Expression of anti - Apoptotic survivin in odontogenic keratocyst, adenomatoid odontogenic tumor and ameloblastoma.

Background: The process of odontogenesis is complex involving epithelial-mesenchymal interactions, along with the molecular signalling pathways triggering the initiating process. The triggering factors and cells precisely involved in the pathogenesis of odontogenic cysts and tumors are unknown. There is a vast array of biomarkers used to stain different sites, thereby helpful in diagnosing and evaluating the prognosis of these cysts and tumors. In the following study, Anti Apoptotic survivin expression patterns were assessed quantitatively in 48 samples (12 each) of Reduced Enamel Epithelium, Adenomatoid Odontogenic Tumor, Odontogenic Keratocyst and Ameloblastoma. Aim: The Aim of this study is to assess the anti-apoptotic survivin expression in Reduced Enamel Epithelium, Adenomatoid odontogenic tumour, Odontogenic Keratocyst and Ameloblastoma. Materials and Methods: The present study is carried out with 12 samples in each group. Routine hematoxylin and eosin staining was performed for confirmatory diagnosis. Later Immunohistochemistry was performed using survivin antibody. Survivin protein expression was analyzed using the parameters like location, intensity, percentage of cells positivity with survivin protein and extent of staining. With the help of Olympus BX 43 microscope, with ProgRes microscope camera, the 48 slides obtained were examined. The region of interest was selected in each slide and number of cells positively stained was counted. Data was analyzed using SPSS software version 23. Descriptive for scale data, results were analysed by using ANOVA with Chi-square test for intergroup comparison. Results: The results showed significant P value <0.05. Expression of survivin was highest in Ameloblastoma, followed by Odontogenic keratocyst, Adenomatoid odontogenic tumor, and Reduced Enamel Epithelium. Conclusion: Survivin was involved in the inhibition of apoptosis as well as the detailed understanding of the biological behaviour of odontogenic cysts and tumours, thereby increasing therapeutic approaches.

Expression of stem cell marker cytokeratin 19 in reduced enamel epithelium, dentigerous cyst and unicystic ameloblastoma - A comparative analysis.

BACKGROUND: The process of odontogenesis is complex involving epithelial-mesenchymal interactions, along with the molecular signaling pathways triggering the initiating process. The triggering factors and cells precisely involved in the pathogenesis of odontogenic cysts and tumors are unknown. There is a vast array of biomarkers used to stain different sites, thereby helpful in diagnosing and evaluating the prognosis of these cysts and tumors. Cytokeratins are the intermediate filament proteins which maintain cell integrity and alter their properties in cysts and tumors. In the following study, cytokeratin 19 expression patterns are assessed quantitatively in reduced enamel epithelium, dentigerous cyst and unicystic ameloblastoma. AIM: The aim of present study is to assess expression of CK 19, a stem cell marker in reduced enamel epithelium, dentigerous cyst and unicystic ameloblastoma, quantitatively. MATERIALS AND METHODS: The present study is carried out with 15 samples in each group. Reduced enamel epithelium is derived from the patients undergoing treatment for impacted teeth. Histopathologically diagnosed cases of dentigerous cyst and unicystic ameloblastoma were considered for the study. With the help of Olympus BX 43 microscope, with ProgRes microscope camera, the 45 slides obtained were examined. The region of interest was selected in each slide and number of cells positively stained was counted. Data were analyzed using SPSS software version 23. Descriptive for scale data, One way anova with post hoc Tukey's test for intergroup comparison. RESULTS: The results showed significant P value <0.05. Expression of CK 19 was highest in reduced enamel epithelium, followed by dentigerous cyst and unicystic ameloblastoma. CONCLUSION: CK 19 can be used as diagnostic marker to differentiate between odontogenic cyst and tumor.

Correlative study on lip prints, fingerprints, and mandibular intercanine distance for gender determination.

CONTEXT: "Identity" is a set of physical characteristics, functional or psychic, normal or pathological, that defines an individual. Identification of an individual is a crucial and an exigent task in forensic investigation. AIMS: The aim of the present pilot study was to investigate the accuracy of various methods employed in gender determination such as lip prints, mandibular canine index (MCI), fingerprints, and correlation between them. SUBJECTS AND METHODS: The pilot study group consisted of 300 samples aged between 18 and 25 years. Lip prints, fingerprints, and impressions of lower mandibular arches were collected. STATISTICAL ANALYSIS USED: The results were analyzed using Chi-square test for lip prints and fingerprints with an independent sample t-test for the MCI. Intergroup comparison between the parameters was analyzed by ANNOVA test. RESULTS: Type II lip print pattern and loop pattern of fingerprints were the predominant patterns in both males and females, and mesiodistal width of right MCI has greater sexual dimorphism than left MCI. CONCLUSIONS: Although lip prints, fingerprints, and MCI had their own specifications, correlation of the three parameters did not show any significance.

Gender determination using barr bodies from teeth exposed to high temperatures.

CONTEXT: Gender determination forms a prime step in the forensic identification process. Teeth form a very important identification aid in forensic studies because they are protected by oral tissues and dental pulp is further protected by the mineralized constituents of the teeth. This allows the conservation and sustainable production of dental pulp to help sex determination in circumstances where other tissues cannot be analyzed like victims when exposed to high temperatures during fire accidents, explosions, and other mass disasters. AIM: The present study aimed at gender determination from pulpal tissue extirpated from teeth exposed to high temperatures. MATERIALS AND METHODOLOGY: The study consisted of sixty teeth samples, thirty male and thirty female. The teeth have been subjected to a series of temperatures of 37°C, 100°C, 200°C, 300°C, 400°C, 500°C, 600°C, 800°C, and 1000°C. The dental pulp is then obtained from these teeth, processed, stained, and checked for Barr bodies. STATISTICAL ANALYSIS USED: Descriptive statistical analysis has been used. RESULTS: The results showed that pulp from the female teeth showed the presence of Barr bodies up to a maximum of 400°C, whereas the male pulpal tissue did not show the presence of any Barr bodies. With increase in temperatures, the cellularity of the connective tissue decreased but the average number of Barr body positive cells remained constant within the range of 19-20. CONCLUSIONS: Dental pulp acts as a potential source of gender determination when no other means of identification are available.

Salivary alkaline phosphatase levels speak about association of smoking, diabetes and potentially malignant diseases???

BACKGROUND: Alkaline phosphatase (ALP) is a hydrolase intracellular enzyme participating in the metabolic processes of cells. Rise in salivary ALP (S-ALP) levels reflects inflammation and destruction of healthy tissues suggesting it as a clinical biomarker. S-ALP is used in analyzing the severity of the disease occurrence in smokers and nonsmokers who are diabetic and nondiabetic. S-ALP levels are analyzed using autoanalyzer in 40 patients who visited our department. AIMS AND OBJECTIVES: To determine the levels of S-ALP in diagnosing potentially malignant conditions and debilitating diseases in early stages of inflammation and altered cellular metabolism. MATERIALS AND METHODS: The study groups include: (1) Group A - 10 smokers who are diabetic. (2) Group B - 10 smokers who are nondiabetic. (3) Group C - 10 nonsmokers who are diabetic. (4) Group D - 10 nonsmokers and nondiabetic as control. Unstimulated saliva samples are collected and run in auto-analyzer with ALP enzyme reagent to analyze ALP levels. Comparison is made between all the four groups. RESULTS: Results were statistically significant with increased activity of ALP levels in saliva from Group A when compared to Group D. The results are Group A > Group B > Group C > Group D. The results also revealed significant raise in levels of ALP levels in saliva from smokers when compared to diabetes. Thus explaining adverse effects of smoking. CONCLUSION: S-ALP can be considered to be the biomarker for evaluating adverse effects of smoking, diabetes and other debilitating diseases in early stages.

Analysis of lipid profile in cancer patients, smokers, and nonsmokers.

BACKGROUND: Lipids play an important role in maintaining the cell membrane integrity. Lipid profile is a panel of blood tests that serve as an initial medical screening for abnormalities in lipids and approximate risk for cancer, cardiovascular diseases, pancreatitis, etc., The present study evaluates the alterations in lipid profile in cancer patients, smokers, and nonsmokers and aims to achieve a correlation between them. MATERIALS AND METHODS: The study is an in vitro type of cross-sectional study with 25 oral cancer patients, 25 chronic smokers (habit persisting for 15 years or more), and 15 nonsmokers as control group. Blood samples had been collected, and triglycerides (TGs), total cholesterol (TC), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), and low-density lipoprotein (LDL) were analyzed using a lipid profile kit and an autoanalyzer. The results were analyzed using the unpaired t-test and ANOVA test (P < 0.05). RESULTS: There was a significant increase in TC, TG, LDL, and VLDL and decrease in HDL in the smokers group when compared to the controls (P < 0.05). A significant increase in LDL, but a decrease in values of HDL, VLDL, TG, and TC was observed in the cancer patients group when compared to the controls (P < 0.05). CONCLUSION: There is an inverse relationship between serum lipid profile in smokers and cancer patients. The decrease in lipid profile in cancer patients might be due to their increased utilization of lipids by neoplastic cells in membrane biogenesis. Therefore, a decrease in lipid profile in smokers can be assumed that they might be more prone to develop cancerous conditions.

Efficacy of Specific Plant Products on Microorganisms Causing Dental Caries.

INTRODUCTION: Dental caries and periodontal diseases are the most common oral diseases seen globally, both in developed and developing countries. Oral microorganisms that is gram positive and gram negative bacteria are known to be involved in causation of these diseases. Nowadays commercially available dentrifices and mouth rinses are known to contain ingredients that can alter the oral microbial flora and have undesirable side effects such as vomiting, diarrhoea, disarrangement of oral, intestinal flora and tooth staining. Naturally available plant products are known to be less harmful with fewer side effects and also economical for the patient. AIM: The aim of this study was to determine the antimicrobial properties of 10 naturally available plant products against oral microorganisms causing caries and to check the efficacy of these products in-vitro and to use these in mouth washes and dentrifices. MATERIALS AND METHODS: Sample of caries material was scrapped out from the extracted teeth and transferred to liquid broth, streaked over the agar media to allow for the growth of microorganisms. Plant products like clove oil, neem, ginger-garlic paste, tea tree oil, ginger, garlic, cinnamon oil, green tea, eucalyptus oil and turmeric were used. Antimicrobial efficacy of these products, was estimated by measuring zones of inhibition in the nutrient agar media. RESULTS: Clove oil was the most effective of all products against microorganisms causing caries with zone of inhibition - 30mm followed by ginger-garlic paste - 25mm, Neem - 15mm, tea tree oil - 15mm. CONCLUSION: Based on the above results, it can be inferred that these natural products have the maximum efficacy against microorganisms and can be recommended in dentifrices, mouth rinses, topical gels, etc.

Intra Oral Fibrosarcoma with Various Histopathological Patterns: A Rare Case Report.

Fibrosarcoma has been defined as a malignant mesenchymal tumour, the cells of which recapitulate the appearance of the normal fibroblast, with variable collagen production. Fibrosarcoma is a very uncommon tumour in the head and neck regions constituting only 0.05% of all the fibrosarcomas presenting in humans. They cause no characteristic symptoms and pose difficulty in clinical diagnosis. They have been classified histologically based on their distinct features into myxoid fibrosarcoma, low grade fibromyxoid fibrosarcoma and sclerosing epitheloid sarcoma. Here we present a rare case report of a 45-year-old male patient presenting with a maxillary fibrosarcoma, which histologically presented with different patterns.

Clear cell odontogenic carcinoma-a rare case report.

Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumour with female predilection occurring in the anterior region of the mandible with peak age incidence of 5th and 7th decade of life. Here we report a case occurred in the posterior mandible of a 42 year old male patient which highlights the clinicopathologic features of CCOC that were confirmed by histopathologic examination. We add up yet another case of CCOC to the published literature.

Metastasis of lung adenocarcinoma to the jaw bone.

Oral cavity is an uncommon site for metastasis and is usually an evidence of widespread disease. The clinical presentation of the metastatic lesions differs between the various sites in the oral region. Metastatic tumors account for 1-3% of all oral malignancies. The jawbones, particularly the mandibular molar area is more frequently affected than the oral soft tissues (2:1). Here, we report a case of a 60-year-old male patient with metastasis from lung to the mandible, where the metastasis was detected before primary tumor.

Juvenile ossifying fibroma with aneurysamal bone cyst: a case report.

The fibro osseous lesions of the jaws represent a diverse group of entities that are characterized by replacement of normal bone by a fibrous connective tissue matrix, with in which varying amounts of osteoid, immature and mature bone and in some instances, cementum like material are deposited. Fibro osseous lesions of the jaws include developmental (hamartomatous) lesions, reactive or dysplastic processes and neoplasms. Juvenile ossifying fibroma (JOF) is a unique fibro osseous neoplasm. It has 2 histopathological variants (1) Trabecular juvenile ossifying fibroma (TrJOF) and (2) Psammomatoid juvenile ossifying fibroma (PsJOF) with TrJOF affecting the jaws of children. Only 20% of the patients are over 15 years of age. JOF is more common in maxilla than mandible. Origin in extragnathic locations is extremely rare. It presents as an asymptomatic progressive, rapid expansion of jaws. Radiographically, tumour is well circumscribed, along with lack of continuity with adjacent bone, cortical expansion & perforation. Histopathologically it consists of a cell rich fibrous stroma with bundles of cellular osteoid and bone trabeculae without osteoblastic rimming, and aggregates of giant cells. It has a recurrence rate of 30-58%. Long standing lesions shows cystic changes. Aneurysmal bone cyst is the most common complication. Here we present a case report of 16 yr old female patient with clinical, radiographic & histopathological features of Trabecular JOF with Aneurysmal bone cyst.

Rhinomaxillary mucormycosis with palatal perforation: a case report.

Mucormycosis are a group of invasive infections caused by filamentous fungi of the Mucoraceae family. Mucormycosis is essentially limited to immunocompromised patients with poorly controlled diabetes mellitus, hematologic malignancy, organ transplant, chemotherapy, chronic renal insufficiency, malnutrition, deferoxamine therapy and severe burns. The fungi invade arteries leading to thrombosis that subsequently causes necrosis of hard and soft tissues. Here, we present a case report of a 50-year-old diabetic patient with rhinomaxillary form of mucormycosis.

Non-Hodgkin's Lymphoma in Buccal Vestibule -Case Report.

Lymphomas are malignant neoplasms arising from lymphocytes B cell or T cell that affects mainly lymph nodes, spleen and other non hematopoietic tissues. They are classified as Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). Diffuse large B-cell lymphoma (DLBL) is the most common variant of non-Hodgkin's lymphomas and frequently involves extranodal sites. In the oral soft tissues lesions can occur as hard and diffuse tumors involving oral vestibule, gums and posterior region of the hard palate. Most lymphomas, including DLBL arise from B cells are characterized by diffuse population of large cells with cleaved or non cleaved oval nuclei. Both histopathlogical and immunohistochemical (IHC) analysis were strongly advisable for proper management and prognosis. We hereby report a rare case of Diffuse large B-cell variant of non-Hodgkin's lymphoma in a male patient of age 50yrs in left upper buccal vestibule.

Ameloblastic Fibro-odontome (AFO) of the Mandible: A Case Report.

Odontoameloblastoma are tumours which represent a histological combination of ameloblastoma and complex odontoma. It behaves in an invasive manner like Ameloblastoma and is more aggressive in nature. We report a new case of ameloblastic fibro-odontoma (AFO). Clinical, radiographic and histopathological features are discussed.

Concomitant occurrence of cemento-ossifying fibroma and adenomatoid odontogenic tumor with bilateral impacted permanent canines in the mandible.

Adenomatoid odontogenic tumor (AOT) is an uncommon, benign and slow growing odontogenic tumor, which is usually located in an anterior region of the maxilla without pain. Cemento-ossifying fibroma (COF) is a relatively rare benign tumor of the jaw. Here we present 2 lesions presenting in unusual forms, follicular variant of AOT in the mandible and COF associated with impacted canine in the mandible, occurring concomitantly in the same patient. Both lesions presented classic histopathologic features.

Paradental cyst associated with supernumerary tooth fused with third molar: A rare case report.

Fusion is the union of two tooth buds that are normally separated. Fusion is more frequent in deciduous teeth, particularly in the anterior region. The etiology of fusion is not known. It has been suggested that the pressure of adjacent dental follicles produces their contact and fusion before calcification. There is no difference between men and women in incidence. The term paradental cyst means that such type of cysts that are close proximity with the root of a tooth. A history of recurrent pericoronitis is reported usually and there is often the presence of a communication between the periodontal pocket and the cyst. We present a rare case report where in partially erupted mandibular third molar is fused horizontally with a supernumerary tooth with paradental cyst.