Expression of EGFR and survivin in ameloblastoma, odontogenic keratocyst and calcifying odontogenic cyst - An immunohistochemical study.

Context: Odontogenic lesions have diverse biological behaviour which is characterised by local invasiveness, and a high recurrence rate. EGFR and survivin was found to be involved in the aggressiveness, recurrences and metastasis of a variety of epithelial malignancies. Aims: To assess and compare the expression of EGFR and survivin in Ameloblastoma (AB), Odontogenic keratocyst (OKC) and Calcifying odontogenic cyst (COC). Settings and Design: The study's goal was to use immunohistochemistry to assess the qualitative and quantitative expression of EGFR and survivin and to correlate their expression patterns in AB, OKC and COC. Methods and Material: Study included 30 AB, 15 OKC and 10 COC. All the slides were immunohistochemically analysed for qualitative, quantitative and semi-quantitative data. In each group, the presence of EGFR and survivin was assessed in terms of stain localisation, intensity and percentage of positive cells. Statistical Analysis Used: Data were analysed using Chi-square test and one-way ANOVA, P value < 0.05 was considered statistically significant. Results: EGFR positivity was found in all cases. Survivin was found to be 96% positive in AB and 100% positive in OKC and COC. Both EGFR and survivin showed predominant cytoplasmic staining. All the slides that are stained with EGFR are also stained with survivin. The intensity varied significantly between the layers. OKC showed higher immunoreactive scores (IRSs). Conclusions: The current study provides insight into the role of EGFR and survivin in the pathogenesis of AB, OKC and COC. OKC appears to be more aggressive than ameloblastoma and COC, owing to its higher IRS.

The relationship between salivary alpha-amylase, nitric oxide, pain and anxiety-induced stress in patients during dental treatment.

Background: Pain and anxiety are the most reported negative effect of orthodontic treatment which can influence the quality of life and are responsible for the discontinuation of treatment. These unpleasant experiences raise the stress levels reflected by the increase in the concentration of salivary alpha-amylase and nitric oxide. These can be assessed through various subjective methods which have limited value as it depends on the patient's honesty, assessing whether using objective methods are reliable. Objectives: To assess pain and anxiety-induced stress levels using both physiological (Salivary alpha-amylase and Salivary nitric oxide) and psychological testing instruments (Visual analog scale and State Trait Anxiety Inventory Y6) during the initial phases of fixed orthodontic treatment. Materials and Methods: A total of 30 patients were included. Pain and anxiety instruments were applied and saliva samples were collected from patients before and after separator placement, before and 48 h after archwire insertion and 1 month after archwire insertion. Results: The mean values of alpha-amylase (235.3600), nitric oxide levels (2.060) and pain scores (7.8667) were higher 48 h after archwire insertion (T3) which are statistically significant, P = 0.00. Anxiety scores (57.7000) were high before separator placement (T0). No statistically significant correlation was found among pain and alpha-amylase, anxiety and nitric oxide levels. Conclusion: Initial alignment phases of fixed orthodontic treatment affect patients' anxiety and stress levels. The findings could be a result of the psychological stress due to procedures in the initial phases of the treatment.

Analysis of Inheritance patterns, gender dimorphism and their correlation in lip and palm prints - A cross-sectional study.

Background: Forensic sciences deal with key areas to be included in judicial makeup that has been approved by both the court and the scientific community, which distinguishes truth from counterfeit. Lip and palmprints are one of a kind and do not change during the lifetime of a person unless any pathologies. Objectives: To evaluate the heritability, and gender dimorphism of lip and palm prints among parents and their offspring. Methods: A total of 280 participants were included in the study. Lip and palm prints were collected from participants using a digital camera. The photographic data obtained is subjected to Adobe Photoshop and analysed for inheritance. Gender dimorphism is evaluated by the predominant lip pattern and palm ridge count in four designated areas. Results: A positive resemblance of 28.4% was found between parents and offspring in lips, and for the right palm, it was 60.2% and 55.12% for the left palm (principal lines) which are statistically insignificant. In all six quadrants, the most predominant lip pattern found in males is type 5, and in females, type 11. The mean palm ridge density was significantly higher among females than males in all designated areas. Conclusion: The digital method of analysing lip and palm print images with Adobe Photoshop 7 software is a convenient method that allows for better visualisation and easier lip and palm print recording and identification. Considerable inheritance patterns and gender dimorphism were observed that aid in personal identification.

Myofibroblasts in Odontogenic Cysts and Tumors: An Immunohistochemical Study.

Objective: The objective of this study was to assess immunohistochemically the presence of myofibroblasts both qualitatively and quantitatively in odontogenic cysts and tumors and to compare with the control cases of squamous cell carcinoma and to correlate the results with biologic behavior of these lesions. Materials and Methodology: Formalin-fixed, paraffin-embedded blocks of odontogenic cysts and tumors were retrieved from institutional archives. The sample size is 40; these include ten cases of odontogenic keratocyst (OKC) (n = 10), five cases of dentigerous cyst (n = 5), ten cases of solid ameloblastoma (n = 10), and five cases of unicystic ameloblastoma (n = 5). Ten cases of squamous cell carcinoma (n = 10) served as control. Sections were taken and stained immunohistochemically using alpha-smooth muscle actin for evaluation of myofibroblasts. The number of positive stromal cells was evaluated both for quantitative and qualitative analyses. Results: The present study showed that the mean number of myofibroblasts among the odontogenic cysts and tumors was higher in locally aggressive lesions such as OKC (23.79 ± 19.95), solid ameloblastoma (26.38 ± 17.00), and unicystic ameloblastoma (20.74 ± 14.86) which were comparable to squamous cell carcinoma (21.49 ± 9.76) when compared to benign lesions like dentigerous cyst which showed the least number of myofibroblasts (13.1 ± 7.71). Qualitatively, the staining intensity of myofibroblasts showed a significant variation within the same lesion and among different lesions. There was a distinct difference in the morphology, pattern of arrangement, and distribution of myofibroblasts among the studied lesions. Conclusion: We conclude that the increase in the number of myofibroblasts could be one of the contributory factors for the locally aggressive behavior of benign lesions such as ameloblastomas and OKCs. Further studies are suggested to understand the mechanism by which these important cellular elements exert their effects on stromal and epithelial tissue compartments.

Adenomatoid hyperplasia of minor salivary glands: A case report in an unusual site.

INTRODUCTION AND IMPORTANCE: Adenomatoid hyperplasia (AH) is an unusual entity which simulates salivary gland neoplasm. As suggested some lesions indicate reactive hyperplasia due to the chronic trauma by the ill-fitting complete dentures but here in the present case it's due to a fixed prosthesis. Here is an AHMSG occurring in a rare location that is in the lingual vestibule. Meticulous histopathological examination is an effective diagnostic tool to arrive in the diagnosis of AH. CASE PRESENTATION: A 60 years male patient with a lesion in the lingual vestibule of slow growth and an ulcer noted on the surface due to the trauma from the prosthesis. The patient was unaware of the growth and a provisional diagnosis made by the clinician was an irritational fibroma with traumatic ulcer but the final diagnosis turned to be AHMSG. DISCUSSION: The present case and previous case series suggest AH has a male preponderance. Histological analysis is a basic fundamental in arriving at a proper diagnosis. It's a 102-case added to the available web knowledge world-wide on AHMSG and the 4th case in India to be noted in the Indian literature. CONCLUSION: The differential diagnosis of the lingual vestibular placed exophytic lesions should include AHMSG.

COVID-19 prevalence and infection control practices among dentists in Andhra Pradesh State, India.

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic posed a new challenge not only to public health but also to the health care systems and dentists are one of the highly vulnerable health care professionals for COVID-19 infection. OBJECTIVE: To assess the COVID-19 prevalence, associated factors, and infection control practices among dentists in Andhra Pradesh State, India. METHODS: A cross-sectional web-based questionnaire survey was conducted among dentists in Andhra Pradesh State, India. 21-item pretested questionnaire was used for data collection between January 30, 2021 and February 21, 2021. 3700 dentists from the Andhra Pradesh state were selected from the Dentists Register of India through systematic random sampling method. RESULTS: Out of 3700 dentists invited to participate in this study, responses from 1876 dentists were received with response rate of 51%. Prevalence of 8 among the study population was 9%. Patients were the primary source of infection for 60.5% of the COVID-19 positive study participants. 65.8% of total respondents using full face shield and two-third of them using N95 or equivalent mask while providing dental care. CONCLUSION: This study found a high prevalence rate of COVID-19 among the dentists. Among the associated factors, being into active practice during the pandemic was found to be statistically significant. This study recommend for additional infection control protocols specific to the COVID-19 pandemic.

Quantification of mast cells in oral reactive lesions - an immunohistochemical study.

BACKGROUND: Reactive lesions (RLs) are the most common oral mucosal lesions that are benign in nature and are more likely to reoccur if the lesion or local irritants at the site are not completely removed. The histopathology is usually determined by the stage of the lesion, which includes neovascularization, inflammation, and fibrosis etc. Aim: To evaluate and compare mast cell counts in different reactive lesions with normal gingiva (NG) and to determine the correlation between mast cell count and inflammation, fibrosis, and angiogenesis using immunohistochemistry. MATERIALS & METHODS: 10 pyogenic granulomas (early and late), 10 irritational fibromas, 5 inflammatory fibrous hyperplasia, and 5 peripheral cemento-ossifying fibromas 5 normal gingiva were evaluated. Mast cell counts were compared. ANOVA and t-tests were used to analyze the data. Spearman correlation was used to compare the mast cell count to the inflammation, fibrosis, and vascular components. A p-value of 0.05 was considered statistically significant. RESULTS: The mean number of mast cells were increased in oral reactive lesions when compared to NG. Although mast cells were significantly higher in IFH and IF, there was no correlation found among mast cells and fibrosis/inflammation/vascularity. CONCLUSION: Reactive process involves multiple interactions among mast cells, endothelial cells, fibroblasts, and other immune cells, among which the role of mast cells has been evaluated. Mast cell count increases in these reactive lesions, possibly reflecting an important role in microenvironment modification, but it is not the sole cause of these lesions' pathogenesis.

Glucose transporter 1 expression in ameloblastoma and odontogenic keratocyst - A comparative immunohistochemical study.

Introduction: Facilitative glucose transporters (GLUTs), which mediate glucose transport across the cell membrane, differ in their tissue distribution and affinity for glucose. GLUT1 is ubiquitously present and help in the basal uptake of glucose into the cells. Its expression is known to be elevated in conditions that induce hypoxia and by growth factors. GLUT1 is known to be increased in many malignant tumors to meet the metabolic requirements, but its role in odontogenic tumors is not known. Objective: The objective of this study is to evaluate and compare the immunohistochemical expression of GLUT1 in ameloblastoma (AM) and odontogenic keratocyst (OKC). Materials and Methodology: Thirty cases each of AM and OKCs were immunohistochemically stained using anti-GLUT1 antibody according to the standard protocol. Qualitative assessment of GLUT1 expression was done under the categories of distribution, intensity and localization of staining. Quantitative assessment was done using Image J software. The results were tabulated and statistically analyzed. Results: GLUT1 positivity was observed in 25 (83.3%) cases of OKC and 26 (86.7%) of AM cases. The majority of cells in the suprabasal layer of OKC showed positivity, whereas the equal distribution of staining was observed in the central and peripheral cells of AM. Conclusion: GLUT1 expression in these tumors is suggestive of an increased glucose uptake and probably increased utilization of energy, which may be correlated with their aggressive behavior.

Comparison of quality of bone and insertion torque values of early implants placed at 6 and 8 weeks in sockets preserved with advanced platelet-rich fibrin: A randomized controlled trial.

Aim: Successful functional and esthetic rehabilitation of edentulous jaws with implants depends on the optimal timing of placement, surgical protocol, materials used, cost-effectiveness, and satisfying patient needs. Increasing demand for shorter treatment times necessitates the immediate placement protocol. However, researchers have demonstrateda higher failure rate. A-PRF (Advanced platelet-rich fibrin) has exhibited accelerated bone regeneration potential. Early implant placement with a limited healing period, along with A-PRF, can be beneficial over conventional and immediate implant placement. Settings and Design: This prospective randomized clinical trial aims to assess the outcome of early implant placement in sockets preserved using A-PRF at six weeks and eight weeks of post-extraction. Two groups of 10 participantseach were formed. All patients underwent atraumatic extraction and socket preservation using A-PRF. Materials and Methods: A Partial-thickness pedicle graft was raised, and the extraction socket wasclosed. Implants wereplaced in at six and eight weeks of post-extraction in group A group B, respectively. The histomorphometric analysisassessedthe bone quality present at the timeof surgery. The insertion torque values were recorded during implant placement. Statistical Analysis Used: The obtained data were statistically analyzed using parametric tests, namely independent T-test for intergroup comparison. Results: T-test for torque values indicated a significantly higher torque value at eight weeks. The meanhistomorphometric value showeda significantly higher percentage of bone formation at eight weeks than at six weeks (P = 0.03). Conclusion: Within the study's limitations, early implant placement in extraction sockets preserved with A-PRF had significantly higher insertion torque values and predictable bone at eight weeks compared to six weeks.

Efficacy of curcumin in the treatment of denture stomatitis: A randomized double-blind study.

BACKGROUND: The prevalence of denture stomatitis has been shown to vary from 15% to 65% in complete denture wearers. In recent years, a number of studies across the globe have investigated the various biological effects of curcumin, curcumin, a polyphenolic compound derived from dietary spice turmeric, possesses diverse pharmacologic effects including anti-inflammatory, antioxidant, antiproliferative and antiangiogenic activities. The aim of this study was to evaluate the efficacy of curcumin local application with common antifungal agent clotrimazole for the treatment of denture stomatitis. MATERIALS AND METHODS: A randomised double-blind clinical trial with approval of institutional ethical committee consisting fifty participants divided into two groups (17 men-33 women) with the clinical signs and symptoms of oral candidiasis. The diagnosis was supported by microbiological cultures. Group A patients were prescribed the clotrimazole and Group B patients were prescribed the curcumin ointment which was dispensed in similar amber coloured bottles. Data were analyzed using Chi-squared tests, Wilcoxon's signed rank sum test and Mann-Whitney test. RESULTS: The mean candidal colony counts before treatment in Groups A and Group B were 63.960 and 37.080, respectively. The mean candida colony counts after treatment in both the groups were 14.080 and 3.720, respectively. There was a statistically significant difference between the two groups when mean candida colony counts were calculated before and after treatment. However, intergroup comparison between the two groups considering the mycological eradication showed that there was no statistically significant difference with P = 0.404. CONCLUSION: Topical application of curcumin as a natural ingredient could be an effective agent for the treatment of denture stomatitis as an alternative to regular clotrimazole therapy.

Immunohistochemical evaluation of survivin in oral lichen planus and oral squamous cell carcinoma - a retrospective study.

INTRODUCTION: Oral cancer is a multistep process involving enhanced activation of proto-oncogenes. Survivin (anti-apoptotic protein) is one of such proto-oncogenes that contribute to the carcinogenesis by deregulating cell proliferation. Expression of these proteins in cancerous and pre-cancerous lesions helps a better understanding of the etiology, treatment and prognosis. AIM: To evaluate qualitative and quantitative expression of survivin in healthy mucosa, oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). METHODS: A total of 70 cases of formalin fixed paraffin embedded blocks, of which 20 healthy mucosa, 20 OSCC and 30 OLP were included in the study and stained immunohistochemically using antibodies against survivin monoclonal antibody. 4 µm sections were stained immunohistochemically, both nuclear and cytoplasmic staining was considered as positive for surviving. Positive and negative stained cells were counted with the help of Olympus BX51 rarefaction microscope and were analyzed quantitatively using image analysis pro plus software. Representative fields were randomly selected at 40× high power magnification. Values obtained were evaluated and tabulated for statistical analysis. RESULTS: There was a statistically significant relation between the expressions of survivin among healthy mucosa, OLP, OSCC with a p value of 0.001. CONCLUSION: Presence of survivin expression in healthy mucosa, OLP and OSCC, which is an inhibitor of apoptosis protein, can be identified as a useful diagnostic tool for the identification of precancerous lesions and conditions which are at higher risk for progression into invasive carcinoma.

Immunohistochemical evaluation of myofibroblasts in oral epithelial dysplasia and oral squamous cell carcinoma.

Aim: The aim of the study is to evaluate the presence of myofibroblasts quantitatively in oral epithelial dysplasia, oral squamous cell carcinoma (OSCC). Materials and Methods: Formalin-fixed, paraffin-embedded blocks were retrieved from the institutional archives. The sample size is 35 and included 15 cases of oral epithelial dysplasia (n = 15), 15 cases of squamous cell carcinoma (n = 15) and 5 cases of normal oral mucosa which served as the control (n = 5). Histologic sections were subjected to immunohistochemical analysis using alpha-smooth muscle actin, and the mean number of myofibroblasts was evaluated. Results: There were no myofibroblasts in the stroma of normal oral mucosa and oral epithelial dysplasia. Whereas all cases of OSCC showed myofibroblasts (mean ± standard deviation: 21.49 ± 9.76). This difference of myofibroblasts between OSCC and oral epithelial dysplasia was statistically significant with a P < 0.05. There was no statistically significant difference in the mean number of Myofibroblasts(MF) between 3 histologic grades of OSCC. Conclusion: The presence of myofibroblasts in the stroma of OSCC and their absence in normal oral mucosa and epithelial dysplasia reveals that these cells may play a role in cancer cell invasion and progression so the treatment strategies targeting the myofibroblasts and their by products may be beneficial in OSCC patients.

Electrical vestibular nerve stimulation as an adjunctive therapy in the management of type 2 diabetes.

OBJECTIVES: Vestibular nerve stimulation using the portable battery-operated vestibular nerve stimulator is a sophisticated method noninvasive, safe, and easy to operate. It was hypothesized that vestibular nerve stimulation is effective in the management of type 2 diabetes. Hence, the present study was undertaken to determine the effectiveness of vestibular nerve stimulation using portable battery-operated vestibular nerve stimulator in the management of diabetes. METHODS: The present study was a double-blind randomized controlled trial with 1:1 split between the control and experimental groups. A total of 30 participants with type 2 diabetes were part of the study after obtaining the written informed consent. After recording the baseline values, the vestibular nerve stimulation was administered to the participants in the intervention group for 90 days. Sham stimulation was administered to the control group for 90 days. Outcome measures were recorded after 30 days and after 90 days of the intervention in both the groups. RESULTS: There was significant decrease in the total body weight, fasting, postprandial blood glucose, glycosylated hemoglobin levels, leptin, very low density lipoproteins levels followed by the intervention. There was significant improvement in both spatial and verbal memory scores. Depression and stress scores and systolic blood pressure decreased and remained in normal limits. CONCLUSIONS: The study results have proven multimodal action of vestibular stimulation. It not only acts on regulation of the glucose metabolism but also can regulate the autonomic activity and improve cognition and relieve stress. This is the interesting finding of our study, which needs detailed further research to support implementation of vestibular nerve stimulation as an adjunctive therapy in the management of diabetes.

Glucose transporter 1 in health and disease.

Glucose, a major source of energy for all cells, is transported into cells with the help of glucose transporters (GLUTs). These transporters are of two types, namely sodium-dependent GLUTs and facilitative GLUTs. These transporters are present in a tissue-specific pattern and have substrate specificity. Among these transporters, GLUT1 (facilitative GLUT) is present ubiquitously on all tissues of the body and helps in the basal uptake of glucose. GLUT1 is known to have many physiological functions in the body from the time of implantation of an embryo and is also seen associated with pathologies, including cancers. This review mainly focuses on GLUT1 in physiological and pathological conditions and the recent advances related to its role in cancer development and applications in cancer therapeutics.

Effect of Initial Periodontal Therapy on Salivary Trefoil Factor (TFF3) in otherwise Healthy Patients with Gingivitis and Chronic Periodontitis.

BACKGROUND: The search for an ideal biomarker which can determine the current disease status that predicts the sites and individuals with increased susceptibility to periodontal disease has been going on since a long time. One such group of molecules which have been investigated recently are the trefoil factors, and the present study aims to determine the role of salivary trefoil factor 3 (TFF3) in periodontitis and gingivitis patients. MATERIALS AND METHODS: A total of fifty participants, of which 25 were diagnosed with moderate-to-severe periodontitis and 25 with chronic gingivitis were included in the study. The routine periodontal parameters were recorded at baseline and at 6 weeks which included plaque index, gingival index, bleeding index, probing depth, and clinical attachment level. The saliva samples were collected from both the groups at baseline and 6 weeks after nonsurgical periodontal therapy and analyzed by enzyme-linked immunosorbent assay to estimate the concentration of trefoil factor 3. RESULTS: All the periodontal parameters improved at 6-week reevaluation in both the groups. There was a significant change in the TFF3 levels in the periodontitis group from baseline to 6 weeks, and the concentrations were found to be higher following nonsurgical therapy, whereas the quantum of change in the gingivitis group was negligible. The levels of TFF3 remained unchanged in those periodontitis participants who required surgical intervention at the 6th-week reevaluation. CONCLUSION: The estimation of TFF3 levels may aid in decision-making in the treatment strategy of patients with moderate-to-severe periodontitis.

Epidemiological study of odontogenic tumours: An institutional experience.

Epidemiological studies on odontogenic tumours conducted in different parts of the world emphasised variation in incidence and distributional pattern. Such epidemiological studies are obscured in Southern state of Andhra Pradesh in India. Present study was conducted at an institutional setup in South Indian population to assess the demographic data of odontogenic tumours. The retrospective study, which included all the odontogenic tumours from the archives of department of oral pathology, Dental teaching and Research Institution in southern part of India. Cases were selected based on the classification of WHO 2005 histopathological typing for odontogenic tumours and the assessment year considered was from 2002 to 2014. Demographic data was analysed for these tumours. Results were analysed using Chi-Square Test. Incidence of the odontogenic tumours was found to be 2.17%. Peak age incidence was recorded highest in third and fourth decade of life. Males were commonly involved [59%] with the male to female ratio of 1.43:1. Posterior mandible [53.4%] was the chief anatomical location involved with the tumours. Considering the individual lesions, Ameloblastoma [49%] was found to be more frequent, followed by Keratinizing cystic odontogenic tumour [32%], Odontome [6.2%], Adenomatoid odontogenic tumour [5.5%], Odontogenic myxoma [2.4%], Ameloblastic fibroma [0.6%], Calcifying epithelial odontogenic tumour [1.8%] and Squamous odontogenic tumour [1.2%]. The total frequency of odontogenic tumours was 2.17%. Ameloblastoma and Keratinizing cystic odontogenic tumours were the predominant tumours, demonstrating significant regional and geographic variation.

Comparison of the number of gingival blood vessels between type 2 diabetes mellitus and chronic periodontitis patients: An immunohistological study.

BACKGROUND: The relationship between diabetes and periodontitis has been studied for more than 50 years and is generally agreed that the periodontal disease is more prevalent in diabetic patients compared to nondiabetics. Vascular changes like increased thickness of basement membrane in small vessels has been reported in diabetic patients, but the quantity of blood vessels in gingiva of diabetic patients has not been discussed much. The aim of this study was to compare the number of blood vessels in gingiva between chronic periodontitis (CP) patients, CP with diabetes (type 2), and normal healthy gingiva. MATERIALS AND METHODS: The study included 75 patients, divided into three groups of 25 patients each-Group I with healthy periodontium (HP), Group II with CP, and Group III with CP with diabetes mellitus (CPDM). Gingival biopsies were obtained from the subjects undergoing crown lengthening procedure for Group I, and in patients with CP and in CPDM biopsies were collected from teeth undergoing extraction. Sections were prepared for immune histochemical staining with CD34. RESULTS: Difference was observed in the average number of blood vessels when compared between HP, CP, and CPDM groups. Statistical significant difference was observed when the HP and CP groups and HP and CPDM groups were compared. CONCLUSION: The results of the study indicated that the number of blood vessels in gingival connective tissue is significantly higher in CP and CPDM patients.

Myofibroblasts in oral lesions: A review.

Myofibroblasts (MFs) are modified fibroblasts that express features of smooth muscle differentiation and were first observed in granulation tissue during wound healing. These cells play a key role in physiologic and pathologic processes like wound healing and tumorigenesis. The presence of MFs has been reported in normal oral tissues and pathologic conditions like reactive lesions, benign tumors, locally aggressive tumors and malignancies affecting the oral cavity. This article briefly reviews the important hallmarks related to the discovery, characterization and tissue distribution of MFs in oral health and disease.

Gingival fibromatosis with hemi-osseous hyperplasia of jaws, focal maxillary viral papillomatosis of gingiva, fissured tongue and congenitally missing anterior teeth: a case report and surgical management of a new syndrome.

Gingival fibromatosis is characterized by fibrotic enlargement of the gingiva that can occur as inherited or sporadic form. Inherited form can be an isolated trait or as a component of a syndrome. This article reports a 35 year old male patient affected by gingival fibromatosis associated with hemiosseous hyperplasia of mandible, maxilla, and zygoma on the right side, viral papillomatosis of maxillary anterior gingiva, fissured tongue and congenitally missing anterior teeth. The patient was subjected to phase I and phase II periodontal therapy. There was no evidence of recurrence of the enlargement after one year but the papillomatosis recurred. Gingival fibromatosis has been reported to be associated with various other abnormalities but not with those described in our case. This observation raises the possibility that the coexistence of these entities in our case may represent a new syndrome.

Role of deeper sections in diagnostic oral histopathology: a retrospective study.

BACKGROUND: Histopathology is a gold standard diagnostic tool for many lesions. Interpretation of tissue sections is a pivotal step in giving the diagnosis. Usually, initial tissue sections may not show complete features of the lesion, so deeper sections of the specimen may play a significant role at times for final diagnosis. In small biopsy specimens, deeper sectioning is routinely used in many laboratories to enhance the sensitivity and accuracy of the diagnosis. AIM: To analyze the percentage of deeper sections taken and its significance in the final diagnosis of oral lesions. MATERIALS AND METHODS: A total of 500 cases from the files of Department of Oral and Maxillofacial Pathology, Vishnu Dental College, Bhimavaram, Andhra Pradesh were analyzed, and cases of deeper sections were selected. The present retrospective study involves comparison of initial histological findings with those seen in deeper tissue levels of same specimen. RESULTS: 40 cases (8%) were selected for our analysis. Out of these, 19 cases (47.5%) required deeper sections as the initial sections were superficial and undiagnostic. 21 (52.5%) cases were advised for additional sections to confirm, rule out or clarify certain diagnoses, out of which 15 (37.5%) disclosed additional pathological findings, whereas 6 cases (15%) showed the same histological features. CONCLUSIONS: Diagnostic laboratories must balance the utility of deeper levels with the additional time required and expense incurred and the impact on patient care. Deeper sections are inevitable in certain situations and periodical auditing of laboratory work will reduce the need for additional sections and delay in the dispatch of biopsy report.