Odontogenic Keratocyst With Moderate Epithelial Dysplasia: A Rare Entity.

We present a rare case of odontogenic keratocyst (OKC) with moderate epithelial dysplasia in a 47-year-old male patient. He presented with a history of pain and swelling on the right side of his face for the past three months. The radiograph revealed multi-locular radiolucency involving the ramus, coronoid process, and condylar process of the right mandible. We have discussed the cytology, incisional biopsy, radiological investigations, surgical management, reconstruction, excisional biopsy report, and follow-up of this rare entity.

Gene expression analysis of microRNA-1285 in the South Indian oral squamous cell carcinoma population.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the most common oral malignant tumor, which has poor prognosis. The traditional investigative modality is invasive biopsy which is the gold standard for diagnosis. In recent years, alternative methods like non-invasive biomarkers have been studied for their potential role in early diagnosis and prognosis. Among them, microRNAs (miRNAs or miRs) are short non-coding RNAs that regulate gene expression in various diseases, including OSCC. Several miRNAs are being researched as non-invasive biomarkers as well as novel therapeutic targets in the treatment of OSCC. MiR expression can be upregulated or downregulated in OSCC. Among the reported miRNAs, miR-1285 is an important miRNA found to be involved in OSCC. The aim of the current study was to quantify the levels of miR-1285 in OSCC samples and to validate their potential role as biomarkers for OSCC detection. METHODS: Sixteen samples of cancer tissue and normal tissue were evaluated from a total of 25 patients, in the study, conducted in the Department of Oral and Maxillofacial Surgery. The tissues were processed for H&E staining and gene expression analysis of miR-1285. The samples were collected after proper informed consent from the patients. Total RNA isolated was reverse transcribed into cDNA which was used in the gene expression analysis using qRT-PCR. RESULTS: The histopathological examination confirmed the OSCC cases and the gene expression analysis revealed that miR-1285 was significantly downregulated in OSCC tissues. Since miR-1285 showed significant difference between the OSCC and normal tissues it could be postulated as a potential biomarker and therapeutic target for OSCC. CONCLUSIONS: Further in-vitro and in-vivo studies could validate their functional role in OSCC.

Expression levels of microRNA-7110 in oral squamous cell carcinoma.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a leading cause of cancer-related deaths worldwide, and it is responsible for more than 95% of head and neck cancers. Despite advancements in research and treatment, patient's survival has not significantly increased in recent years. On the other hand, microRNAs (miRNAs) are a major class of small non-coding RNAs that regulate gene expression of the target mRNAs. Thus, understanding the mechanisms behind OSCC formation and progression may lead to the identification of potential diagnostic biomarkers and therapeutic molecules for the treatment of OSCC. The aim of the current study was to analyze expression levels of miR-7110 in OSCC tissues and adjacent normal tissues as it could provide insights into its potential role in OSCC development or progression as a valuable biomarker. METHODS: A total of 20 OSCC and adjacent normal tissues were collected from the Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals (Chennai, India). The tissues were processed for hematoxylin and eosin staining and expression studies. The data were shown as mean±standard deviation and P<0.05 was considered statistically significant. RESULTS: Our histopathological observations revealed an invasive malignant epithelial neoplasm with malignant epithelial cells exhibiting features of severe epithelial dysplasia invading the connective tissue stroma as islands, strands and cords with varying degrees of differentiation. Our results have also revealed that the expression levels of miR-7110 were found to be significantly higher in OSCC samples when compared to the normal tissue. CONCLUSIONS: We can preliminarily conclude that based on the increased expression of miR-7110 in OSCC tissue samples, they can be used as an early diagnostic or prognostic biomarker and/or a therapeutic target for the treatment of OSCC even though more focused research in that direction is needed.

Pilar Cyst From a Maxillofacial Surgeon's Perspective: A Case Report and Review of Literature.

Pilar cysts/trichilemmal cysts are benign lesions that arise from the hair follicle epithelium. The commonest area of occurrence is the scalp but it can also occur in the head and neck region. The pilar cyst grows at a prolonged rate. They are relatively rare and occur in about 10% of the population. They appear in the region of high concentrations of hair follicles. A 75-year-old male patient came to the Department of Oral and Maxillofacial Surgery with a chief complaint of swelling on the left side of the face for the past one year. Cytological examination revealed an infected cystic lesion. Computed tomography (CT) showed a well-defined lesion in the left temporal region. After surgical excision of the lesion, it was sent for histopathological examination. Excisional biopsy revealed a pilar cyst. We report a rare case of pilar cyst in the left temporal region in a patient who was previously operated on for osteomyelitis of the left side of the mandible up to the coronoid process. These cysts may mimic temporal space infection and lead to an incorrect treatment plan.

Adenoid Cystic Carcinoma of the Oral Cavity- A Case Report Comparing the Differences and Similarities Between a Child and an Adult Patient.

Adenoid cystic carcinoma is a malignant neoplasm primarily of the salivary gland, which can also involve lacrimal glands and other exocrine glands. Adenoid cystic carcinoma rarely presents in the buccal mucosa and young children, and among the major salivary glands, it rarely occurs in the sublingual gland. We are presenting two cases of Grade 1- adenoid cystic carcinoma. One in the buccal mucosa of an eight-year-old boy and another in the sublingual gland of a 50-year-old female patient. The site and age of occurrence can make a huge difference in diagnosis and treatment planning due to the unpredictability of the lesion. Proper diagnosis, treatment planning, and appropriate treatment help improve the lesion's prognosis. Even though such lesions rarely occur, awareness among the Oral and maxillofacial fraternity is very important in providing proper patient care.

Quality of Life: determinant of success of head and neck cancer therapy in the battle of survival vs. rehabilitation.

BACKGOUND: Surgical treatment for cancers in the oral and maxillofacial region significantly impacts a patient's physical, social, functional, and psychological well-being, which can in-turn affect the Quality of Life (QoL) negatively. The goal of our study was to assess the Quality of Life (QoL) of patients who underwent surgery in our hospital, and we attempted to extrapolate the data which could in the future help improve the QoL of other patients who undergo similar treatments. METHODS: This was a retrospective study, including patients who have been treated for oral cancer in the last few years in the institute. The standard EORTC Questionnaires QLQ C-30 (version 3.0) and QLQ H and N-35 (version 1.0) were used in this study. RESULTS: GHS scores were lower in patients with T3 stage tumor than in patients with T1 stage tumor. Patients who underwent surgery along with radiotherapy and those who underwent surgery, radiotherapy, and chemotherapy showed a substantial difference in their GHS and FS ratings when their treatment options were compared. Patients who had undergone surgery, radiation, and chemotherapy had higher scores on the symptom scale and QoL H&N-35 than patients who had just undergone surgery and radiotherapy There was no statistically significant difference in the scores, pertaining to the location, age, gender and stage of the tumor but when the comparison was made on the basis of treatment modality chosen, there was a significant difference in the scores. CONCLUSIONS: The aim of any treatment is to improve the Quality of Life. The EORTC questionnaires QLQ 30 and QLQ H and N-35 proved to be very appropriate instruments to evaluate QoL in patients with oral cancer. Assessment of QoL should always receive adequate attention in treatment planning and rehabilitation. Choice of treatment modality plays a significant role in QoL of patients treated for oral cancer. Henceforth, any treatment modality should be selected not only with a curative intent but also with the goal of improving the Quality of Life as this ultimately decides the success of the therapy from the patient's perspective.

Comparative Extraction and Bioactive Potential of the Leaf Extracts of Azadirachta indica for Combatting Postoperative Head and Neck Infections: An In Vitro Study.

INTRODUCTION: Surgical site infections (SSIs) following head and neck cancer surgery are very common postoperative sequelae. Delayed wound healing leads to a poor aesthetic outcome, delay in restarting oral intake, and delay in getting or starting adjuvant therapy. Antibiotic resistance is on the rise necessitating studies that use alternatives to combat the rising antibiotic resistance. Many plant compounds have been studied to explore the possibility. Neem (Azadirachta indica), a high medicinal value plant, possesses a vast array of phytocompounds, which are broadly grouped into isoprenoids and non-isoprenoids. These phytocompounds are crucial for its anti-inflammatory, antioxidant, antimicrobial, antipyretic, and various other pharmacological activities. MATERIALS AND METHODS: In this study, we examined the impact of the extraction solvents on the bioactive potential of neem. Neem leaf samples were extracted with water and ethanol; followed by their biological activities like extraction yield, antioxidant, antimicrobial, and cytotoxicity studies were performed. The extraction yield was found to be higher in the ethanolic extract than in the aqueous extract, which also corroborates with increased antioxidant and antibacterial activity. Both the aqueous and ethanolic extracts of neem exhibited antibacterial activities against dental biofilm-producing pathogens like Staphylococcus aureus, Streptococcus mutans, Pseudomonas aeruginosa, and Escherichia coli. Results: Extraction yield was higher in the ethanolic extract of neem. Antioxidant activity was found to be higher in the ethanolic extract than in the aqueous extract. Neem extract has no toxicity, which was observed through hemolytic and zebrafish embryo toxicity assays. The ethanolic extract of neem was shown to be more effective against the Gram-positive and Gram-negative drug-resistant bacterial pathogen Discussion and conclusion: Thus, the utilization of neem extracts is certainly useful in controlling pathogenic bacterial growth in clinical applications. Further, a detailed mechanism of action of neem extract in bacterial growth inhibition at the molecular level is warranted to utilize their potential in disease management.

Knowledge, awareness, and prevalence of various types of suturing techniques used for intraoral wound closure.

Wound closing is critical to the completion of any surgical operation. An imperfect closure causes edge isolation, creating a possible route for bacterial contamination, which can lead to infection and scarring. While tissue adhesives and staples are now used as substitutes, surgical sutures remain the gold standard for a safe wound. The aim of this survey is to assess dental students' knowledge on the variety of suturing techniques. A comprehensive online survey of 100 dental students with simple questions about different types of sutures was performed. Each student was asked to complete a questionnaire of 20 questions. This study saw a total of 100 students take part in it. It was found that 58% of the participants opted for interrupted suturing technique and the rest 42% opted for simple continuous technique. It was found that 23% of the participants were not aware of the simple loop suturing technique and the rest 77% were aware of this suturing technique. Thus from the above results and discussion, we will conclude that almost all of the members are fairly privy to the distinctive suturing strategies; however; intensive expertise is required.

Modified Bilateral Perialar Crescent Flap for Reconstruction of Combined Upper Lip and Premaxillary Defect.

Many reconstruction methods are performed for combined defects of upper lip and premaxilla in oral cancer patients, which are complicated and multiple staged procedures, compromising the functional or structural unit. In this case report, we present a modification of the bilateral perialar crescent flap for reconstructing the combined defect of upper lip and premaxilla in a single stage. A patient diagnosed with well-differentiated squamous cell carcinoma of premaxilla and upper lip, involving a surgical defect of more than one-third but less than two-thirds of the lip underwent two cycles of neoadjuvant chemotherapy. Later wide local excision of the lesion and simultaneous reconstruction with a modified perialar crescent flap was performed in a single stage. Patient recovered uneventfully and tolerated the procedure well, without any complications. The patient was found to be satisfied with the functional and esthetic result. The reduced upper lip support which was a result of the bony defect of the premaxilla, was corrected with a dental prosthesis. This modification is a useful reconstruction tool for oral cancer patients with combined defects of upper lip and premaxilla.

Metastatic Tumour to the Mandible - A Diagnostic and Management Dilemma.

Metastatic tumours of the jaw are overlooked due to their relatively rare incidence. However, they are often the first indicators of an unknown primary malignant lesion. In this case report, we present a 68-year-old male patient with a suspected intraosseous malignancy of the mandible who was treated by a right segmental mandibulectomy. The final histopathology report was indicative of a secondary metastatic tumour. Positron emission tomography scan revealed a suspicious lesion in the right lung, which was identified as the primary tumour by biopsy using the Tru-Cut® biopsy device (MeritMedical, Jordan UT). The metastatic lesion to the oral soft tissues was easily recognized, in contrast to the jawbone metastasis. Differentiating between primary intraosseous and metastatic mandibular tumours relies on the histopathologist and the surgeon working in tandem to arrive at an early conclusive diagnosis. Knowledge of metastatic tumours to the facial bones is indispensable to a surgeon as it can often be the first indication of an unknown primary malignancy. Identification of early signs, appropriate and timely investigative procedures, coordination between pathologist and surgeon, and choosing the correct treatment modality can help prolong and improve the quality of life of the patient.