups may be indicative of the different motility of osteoclastic giant cells which may influence bone resorption. Lower CD44 expression probably indicates higher osteoclastic giant cell motility in CGCG, which with its higher angiogenesis may explain the different clinical behavior of CGCG compared with that of PGCG.

Comparative study of ß-catenin and CD44 immunoexpression in oral lichen planus and squamous cell carcinoma.

BACKGROUND: Dysfunction of adhesion molecules is believed to play an early and important role in developing cancer. Accordingly, this study aims to compare beta-catenin (ß-catenin) and CD44 expression in oral lichen planus (OLP) as a condition with malignant potential and oral squamous cell carcinoma (OSCC). METHODS: ß-Catenin and CD44 expression were evaluated in 15 patients with epithelial hyperplasia (group A), 20 OLP (group B), and 20 OSCC (group C) by immunohistochemistry. RESULTS: Quantitative and semi-quantitative evaluations revealed ß-catenin, and CD44 membranous expression had significant differences among the three groups. Expression of these markers in the OSCC group decreased significantly compared to that of the OLP. Also, nuclear/cytoplasmic expression of ß-catenin was significantly different among the three groups, considering that nuclear expression was not observed in any of the epithelial hyperplasia and OLP samples. CONCLUSIONS: According to the findings of this study, ß-catenin and CD44 can differentiate between behavior of OLP and OSCC, while the precancerous nature of OLP and malignant transformation potential of it are not suggested.

Immunohistochemical Comparison of the Expression of CD34 and CD105 in Odontogenic Keratocyst and Dentigerous Cyst.

STATEMENT OF THE PROBLEM: Odontogenic keratocyst (OKC) is a developmental odontogenic cyst with specific histopathological features, high recurrence rate, and aggressive clinical behavior. Angiogenesis might be considered as an important factor for the growth, expansion, and distribution of this lesion. PURPOSE: The aim of the present study was to determine the mean vascular densities (MVD) of OKCs and dentigerous cysts to evaluate their relationship with the biologic behavior of these lesions. MATERIALS AND METHOD: In this cross-sectional analytical study, angiogenesis was assessed in OKC and dentigerous cyst by measuring the MVD. Immunohistochemistry was carried out using CD34 and CD105. The results were analyzed with independent samples t-test. The data were analyzed, setting p value at 0.05. RESULTS: The MVDs with the use of CD34 and CD105 markers were significantly higher in OKC compared to dentigerous cyst (p< 0.05). In addition, MVDs obtained by CD105 in dentigerous cysts and OKC were significantly less than those based on CD34 (p< 0.05). CONCLUSION: Based on the results of the present study, it can be suggested that angiogenesis might be one of the possible mechanisms involved in higher aggressive biologic behavior and greater recurrence rate of OKC compared to dentigerous cysts.

A Comparative Study of Cathepsin D Expression in Peripheral and Central Giant Cell Granuloma of the Jaws by Immunohistochemistry Technique.

STATEMENT OF THE PROBLEM: Peripheral and central giant cell granuloma are two common benign lesions of the oral cavity. In spite of histopathological similarities, they have different clinical behaviors. Cathepsin D is a lysosomal enzyme which has different functions on the basis of protein and applied peptide cleavage. PURPOSE: This research aimed to evaluate and compare the expression level of Cathepsin D in these two lesions to find the reasons for the differences in clinical and biologic characteristics. MATERIALS AND METHOD: The expression of Cathepsin D was investigated by using the immunohistochemistry method in 20 samples of peripheral giant cell granuloma and 20 samples of central giant cell granuloma. The percentage of stained giant cells (labeling index), the intensity of staining of giant cells, and staining-intensity-distribution in both groups were calculated and compared. RESULTS: The labeling indices of Cathepsin D in peripheral giant cell granuloma and central giant cell granuloma were 95.9±4.03 and 95.6±2.34, respectively. There was no significant difference in the percentages of stained giant cells between the two groups (p= 0.586). The intensity of staining of giant cells in central giant cell granuloma was stronger than that of peripheral giant cell granuloma (p> 0.001). Staining- intensity- distribution of giant cells in central giant cell granuloma was significantly greater than that of the peripheral type of lesion (p= 0.001). CONCLUSION: The higher expression level of Cathepsin D in central giant cell granuloma compared to peripheral type of lesion can explain more aggressive behavior of central giant cell granuloma.

Study of P21 Expression in Oral Lichen Planus and Oral Squamous Cell Carcinoma by Immunohistochemical Technique.

STATEMENT OF THE PROBLEM: Lichen planus is a mucocutaneous disease that is relatively common in middle aged individuals. Some studies have shown that oral lichen planus has a potential to progress to squamous cell carcinoma.p21 is a cyclin-dependent kinase inhibitor that regulates the cell cycle, thus it acts as an inhibitor in cell proliferation. PURPOSE: This study was aimed to evaluate and compare the immunostaining of p21 (as a proliferation inhibitory factor) in oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). MATERIALS AND METHOD: In this descriptive cross-sectional study, p21expression was investigated in 24 samples of oral lichen planus (OLP), 24 samples of oral squamous cell carcinoma (OSCC) and 24 samples of oral epithelial hyperplasia (OEH) by employing immunohistochemical staining. RESULTS: The mean percentage of p21-positive cells in OSCC (54.5±6.6) was significantly higher than that in OLP (32.8±6.08) and OEH (9.4±3.8). Moreover, OLP samples expressed p21 significantly higher than the OEH. Kruskal Wallis test revealed a statistically significant difference between the groups regarding the intensity of staining (p< 0.001). CONCLUSION: According to the findings of this study, the expression of p21 might be related to the potential carcinogenic transformation of lichen planus to SCC. Therefore, continuous follow-up periods for OLP are recommended for diagnosis of the malignant transformations in early stages.

Effect of dietary ascorbic Acid on osteogenesis of expanding midpalatal suture in rats.

OBJECTIVES: After maxillary expansion, a long period of retention is necessary to prevent early relapse. Therefore, it is beneficial to accelerate bone formation in the expanding midpalatal suture to reduce relapse. This study was designed to evaluate the effect of dietary vitamin C on osteogenesis of rat midpalatal suture during expansion. MATERIALS AND METHODS: Fifty-four male Wistar rats were randomly divided into three groups, each with a control and an experimental subgroup. An open-loop spring was bonded to maxillary incisors of each animal to expand the premaxillary suture. Experimental groups received dietary vitamin C in their water. The rats in the three groups were sacrificed at three, nine or 17-day intervals after bonding the spring. Then, the premaxilla was dissected and sections were made and stained with hematoxylin and eosin and osteopontin marker. Osteoblasts and osteoclasts were counted in the suture. Two-way ANOVA and the Mann-Whitney-U test were used for analyzing the data. RESULTS: After three days, the number of osteoblasts was significantly higher in the vitamin C group but after nine days it was significantly higher in the control group and after seventeen days there were no significant differences between the groups. Osteoclast counts were not significantly different between vitamin C and control groups. CONCLUSION: Vitamin C had a positive effect on osteogenesis at the beginning of bone formation in the expanding suture, but after nine days it had a negative effect on suture osteogenesis in rats.

A clinicopathological study of odontogenic cysts and tumors in hamadan, iran.

STATEMENT OF THE PROBLEM: Odontogenic cysts and tumors are the most frequent osseous destructive lesions of the jaws; however, there is little information regarding the relative frequency of these lesions among the Iranian population. PURPOSE: The purpose of this study was to determine the distribution of clinically and histologically- diagnosed odontogenic cysts and tumors during a period of 13 years in Hamadan, and also its correlation with age, gender, and the site of the lesion. MATERIALS AND METHOD: A descriptive cross-sectional study was performed on 413 oral and maxillofacial specimens during 1996 to 2008.The age and the gender of patients, as well as the site of lesion were recorded. The data were analyzed using SPSS software. RESULTS: Totally, 70 specimens were recorded as odontogenic cysts and 11 specimens were diagnosed as odontogenic tumors. The most frequent odontogenic cysts were dentigerous cysts (27.2%), followed by radicular cysts (18.6%) and odontogenic keratocysts (18.6%). In addition, cysts were more frequent in male than female individuals. Ameloblastoma was the most frequent odontogenic tumor (64%). CONCLUSION: Odontogenic cysts were in correlation with age, gender and location. These results showed that dentigerous cyst and odontogenic keratocyst were more frequent than other studies. More investigations should be performed to determine the frequency of odontogenic tumors in Iran.