Immunohistochemical expression of paxillin in ameloblastoma and odontogenic keratocyst: An observational study.

Background: Cell adhesion molecules (CAMs) are found on the surface of all cells, where they allow dynamic processes to take place. These include cadherins, integrins, selectins and Immunoglobulin superfamily. Directly associated with ß-integrin tails is a multidomain protein known as paxillin. However, CAMs participate in cell-cell and extracellular matrix-cell interactions during histomorphogenesis in the various phases of odontogenesis. Some tumours or cysts like ameloblastoma (AB) or odontogenic keratocyst (OKC) having odontogenic origin show disturbance in the interaction of these CAMs. Hence, the assessment of paxillin expression in AB and OKC was carried out. Materials and Methods: The present observational study comprised 30 clinically and histologically confirmed cases of AB and OKC. All the slides were stained immunohistochemically using a paxillin antibody. Results: Upon comparison of staining intensity of paxillin among AB and OKC showed statistically significant result, whereas quantitative staining and final summation showed non-significant result. Gender-wise comparison of paxillin staining intensity, quantitative staining and final summation among OKC showed significant result; however, in AB, staining intensity showed non-significant result, whereas quantitative staining and final summation showed significant result. Conclusion: Paxillin has the greatest influence on tissue morphogenesis and development. The regulation of cell mobility is aided by the multiple roles that paxillin plays in a range of cells and tissues. However, further studies using a large sample size, along with other molecular analytical methods, may be essential to draw a definite conclusion about the association of paxillin and its exact function in OKC and AB.

Immunohistochemical expression of paxillin in potentially malignant disorders and squamous cell carcinoma patients.

Background: Cell adhesion molecules are essential to maintain the integrity of stratified squamous epithelium but their expression has to be dynamic to aid the mobility and turnover of cells. Paxillin is one such multi-domain protein which integrates numerous signals from cell surface receptors, integrins and growth factors. It thus functions as a regulator of various physiological and pathological processes including tissue remodeling, cell motility, gene expression, matrix organization, cell proliferation, metastasis and survival. Hence, the assessment of paxillin expression in normal control, potentially malignant disorders and oral squamous cell carcinoma patients was carried out. Material and Methods: The present retrospective study comprised of 20 each clinically and histologically confirmed case of normal control, potentially malignant disorders, and oral squamous cell carcinomas. All the slides were stained immunohistochemically using Paxillin antibody. Results: The localization, staining intensity and percentage of positivity for paxillin expression was statistically significant among normal control and potentially malignant disorders, whereas oral squamous cell carcinoma showed a non-significant difference. Upon comparison of histopathological grading of potentially malignant disorders, mild versus severe and moderate versus severe epithelial dysplasia showed a statistical significant difference among all the parameters of paxillin expression. However, WDSCC & MDSCC a statistically significant difference among localization and staining intensity of paxillin. Conclusion: Paxillin may play an important role in pathogenesis of oral squamous cell carcinoma by altering the adhesive properties of the tumor cells interacting with the extracellular matrix which in turn affects their invasive behavior and histologic differentiation.

Relative frequency of oral focal reactive overgrowths: An institutional retrospective study.

CONTEXT: Focal fibrous hyperplasia, peripheral ossifying fibroma, pyogenic granuloma, peripheral giant cell granuloma, giant cell fibroma and focal reactive overgrowth (FROGs) are one of the foremost numerous benign soft-tissue growths in the oral cavity. Chronic irritation or trauma is with identified as the causative aspect. It may develop up to few centimeters in diameter, pedunculated or sessile and may arise on the gingiva or buccal mucosa. Treatment involves surgical excision, and recurrences are infrequent. AIMS: The aim of this study was to assess the prevalence of FROGs of oral mucosa in an institutional setup. SUBJECTS AND METHODS: All the histopathologically diagnosed cases of FROGs within a period of 10 years (January 2008-December 2017) were retrieved from the archives of the Department of Oral Pathology. The information such as age, sex, site, anatomical side and its prevalence were recorded on customized case history performa. STATISTICAL ANALYSIS USED: The significance of difference was assessed using the Chi-square test and Fisher's exact test. RESULTS: A total of 2849 cases were identified, of which 449 (15%) were FROGs. The most prevalent lesion amid them were focal fibrous hyperplasia (277, 62%), followed by pyogenic granuloma (92, 20%), whereas the least common was giant cell fibroma with 2 (0.5%) cases. All the FROGs were distributed among 21-40 years of age showing female predominance. The commonly affected site was the right buccal mucosa. CONCLUSIONS: Nevertheless, information of the frequency and distribution of these lesions is favorable when establishing a diagnosis and treatment plan in clinical practice.

Evaluation of candidal species among individuals with oral potentially malignant disorders and oral squamous cell carcinoma.

CONTEXT: Cancer afflicts almost all communities worldwide. Although it arises de novo in many instances, a significant proportion of oral squamous cell carcinoma (OSCC) develops from potentially malignant disorders (PMDs). Further, the association of Candida with various potentially malignant and malignant lesions has been reported as a causative agent. AIMS: The aim of the study is to evaluate and intercompare the predominant candidal species among individuals with PMD and OSCC. SUBJECTS AND METHODS: The swab samples were collected for the microbiological culture followed by incisional biopsy for histopathological confirmation. The swab samples were streaked and incubated on Sabouraud-dextrose agar medium and positive candidal colonies were incubated on CHROM agar for speciation. SETTINGS AND DESIGN: A total of clinically diagnosed 95 subjects of which 25 as normal controls, 30 as PMDs and 40 as OSCC were included. The collected swab samples were initially streaked and incubated on Sabouraud dextrose agar (SDA) medium, and later, only positive candidal colonies were incubated on CHROM agar for speciation. STATISTICAL ANALYSIS: Chi-square test was utilized. RESULTS: Positive candidal growth on SDA medium was seen in 24%, 43% and 82% and negative in 76%, 57% and 18% individuals of normal controls, PMDs and OSCC, respectively. On evaluation on Chromagar medium, Candida species was present in 20%, 40% and 77% and absent in 80%, 60% and 23% individuals among controls, PMDs and OSCC group, respectively. On speciation of Candida in CHROMagar among the controls, PMDs and OSCC, Candida albicans species was present in 4 (16%), 7 (23%) and 4 (10%); Candida krusei in 1 (4%), 5 (17%) and 10 (25%); Candida glabrata in nil, nil and 6 (20%) and Candida tropicalis in nil, nil, and 2 (5%) cases, respectively. CONCLUSION: There was predominant carriage of candidal species in PMDs and OSCC, but whether Candida has specific establishment in PMDs or in malignancy is still a matter of debate.

Prevalence of oral squamous cell carcinoma in Bareilly Region: A seven year institutional study.

BACKGROUND: Oral squamous cell carcinoma is a major contributor to disability and death caused by malignant tumors. Variations in social, cultural, and geographic factors affect the tumor behavior and response to treatment. In this study, we undertake a seven years institutional review and analysis of Oral squamous cell carcinoma cases in Bareilly. MATERIALS AND METHODS: A total of 1938 histologically diagnosed cases during the period of seven years i.e. from 2010 to 2016 were extracted from the archives of Department of Oral & Maxillofacial Pathology, Institute of Dental Sciences, Bareilly and evaluated to know the prevalence of Oral squamous cell carcinoma. The details like age, sex, habits and anatomical site were also recorded from the archived patient's case sheets. RESULTS: Out of the total 1938 cases, 318 were found to be Oral squamous cell carcinoma of which 232 were males and 86 were females. Incidence was highest in 40-49 year age group. The most common site was buccal mucosa (190 cases), followed by tongue (68 cases). Most lesions were well differentiated Oral squamous cell carcinoma (230 cases). Patients with poorly differentiated lesions had a comparatively lower mean age than their counterparts with other histological varieties. CONCLUSION: The pattern of Oral squamous cell carcinoma differs from that of previous studies in relation to incidence and age correlation with the grade of carcinoma. The majority of the lesions were well differentiated. There is a need for intensive oral health awareness to encourage early presentation to cancer center as early detection will further enhance prognosis.

Diffuse large B cell lymphoma of hard palate: a case report with literature review.

OBJECTIVE: Lymphomas are diverse group of neoplasm affecting the lymphoreticular system. Diffuse large B cell lymphoma is the most frequently diagnosed type of non-Hodgkin lymphoma and is the fifth most frequent malignancy, accounting for about 40% of cases reported. In the present case report a 40 year old female patient complains of swelling on right side of face since 45 days and gradually increased to present size. Intra-orally an ulcero-proliferative growth was present on the right side of hard palate. Incisional biopsy was suggestive of Lymphoproliferative disorder. Panel of immunohistochemical antibodies were used; which showed positivity for CD45, PAX5, Bcl2, Ki67, CD138 and negativity for CD3, CD10, CD20 and CD30. Therefore through routine standard hematoxylin and eosin staining a clear cut diagnosis of specific lymphoma was difficult to obtain and thus immunohistochemistry plays an important role in confirming the pinpoint diagnosis.

Neck dissections: emerging role of oral pathologists.

BACKGROUND: Surgical resection has been the principle treatment approach for early lesions as well as advanced stage carcinomas of upper aero digestive tract. Neck dissection is the primary treatment given to nodal metastasis of oral carcinomas. Choice of irradiation and chemotherapy post surgery relies heavily on the histopathological assessment of surgical margins of resected tumor, dissected lymph nodes and accessory tissues. METHODS: A total of ten cases of head and neck carcinomas reported in two years period were analyzed. The tissues were assessed histopathologically for tumor grade, margin status, nodal metastasis and vascular invasion. RESULTS: Out of the total 10 neck dissection specimens, eight cases were of Well Differentiated Squamous Cell Carcinoma, one each of ameloblastic carcinoma and occult cancer with metastasis in cervical lymph nodes. In case of marginal clearance, two cases were negative, one case was of occult primary and seven cases had positive involvement at the margin, of which five cases demonstrated tumor component at <5mm from the surgical cut margin and two cases at >5mm. Concerning the nodal involvement, four cases were positive, five were negative, while in one case no lymph node was available for assessment. Among the accessory tissues received, submandibular gland and perinodal tissue involvement was seen in one case each whereas skin and muscle involvement was negative for tumor cells in all the cases. CONCLUSION: The emphasis is on the role of oral pathologists in assessment of such neck dissection specimens. The information provided would maximize treatment outcome and minimize recurrence.

Effect of an herb root extract, herbal dentifrice and synthetic dentifrice on human salivary amylase.

BACKGROUND: Salivary amylase is an enzyme, which plays a vital role in formation of dental plaque. It has the ability to bind on the bacterial surfaces and to hydrolyze starch, giving rise to products that are transformed into acids leading to dental caries. Suppression of salivary amylase activity can lead to decrease in risk of dental caries and plaque associated periodontal diseases. The aim of this study was to evaluate the effect of an herb, Spilanthes calva (in form of a test dentifrice) on human salivary amylase activity and to compare it with other dentifrices. MATERIALS AND METHODS: A total of 80 subjects of age 18-35 years were randomly selected and divided equally into 4 groups. Group 1 subjects were assigned to use Test Dentifrice (with S. calva root extract), while Group 2, Group 3, and Group 4 subjects were assigned to use Herbal Dentifrice (Arodent(™)), Synthetic Dentifrice (Colgate(®)), and Control Dentifrice respectively. Salivary amylase activity was determined by Bernfeld method in each group, before and after using the given dentifrices. RESULTS: Maximum inhibition of salivary amylase activity was found in the group using test dentifrice as compared to others. CONCLUSION: The present study indicates that, the root extract of S. calva possess significant inhibitory activity for salivary amylase. Use of S. calva root extract will provide a wider protection against different pathogenic oral microflora. Use of this extract singly or in combination is strongly recommended in the dentifrice formulations.

Oral hobnail hemangioma: a case report.

Hobnail hemangioma is a benign vascular lesion and intraoral of the lesions are relatively rare. Histopathologically, it shows distinctive biphasic pattern with vascular channels lined by endothelial cells showing characteristic "hobnail" cytomorphology. Since hobnail hemangioma shares similar clinical and histopathologic features with many other benign and malignant vascular tumors, accurate diagnosis is mandatory for proper treatment and prognosis. In the present study, emphasis was given to discuss the differential diagnosis and delineate the hobnail hemangioma from other vascular lesions. Further, immunohistochemical study was performed which showed strong immunopositivity for CD31 and factor VIII in all endothelial cells lining the vascular channels. CD34 was moderately immunopositive and vascular endothelial growth factor was negative.

Psammomatoid juvenile aggressive ossifying fibroma of mandible.

A female patient, aged 14 years, came to dental OPD, with a large swelling of the right mandibular region, progressing since 4-5 years. The swelling initially started with a small size and later it became a large swelling extending from left lower premolar region to right mandibular angle region. Inferiorly, the swelling was extending below the inferior border in the symphysis region. No paresthesia was experienced by the patient. There was quite a marked facial disfigurement of the right mandibular body and symphysis region extending to left side. No other bones were involved and no other abnormalities were found on general physical examination. The medical history was noncontributory. There was no family history of skeletal disease. The case was surgically treated by segmental resection of the mandible and reconstruction was done using stainless steel reconstruction plate. With the follow-up period of 1 year, there was no recurrence.