Evaluating Static Bone Cysts (SBCs) Through Long-Term Volumetric Analysis Using CBCT: A Study with 6-Month Follow-Up.

Background: Salivary gland bone defects are static lesions which are rare entities, generally asymptomatic and found in routine imaging exams. However, in atypical cases or when misdiagnosed, surgical intervention is carried out. Purpose: a) The study is intended to investigate the frequency of SBC's and to describe the radiological characteristics of its subtypes; b) To evaluate the efficacy of volumetric analysis tool in CBCT and; c) To describe the confirmative role of CBCT in the diagnosis of SBC's without the need for surgical intervention. Material and Methods: The study was conducted on 11 subjects with SBC detected on 3304 panoramic radiographs. CBCT images for each patient were captured at baseline and at an interval of 6 months. Radiographic sub-types of SBC based on the relationship to mandibular canal and bucco-lingual expansion were studied. Files in DICOM format were transferred into OnDemand 3D program (Cybermed Co, Seoul, Korea) and volumes in mm3 of the cavities were measured by 2 observers at both intervals. Inter and intra reliability of volumetric measurements between observers was compared using correlation coefficient and student t test. Results: There were 8 males and 3 females who had SBC in this study (age range: 22-70 years). According to the relationship of SBC with mandibular canal, most SBCs were Type 1 (63.5 %) followed by Type 2 & 3 (18.5 %) each. The total volume of SBC in patients ranged from 146 mm3 to 650 mm3 (mean: 332.5 mm3). There was no significant difference between observers for volume measurements at baseline and at 6 months interval (p>0.05). Conclusions: Based on the results of this study, CBCT should be considered as a definitive diagnostic modality for volumetric analysis of SBCs. Over diagnosis, unnecessary surgical exploration and agony to patients can be avoided using this tool. Key words:Stafne bone cavity, CBCT, Volumetric analysis, salivary gland, panoramic radiography.

Exploring the oral microbiome: an updated multidisciplinary oral healthcare perspective.

The oral cavity is home to diverse microbial content, collectively called as the oral microbiome. The latest technological advancements have unraveled the intricacies of the oral microbiome.  It can be of great importance for oral health care givers to know the fundamentals and latest developments in the field of the oral microbiome, as oral dysbiosis is associated with many common diseases frequently seen and managed by them. These diseases include dental caries, periodontitis, mucosal diseases (such as oral leukoplakia, oral lichen planus, and systemic lupus erythematosus), oral cancers, and even co-infections related to the current COVID-19 pandemic. The emergence of new genomic and molecular biology methodologies has been pivotal for understanding the role of the human microbiome in health and disease. The current review compiles oral microbiome in health and disease with a multidisciplinary dental approach. The insight into the oral microbiome, which is provided dental specialty wise in the current article will initiate and guide researchers of various disciplines in developing microbiome-based therapeutic or prophylactic management strategies, managing public health challenges by microbiome-based boarder interventions and divert resources for preserving and achieving a balanced oral microbiome.

Mapping of journal of oral and maxillofacial pathology from 2011 to 2022: A VOSviewer-based bibliometric visualisation.

Background: Journal of Oral and Maxillofacial Pathology (JOMFP) is a periodical publication and is one of the most prestigious dental specialty journals in India. Aim: To perform bibliometric analysis and network visualisation of articles published in the JOMFP. Methodology: Scopus online bibliometric search of articles published in JOMFP from 2011 (Issue 2, May-August) to 2022 (Issue 2, April-June) was performed. A total of 1385 articles out of 1453 were included for analysis. VOSviewer software was used for science mapping and network analysis of extracted data from JOMFP. Basic steps of bibliometric analysis including performance analysis, science mapping, and network analysis were performed to draw conclusions and recommendations. Results: The annual frequency of articles was maximum in the year 2019 with 150 articles. The most frequently appearing keywords were "oral squamous cell carcinoma" and "immunohistochemistry". The mean count of the top 10 cited articles and authors was 144.6 and 293.2, respectively. Conclusion: More efforts are warranted not only for increasing the volume of quality papers in JOMFP but also to enhance the collaborations between the various authors and research groups. Large volumes of laboratory and clinical-based research have been published in JOMFP from every part of India; thus, this journal truly represents the global face of Indian oral and maxillofacial pathologists.

Comparison of Demirjian's comprehensive chart with the London atlas of tooth development in children and adolescents: a pilot study.

Dental age estimation has its application in various subdisciplines of medicine and dentistry. New methods of dental age (DA) estimation are emerging and it is important that we compare different methods to determine which one is more closely related to the chronological age. Demirjian's method is one of the most widely used techniques and has been tested in various ethnic populations globally. In 2016, another approach to DA estimation is the London atlas of human tooth development and eruption. No study has compared Demirjian's comprehensive chart and London atlas method in the Indian population. Hence, in the current study, we estimated DA using Demirjian's comprehensive chart and London atlas method for association with the known chronologic age in children and adolescent population. The study also attempted to determine if sexual dimorphism existed in DA estimated by the two methods. Estimation was performed for both methods on 100 orthopantomogram records (50 males and 50 females, aged 6-16 years) of orthodontic patients. The data were compared and analysed using paired t-tests. There was an overestimation of DA by Demirjian's comprehensive chart on an average of +1.3 years in males and +0.5 years in females, whereas using London atlas, it was +1.4 years in males and +0.5 years in females. The mean of underestimation was -0.6 years in males and -0.8 years in females using Demirjian's comprehensive chart, whereas it was -0.8 years in males and -0.5 years in females. A statistically significant difference (P < 0.0001) was found when mean chronological age (11.6 ± 2.6) years of the participants was compared with DA estimated using either Demirjian's comprehensive chart (12.3 ± 2.8) years or London atlas (11.8 ± 2.9) years. The trends in this pilot study point towards more accuracy of London atlas over Demirjian's method when done using comprehensive chart for estimating DA. In summary, the results of the current pilot study indicates greater accuracy of London atlas method over Demirjian's comprehensive chart method for estimating DA in Indian population. This finding should be validated by conducting similar studies using larger sample, on diverse Indian ethnic populations, for applicability in pedodontic, orthodontic, and forensic domains. Key points: No study has compared Demirjian's comprehensive chart and London atlas method in the Indian population.The dental age estimated by London method was closer to chronological age as compared to Demirjian's method in our study sample.Significant difference was found in chronological age and estimated age using London atlas method in both males and females.

Biomarkers in External Apical Root Resorption: An Evidence-based Scoping Review in Biofluids.

BACKGROUND: External apical root resorption (EARR), an unwanted sequela of orthodontic treatment, is difficult to diagnose radiographically. Hence, the current scoping review was planned to generate critical evidence related to biomarkers in oral fluids, i.e. gingival crevicular fluid (GCF), saliva, and blood, of patients showing root resorption, compared to no-resorption or physiologic resorption. METHODS: A literature search was conducted in major databases along with a manual search of relevant articles in the library, and further search from references of the related articles in March 2021. The initial search was subjected to strict inclusion and exclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS: Following PRISMA guidelines, 20 studies were included in the final review. The studies included human clinical trials and cross-sectional and prospective studies with/without control groups with no date/language restriction. Various biomarkers identified in EARR included dentinal proteins, enzymes, cytokines, and salivary proteins. Severe resorption had higher dentin sialoprotein (DSP) and resorption protein concentrations as well as lower granulocyte-macrophage colony-stimulating factor (GM-CSF) as compared with mild resorption. Increased DSP and dentin phosphophoryn (DPP) expression was found in physiologic resorption. Compared to controls, resorbed teeth showed a higher receptor activator of nuclear factor kappa B ligand/osteoprotegerin (RANKL/OPG) ratio. In contrast, levels of anti-resorptive mediators (IL-1RA, IL-4) was significantly decreased. Differences in force levels (150 g and 100 g) showed no difference in resorption, but a significant rise in biomarkers (aspartate transaminase [AST] and alkaline phosphatase [ALP]) for 150 g force. Moderate to severe resorption in young patients showed a rise in specific salivary proteins, requiring further validation. Limitations of the studies were heterogeneity in study design, biomarker collection, sample selection, and confounding inflammatory conditions. CONCLUSIONS: Various biomarkers in biofluids indicate active resorption, while resorption severity was associated with DSP and GM-CSF in GCF, and a few salivary proteins. However, a robust study design in the future is mandated.

Role of nano curcumin on superoxide dismutase levels in leukoplakia.

Introduction: Oral leukoplakia has an estimated prevalence of 2% of the oral cavity, one of the risk factors for oral cancers. The most commonly linked etiology being tobacco smoking causing reactive oxygen species (ROS) induced DNA damage. Curcumin, a polyphenol derivative from herbal remedy, possesses diverse properties ranging from centuries old documented anti-inflammatory properties to recently documented anticancer properties. Aims: Role of nano curcumin on superoxide dismutase (SOD) levels in leukoplakia patients' pre- and post-treatment. Materials and Methods: The study group comprised thirty test subjects. Single capsule of 250 mg (Brecan Plus) was given to the test group for 30 days with weekly follow-up. Blood samples were taken from the test group and were evaluated for SOD levels before and after the completion of the trial. Results: In the study, there was a decrease in size of the lesion, number of lesions, down staging of the disease, and increase in serum SOD levels after the therapy. Binary logistic retrogression analysis was done to assess the predictive ability of serum SOD-dependent variable, and a positive association was noted between increase in serum SOD level and down staging of the disease. Conclusion: Nano curcumin is an excellent medical nutrition intervention derived from traditional natural products. The study has demonstrated the clinical efficacy of these new classes of therapeutic nutraceuticals such as nanocurcumin in treating oral leukoplakia, which are suitable for long-term use.

Ewing's sarcoma of the mandible with multilocular radiolucency.

Ewing's sarcoma (ES) is a small blue round cell tumor, malignant in nature typically affecting long bones and pelvis. Occurrence of ES in the head and neck region is rare and is reported to be 2%-3%, of which the chances of having primary lesion are rare. In the head and neck region, it has been reported to strike skull, supraclavicular region, parotid region, orbital floor, nasal cavity, maxilla, mandible and zygoma. We present a case of primary ES of the mandible in a 22-year-old female who reported with a palpable swelling on the lower left part of the face; and intraorally, there was a growth in the molar region. Orthopantomogram showed multilocular radiolucency in the molar-ramus region. The diagnosis was made after surgical resection, histopathology and immunohistochemistry profiling. The patient was treated by cortical segmental resection of mandible combined with chemotherapy and a follow-up was done for 2 years.

MicroRNAs in oral fluids (saliva and gingival crevicular fluid) as biomarkers in orthodontics: systematic review and integrated bioinformatic analysis.

BACKGROUND: MicroRNAs (miRNAs) are non-coding short, single-stranded RNA molecules that may serve as biomarkers for various inflammatory and molecular mechanisms underlying bone and tissue remodeling consequent to orthodontic force application. METHODS: A thorough literature search in major databases was conducted in March 2021 to generate evidence for miRNAs in orthodontics, with prior PROSPERO registration. The initial search revealed 920 articles, subjected to strict selection criteria according to PRISMA, and resulted in final inclusion of four studies. Quality assessment by QUADAS-2 classified three studies as unclear risk-of-bias while the applicability was high. Further, bioinformatic analysis was performed to identify the target genes from the miRNA database (miRDB) and TargetScan databases and their protein-protein interaction pathways with the STRING analysis. RESULTS: Multiple miRNAs in gingival crevicular fluid (GCF) of orthodontic patients were seen, including miRNA-21, 27(a/b), 29(a/b/c), 34,146(a/b), 101, and 214 along with matrix metalloproteinases (MMPs)-1, 2, 3, 8, 9, 14 in one study. A statistically significant increase in expression of miRNA-29a/b/c,101, 21 from pre-treatment (before initiation of retraction) was seen to reach a peak at 4-6 weeks (wk) of retraction. On the contrary, miRNA-34a showed downregulation from the 1 day to 4 wk of retraction and also, negatively correlated with MMPs-2,9,14 levels at the same observation times. The distance of canine movement showed mild correlation with miRNA-27a/b, 214 at 2 wk of retraction. Bioinformatics revealed 1213 mutual target genes which were analyzed for inter-relational pathways using Cytoscape plugin, MCODE. Further, 894 prominent protein interactions were identified from the STRING database and SMAD4, IGF1, ADAMTS6, COL4A1, COL1A1, COL3A1, FGFR1, COL19A1, FBN1, COL5A1, MGAT4A, LTBP1, MSR1, COL11A1, and COL5A3 were recognized as the hub genes. Their interactions were able to isolate multiple miRNAs: hsa-miR-34a-5p, hsa-miR-29b-2-5p, hsa-miR-29b-3p, hsa-miR-34a-3p, hsa-miR-27a-5p, hsa-miR-29a-5p, hsa-miR-29b-1-5p, hsa-miR-29c-3p, hsa-miR-214-5p, hsa-miR-27a-3p, hsa-miR-29a-3p, hsamiR-146-5p, which were found promising as biomarkers for tooth movement. CONCLUSIONS: Our results support using miRNAs as biomarkers in varied orthodontic study designs and for inter-relationships with pathological settings like periodontal disease, pre-malignancies, or conditions like obesity or metabolic irregularities, etc. The identified target genes and their protein interaction pathways can be used to propose precision therapies, focusing on ideal tooth movement with minimal iatrogenic side-effects.

Histopathologic and immunohistochemical findings of odontogenic jaw cysts treated by decompression technique.

CONTEXT: Odontogenic cysts are among the most common lesions to affect the oral and maxillofacial region. Cysts are capable of causing significant bony disfigurement, tooth displacement and pathological fractures. Several surgical approaches exist for the management of larger cysts of the jaws. These include enucleation, marsupialization and decompression. AIMS: 1. Analysis of histopathologic findings in odontogenic cysts before and after decompression2. Analysis of Ki-67 expression in odontogenic jaw cysts before and after decompression. SETTINGS AND DESIGN: Decompression technique was used for the treatment of 10 cases of odontogenic cysts in the study. Incisional biopsies of cystic lining (pretreatment) and corresponding excisional biopsies (posttreatment) were received for histopathologic and immunohistochemical examination. SUBJECTS AND METHODS: Hematoxylin and eosin stain was used for histopathologic findings, and Ki-67 was used for immunohistochemical findings using antibody Ki-67 in fresh tissue samples. RESULTS: Overall, radicular cysts, dentigerous cysts, and sialo-odontogenic cyst contained fewer Ki-67 + cells than odontogenic keratocysts. The average scores were found to be 2.2 and 1 for before and after decompression, respectively. A statistically significant difference was observed between the two groups. The two-tailed P value was found to be <0.0001. The confidence interval was found to be 95%. CONCLUSIONS: The proliferative activity evaluated by Ki-67 marker was greater in predecompression epithelial lining compared to postdecompression. Our study infers that proliferative rate of the cystic epithelial lining is significantly diminished after decompression.

Structure, function and role of CD44 in neoplasia.

CD44 is a group of protein molecules which perform a variety of functions. Their wide range of functions are mainly based on their multiple variations in their molecular structure. Furthermore, they are distributed in various tissues of the human body. They have a unique property of cell adhesion, which can lead to interaction between two different cells or a cell and its pericellular matrix. CD44 as a cell surface adhesive molecule helps in aggregation and migration of tumor cells. CD44 plays an important role in cancer of bladder, liver, lungs, pancreas, etc. Expression profile of CD44 has been seen in the epithelia of the lip, tongue, gingiva, hard palate, floor of the mouth, buccal mucosa and pharynx. The relationship between the expression of CD44 v6 and regional lymph node metastasis has been studied immunohistochemically. The expression of CD44 v6 was apparently downregulated in oral squamous cell carcinoma, but not in normal oral mucosa. Carcinomas expressing lower levels of CD44 v6 exhibited more frequent regional lymph node metastasis. No significant relation was found between the expression of CD44 v6 in primary and metastatic lesions. Still, the precise function of CD44 in the metastatic process and the degree of involvement in human malignancies is yet to be established.

Cytogenetic Analysis of Micronuclei in Tobacco Chewers: A Study in North Indian Population.

AIM: Oral cancer ranks in top three of all cancers in India and accounts for over 30% of all cancers reported in the country. The present study aims at an in vivo cytogenetic analysis to assess the applicability of the micronucleus test in diagnosing early detection of dysplastic changes. MATERIALS AND METHODS: Exfoliated scrape smears were collected from 75 patients suffering from premalignant lesions. The wet-fixed smears were stained by adopting Papanicolaou's staining protocol. The analysis of variance (ANOVA) test was used to analyze the data statistically. RESULTS: The results of the above study give a fair assessment of the amount of nuclear alterations seen in individuals exposed to genotoxic agents, such as tobacco, and also to a certain extent, an insight into the expected biological behavior of the lesions present in such individuals. Detection of micronuclei and their assay is an upcoming research domain in the field of cancer detection and therapeutics. These miniature nuclear offshoots if properly identified can turn out to be important biomarkers with huge potential for screening and predicting patients with oral precancers and also can act as risk assessors in patient's ongoing treatment for invasive cancers. CONCLUSION: The frequency of micronucleated cells has been observed to be in increasing order with the increase in the age-groups and from control to precancerous cases significantly in both sexes.

A rare case report of craniofacial fibrous dysplasia.

Fibrous dysplasia (FD) is a fibro-osseous lesion of the osseous structures of the body. The exact cause is unknown; however, recently, the cause has been reported to be postzygomatic somatic mutation in guanine nucleotide-binding protein, alpha stimulating 1 gene located at chromosome 20q13.2. The three subtypes of FD are monostotic, polyostotic and craniofacial. The term craniofacial FD (CFD) is used to describe FD where the lesions are confined to contiguous bones of the craniofacial skeleton. This report describes the case of CFD of a 20-year-old male patient who had unusual presentation involving right maxilla and frontal bone of the left side of the face. The clinical features, radiological findings and treatment have been discussed.

Drug carrier systems for solubility enhancement of BCS class II drugs: a critical review.

Poor aqueous solubility impedes a drug's bioavailability and challenges its pharmaceutical development. Pharmaceutical development of drugs with poor water solubility requires the establishment of a suitable formulation layout among various techniques. Various approaches have been investigated extensively to improve the aqueous solubility and poor dissolution rate of BCS class II and IV drugs. In this literature review, novel formulation options, particularly for class II drugs designed for applications such as micronization, self-emulsification, cyclodextrin complexation, co-crystallisation, super critical fluid technology, solubilisation by change in pH, salt formation, co-solvents, melt granulation, and solid dispersion, liposomal/niosomal formulations, are discussed in detail to introduce biopharmaceutical challenges and recent approaches to facilitate more efficient drug formulation and development.

Plasmacytoma masquerading as an abscess.

Plasma cell neoplasia is a lymphoid neoplastic proliferation of B cells and has been classified as multiple myeloma, solitary plasmacytoma, and extramedullary plasmacytoma. Extramedullary plasmacytoma is defined as neoplastic proliferation of plasma cells in the soft tissue. Extramedullary plasmacytoma of the head and neck is very uncommon tumors, representing approximately 0.4% of all head and neck malignancies; amongst them, plasmacytoma of the maxilla is extremely rare. We present a case of a 70-year-old male with swelling on the right middle third of the face, mimicking an abscess, but proven to be extramedullary plasmacytoma. This report discusses the clinical, radiographic, histological, and immunohistochemical features of extramedullary plasmacytoma.

Hand-Schüller-Christian disease.

Langerhan cell histiocytosis, formerly known as histiocytosis X, traditionally denotes a group of diseases that stem from proliferative reticuloendothelial disturbances.The etiology and pathogenesis of the disease remain debatable. In this paper we report a case of Langerhan cell histiocytosis in a 3 1/2 -year-old child who reported to the department of oral pathology with gingival enlargements. The radiological features and histopathological features are also discussed.

Ameloblastic fibrodentinoma.

Odontogenic tumors comprise a complex group of lesions of diverse histopathological types and clinical behavior. The group of mixed odontogenic tumors, which are also rare, is composed of proliferating odontogenic epithelium in a cellular ectomesenchyme resembling dental papilla. Ameloblastic fibrodentinoma is a rare benign odontogenic tumor. The present case report discusses this tumor composed of odontogenic epithelium and odontogenic mesenchyme with dentin or dentin like tissue. The present paper also throws light on various histological similarities and complexities which make the interpretation of these set of odontogenic tumors a diagnostic dilemma.