Potentiality and Inflammatory Marker Expression Are Maintained in Dental Pulp Cell Cultures from Carious Teeth.

OBJECTIVES: This investigation aimed to isolate and culture human dental pulp cells from carious teeth (cHDPCs) and compare their growth characteristics, colony-forming efficiency, mineralization potential and gene expression of Toll-like receptors (TLR)-2, TLR-4, TLR-9, tumour necrosis factor (TNF)-α, interleukin (IL)-1ß, IL-6, IL-8, IL-17A, 1L-17R, IL-23A, nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK1), dentin matrix protein (DMP)-1, dentin sialophospho protein (DSPP), sex determining region Y-box 2 (SOX2) and marker of proliferation Ki-67 (MKi67) with cells isolated from healthy or non-carious teeth (ncHDPCs). METHODS: Pulp tissues were obtained from both healthy and carious teeth (n = 5, each) to generate primary cell lines using the explant culture technique. Cell cultures studies were undertaken by generating growth curves, a colony forming unit and a mineralization assay analysis. The expression of vimentin was assessed using immunocytochemistry (ICC), and the gene expression of above-mentioned genes was determined using quantitative real-time reverse-transcription polymerase chain reaction. RESULTS: ncHDPCs and cHDPCs were successfully isolated and cultured from healthy and inflamed human dental pulp tissue. At passage 4, both HDPC types demonstrated a typical spindle morphology with positive vimentin expression. No statistical difference was observed between ncHDPCs and cHDPCs in their growth characteristics or ability to differentiate into a mineralizing phenotype. ncHDPCs showed a statistically significant higher colony forming efficiency than cHDPCs. The gene expression levels of TLR-2, TLR-4, TLR-9, TNF-α, IL-6, IL-8, IL-17R, IL-23A, NF-κB, MAPK1, DMP1, DSPP and SOX2 were significantly higher in cHDPCs compared with ncHDPC cultures. CONCLUSION: cHDPCs retain their differentiation potential and inflammatory phenotype in vitro. The inflamed tooth pulp contains viable stem/progenitor cell populations which have the potential for expansion, proliferation and differentiation into a mineralizing lineage, similar to cells obtained from healthy pulp tissue. These findings have positive implications for regenerative endodontic procedures.

miRNA for the assessment of lymph node metastasis in patients with oral squamous cell carcinoma: Systematic review and metanalysis.

BACKGROUND: miRNA is one of the advanced epigenetic molecular markers correlating with lymph node metastasis in patients with Oral squamous cell carcinoma (OSCC). Numerous published papers are showing correlation of miRNA with metastasis. There is a need to analyze and validate such correlation. METHOD: English language literature in major databases from the last 20 years was searched using controlled vocabulary and keywords. Strict inclusion and exclusion criteria were followed for selection of studies. The quality assessment was done as per the QUADAS tool 2 by three independent reviewers. The metanalysis was performed by using random effect model. Standardized mean difference (SMD) was considered as the effect measure. Statistical software used was STATA version 13.1. RESULTS: With all inclusion and exclusion criteria, eight studies could qualify for metanalysis. The pooled estimate is found to be 0.13 (-0.35, 0.62), P = .585, which is statistically not significant. This indicates that there is a no significant difference in the fold change between metastasis and no metastasis groups. P-value of chi-square statistic for heterogeneity is <.001 (significant), and I-squared statistic is 87.2%, which indicates that heterogeneity is present to a considerable extent. Egger's test shows there is no publication bias involved (P = .819). CONCLUSION: The metanalysis showed no significant difference in the fold change of miRNA expression between metastasis and non-metastasis OSCC patients. Future studies can be directed to eliminate the heterogeneity among the studies noted in this analysis to confirm the role of miRNA for assessment of regional metastasis with special focus on tongue squamous cell carcinoma.

Knowledge about human papillomavirus (HPV) related oral cancers among oral health professionals in university setting-A cross sectional study.

INTRODUCTION: Scientific literature suggests that human papillomavirus (HPV) infection may be associated with oral squamous cell carcinoma (OSCC). However, knowledge regarding HPV-OSCC link among oral health professionals (OHP) has been insufficient. So, the aim of this study was to assess the knowledge about HPV associated OSCC among OHP working in dental faculties in Malaysia. METHODOLOGY: Ethical committee of the University approved this study. A validated, pre-tested questionnaire was sent electronically to 224 OHP. Questionnaire collected information regarding demography, knowledge about HPV-OSCC link, HPV vaccine, and willingness to educate patients about HPV OSCC link among the participants of this cross-sectional study. Data collected was analysed using "Stata/IC-13" and was summarised using descriptive statistics like frequency, percentage, mean and standard deviation. RESULTS: Out of 179 participants, around 39% of the participant's opined virus was not a causative factor for OSCC. Around, 44% replied posterior portion of the tongue/oro-pharynx was the commonest site for HPV related OSCC, whereas 29% replied that lateral border of the tongue was the common site for HPV related OSCC. Forty one percent educated patients regarding HPV infection being a causative factor for OSCC. HPV vaccine can prevent OSCC was stated by 70% OHP. Only 12% were aware of the availability of HPV vaccine in Malaysia. Majority (99%), agreed that there is a need to offer continuing education programmes to dentists highlighting advances and preventive strategies in the fight against OSCC. CONCLUSION: Substantial increase in awareness is required among OHP regarding HPV-OSCC link.

Granular ameloblastoma: report of two cases with atypical cytological aspects.

Ameloblastoma is an aggressive odontogenic tumor, which arises from odontogenic epithelium. Ameloblastomas can present in several clinical and histomorphological patterns. The granular cell variant accounts for only 3.5% to 5% of ameloblastomas. We have presented two cases of granular cell ameloblastoma (GCA) occurring in a 44-year-old and 50-year-old man, respectively. Case No. 1 on incisional biopsy was diagnosed as unicystic ameloblastoma (UA), which later after excisional biopsy was finally diagnosed as GCA owing to the features observed in excisional biopsied tissue. Case No. 2 on incisional biopsy showed darker and lighter stained cells arranged in small follicular pattern, and anastomosing cords. Meticulous immunohistochemistry, histochemical examination and careful literature search helped us to diagnose it as GCA. We have made an attempt to elucidate the diagnosis of GCA especially in cases of GCA with unusual granular component.

Prevalence of oral tori and exostosis in Malaysian population - A cross-sectional study.

INTRODUCTION: Oral tori and exostosis are non-pathological bony protuberances seen on the alveolar surfaces of the jaw bones. These are commonly seen on the palatal surfaces of the maxilla [torus palatinus (TP)] and around the premolars in the lingual surface of the mandible [torus mandibularis (TM)]. The aim of this cross-sectional study was to determine the prevalence of tori/exostosis in the Malaysian population. METHODOLOGY: A total of 2666 patients were examined for the presence of tori and exostosis in the maxilla and mandible and were categorized into TP, TM, and exostosis (facial/labial). Collected data was analysed for obtaining descriptive statistics. RESULTS: 882 subjects were noticed with oral tori/exostosis among the population studied with a prevalence rate of 33%. TP was seen more in females (35%), compared to males (20%), and this difference was statistically significant (p value < 0.001). Highest prevalence of TP was seen in Malays (43%), followed by Chinese (31%) and Indians (21%), which was statistically significant (p value < 0.00). DISCUSSION: High prevalence of tori and exostosis was seen in the population studied. Though harmless, in certain circumstances, their presence necessitates changes in the denture design during fabrication of prosthesis, which the dentist should be mindful.

An Expansile Well-defined Radiolucency in Anterior Mandible: Case Presentation with Treatment Approach and Literature Update.

A 15-year-old Indian male patient presented with a history of pain and swelling in left mandible. Imaging studies revealed a well-defined unilocular radiolucency in the body of the mandible. Patient also gave the past history of the surgery of the jaws, which was histopathologically diagnosed as dentigerous cyst. Following this patient underwent incisional biopsy and later excisional biopsy. The histopathologic diagnosis for incisional biopsy was unicystic ameloblastoma but final diagnosis was dentinogenic ghost cell tumor for the excised tissue. To the best of our knowledge, this appears o be the first case of dentigerous cyst transforming into dentinogenic ghost cell tumor. The clinical presentation of the case, differential diagnosis and treatment modalities are being discussed.

Prevalence and Difficulty Index Associated with the 3(rd) Mandibular Molar Impaction among Malaysian Ethnicities: A Clinico-Radiographic Study.

BACKGROUND: The mandibular third molars (3Mms) are the most common impacted teeth in the human dentition and their prevalence ranges from 27-68.8% in various parts of the world. The assessment of surgical difficulty of 3Mms extraction helps in better formulation of treatment plan by minimizing postoperative complications. OBJECTIVES: The aim of this retrospective study was to investigate the prevalence and pattern of 3Mm impaction in patients between 20-44-year-old among Malaysian's ethnicities attending Oral Health Center/ SEGi University, Faculty of dentistry. MATERIALS AND METHODS: This study reviewed 1249 orthopantomograms (OPGs) of subjects aged 20 to 44 years of three Malaysian ethnic groups. Of the study population 918 OPGs were considered for the study. Patient's details include age, gender and ethnicity were extracted from the patient's clinical record and all details related to impaction were obtained from patient's panoramic radiograph that was individually examined by two investigators. The data collected was statistically analysed using SPSS 16. RESULTS: This study found that Chinese female recorded the highest number of patients with "very difficult" category of impacted mandibular third molars. The most common age group involved was 20-24 years, mesioangular impaction, deep occlusal level and no ramus space for impacted mandibular third molars (3ms) were the most common findings observed. CONCLUSION: The present study suggests that predicting the level of difficulty preoperatively for impacted 3m surgery will help in formulating the better treatment plan, thereby minimizing the postoperative complication for the ultimate benefit of the patient.

Unicystic Ameloblastoma: A Perception for the Cautious Interpretation of Radiographic and Histological Findings.

The term Unicystic Ameloblastoma (UA) refers to those cystic lesions that show clinical and radiological characteristics of an odontogenic cyst but on histological examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Till date, lot of controversies exist among oral surgeons and oral pathologists regarding this entity. An attempt is being made here to discuss all the diagnostic dilemmas associated with UA.

Intra-osseous jaw lesions in paediatric patients: a retrospective study.

OBJECTIVE: This study was undertaken to comprehensively analyze the distribution of intra-osseous paediatric jaw lesions (0-16 years) and to correlate the same with the data which has been published in the literature. STUDY DESIGN: A total of 171 hard tissue paediatric pathologies obtained from the archives of Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, India were retrospectively reviewed over a period of 6 years. All the cases were analyzed for gender, site, radiographic findings, histopathological diagnosis, treatment modality and recurrence rate. RESULTS: The present study revealed 54/171 odontogenic cysts, 45/171 odontogenic tumours, 33/171 bone pathologies, 2 malignant tumours, 1 connective tissue pathology and 36/171 miscellaneous category cases. The highlights of this analysis showed a relatively higher incidence of odontogenic tumours (26.3%) as compared to those seen in other studies which have been published in literature. KCOT and ameloblastoma (solid and unicystic) were the most frequently diagnosed tumours. Also, one case of dentigerous cyst which was converted into calcifying ghost cell odontogenic tumour was a unique feature which was noted in the current study. CONCLUSION: In the current study, a preponderance of odontogenic pathosis was seen in the paediatric age group which was studied.

Pediatric solitary intraosseous infantile myofibroma of the mandible.

Myofibroma is a rare benign tumor of myofibroblastic origin that presents as solitary or multiple, and as an intraosseous and/or soft tissue lesion. It most commonly occurs in infants and children, although adult myofibromas have also been reported. Solitary central infantile myofibroma of the jaws is very rare and should be considered in the differential diagnosis of central jaw lesions involving the mandible in children. Its etiology is unknown. The purpose of this manuscript is to report a case of solitary intraosseous infantile myofibroma of the mandible wherein trauma may have been a contributory factor to the development of the tumor. The importance of immunohistochemistry in diagnosing this entity has also been emphasized. Resection should be preferred over enucleation when the lesion infiltrates the surrounding bone.

Potential carriers of chemotherapeutic drugs: matrix based nanoparticulate polymeric systems.

In this work matrix based nanoparticulate polymer systems have been designed using the diacrylate derivative of the well-known biocompatible polymer, poly(ethylene glycol) (PEG). This has been crosslinked using bifunctional (ethyleneglycol dimethacrylate) and tetrafunctional (pentaerythritol tetraacrylate) crosslinkers in varied concentrations (10-90%) to result in a polymeric network. The crosslinked polymers thus obtained were characterized by spectroscopic techniques (NMR and FTIR) and then prepared nanoparticles by the nanoprecipitation technique. Particle size analysis showed sizes of ~150 nm (PDI < 1) (with tetrafunctional crosslinker) and ~300 nm (with bifunctional crosslinker). Both the systems however showed unimodal narrow particle size distributions with negative zeta potential values of -15.6 and -7.3 respectively. Cytotoxicity of these formulations was evaluated by MTT assay showing non-cytotoxic nature of these carrier systems. In vitro drug loading and release studies were carried out using a model chemotherapeutic drug, methotrexate(MTX). These MTX loaded nanoformulations have also been evaluated biologically with the help of in vivo studies using radiolabeling techniques (with 99mTc radionuclide). The blood kinetics profile of the formulations was studied on New Zealand Albino rabbits while the biodistribution studies were performed on balb/c mice (with EAT tumours), which revealed a hepatobiliary mode of elimination. These preliminary studies clearly demonstrated the ability of these multifunctional crosslinkers to result in tight nanosized networks with biocompatible polymers such as PEG and their potential to carry chemotherapeutic drugs.

Xanthomatous oophoritis following uterine artery embolisation: successful conservative surgical management with favourable outcome.

Xanthomatous oophoritis is a rare inflammatory condition of the ovaries. We are reporting a case of a 28-year-old woman, who had undergone uterine artery embolisation 4 years ago due to symptomatic focal adenomyosis. After 3 years of embolisation, the patient started having chronic pelvic pain, dysmenorrhoea and polymenorrhagia along with inability to conceive. Abdominal examination showed 16 weeks size mass arising from the pelvis. Ultrasound findings were suggestive of focal adenomyosis and bilateral tubo-ovarian masses. A CT scan report showed cystic enlargement of ovaries showing high-density fluid contents. MRI showed two well-defined, thick-walled, septated, cystic lesions appearing hyperintense on both T1-weighted (T1w) and T2w images with peripheral and septal enhancement. Bilateral abscess walls were excised and the healthy ovarian tissue was left behind during surgery. Histopathology of the cyst wall showed xanthomatous oophoritis. After the conservative surgery, she received three doses of goserelin. She conceived spontaneously thereafter and delivered a healthy term baby.

Infiltrating lipomatosis of the face: A case series.

Infiltrating lipomatosis of the face is a very rare entity which is characterized by the collection of non-encapsulated mature adipocytes infiltrating local tissues, resulting in craniofacial deformities. Psychomotor development of the patients is normal, esthetics often being the primary concern to seek treatment. The presentation is always unilateral with hypertrophy of hard and soft structures on the affected side of the face. The pathogenesis of the condition is unclear. This condition shows a wide phenotypic range, uncertain prognosis with high rates of recurrence after surgery, and variable post-op cosmetic improvement. The condition shows no gender predilection, with most of the cases presenting in and beyond the second decade of life. Here, we present a series of four cases presenting in varying age groups with history of recurrence in three cases.

Rare pediatric presentation of aneurysmal bone cyst with trabecular juvenile ossifying fibroma and ossifying fibroma.

Aneurysmal bone cyst (ABC) is a benign intraosseous lesion characterized by blood filled spaces of varying sizes associated with a fibroblastic stroma containing multinucleated giant cells, osteoid and woven bone. ABC can present either singly or in association with osseous neoplasms such as ossifying fibroma (OF), giant cell granuloma etc. Juvenile ossifying fibroma has two variants: psammomatoid JOF (PJOF) and trabecular JOF (TJOF). ABC formation in TJOF is very rare in pediatric patients with only three cases reported in literature till date to the best of our knowledge. We hereby report three pediatric cases of ABC, two of which were associated with TJOF and one associated with OF.

Unicystic ameloblastoma in 3 year old paediatric patient - A rare entity.

Unicystic ameloblastoma (UA) is a benign epithelial odontogenic tumor of the jaws that commonly occurs in 2nd and 3rd decade of life. In fact, this entity is rare in children under 12 years of age. It is characterised as a distinct variant of ameloblastoma, exhibiting a less aggressive behaviour and a lower rate of recurrence than solid conventional ameloblastoma. There are very few reported cases of UA occurring in children below five years of age. The purpose of this case report is to describe a case of UA involving the crown of an unerupted maxillary second premolar in a 3 year old girl. The pathogenesis, clinical appearance, radiographic presentation, histological findings and management of the tumour have also been discussed.

Clinicopathologic and radiologic correlation of ossifying fibroma and juvenile ossifying fibroma--an institutional study of 22 cases.

To analyze the clinical, radiographic, and histopathologic features of ossifying fibroma (OF) and juvenile OF (JOF), an archival study of 17 cases of OF and 5 cases of JOF reported over a period of 4.5 years was undertaken to analyze the aforementioned features. Age incidence of OF varied from 8 to 53 years, and JOF was seen in a comparatively younger age of 8 to 28 years. Both tumors were almost equally distributed between men and women. Thirteen cases of OF were found to occur in posterior mandible, whereas JOF was predominant in the anterior maxilla. Radiographically, OF varied from completely radiolucent (n = 7), mixed (n = 5), to completely radiopaque (n = 5), whereas JOF was predominantly radiolucent. Microscopically, stroma in OF varied from fibrous to highly cellular with overlap between various types of calcification. Juvenile OF showed highly cellular stroma and 2 distinct patterns of mineralization-psammomatoid and trabecular with osteoid seams. The origin of OF and JOF seems to be distinct from each other with OF arising from periodontal ligament and JOF arising from precursor myxoid tissue of paranasal sinuses.

Case report on cherubism: non-familial variant / Relato de caso de querubismo: uma variante não familiar

Introduction: Cherubism is a rare, non-neoplastic, self-limiting, fibro-osseous disease, characterized by painless expansion of the maxilla, mandible or both. It usually develops in the first and second year of life. The radiographic appearance presentation is ordinarily bilateral, multilocular appearance in the mandible. To the best of our knowledge, very few cases (less than ten) of non-familial cherubism have been reported in the English literature. Objective: To describe non-familial case of cherubism in a 10-year-old child. Materials and methods: The current case was clinically, radiographically and histopathologically analysed for confirmatory diagnosis. Results: H & E stained section showed vascular and cellular stroma containing numerous multinucleated giant cells. Conclusion: Correlating radiographically and histopathologically the case was finally diagnosed as non-familial variant of cherubism.

Introdução: Querubismo é uma doença rara, não neoplásica, autolimitada, fibro-óssea, caracterizada pela expansão indolor da maxila, mandíbula ou ambas. Ela geralmente se desenvolve no primeiro e no segundo ano de vida. A aparência radiográfica é normalmente bilateral, multilocular e localizada na mandíbula. Para melhor conhecimento, poucos casos (menos de dez) de querubismo não familiar foram relatados na literatura. Objetivo: Descrever um caso de querubismo não familiar em uma criança de 10 anos. Materiais e métodos: Para confirmação do diagnóstico, foram realizadas avaliações clínicas, radiográficas e histológicas deste caso. Resultados: Seção corada de H & E mostrou estroma vascular e celular contendo numerosas células gigantes multinucleadas. Conclusão: Na correlação radiográfica e histológica, ficou confirmado diagnóstico de variante não familiar de querubismo.

Serum lipid profile in oral cancer and leukoplakia: correlation with tobacco abuse and histological grading.

INTRODUCTION: Role of alterations in serum lipid profile in oral cancer remains controversial. The present study aimed to evaluate the implications of altered serum lipid profile in patients with oral cancer (OC), oral leukoplakia (OLP), and tobacco habits. MATERIALS AND METHODS: Thirty patients with OC, 30 with OLP, 30 tobacco abusers (TAs), and 30 age and sex matched healthy controls were included in the study. Serum lipid profile including total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), Very low density lipoprotein (VLDL), and triglycerides (Tg) were evaluated using a fully automatic Biochemistry analyzer. Difference in lipid profile in various types of TA, that is, smokeless tobacco (SLT), smoking tobacco (ST), and a combination (Comb) usage of both forms were also analyzed. RESULTS: TC, HDL, and LDL were much lower in the OC group compared with control. Although these parameters were low in the OPC group compared with controls, the difference was not significant. On histological analysis, TC and HDL were found to decrease marginally with loss of tumor differentiation in OC. No correlation was found between the mean serum lipid profiles and degree of dysplasia in OLP. TC and HDL were significantly lesser in all forms of TA when compared with control. CONCLUSIONS: There may be an inverse relationship between serum lipid profile and OC. No significant reduction in lipid profile was observed in the OLP group. This may indicate that hypolipidemia is a late change occurring during carcinogenesis or is an effect rather than the cause of cancer.