Quantum dots: The trailblazers of early detection.

Considering the robust awareness of early detection among oral clinicians and patients the increasing imposition of better methods for screening of oral precancerous/cancerous lesions has become imperative. Although histopathology has been considered the indispensable gold standard, it has its pros and cons, as sometimes the diagnosis is compromised with the variabilities subject to the histopathologist under concern. In the realm of oral healthcare, one pioneering trailblazer is making waves, which are 'quantum dots'. Quantum dots are poised to transform the landscape of oral precancer and cancer screening. These nano-sized semiconductor particles possess extraordinary properties that set them apart from conventional detection methods. Their ability to emit distinct wavelengths of light when excited makes them ideal candidates for early detection. The keywords were pitched in and the research literature from the last 15 years (2008-2022) was extirpated to find out the information that existed, the discrepancies and the void left for upcoming research. Its nature and ingenuity have given rise to a transformative approach that holds the potential to redefine the future of oral healthcare. With each breakthrough, we edge closer to a world where the early detection of oral precancerous/cancerous lesions becomes the norm rather than the exception.

Syringoma - a rare tumour: Case report and review of literature.

Syringomas are benign tumours originating from the eccrine ducts. Lower eyelid is the commonest site of origin. Very few cases have been reported in literature till date. Histopathology demonstrates normal compressed eccrine ducts in the fibrous capsule along with tumour cells arranged in tubules and solid islands. This report describes a case of syringoma on the lower eyelid in a female patient.

Oral microbiome research - A Beginner's glossary.

Oral microbiome plays a key role in the etiology of oral diseases and is linked to many diseases in other parts of the body as well. This makes the oral microbiome an area of interest for researchers globally. A meticulous planning of the research project is the first and most crucial step while conducting an oral microbiome study. For beginners in this field, it is essential to be familiar with the terminologies used in oral microbiome research for a better understanding. The purpose of this article is to familiarize new researchers to the frequently used terms for the field of oral microbiome research.

Expression of S100A7 in oral potentially malignant disorders: An immunohistochemical study.

Context: Oral potentially malignant disorders (OPMDs) are a group of heterogeneous lesions with an increased risk of malignancy. S100A7 expression serves as a biomarker to identify the dysplastic lesion. Aims: To study the status of S100A7 antigen in healthy oral mucosa and OPMDs. Settings: Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune. Design: S100A7 antigen in healthy oral mucosa and OPMDs. Methods: Biopsies were collected of clinically diagnosed OPMDs as well as of healthy oral mucosa and analysed for the malignancy potential. Material: Polyclonal rabbit S100A7 25 µl, BioGenex detection system, hydrogen peroxide, non-streptavidin biotin-HRP, wash buffer, DAB chromogen, TRIS buffer, Harris haematoxylin and eosin. Statistical Analysis Used: Data analysis was performed using Statistical Package for Social Sciences Version 27.0. Qualitative data variables expressed were analysed using frequency and percentage. Quantitative data variables were expressed using mean and standard deviation. The Chi-square test was used to compare the grade of intensity, where P value <0.05 was considered significant. Results: Healthy oral mucosa did not reveal any immunopositivity. Oral leukoplakia showed some focal expression till middle middle third of epithelium. Oral erythroplakia was found with maximum expression while submucous fibrosis showed increased intense staining in six cases. Conclusions: S100A7 antigen showed significant immune expression in OPMDs and may be used as a marker for early diagnosis and precision therapy.

Expression of tyrosinase gene in gingiva: A pilot study.

Background: Melanin is the predominant pigment responsible for the color of skin, hair, iris of eyes, and oral mucosa. Tyrosinase (TYR) is the key enzyme involved in melanin synthesis. Studies in dermatology have shown a positive correlation between TYR enzyme levels and melanin pigmentation of the skin. However, no study has been conducted to assess TYR levels in the gingiva. Hence the present study was conducted to assess TYR levels in gingival melanin hyperpigmentation. Aim: To assess the TYR gene expression in gingiva in individuals with moderate to severe gingival melanin hyperpigmentation. Methodology: Subjects with a chief complaint of blackish appearance of gums with an unesthetic smile were included in the study. Informed consent was obtained. Scaling and root planning were done and subjects were recalled after 2 weeks. The gingival depigmentation procedure was performed using the conventional scalpel technique under adequate local anesthesia. The selected sites underwent conventional gingival depigmentation technique using Bard-Parker handle no: 3 and blade no: 11. The excised layer of epithelium along with a thin layer of underlying connective was sent to the laboratory to assess the TYR gene expression by real-time polymerase chain reaction technique. Results: The levels of the TYR enzyme activity in the gingival tissues from the selected sites were assessed. Table 1 and Graph 1 show the levels of TYR enzyme gene expression in the gingival tissue. Conclusion: TYR gene expression and the degree of gingival melanin hyperpigmentation are positively correlated. Hence the assessment of TYR enzyme activity in gingiva could be of great value in today's cosmetologically conscious individuals.

Myofibroblasts as important diagnostic and prognostic indicators of oral squamous cell carcinoma: An immunohistochemical study in normal oral mucosa, epithelial dysplasia, and oral squamous cell carcinoma.

BACKGROUND: Cancer invasion is a critical step for tumor growth and its progression. The focus on epithelial changes is shifting to increasing recognition that the microenvironment makes significant contributions to tumor progression. Stromal myofibroblasts play an important role in tumor invasion and metastasis due to its ability to modify the extracellular matrix. Based on this literary evidence, we carried out an immunohistochemical study to observe the expression of myofibroblasts in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). AIM: The aim of the study was to evaluate, compare, and correlate the presence of myofibroblasts in normal oral mucosa, oral epithelial dysplasia, and OSCC and to observe different patterns of myofibroblast arrangement using alpha-smooth muscle actin (α-SMA) as a marker, Thus assisting in early diagnosis, treatment, and prognosis of oral carcinomas. MATERIALS AND METHODS: Thirty-six cases including 12 cases of OSCC, 12 cases of epithelial dysplasia, and 12 cases of normal oral mucosa were stained with hematoxylin and eosin to confirm the diagnosis and immunohistochemically using α-SMA antibody. The slides were evaluated for positivity and intensity of staining. STATISTICAL ANALYSIS: The result was subjected to statistical analysis using Fisher's exact test. RESULTS: α-SMA expression in the stroma of squamous cell carcinoma was greater than its expression in epithelial dysplasia and normal oral mucosa.

Intraoral plasmablastic lymphoma as a primary oral manifestation: A case report and review of literature.

Plasmablastic lymphoma (PBL) is an aggressive type of large B-cell lymphoma as stated in the WHO classification of 2008. It is a rare form of non-Hodgkin's lymphoma, generally seen in human immunodeficiency virus (HIV)-acquired immunodeficiency syndrome affected individuals. A case of a 42-year-old female patient is presented here. The patient complained of swelling in the lower right back tooth region and presented with a history of extraction of molars. The underlying HIV status was detected after the oral examination. The diagnosis of PBL was confirmed with immunohistochemical analysis.

Oral microbiome and oral cancer - The probable nexus.

Oral squamous cell carcinoma is one of the most common malignancies and is the leading cause of morbidity and mortality. The known risk factors for oral cancer are tobacco, alcohol consumption and betel quid chewing. Nutritional deficiencies and certain microorganisms are also associated with oral cancer. Oral cavity is a host to numerous microorganisms, majority of which are bacterial communities along with fungi and viruses. A possibility of the dysregulation of the oral microbiome cannot be ignored. Oral microbiome is defined as the collective genome of microorganisms that reside in the oral cavity. With the development of culture-independent techniques, the detection and identification of the bacteria which cannot be cultured has become possible. Revolution in technology has led to increased research in this area in an attempt to find the role of microbiome in health and disease. Before identifying the exact role the microbiome plays in the development of oral cancer, it is essential to profile the microbiome in healthy individuals and patients with oral cancer. It is essential to note that oral cancer may sometimes occur without any habit too!! This article is an attempt to review the role of oral microbiome in oral cancer with a focus on the bacteriome, its related studies and in brief about the omics technologies in understanding the microbiome.

The effect of Vitamin C on melanin pigmentation - A systematic review.

Vitamin C, also known as ascorbic acid, is used as a treatment modality in depigmentation of hyperpigmented spots on the skin and gingiva. This systematic review discusses the studies conducted to assess the effect of Vitamin C on melanin pigmentation. The primary objective was to evaluate the effect of Vitamin C on melanin pigmentation. The secondary objective was to analyze the effect of Vitamin C administration on melanin pigmentation. An electronic database search was conducted from the following databases: PubMed, EBSCOhost, ScienceOpen, EMBASE and Google Scholar. Randomized controlled trials, experimental studies, case-control studies and cohort studies published in peer-reviewed journals in English language were included. Case reports, case series, animal model studies, in vitro studies, studies where Vitamin C was used along with other agents and unpublished research were excluded. Out of 22,580 studies, only 7 studies satisfied the selection criteria. Data extraction sheet was prepared, and the studies were analyzed. Out of the 7 studies analyzed, 1 was a randomized controlled trial and 6 were experimental studies. Vitamin C has been used widely as a depigmenting agent in dermatology. However, there are limited studies conducted on the use of Vitamin C for gingival depigmentation.

Oral microbiome: Unveiling the fundamentals.

The oral cavity has the second largest and diverse microbiota after the gut harboring over 700 species of bacteria. It nurtures numerous microorganisms which include bacteria, fungi, viruses and protozoa. The mouth with its various niches is an exceptionally complex habitat where microbes colonize the hard surfaces of the teeth and the soft tissues of the oral mucosa. In addition to being the initiation point of digestion, the oral microbiome is crucial in maintaining oral as well as systemic health. Because of the ease of sample collection, it has become the most well-studied microbiome till date. Previously, studying the microbiome was limited to the conventional culture-dependent techniques, but the abundant microflora present in the oral cavity could not be cultured. Hence, studying the microbiome was difficult. The emergence of new genomic technologies including next-generation sequencing and bioinformatics has revealed the complexities of the oral microbiome. It has provided a powerful means of studying the microbiome. Understanding the oral microbiome in health and disease will give further directions to explore the functional and metabolic alterations associated with the diseased states and to identify molecular signatures for drug development and targeted therapies which will ultimately help in rendering personalized and precision medicine. This review article is an attempt to explain the different aspects of the oral microbiome in health.

Odontogenic keratocyst with granular cell changes: A distinctive finding.

Odontogenic keratocyst (OKC) originates from the dental lamina and is more commonly seen in the posterior mandible than in the maxilla. OKC is the most aggressive cyst of the oral cavity and is known for its rapid growth and its tendency to invade bone of the adjacent tissues. The recurrence rate of OKC is very high due to various reasons debated upon. Cases of OKC have shown the presence of calcifications, dentinoid formation and ossification. Here, we report the first case of OKC in a 27-year-old male showing granular cell changes.

Pathophysiology of keratinization.

Cytoskeleton of a cell is made up of microfilaments, microtubules and intermediate filaments. Keratins are diverse proteins. These intermediate filaments maintain the structural integrity of the keratinocytes. The word keratin covers these intermediate filament-forming proteins within the keratinocytes. They are expressed in a specific pattern and according to the stage of cellular differentiation. They always occur in pairs. Mutations in the genes which regulate the expression of keratin proteins are associated with a number of disorders which show defects in both skin and mucosa. In addition, there are a number of disorders which are seen because of abnormal keratinization. These keratins and keratin-associated proteins have become important markers in diagnostic pathology. This review article discusses the classification, structure, functions, the stains used for the demonstration of keratin and associated pathology. The review describes the physiology of keratinization, pathology behind abnormal keratin formation and various keratin disorders.

Clinicopathological characteristics of desmoplastic ameloblastoma: A systematic review.

The aim of the present review was to systematically present the clinicopathological data of desmoplastic ameloblastoma (DA) from articles published in the literature. A comprehensive search of the databases (PubMed, Medline, SCOPUS, Web of Science, and Google Scholar) for published articles on DA was conducted. A total of 238 cases were identified and analyzed from 76 published papers. DA showed a slight male predilection (male: female=1.07:1) with a predominance in the fourth and fifth decades of life. Mandibular involvement (52.55%) was most commonly seen with a marked tendency for the anterior region (mandible: 40.9%, maxilla: 48.07%). The size of the lesion ranged from .5 cm to 20.4 cm, with the majority of cases measuring more than 3 cm in size (53.84%). Radiologically, most of the lesions presented mixed radiolucency and radiopacity (62%), and root resorption was observed in only seven cases. The majority of the lesions showed ill-defined margins upon radiographic examination (65.78%). Most of the cases were treated with resection (78.57%), and five of the 10 recurrent cases were treated by enucleation/curettage. DA is characterized by the unique presentation of clinicopathological parameters. It is not possible to comment on its aggressive/recurrent nature and best treatment modality due to inadequate follow-up data.

Tumor Budding in Oral Squamous Cell Carcinoma.

Tumor budding is defined as the presence of a single tumor cell or a small cluster of up to five cells in the tumor stroma, linking it to the epithelial-mesenchymal transition (EMT).1 Imai2 illustrated that tumors with this trait have more aggressive qualities and allocated the term "sprouting" instead of "budding." The term "tumor budding" was coined by Morodomi et al in 1989.3 Tumor budding in vitro or in experiments has been addressed by many names, depending on the researcher's background, few of which are tumor cell dissociation, focal dedifferentia-tion, or EMT.4.

Nonfamilial cherubism: A case report and review of literature.

Cherubism is a rare hereditary developmental condition of the jaws and generally inherited as an autosomal dominant trait. It is also known as familial fibrous dysplasia of the jaws, familial multilocular cystic disease and hereditary fibrous dysplasia of the jaws. The gene for cherubism is mapped to chromosome 4p16.3 may lead to pathologic activation of osteoclasts and disruption of jaw morphogenesis. The lesion usually appears between 2 and 5 years shows a predilection for the mandible and causes a bilateral swelling giving rise to a cherubic chubby appearance. The eosinophilic cuffing of blood vessels appears to be specific for cherubism. The diagnosis is based on clinical, radiographic and histopathologic findings. The purpose of this article is to present a rare case of nonfamilial cherubism as there are very few cases reported and to review the literature with its cone beam computed tomography findings.

Myofibroblasts could be recruited in a chemokine (C-C motif) ligand 2-dependent manner in pathogenesis of oral submucous fibrosis.

BACKGROUND: Monocyte chemoattractant protein-1 (CCL2) is a major profibrotic mediator with a proven role in fibrosis of different organs of the body. Recently, increased fibrosis in oral submucous fibrosis (OSMF) is linked with betel quid-related chronic irritation and myofibroblast. Hence, this study is designed to investigate expression of CCL2 in OSMF and its correlation with myofibroblasts. MATERIALS AND METHODS: Paraffin-embedded specimens of 30 OSMF and 10 tissues of normal buccal mucosa were subjected to immunohistochemical analysis for CCL2 and alpha-smooth muscle actin (α-SMA) expression. RESULTS: CCL2 expression in basal cells (CCL2-B) and connective tissue (CCL2-CT), and α-SMA showed significantly increased expression in advanced OSMF as compared with early OSMF and controls. Significant differences were observed in the expression of CCL2-B between control vs. OSMF (P = 0.002), control vs. advanced OSMF (P = 0.005), and early vs. advanced OSMF (P = 0.0377). Similarly, differences in the CCL2-CT expression were statistically significant between control vs. OSMF (P = 0.00086), control vs. early OSMF (P = 0.02914), and control vs. advanced OSMF (P = 0.0006). For α-SMA expression, significant differences were observed between control vs. OSMF (P = 0.0003), control vs. early OSMF (P = 0.036), control vs. advanced OSMF (P = 0.00008), and early vs. advanced OSMF (P = 0.0009). In OSMF group, a significant correlation was observed between CCL2-B and CCL2-CT (P < 0.00001), CCL2-B and α-SMA (P < 0.00001), and CCL2-CT and α-SMA (P < 0.00001). CONCLUSION: CCL2 could be responsible for pathogenesis of OSMF by recruiting myofibroblasts.

Pathogenesis of Rushton bodies: A novel hypothesis.

Rushton bodies (RBs) are one of the characteristic features seen in the epithelial lining of odontogenic cysts mainly radicular, dentigerous and odontogenic keratocyst. It has two different histo-morphological appearances; granular and homogeneous. Although widely investigated, the exact pathogenesis and histogenesis of RBs is still an enigma. Many hypotheses were made in the literature but none has explained conceivably the two histo-morphological appearances of RBs and their association with inflammation. In the present paper the various pathogenesis for the formation of RBs proposed till date are discussed along with proposal for a novel hypothesis. The given hypothesis is mainly related to inflammation and its effect on pore size of basement membrane of odontogenic cystic epithelium. It explains RBs association with inflammation as well as existence of two histo-morphological appearances. The proposed hypothesis also justifies the RB's presence inside the lining epithelium of odontogenic cyst despite its hematogenous origin. Future studies are advocated for isolating RBs using laser capture microdissection and subsequent biochemical, histochemical and electron microscopic analysis to substantiate the proposed hypothesis.

Prevalence of fungal hyphae in potentially malignant lesions and conditions-does its occurrence play a role in epithelial dysplasia?

BACKGROUND: Oral cancer is a major public health problem in India. A key factor that has led to lack of improvement in prognosis of oral cancer over the years, is delay in diagnosis and treatment. In many instances, a significant proportion of oral squamous cell carcinomas develop from premalignant lesions and conditions. Identification of such lesions and conditions is very important in order to prevent malignant transformation. The role of fungal infections has been studied and holds promise as an indicator to predict malignant transformation. So we designed a study to analyze the prevalence of fungal hyphae in biopsies of patients with clinically diagnosed cases of premalignant lesions and conditions. AIMS AND OBJECTIVES: To determine and compare the prevalence of fungal hyphae in biopsies of patients with clinically diagnosed cases of potentially malignant lesions and conditions and to assess the possible association between the degree of epithelial dysplasia and presence or absence of fungal hyphae. MATERIALS AND METHODS: Clinically suspected and histopathologically diagnosed 70 cases of potentially malignant lesions and conditions (29 leukoplakia, 16 submucous fibrosis and 25 lichen planus) made up the study group. Three tissue sections (5µm) of each were stained with hematoxylin and eosin (H and E), periodic acid-Schiff's reagent (PAS) and Grocott's methenamine silver (GMS) and evaluated for fungal hyphae. The data collected was statistically analyzed by using Chi-square test and Statistical Package for Social Sciences (SPSS) software. RESULTS: The estimated prevalence of fungal hyphae in cases with or without dysplasia in leukoplakia was 41.4%, lichen planus 36% and submucous fibrosis 25%. There was a significant association between degree of epithelial dysplasia with presence or absence of fungal hyphae in all the study groups. CONCLUSION: Presence of fungal hyphae in potentially malignant lesions and conditions may prove to be a useful indicator in predicting malignant transformation.

Branchial cleft cyst: A case report and review of literature.

First branchial cleft anomaly is a rare disease of the head and neck. Because of its rarity, first branchial cleft anomaly is often misdiagnosed and results in inappropriate management. In this article, we present a case of type II first branchial cleft anomaly. A middle-aged woman who had suffered from swelling on lower jaw visited our department with the chief complaint of a swelling. She underwent complete excision of the lesion with preservation of the facial nerve. The patient recovered well and had no recurrence at 1-year of follow up.

Quantitative estimation of AgNORs in normal, dysplastic and malignant oral mucosa.

AIMS: Silver stainable nucleolar organizer regions (AgNORs) have received a great deal of attention recently as their frequency within the nuclei is significantly higher in malignant cells than in normal, reactive or benign neoplastic cells. The objective of this study was to carry out a quantitative assessment of large and small AgNORs in oral normal mucosa, precancerous lesions and infiltrating squamous cell carcinomas. METHODS: The study comprised 110 formalin-fixed, paraffin-embedded oral mucosal biopsies consisting of 30 oral dysplasia, 60 oral squamous cell carcinomas and 20 normal oral mucosa. AgNORs were counted in each nucleus, categorized as small, large and total number of AgNORs in each cell and their means were calculated. RESULTS: The mean value of small AgNORs, large AgNORs and total AgNORs increased gradually from normal mucosa to dysplastic lesions to squamous cell carcinomas. The study clearly indicates that in oral squamous cell carcinomas, AgNORs diminish in size as they increase in number. Further, AgNOR counts increase as the degree of malignant potential of the cell increases. CONCLUSIONS: By combining both the enumeration of AgNORs and their size, good distinction can be made between normal, dysplastic and infiltrating squamous cell carcinomas. This could help in the early diagnosis and prognosis of dysplastic mucosal lesions and their malignant transformation.