Systematic Analysis of Palatal Rugae Pattern for Use in Human Identification between Two Different Populations.

BACKGROUND: Forensic odontology plays important role in identification of human remains in mass disasters such as air crash, tsunami, and accidents. Palatal rugae act as an ideal requisite for human identification as they are present in all victims and are resistant to changes such as aging and trauma. The study aimed to analyze differences in shape and number of palatal rugae in population from Andhra Pradesh and Telangana states. METHODS: This study was conducted in SIBAR institute of Dental Sciences, Guntur, India in 2012 on 200 subjects, gender matched and equally divided as 100 from Andhra Pradesh and 100 from Telangana states. Rugae were studied using Kapali.S classification. Association between rugae shape and gender variation between the two populations were tested by chi-square analysis and student t-test. RESULTS: Average number of rugae was more (11.84±3.03) in subjects of Andhra Pradesh, compared to Telangana (9.50 ±1.65) population. Males of Andhra Pradesh showed significantly higher mean number of total rugae than in Telangana males. Distribution of total number of different rugae shapes in males and females of both the populations showed significant variation in wavy and circular rugae patterns. Wavy, curved and straight rugae were significantly higher in males and females of Andhra Pradesh compared to Telangana population. Telangana population showed significant increase in circular rugae. CONCLUSION: Our study revealed statistically significant variation in shape and total number of rugae between observed populations of Andhra Pradesh and Telangana states.

Minor Salivary Gland Changes in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma - A Histopathological Study.

INTRODUCTION: The most common etiology for Oral Squamous Cell Carcinoma (OSCC) is tobacco and tobacco related products which cause nuclear damage to the keratinocytes. The chemical carcinogens not only affect the lining of oral epithelium but also affect the lining epithelium of the excretory ducts of the salivary glands. Thus, there is a possibility of epithelial dysplasia of the salivary duct epithelium which may lead to potential malignant transformation. AIM: The study was performed to see the changes in the minor salivary glands and excretory ducts in cases of oral epithelial dysplasia and OSCC. MATERIALS AND METHODS: A total of 278 archival cases of mild, moderate and severe epithelial dysplasia, carcinoma in situ, OSCC including verrucous carcinoma were histopathologically evaluated to observe changes in the excretory ducts and the minor salivary glands. RESULTS: In the study there were 56.5% males and 43.5% females. The age group that was most commonly affected in both the sexes was 50-60 yr old. Buccal mucosa was the most common site of involvement. Ductal changes observed in the excretory duct include simple hyperplasia, metaplastic changes such as mucous, oncocytic & squamous, and infiltration of inflammatory cells and malignant cells. Acinar changes observed were degeneration, squamous metaplasia, myoepithelial cell proliferation and inflammatory cell infiltration. Both the excretory ducts and ducts within the gland showed dysplasia. CONCLUSION: According to observations in our study it is suggested that histopathological interpretation for oral mucosal lesions especially oral epithelial dysplasias and OSCC should also include changes related to salivary gland tissue to provide a better treatment plan and prevent recurrence of the malignant tumours.

Gene Expression Profiling and Molecular Signaling of Various Cells in Response to Tricalcium Silicate Cements: A Systematic Review.

INTRODUCTION: The aim of this study was to present a systematic review investigating the gene expression of various cells (other than dental pulp cells) in response to different variants of tricalcium silicate cements (TSCs). METHODS: A systematic search of the literature was performed by 2 independent reviewers followed by article selection and data extraction. Studies analyzing any cell type except dental pulp stem cells and any variant of tricalcium silicate cement either as the experimental or as the control group were included. RESULTS: A total of 41 relevant articles were included in this review. Among the included studies, ProRoot MTA (Dentsply, Tulsa, OK) was the most commonly studied (69.1%) TSC variant, and 11 cell types were identified, with 13 articles investigating gene expression in osteoblasts. A total of 39 different genes/molecules expressed were found in the selected studies. The experimental group (irrespective of the TSC variant) was identified to express significantly increased gene expression compared with the control group (untreated) in all included studies. Recent studies have provided useful insight into the gene expression and molecular signaling of various cells in response to TSCs, and new elements have been supplied on the pathways activated in this process. CONCLUSIONS: TSCs are capable of eliciting a favorable cellular response in periapical regeneration.

Myoepithelial Cells (MEC) of the Salivary Glands in Health and Tumours.

Myoepithelial cells (MEC) are found in the secretory units of many mammalian exocrine glands such as mammary, sweat, lacrimal and salivary glands. They are interposed between the secretory cells and the basal lamina. Immunohistochemically they are found to contain keratin intermediate filaments and are, therefore, considered to have an epithelial origin but at the same time they contain a large number of myofilaments which represent a massive expression of contractile proteins such as actin, myosin, calponin and caldesmon. Thus have smooth muscle like property also and hence the name. Numerous functions of MEC have been described, the most important of them being important for contraction of the glands and recently it has been found to prevent tumour progression. It should be noted that the diversity in the occurrence and dilemma regarding the pathogenesis of salivary gland tumours is due to lack in uniformity regarding the cells participating in its oncogenesis, especially the MEC. Also proper and extensive studies regarding MEC are very limited and thus have posed difficulty for a pathologist to understand this cell. In this review we try to bring about a thorough description of this cell in both physiological and pathological aspects.

Gene Expression Profiling and Molecular Signaling of Dental Pulp Cells in Response to Tricalcium Silicate Cements: A Systematic Review.

INTRODUCTION: Signaling molecules and responding dental pulp stem cells are the 2 main control keys of dentin regeneration/dentinogenesis. The aim of this study was to present a systematic review investigating the gene expression of various dental pulp cells in response to different variants of tricalcium silicate cements. METHODS: A systematic search of the literature was performed by 2 independent reviewers followed by article selection and data extraction. Studies analyzing all sorts of dental pulp cells (DPCs) and any variant of tricalcium silicate cement either as the experimental or as the control group were included. RESULTS: A total of 39 articles were included in the review. Among the included studies, ProRoot MTA (Dentsply, Tulsa Dental, OK) was the most commonly used tricalcium silicate cement variant. The extracellular signal regulated kinase/mitogen-activated protein kinase pathway was the most commonly activated pathway to be identified, and similarly, dentin sialophosphoprotein osteocalcin dentin matrix acidic phosphoprotein 1, alkaline phosphatase, bone sialoprotein, osteopontin, type I collagen, and Runx2 were the most commonly expressed genes in that order of frequency. CONCLUSIONS: Biodentine (Septodont Ltd, Saint Maur des Faussés, France), Bioaggregate (Innovative Bioceramix, Vancouver, BC, Canada), and mineral trioxide aggregate stimulate the osteogenic/odontogenic capacity of DPCs by proliferation, angiogenesis, and biomineralization through the activation of the extracellular signal regulated kinase ½, nuclear factor E2 related factor 2, p38, c-Jun N-terminal kinase mitogen-activated protein kinase, p42/p44 mitogen-activated protein kinase, nuclear factor kappa B, and fibroblast growth factor receptor pathways. When DPCs are placed into direct contact with tricalcium silicate cements, they show higher levels of gene activation, which in turn could translate into more effective pulpal repair and faster and more predictable formation of reparative dentin.

The role of myofibroblasts in wound healing, contraction and its clinical implications in cleft palate repair.

Myofibroblasts after its discovery in 1971 as the principal cell for wound healing has come a long way as far as research is concerned. The primary focus of research has been regarding preventing certain unwanted effects of this cell such as wound contraction and scarring. As far as the oral and maxillofacial region is concerned, the primary concern of this untoward effect is during repair of cleft palate surgically which results impaired development of palate and the dentoalveolar structures. This review focuses on the basic aspects of myofibroblasts such as its origin, formation, function in wound healing, role in wound contraction and ways by which its unwanted effects can be overcome to improve the quality of the post surgical complications of cleft palate surgery.

Evaluation of salivary glucose, amylase, and total protein in Type 2 diabetes mellitus patients.

BACKGROUND: Diabetes mellitus is a complex multisystem metabolic disorder characterized by a deficit in the production of insulin. The oral complications of uncontrolled diabetes mellitus are devastating. Saliva is an organic fluid that can be collected noninvasively and by individuals with limited training. These reasons create an interest in evaluating the possibility of using saliva as a diagnostic tool. AIMS AND OBJECTIVES: The aim of this study was to determine, if saliva can be used as a noninvasive tool to monitor glycemic control in Type 2 diabetes. Comparative assessment of salivary (glucose, amylase, total protein levels) in patients with Type 2 diabetes and controls. MATERIALS AND METHODS: A total of 40 individuals, 20 with Type 2 diabetes and 20 controls of age group 40-60 years were selected for the study. Diabetic status was assessed by estimating random blood glucose levels. Unstimulated saliva was collected from each participant and investigated for glucose, amylase, and total protein levels. Salivary glucose estimation was performed using glucose-oxidase method, amylase by the direct substrate kinetic enzymatic method, and total protein by pyrogallol red dye end point method. All the parameters were subjected to statistical analysis using SPSS version 20.0. RESULTS: Significantly higher salivary glucose, lower amylase, and total proteins were observed in patients with Type 2 diabetes than controls. There was no significant correlation between salivary and blood glucose levels. CONCLUSION: These results suggest that diabetes influences the composition of saliva. Since a significant correlation was not observed between salivary and blood glucose levels, further research is needed to determine salivary glucose estimation as a diagnostic tool for diabetes mellitus.

A clinical study on oral lichen planus with special emphasis on hyperpigmentation.

BACKGROUND: Oral lichen planus (OLP) is a unique disorder affecting generally the older age group. Numerous studies have been done on various aspects of OLP such as pathogenesis, rate of malignant transformation, etc. However, very few studies are available with respect to clinical features especially association of hyperpigmentation and OLP. This study aims at studying the clinical aspects of OLP and study the association between hyperpigmentation and OLP in a south Indian population. MATERIALS AND METHODS: A total of 58 patients with OLP who attended the outpatient department of our institution were included in the study and a complete history, followed by thorough intraoral examination was done. All the data were recorded and assessed for statistical analysis using SPSS software. RESULTS: We found that the male to female ratio affected with OLP was 1:1 and the most common form of OLP that was seen was the reticular subtype. Also, buccal mucosa was the most common affected site and more than 60% patients had hyperpigmentation associated with the site affected by OLP. We found a statistically significant relation between the reticular type of OLP and the older age group (51-70 years) with hyperpigmentation. CONCLUSION: Although further studies are required to say anything conclusively, post-inflammatory changes occurring the mucosa due to OLP could be a cause for hyperpigmentation in the sites affected.

Impact of highly active antiretroviral therapy on oral manifestations of patients with human immunodeficiency virus/acquired immuno deficiency syndrome in South India.

BACKGROUND: Human immunodeficiency virus (HIV) infection remains a global health problem, although the development of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV disease into a manageable disease with improved quality-of-life mainly in the developed countries. Very few studies are available regarding effect of HAART on oral lesions in developing countries like India. AIMS AND OBJECTIVES: The aim was to document and compare oral lesions in HIV-seropositive patients before and after HAART. MATERIALS AND METHODS: Oral manifestations were recorded in 320 HIV seropositive patients attending to the Voluntary Counseling and Confidential Testing Centre at the Government General Hospital, Guntur, before and after treating with HAART and the results were statistically analyzed using Student's t-test and Chi-square test. RESULTS: Oral Candidiasis was significantly reduced in patients under HAART after 3 months. Furthermore, there was decreased incidence of periodontal diseases, but increased hyperpigmentation in patients undergoing HAART. CONCLUSION: The oral manifestations of HIV infection have changed due to the advent of HAART. Many opportunistic infections have resolved as a result of an improved immune system. Though the risk of hyperpigmentation in those with HAART has increased the prevalence of oral candidiasis and periodontal diseases were less in patients who had access to HAART.

Evaluation of ploidy status using DNA-image cytometry of exfoliated mucosal cells in oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is one of the potentially malignant disorders (PMDs) with a malignancy rate of 0.2-2%. Aneuploidy is considered to be one of the important markers for malignant transformation and DNA-image cytometry (DIC) has been successfully employed in oral mucosal PMDs and also in tumors of the cervix, lung and biliary tract. AIMS: In this study, we intend to assess the ploidy status of exfoliated cells in OLP using DIC. MATERIALS AND METHODS: Exfoliated cells from 48 patients with different subtypes of OLP (reticular, plaque type, erosive and atrophic) and 10 controls were stained using Feulgen reaction and assessed for integrated optical density using image analysis software and the ploidy status was assessed. RESULTS: All the patients in the control group and most of the patients (93.5%) who had reticular or plaque type of OLP (29 out of 31) exhibited diploid nuclei in the smears, whereas 11 patients who had erosive or atrophic types of OLP showed aneuploid nuclei. CONCLUSIONS: The patients with erosive or atrophic types of OLP are at more risk and assessment of ploidy status by exfoliative cytology can be used as an adjuvant for diagnosis.

Age estimation by assessment of dentin translucency in single rooted permanent teeth.

BACKGROUND: To estimate the age by evaluating the area and length of dentin translucency in single-rooted ground sections of extracted teeth using digital Vernier caliper and stereomicroscope. MATERIALS AND METHODS: Ground sections of single rooted permanent anterior teeth were made and stained with 1% methylene blue. The area and length of dentin translucency were measured using digital Vernier caliper and with the help of stereomicroscope. RESULTS: Linear regressive analysis showed that estimation of age by assessing the area of dentin translucency with Vernier caliper was statistically significant and showed a high regression co-efficient (R = 0.7738) when compared to evaluation of age by assessment of length. Multilinear regressive analysis done to calculate age by both area and length also showed a high co-efficient of regression (R = 0.7797). CONCLUSION: The area of dentin translucency showed good correlation with age when compared to the length.