Questionnaire-based survey regarding the opinion of general pathologists on the need for oral pathology services.

Context: Oral and maxillofacial pathology (OMFP) is a subspecialization having a masters course in India. Due to lesser number of oral pathologists in the country, the biopsy material from the head and neck is catered to by the general pathologist. Aim: This survey was conducted to acquire responses from general pathologists and gathering knowledge on their perspective of oral pathology. Methods: Pathologists at various medical institutions and at laboratories all over Karnataka were requested to answer a questionnaire comprising 13 questions pertaining to the need and scope of oral pathology. Results: In total, 37 (57%) general pathologists completed the questionnaire, of whom 97% (36) were aware of the specialty and 30 (81%) perceived a need for it. Eleven (30%) of them referred oral biopsy specimens to oral pathologists. The most common sources of diagnostic difficulty were identified as odontogenic tumors and cysts. Twenty-six (70%) pathologists felt the need for a short-term posting for their postgraduates in oral pathology, while 28 (76%) of them expressed their opinion about considering an oral pathologist as a part of their team when diagnosing complex head and neck pathologies. Twelve (71%) of them mentioned that they sometimes found that head and neck lesions took longer time to diagnose. Conclusion: Although the utilization of OMFP specialists' services in the state is quite low, general pathologists strongly feel the need for OMFP training as head and neck specimens form a considerable proportion of biopsies received by them.

Carcinoma ex Pleomorphic Adenoma in the Floor of the Mouth: An Unusual Diagnosis in a Rare Location.

Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignant salivary gland tumor, mostly involving the parotid and submandibular glands. Minor salivary gland involvement is even rarer, palate being the most common site. Other reported sites are upper lip, sinonasal tract, and buccal mucosa. Here, we report a case of CXPA in an unusual location, the floor of the mouth.

Clinicopathologic Trends in Pediatric Oral Biopsies: A 10-Year Institutional Archival Study.

AIM: The aim of this study is to determine the clinicopathologic trends in oral pathological biopsies in children aged 14 years and below received for histopathological diagnosis in the institution. MATERIALS AND METHODS: The archives of the Department of Oral Pathology and Microbiology were retrospectively analyzed. Biopsy records of all oral lesions from pediatric patients, aged 0-14 years, in the files of the Department of Oral Pathology and Microbiology, A B Shetty Memorial Institute of Dental Sciences, Mangalore, DK, from 2007 to 2017 were considered. Descriptive statistical analysis and Pearson's Chi-square test using computer software were performed. RESULTS: About 3,590 biopsies were received during the period of which 93 (2.6%) belonged to pediatric population. Prevalence was more in males (58%) compared to females (42%). Commonly affected age group was 10-14 years. The most common category of lesions diagnosed was cysts, and pulp pathologies were the least. The most common location was the jaws of which mandible was more common compared to maxilla followed by the lower lip and buccal mucosa. Histopathologically, radicular cysts (11%) were the most common followed by equal frequency of dentigerous cysts, mucoceles, and odontomes (9%). A statistically significant association of age and gender was seen with the category of the lesion. CONCLUSION: This study shows a blend of similarities and contradictions as compared to other similar studies, which could be attributed to geographical diversity, and a number of biopsies received each year which needs to be further explored.

Spindle cell carcinoma in the maxilla: A rare case and literature review.

In India, oral squamous cell carcinoma accounts for 90%-95% of oral malignancies. The WHO classifies spindle cell carcinoma (SpCC) under malignant epithelial tumors of squamous cell carcinoma (SCC) and is a rare entity accounting for only 1% of SCCs. It is an aggressive biphasic neoplasm exhibiting high mortality rate owing to increased metastasis and recurrence which signifies the need for recognition and treatment of this perplexed tumor. We present a case of maxillary SpCC where histopathological evaluation alone was indecisive, requiring immunohistochemistry for confirmation of the diagnosis.

Mesenchymal tumours of the head and neck: a 10-year institutional archival study / Tumores mesenquimales de cabeza y cuello: estudio de archivo institucional de 10 años de duración

Introduction: Histopathological characterisation of benign and malignant lesions of the head and neck in a systematic and coherent way is an essential part of Oral Pathology and Oral Medicine. Objective: To describe the frequency and histopathological profile of connective tissue tumours in the head and neck region reported in an Indian institute. Methods: A retrospective analysis was made of the 10-year records of reports of biopsy samples of patients maintained by the department of oral pathology showing histopathological diagnosis of connective tissue neoplasms. The data obtained was compiled for age, gender, site and histopathology of the lesions. Results: Majority of the tumours were benign and patients were found to be in the 2nd or 4th decade of life with female preponderance. The most common benign tumour was fibroma where buccal mucosa was the commonest location and malignant tumour was osteosarcoma where mandible was the commonest site. While fibromas were seen among general adult population, osteosarcomas were more in the males (7.2 percent) and in the younger population (< 20 years). The uncommon tumours among benign variety were leiomyoma and teratoma while in malignant category 1 case of undifferentiated sarcoma was reported. Conclusion: The findings in this study may be of help to oral and maxillofacial surgeons and general dentists in formulating diagnosis and rendering patient care in the existing local population(AU)

Introducción: La caracterización histopatológica de las lesiones benignas y malignas de cabeza y cuello de forma sistemática y coherente es una parte esencial de la Patología Oral y la Medicina Oral. Objetivo: Describir la frecuencia y el perfil histopatológico de los tumores del tejido conjuntivo de la región de cabeza y cuello notificados en un instituto indio. Métodos: Se realizó un análisis retrospectivo de los registros de 10 años de informes de muestras de biopsia de pacientes mantenidos por el departamento de patología oral que mostraban diagnóstico histopatológico de neoplasias del tejido conectivo. Se recopilaron los datos obtenidos en cuanto a edad, sexo, localización e histopatología de las lesiones. Resultados: La mayoría de los tumores eran benignos y los pacientes se encontraban en la 2ª o 4ª década de la vida, con preponderancia del sexo femenino. El tumor benigno más frecuente fue el fibroma, cuya localización más frecuente fue la mucosa bucal, y el tumor maligno fue el osteosarcoma, cuya localización más frecuente fue la mandíbula. Mientras que los fibromas se observaron entre la población adulta general, los osteosarcomas fueron más frecuentes en los varones (7,2 por ciento) y en la población más joven (< 20 años). Los tumores menos frecuentes en la variedad benigna fueron el leiomioma y el teratoma, mientras que en la categoría maligna se registró un caso de sarcoma indiferenciado. Conclusiones: Los hallazgos de este estudio pueden ser de ayuda para los cirujanos orales y maxilofaciales y los odontólogos generales en la formulación de diagnósticos y la prestación de atención al paciente en la población local existente (AU)

Root Canal Morphology of Maxillary First Premolars Using the Clearing Technique in a South Indian Population: An In vitro Study.

BACKGROUND: The success of root canal therapy requires a good knowledge of root canal morphology. Literature review shows variations in a number of roots and canal morphology in studies done across the globe. AIM: The purpose of this study was to evaluate the root canal morphology in maxillary first premolars using the clearing technique in a South Indian population. METHODOLOGY: Two hundred and twenty-five extracted noncarious, nonfractured, sound maxillary first premolars were collected, cleaned, and were injected with India ink to stain the root canals. Teeth were then decalcified and cleared using methyl salicylate. Teeth were then viewed under a stereomicroscope to evaluate the number of roots, root canal morphology based on the Vertucci's classification, variations, and additional features such as accessory root canals, lateral canals, furcation canals, isthmus, and apical delta. RESULTS: Nearly 52.88% of maxillary first premolars were single rooted, 44.88% had two roots, and 2.22% had three roots. Vertucci's Type IV root canal configuration was the most common type in maxillary first premolars and was seen in 66.51% of cases followed by Type II in 13.4%. Type I was seen in 9.76%, Type VI in 6.51%, Type VIII in 2.32%, Type III in 0.46%, Type V in 0.46%, and Type VII in 0% of teeth. CONCLUSION: The majority of the maxillary first premolars included in our study were single rooted and Vertucci's Type IV was the most common type of root canal configuration.