Proliferative Index in Invasive Tumor Front of Oral Squamous Cell Carcinoma: A Potential Prognostic Indicator.

AIM: The aim of the study was to evaluate the proliferative index (PI) at their invasive front of oral cancer and their association with Bryne's grades of oral squamous cell carcinoma (OSCC) and compare the PI with lymph node metastasis, site of involvement, and habits. MATERIALS AND METHODS: The Ki-67 antigen expression was immunohistochemically evaluated in a total of 102 cases that included the histopathologically diagnosed archival specimens of OSCCs. They were subdivided by Bryne's histopathological grading into grade I (40 cases), grade II (32 cases), and grade III (30 cases). The nucleus with brown stain was considered positive. Cells were counted under 400× magnification. The proliferative activity thus determined was then expressed as a percentage of Ki-67 labeling index (Ki-67 LI) positive cells. RESULTS: A stepwise increase in the mean Ki-67 LI was found from grade I to III squamous cell carcinoma, thus correlating with the histological grading. In addition, there was a higher PI seen in cases associated with metastatic lymph node, which concords with the higher biologic aggressiveness and poor prognosis of the lesion. CONCLUSION: The present study shows a definitive correlation of Ki-67 antigen with the Bryne's histological grading, all the parameters of Bryne's grading for OSCC and lymph node status of the patient proving its association as an effective tool to grade the tumors and finally read the prognosis of the tumor. CLINICAL SIGNIFICANCE: Cell proliferation is regarded as one of the most important biologic mechanisms in oncogenesis. The role of cell proliferation in tumor progression has been inferred in studies concerned with human cancer by comparing the PI of normal tissue, preneoplastic and neoplastic lesions. The Ki-67 antigen-labeled cells can prove to be an effective aid to grade the tumors. It might be possible to standardize and objectify tumor grading among pathology laboratories.

Awareness of Biomedical Waste Management among Dentists associated with Institutions and Private Practitioners of North India: A Comparative Study.

AIM: The present study aimed to obtain information about knowledge, execution, and attitude toward biomedical waste (BMW) and its management. MATERIALS AND METHODS: In the present study, a self-administered closed-ended questionnaire was designed to conduct a cross-sectional survey. It was distributed among 614 dentists (institution associated or private practitioners) in the cities of North India. The questionnaire comprised 36 questions regarding knowledge, execution, and attitude toward BMW and its management. Frequency distribution and chi-square test along with paired t-test were used to compare the data obtained between the private practitioners and institution-associated dentists. RESULTS: The study showed that 80% private practitioners were aware of the categories of BMW as compared with 100% of institution-associated dentists. However, 41% dentists associated with institution were disposing the chemical waste directly into sewer and a surprising high number of private practitioners were discarding directly without any treatment. Furthermore, regarding the mandatory maintenance of BMW records, 100% institution-associated respondents were aware, whereas only 6.5% private practitioners knew about it. Regarding BMW management not frequently being followed, 78% of private practitioners believed extra burden as the reason. CONCLUSION: Most of the dentists had adequate knowledge regarding BMW policies and its management. Although it was being practiced in mostly all the institutes on a regular basis, the majority of private practitioners were not practicing it due to various reasons, such as financial burden, lack of availability of service, and poor attitude toward its management. CLINICAL SIGNIFICANCE: There is a need to make it compulsory and organize training sessions to educate the dental personnel and to establish the importance of proper management.

Prevalence of Dental Anomalies in Odisha Population: A Panoramic Radiographic Study.

AIM: The aim of this study was to evaluate the prevalence of dental anomalies (DAs) in Odisha population using panoramic radiographs. MATERIALS AND METHODS: In this study, 1,080 panoramic radiographs were evaluated for DAs. Dental records were reviewed for diagnostic confirmation. Anomalies related to the shape, size, position of teeth, and number of roots (supernumerary roots) were evaluated. RESULTS: The study results showed the prevalence of DAs to be 35.27%. The most prevalent was dilaceration, which was seen in 46.71% cases followed by peg laterals in 20.99%. CONCLUSION: Dental anomalies were present in more than one-third of the study group, which was mostly related to shape of the teeth. Early diagnosis of these DAs helps in avoiding complications. CLINICAL SIGNIFICANCE: Identification of DAs requires proper examination and thereby subsequent correct diagnosis. These anomalies can pose complications in normal functioning of orofacial complex. The knowledge of the prevalence of such anomalies aids dental practitioners for a proper treatment plan.

Assessment of Oral Hygiene Knowledge, Practices, and Concepts of Tobacco Usage among Engineering Students in Bhubaneswar, Odisha, India.

AIM: This study aimed to assess oral hygiene-related knowledge and practices among engineering students of Bhubaneswar city and also to evaluate the concepts about the side effects of tobacco usage among those students. MATERIALS AND METHODS: The study was conducted using a self-administered, close-ended questionnaire to assess the oral hygiene knowledge and practices and study the concepts on tobacco usage among 362 engineering students of Bhubaneswar city, Odisha, India. The obtained data were statistically analyzed using Statistical Package for the Social Sciences software version 20.0. RESULTS: This survey found that 26.51% of the students had never visited a dentist. Nearly 43.64% of the participants were cognizant of the fact that improper brushing is the reason of tooth decay. About 47% of the participants consumed alcohol and 32.6% had the habit of chewing tobacco, though 80% were aware that use of smokeless tobacco can impair oral health and cause cancer and use of alcohol has detrimental effect on oral health. CONCLUSION: Knowledge with respect to oral health among engineering students of Bhubaneswar city is adequate regarding using fluoridated toothpaste and flosses. However, an unhealthy snacking habit, overusage of toothbrushes, consumption of alcohol, and practicing tobacco habit show the lack of oral health knowledge in these students. CLINICAL SIGNIFICANCE: Our study provides an idea about the present scenario in terms of oral hygiene and tobacco usage in young individuals. This can form the basis for oral health education and tobacco cessation program. Moreover, as the habit of tobacco usage starts early during college life, adequate knowledge about its ill-effects would prevent deadly diseases, such as potentially malignant disorders and oral cancer.

Dissolution of Enamel on Exposure to Various Commercial Beverages Available in India.

AIM: The study was aimed to estimate the pH of the commonly available soft drinks in the Indian market and to assess the detrimental effects of the juices and beverages on the tooth surface by measuring the weight loss of the tooth sample. MATERIALS AND METHODS: The study was done with eight different types of commercially available carbonated drink and fruit juices available in the Indian market among which six were carbonated drinks and two were juices. Carbonated drinks experimented were Coca-Cola, Pepsi, Fanta, Mirinda, 7Up and Sprite, and two fruit juices were Tropicana orange juice and real orange juice. Ten different bottles from each category were obtained, and the pH was estimated. Each of the beverages was divided into batch of 10 containers containing the tooth sample. Weight of all samples was measured at 24, 48, 72, 96, and 120 hours with subsequently changing each solution at an interval of 24 hours. RESULTS: The mean pH of the beverages was found ranging from 2.13 ± 0.02 in Pepsi to 3.41 ± 0.02 in Tropicana on opening. The mean pH of water was found to be 6.98 ± 0.01. Among carbonated drinks, the mean weight loss after 24 hours was highest in Coca-Cola and least in 7Up. Tropicana fruit juice had a higher tooth loss than real orange juices. When compared with water, the tooth loss was significantly higher in Coca-Cola after all specified time (hours). CONCLUSION: The pH of both carbonated drinks and fruit juices was below the critical pH. The weight loss was also seen after every 24 hours in all the carbonated drinks and beverages. The study showed that these commercial beverages are harmful to the tooth structures, and hence, the health professionals play a major role in educating the population about its effects and advising them to use these products precisely. CLINICAL SIGNIFICANCE: The change in lifestyle has increased the demand of soft drinks and artificial juice in Indian market. The use of these carbonated drinks and fruit juices causes damage to the tooth structure in all ages, especially in young mass. Our study provides an idea about the deleterious effects of these commercial drinks on dental hard tissues.

Thurston Syndrome: An Insight of a Rare Case and Literature Review.

This article reports an infant presented with multiple congenital abnormalities, which is considered a rare case. A 2-month-old girl presented with cleft palate, lobulated tongue, frontal bossing, postaxial polydactyly of hands, and other clinical manifestations involving oral, facial, and digital malformations. Hence, a provisional diagnosis of oral-facial-digital syndrome (OFDS), a rare genetic disorder, was contemplated. A genetic test was undertaken, and a confirmatory diagnosis of OFDS type-V (Thurston syndrome) was made. A brief description of the case and literature review of OFDS, including various aspects like etiology, inheritance, clinical features, and management, are discussed here. How to cite this article: Sreekumar D, Dutta B, Dhull KS, et al. Thurston Syndrome: An Insight of a Rare Case and Literature Review. Int J Clin Pediatr Dent 2024;17(2):206-210.

A rare case of undifferentiated pleomorphic sarcoma affecting the mandible - A case report.

Undifferentiated pleomorphic sarcoma (UPS) is a rare entity found in the oral cavity which involves the mandible in only 3% of all UPS bone lesions. The correlation of the clinical presentation of the neoplasm with the histopathological and immunohistochemistry findings is very important for appropriate diagnosis. Its incidence in membranous bone like mandible is rare. According to our literature search in the PubMed database, there are only four reported cases from India some of which does not have any immunohistochemistry findings to confirm the diagnosis. We present a rare case of UPS of mandible which was clinically mimicking squamous cell carcinoma. Upon immunohistochemical analysis, we found vimentin, KI67, CD68 positive and desmin, Melan A, LCA, S100 and myogenin negative, which lead us to the diagnosis of UPS.

Reliability of Radiovisiography and Cytomorphometry in Determining the Age of an Individual: A Clinical Comparative Study.

The oral cavity can be explored as an area to identify the impacts of aging. Exfoliative cytology is a painless, rapid, and effective method for collecting intact cells from various epithelial layers for microscopic examination. Therefore, the current study's objective was to determine the average cell size using morphometric analysis and radiovisiography (RVG) to estimate an individual's age utilizing buccal smears and the pulp/tooth ratio. A software program was utilized to determine the cell size using exfoliative cytology, and the pulp and tooth area was measured using RVG of mandibular canine with the help of an image analysis software. Appropriate statistical tests were performed using IBM SPSS statistical software for Windows (version 25). The patient's chronological age, pulp area, and the associated pulp-tooth area ratio values were determined, along with Karl Pearson's correlation coefficient. It was discovered by using a paired t-test to compare chronological age to the age deduced from cell size and pulp-tooth area ratio. According to the current study, age estimation could be done based on average cell size, pulp size, and pulp-tooth area ratio for forensic odontology. Studies with bigger sample sizes and diverse population would help achieve definitive conclusions about the reliability of this particular method.

New Horizons and Prospects in Oral Cancer Detection.

Recent advancements in oral cancer detection prioritize non-invasive and minimally invasive techniques for efficient and accurate screening. This review outlines progress in methods such as narrow band imaging, fluorescence imaging, and optical coherence tomography, showing promise in early lesion detection. Biomarker detection in saliva and targeted nanoparticles enhance early diagnosis, while machine learning improves diagnostic accuracy. However, clinical validation and large-scale studies are needed for widespread adoption.

Correction: Carcinoma Ex Ameloblastoma of the Mandible: A Rare Case Report.

[This corrects the article DOI: 10.7759/cureus.49536.].

Unveiling the In Vitro Anti-Biofilm Potential of Lactobacillus rhamnosus Against Saliva-Based Pathogens: A Gender-Age-Area Specific Study.

Probiotics, like lactobacilli and bifidobacteria, benefit health by populating the digestive system, which houses numerous microbial species. Studies demonstrate their ability to inhibit biofilm formation, crucial in preventing oral conditions like dental caries. Our research evaluated a probiotic strain's anti-biofilm efficacy against oral pathogens in 45 individuals' saliva, alongside its biofilm-forming potential. Analysis revealed significant biofilm inhibition in 36 samples. Comparisons based on age, gender, and geography further supported these findings. We propose further exploration of probiotics tailored to specific demographics to enhance oral health outcomes, suggesting a promising avenue for preventing oral microbial diseases.

Comparing the Diagnostic Accuracy of Direct Digital and Conventional Intraoral Peri-apical Radiographs in Identifying Interdental Bone Loss: An Observational Study.

The evaluation of conventional two-dimensional radiography is crucial in making the diagnosis of periodontitis. Radio-visiography (RVG) is one of the digital imaging modalities that have received significant recognition as a replacement for film-based radiography due to its improved image quality, quick turnaround time, and minimal radiation dose. In order to compare the diagnostic efficacy of Direct Digital and Conventional Intraoral Peri-apical Radiographs in identifying Interdental Bone Loss, the present investigation was carried out. A cross-sectional observational study was conducted among 96 patients prospectively. Radiographs were exposed using a Gendex Oralix AC machine. Statistical data was analyzed using IBM SPSS statistical software using appropriate statistical tests. For both age categories, the radiographic method yielded a higher mean score than the periodontal probe method. The mean scores were noted to be higher following surgery. The radiographic approach recorded a greater mean score when gender groups were compared than the periodontal probe, which had a lower mean score. The mean scores after surgery were noted to be lower than the radiography approach and higher than the periodontal probe. The results demonstrate the radiographic technique's significant advantage over clinical tests in determining furcation regions as well as its superior accuracy in spotting periodontal disintegration over clinical probing.

Casting Machines in Dentistry - A Review Part I.

Dental casting machine is an electrical device used to extrude molten materials to fabricate dental prostheses such as crowns, bridges, intracoronal and extracoronal restorations, and removable partial dentures. The casting process basically include melting and casting. Firstly, the solid material is heated in a crucible in temperature-controlled conditions to melt the material to its smelled form. The dental casting process is a complex one with multifaceted steps and equipment. Different types of casting machines are available to produce heat using different sources and techniques. It includes Arc melting, Open flame casting, and Electrical resistance. Arc melting involves the application of an electric or gas discharge on tungsten electrodes, causing the metal base to melt utilizing the heat produced by arcing. Open flame casting or induction melting employs water-cooled alternate current induction coils to induce heat. However, resistance heating uses electric current to melt precious metals.

Efficacy of Chewable Brush Compared to Manual Brush in School Going Children of Age Group 10-12 Years.

Aim: Chewable toothbrushes were compared to traditional manual toothbrushes in terms of their ability to remove plaque and their impact on salivary pH in a sample of school-aged children. Materials and Methods: The sample size for this research was 200 youngsters aged 10-12. Saliva was collected by spitting into a clean container, and the pH levels were measured using color-coded pH strips to determine where the person was starting from. The plaque score was measured using the OHI-S index after the application of the disclosing agent. The pH and plaque scores were also recalculated after brushing to see how they had changed after surgery. Results: Results indicated that both manual and chewable brushes significantly improved post-brushing pH ratings (P = 0.001), and that plaque scores decreased (P = 0.001). When compared to conventional manual toothbrushes, the chewable brush was much more successful in reducing plaque and elevating salivary pH (P = 0.001). Conclusion: As a result, parents may offer their kids a chewable toothbrush to help them maintain good oral hygiene after lunch and on lengthy car trips, when they would not have time to wash their teeth properly.

The Study of Expression of Hypoxia-Inducible Factor-1 Alpha (HIF-1 Alpha) and Hypoxia-Inducible Factor-2 Alpha (HIF-2 Alpha) in Oral Squamous Cell Carcinoma: An Immunohistochemical Study.

CONTEXT: Oral cancer is the major cause of mortality and morbidity worldwide. There are many factors that influence the tumor microenvironment that promotes tumorigenesis. Hypoxia is one of the factors that affects the process of angiogenesis by inducing proangiogenic factors to maintain the blood supply which in turn enhances the aggressiveness of the tumor and prognosis of solid tumors such as oral squamous cell carcinoma. AIM AND OBJECTIVE: The aim of the study was to compare the expression of hypoxia-inducible factor 1α (HIF-1α) and hypoxia-inducible factor 2α (HIF-2α) in various histological grades of oral squamous cell carcinoma immunohistochemically. METHODOLOGY: Immunohistochemical evaluation of HIF-1α and HIF-2α was done in 90 samples of oral squamous cell carcinoma which were graded histologically into 30 samples each of well, moderately and poorly differentiated squamous cell carcinoma. Statistical evaluation: Statistical analysis was done to study the prognostic significance of the biomarkers. RESULTS: All the cases showed positivity for expression of HIF-1α and HIF-2α. The number of positive staining in both markers reduced as the tumor severity increased from well to poorly differentiated. The expression of MIL of HIF-2α was higher than HIF 1α and HIF 2α expression was mostly seen in cytoplasmic in well-differentiated and nuclear in both moderately and poorly differentiated OSCC suggestive that HIF-2α is a more specific marker to hypoxia. CONCLUSION: Hypoxia is an essential factor that triggers other angiogenic switch and inflammatory factors which facilitates the process of tumorigenesis. This is also important for predicting the treatment outcome and prognosis of the patients. HIF-2α is a more sensitive marker that appears to be correlated and could perhaps serve as a good surrogate marker of hypoxia.

Carcinoma Ex Ameloblastoma of the Mandible: A Rare Case Report.

Ameloblastoma is a benign yet locally aggressive tumor of the jaw bones and is most commonly found in the lower mandibular region. Histologically, it shows benign characteristics. However, ameloblastoma can turn malignant to show a more aggressive clinical course. Carcinoma ex ameloblastoma is an extremely rare malignancy arising from a pre-existing long-standing ameloblastoma or a recurrence of an ameloblastoma. According to the literature search, six to seven cases have so far been documented, and the majority of the lesions had a propensity to metastasize. Here, we present a case of carcinoma ex ameloblastoma implicating a 19-year-old male patient manifesting in the mandible, which arises from pre-existing ameloblastoma.

An Exquisite Case Report of Follicular Variant of Acinic Cell Carcinoma of the Parotid Gland With Review of Literature.

Acinic cell carcinoma (ACC), previously called acinic cell tumor, is an uncommon malignant neoplasm that tends to recur locally without proper treatment measures. This low-grade neoplasm has four histological subtypes. We hereby report a case of a follicular variant of ACC, which is a rare subtype. A 20-year literature search encompassing this variant of ACC of the parotid region was also performed, which showed four reported cases. A 60-year-old woman reported to our college, Kalinga Institute of Dental Sciences, with the chief complaint of pain and swelling in her upper right back tooth region for the past three months. Upon incisional biopsy, histopathological examination revealed a follicular variant of ACC. Further, immunohistochemistry was also performed using markers such as DOG-1, CK7, S-100, and thyroglobulin, which showed CK7 marker positivity. Subtotal parotidectomy was performed and the tissue was sent for histopathological analysis. Although ACCs are slow-growing and indolent in character, they can frequently recur locally decades later and spread to distant organs. Long-term follow-up is necessary following therapy as ACC has a noticeably high propensity to relapse and create latent metastases.

Delayed Eruption of Tooth Due to Peripheral Giant-Cell Granuloma: An Unusual Presentation and Treatment in 15-Year-Old Child Patient.

Peripheral giant-cell granulomas (PGCGs) are reddish color lesions of the gingiva which are frequently diagnosed on a routine basis by many dentists in the regular dental practice. Most of the lesions of PGCG are slow-growing, nonaggressive with asymptomatic, and tend to recur. Here, we exhibit a case of PGCG of the upper jaw in a 15-year-old girl child. She presented with a chief complaint of a lump on her upper anterior tooth region for 2-3 months. A well-defined painless, sessile exophytic growth, measuring about 1 cm × 0.5 cm in dimension with pinkish red in color with a firm consistency, was noted. Moreover, no secondary changes were seen. On the radiograph also, no changes in the bone/tooth were observed. The provisional diagnosis was identified as benign lesions such as pyogenic granuloma, peripheral ossifying fibroma, and PGCG and was made based on the clinical history and radiographic findings, and the confirmative diagnosis was given after histopathological examination. To improve the esthetic and function of teeth as well as psychological problems in the young patient, we tend to manage the case more simply by conservative surgical procedure at the earliest to prevent a recurrence.

Impression Cytology's Reliability as an Effective Method for Ophthalmic Neoplasm Detection.

Background: The current investigation was intended to evaluate the precision of impression cytology and tissue histology in the detection of ocular surface neoplasia. Materials and Methods: We examined the histories of patients detected with ocular surface neoplasia at the Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar. All the patients had their impressions cytology and tissue samples taken. The outcomes of both strategies were compared. Results: There were a total of 55 patients (33 males and 22 females) aged 12-99 years (average age, 51 years). Twenty patients had injuries to the right eye and 35 had injuries to the left eye. Conjunctival-corneal intraepithelial neoplasia (38.2%), squamous cell carcinoma (34.5%), squamous epithelium (10.9%), squamous papilloma (7.3%), conjunctival nevi (7.3%), Along with the most common histological research, malignant melanoma (1.8%). Compared with the histological results, impression cytology showed positive and negative assessment accuracies of 97.4% and 52.9%, respectively. In squamous neoplasms, squamous cell carcinoma exhibited a strong link with histology. The occurrence of dysplastic cells raised suspicion of malignancy. Conclusion: Because of its increased accuracy in detecting lesions, along with tissue histology, impression cytology exhibits enormous potential in identifying ocular surface neoplasia. However, impression cytology has an undesirable prognostic accuracy, indicating that it is a useful screening tool but cannot be considered as a "gold standard."

A Cheiloscopy Study among Students of Different Regional States in Eastern India: An Institutional Study.

Introduction: India is one of the largest countries which is inhabited by diverse populations of different tribes, castes, religious, and migrant groups. In forensic investigation, personal identification plays the greatest importance. Lip prints are considered as one such tool for personal identification. Study of lip prints is referred to as cheiloscopy and they are considered as unique in every individual just like fingerprints. Materials and Methods: Three hundred randomly selected specimens were taken in our study comprising of both the genders and of various regions from Odisha, West Bengal (WB) and Bihar was considered in the study. The age selected in our study ranged from 18 to 25 years comprising of 151 males and 149 females. Lip impression was made and viewed for different lip prints pattern under a magnifying glass of 10X. Results: There was a total of six lip print type identified in the present study. The type of lip print pattern found more in males was Type 2 and in females was Type 1. The type of lip print pattern found more in Bihar and WB was Type 2 and Odisha was Type 1. Conclusion: As the lip print is unique for every individual, Cheiloscopy is considered as a useful method of identification in forensic odontology. The study showed statistically significant difference in gender with a variation in geographical location.