Calcifying cystic odontogenic tumour: Dilemma and pitfalls.

Odontogenic lesions are a category of lesions, which are found to be arising from the remnants of the tooth-bearing tissues of the body, that can be cystic in nature as a result of degeneration or as a result of excessive proliferation of these cells, can result in the formation of odontogenic tumours which are found in gnathic bones in the body. Since their discovery in literature and the explanation provided for their pathogenesis, these lesions have been the subject of debate and controversy amongst researchers as well as practitioners. Thereby, this review has taken into consideration one such odontogenic tumour, Calcifying Cystic Odontogenic Tumour (CCOT), which first were included under the namesake (Calcifying odontogenic cyst) as a sperate subheading under this cyst, but now has been designated under the category of tumours along with various histologic subtypes classified and described henceforth. Although the lesion has been removed in the recent classification, a wide variety of lesions in biphasic form has been reported in the past. Therefore, this present review takes a sneak-peek into this lesion with insight into its presentation, incidence, aetiology, pathogenesis, histopathology and all the controversies surrounding this category of lesion and the current literature about this lesion with proving the fact that this needs to be considered again in the category of odontogenic tumours.

Impedance Spectroscopy for Bacterial Cell Monitoring, Analysis, and Antibiotic Susceptibility Testing.

Conventional approaches for bacterial cell analysis are hindered by lengthy processing times and tedious protocols that rely on gene amplification and cell culture. Impedance spectroscopy has emerged as a promising tool for efficient real-time bacterial monitoring, owing to its simple, label-free nature and cost-effectiveness. However, its limited practical applications in real-world scenarios pose a significant challenge. In this review, we provide a comprehensive study of impedance spectroscopy and its practical utilization in bacterial system measurements. We begin by outlining the fundamentals of impedance theory and modeling, specific to bacterial systems. We then offer insights into various strategies for bacterial cell detection and discuss the role of impedance spectroscopy in antimicrobial susceptibility testing (AST) and single-cell analysis. Additionally, we explore key aspects of impedance system design, including the influence of electrodes, media, and cell enrichment techniques on the sensitivity, specificity, detection speed, concentration accuracy, and cost-effectiveness of current impedance biosensors. By combining different biosensor design parameters, impedance theory, and detection principles, we propose that impedance applications can be expanded to point-of-care diagnostics, enhancing their practical utility. This Perspective focuses exclusively on ideally polarizable (fully capacitive) electrodes, excluding any consideration of charge transfer resulting from Faradaic reactions.

International medical students' experiences of psychological safety in feedback episodes: a focused ethnographic study.

BACKGROUND: Feedback and psychological safety are well-established concepts within medical education, vital for student learning and progress. However, the concepts remain unexplored in the context of international students. This area deserves attention given the unique challenges faced by the overseas medical students due to cultural differences. The present study examines international students' experiences of psychological safety in feedback interactions in a Scottish undergraduate medical programme. METHODS: A focused ethnographic approach was adopted to explore international students' experiences and perceptions of psychological safety in their feedback experiences. Data were collected in the form of field observations and semi-structured interviews, involving both student and faculty participants. Approximately 13hrs of fieldwork and a total of 11 interviews were conducted. These were analysed using a combination of inductive and deductive thematic analysis. RESULTS: Data analysis identified four key themes: feedback delivery, educator attributes, cultural factors and longitudinal educational relationships. Both staff and student participants highlighted how environmental factors such as room design and group size functioned as enablers or barriers to psychological safety in feedback episodes. Additionally, students appreciated tutors who expressed vulnerability and demonstrated awareness of their cultural backgrounds. Students described significant differences between the feedback approaches in the host (UK) institute and that in their home country. Longitudinal associations fostered trust and familiarity with peers and tutors, enhancing students' receptivity to learning and feedback. CONCLUSION: This present study highlights cultural differences in feedback practices across countries and their impact on psychological safety among international students. It stresses the importance of integrating overseas students by considering group dynamics, environment and diverse student needs. Staff awareness of cultural variability, openness to tutor vulnerability and fostering long-term educational relationships can greatly enhance psychological safety in learning and teaching activities. These insights are relevant amidst the growing globalisation of medical education and the mobility of students across borders, advocating for tailored integration to optimise their learning experience and achievement.

Management of Cardiovascular Disease Patients with Periodontitis Requiring Dental Treatment - A KAP Study among Dental Students.

Background: It is frequently observed that dental students require so many consents to manage medically compromised patients, especially cardiovascular patients with periodontitis requiring dental treatment. Aims and Objectives: The present study aimed to assess the dental students' knowledge, attitudes, and practices regarding the management of cardiovascular disease (CVD) patients with periodontitis requiring dental treatment. Material and Methods: The cross-sectional study was conducted among 611 dental undergraduate and postgraduate students (branches of Periodontology, Oral and Maxillofacial Surgery, Oral Medicine and Radiology, Endodontics, Prosthodontics, and Public Health and Dentistry) of central Gujrat. Self-administered structured questionnaires with 23 questions were distributed in pen-and-paper physical format. Statistical analysis for descriptive statistics like frequency, percentage, mean, standard deviation, confidence interval, one-way analysis of variance, post hoc test for multiple comparisons, Fisher's exact test, and Pearson's correlation has been done by MS Excel and STATA/IC-13. Results: As per the post hoc test, both groups of students have significantly different knowledge (-4.20210*, P = 0.028) and their practices (0.68632, P = 0.968) but no significant difference between their attitudes (-6.22828, P = 0.089). According to the Pearson correlation test, a weak positive/no relationship between knowledge, attitudes, and practice is reported in both study groups. There is a weak positive relation between knowledge and attitudes (0.270) and between knowledge and practices (0.121), and a similar relationship between their attitudes and practices (0.172) was observed in both groups. Conclusion: Correct knowledge, attitudes, and practices regarding dental management of CVD patients with periodontitis can reduce medical consent to improve the treatment quality of dental students.

Analysis of non-metric dental traits for ethnicity identification in a mixed population of Uttar Pradesh.

BACKGROUND: Forensic odontology involves the identification of individuals through dental records, making it a crucial tool in legal investigations. Non-metric dental traits (NMDT), which are variations in dental morphology play a key role as these traits are inherited characteristics that can help establish biological relationships or ancestry. Thus, we aim to assess the frequency and variability of NMDT in the human dentition of four ethnically mixed populations in Uttar Pradesh. This study can aid in the future by maintaining records of ethnic groups and their variability, which can be crucial for disaster victim management and forensic odontology. METHODS: The study was conducted on a total of 100 patients coming to the OPD of Oral Medicine and Oral Pathology and Microbiology of King George's Medical University from January 2022 to July 2023. Impressions of both arches were made for participants using irreversible hydrocolloid (alginate), and casts were examined under a stereomicroscope to assess 15 different morphological characteristics. RESULTS: NMDTs such as winging, shoveling, double-shoveling interruption groove, canine mesial ridge, hypocone, metacone, carabelli's trait, peg-shaped incisors, peg-shaped molar, premolar lingual cusp variation, deflecting wrinkle, protostylid, metaconulid, entoconulid was evaluated. The NMDTS were evaluated in four different ethnics Nordics, Mediterranean, Oriental Mediterranean, and Protoaustraloid amongst which various traits showed a statistically significant variation among the population of Uttar Pradesh. CONCLUSION: The sample studied presented confirmed supernumerary traits like metacone, protostylid, carabellis trait, metaconulid, premolar lingual cusp variation, and deflecting wrinkle were seen highest in Nordic, Mediterranean, Oriental Mediterranean, and Protoaustraloid ethnicity have a significant association with the Uttar Pradesh population.

Sclerosing Odontogenic Carcinoma: UPLIFTS and pitfalls.

Sclerosing Odontogrenic Carcinoma (SOC) is a recent addition to the category of odontogenic tumours, which was first described by Koutlas et al. in 2008. It was described as primary intraosseous carcinoma with bland cytology, sclerotic stroma with presence of local infiltration showing aggressive behaviour. Following its discovery and the presentation of first case, only a handful of cases have been reported till date, which may be due to underreporting of the cases or inclusion of the case to other diagnosis since the features of this tumour overlaps with many other lesions of the oral cavity. Due to this factor, the pathogenesis of this category of tumours still remains enigmatic. The clinical features as a result of this factor are also not reported of the consistent type and overlaps with the already existing clinical features of other lesions. This lesion has only appeared till date twice in WHO classification of Odontogenic Cysts and Tumours. Thereby, the literature on this category is still in paucity. Therefore, the present review takes into account all of the features, diagnostic criteria and the markers discovered for this lesion and would provide an insight into whether this lesion is justified as a malignant lesion or should not be considered as a separate category of odontogenic tumour.

Giant Cell Lesions of the Jaws: A Work on Current Concepts and Making Through a Working Classification.

INTRODUCTION: Giant cell-rich lesions are a diverse group of lesions that usually occur in bone and contain varying numbers of reactive osteoclastic-type multinucleate giant cells. These lesions present a challenge in pathologic diagnosis, often requiring a combination of clinical, radiographic, and histopathological assessments. The present retrospective observational study aims to provide a concise diagnostic criterion by combining all these parameters, which will aid in effective diagnosis and targeted treatment planning in the future. MATERIAL AND METHOD: Previously diagnosed cases of these lesions were taken from the archives and categorized as Central Giant Cell Granuloma (CGCG), CGCG with secondary Aneurysmal Bone Cyst (ABC), primary ABC, and Brown's Tumour. Their demographic characteristics along with clinical, radiological, and histological data were retrieved and compiled into the table. The data was then analyzed and classified into aggressive and non-aggressive CGCG according to the criteria set in the study. RESULT: 10 reported cases were of isolated CGCG, 5 were CGCG with secondary ABC, 5 of Brown's tumor and 3 were that of conventional ABC. Out of these, the lesions showing extensive size along with an increased number of giant cells were categorized under aggressive CGCG, whereas those with less aggressive characteristics were categorized under non-aggressive CGCG. The aggressive category comprised 5 cases of isolated CGCG, 2 cases of CGCG with secondary ABC, 3 cases of primary ABC, and 5 of brown tumor, whilst the rest of the cases were categorized under non-aggressive CGCG. CONCLUSION: Since all these share overlapping features, thereby this type of concise categorization is the dire need so that the lesions can have a precise diagnosis with treatment and follow-up intervals for aggressive lesions.

An unusual presentation of calcifying odontogenic cyst with literature review.

The calcifying odontogenic cyst (COC) is an uncommon developmental odontogenic cyst, the oral counterpart of Malherbe's cutaneous calcifying epithelioma (pilomatricoma). This article presents two unique cases of calcifying odontogenic cysts each exhibiting distinctive histopathological features and its literature review. One case with an unexpected finding of cholesterol granuloma (CG), a rare occurrence in non-inflammatory cysts within an unusual location between two maxillary central incisors. One more instance involves the presence of a compound odontome in conjunction with COC. The cases underscore the clinical and histopathological diversity of COC and highlight the importance of radiological and histopathological assessments for accurate diagnosis. The unexpected association of COC with cholesterol granuloma challenges traditional diagnostic expectations. Additionally, the second case suggests that COCs may warrant sub-categorization to better understand their varied presentations and biological behavior. This article contributes to the expanding knowledge of COC, emphasizing the significance of documenting rare cases to enhance comprehension of its nature, pathogenesis, and oral cavity origin.

Calcifying odontogenic cysts: A novel outlook on classification, diagnosis and management.

BACKGROUND: The Calcifying Odontogenic Cysts (COC) displays a wide range of clinical and histopathological variations as well as diverse biological behaviors. This diversity has led to confusion and disagreement regarding the terminology and classification of this lesion. The previous classification attempts to categorize COC into two concepts. The first concept, termed "monistic," suggests that all COCs are neoplastic despite the majority being cystic in structure and seemingly non-neoplastic. The second concept, known as "dualistic," posits that COC comprises two distinct entities: a cyst and a neoplasm. This research discusses various previous classifications of COC found in the literature and proposes a new, straightforward universal classification based solely on histopathology, aiming to facilitate understanding for surgeons. MATERIAL AND METHODS: Fifteen cases of COC have been collected with clinicopathological parameters including detailed information regarding patient demographics, symptoms, anatomical site, radiological characteristics, duration of evolution, recurrence, and types of histopathology according to the proposed classification. RESULT: A total of fifteen cases of COC were analyzed. According to the histological analysis of the proposed classification Type 1: 5 (33.3), Type II: 4 (26.6), Type III: 3(20), and Type IV:3(20) and recurrence in 3 (20 %) of cases. CONCLUSION: It simplifies the complexities arising from variations in the cystic linings of type IV of COC, which can be overlooked and have caused recurrence in the current research. Therefore, the key requirement for arriving at a validated and practical conclusion lies in the accurate histological classification of calcifying odontogenic cysts and their impact on treatment.

Preliminary Evaluation of Fine-Tuning the OpenDeLD Deidentification Pipeline Across Multi-Center Corpora.

Automatic deidentification of Electronic Health Records (EHR) is a crucial step in secondary usage for biomedical research. This study introduces evaluation of an intricate hybrid deidentification strategy to enhance patient privacy in secondary usage of EHR. Specifically, this study focuses on assessing automatic deidentification using OpenDeID pipeline across diverse corpora for safeguarding sensitive information within EHR datasets by incorporating diverse corpora. Three distinct corpora were utilized: the OpenDeID v2 corpus containing pathology reports from Australian hospitals, the 2014 i2b2/UTHealth deidentification corpus with clinical narratives from the USA, and the 2016 CEGS N-GRID identification corpus comprising psychiatric notes. The OpenDeID pipeline employs a hybrid approach based on deep learning and contextual rules. Pre-processing steps involved harmonizing and addressing encoding and format issues. Precision, Recall, F-measure metrics were used to assess the performance. The evaluation metrics demonstrated the superior performance of the Discharge Summary BioBERT model. Trained on three corpora with a total of 4,038 reports, the best performing model exhibited robust deidentification capabilities when applied to EHR. It achieved impressive micro-averaged F1-scores of 0.9248 and 0.9692 for strict and relaxed settings, respectively. These results offer valuable insights into the model's efficacy and its potential role in safeguarding patient privacy in secondary usage of EHR.

Total Synthesis of Lipopeptide Bacilotetrin C: Discovery of Potent Anticancer Congeners Promoting Autophagy.

A convergent strategy for the first total synthesis of the lipopeptide bacilotetrin C has been developed. The key features of this synthesis include Crimmins acetate aldol, Steglich esterification, and macrolactamization. Twenty-nine variants of the natural product were prepared following a systematic structure-activity relationship study, where some of the designed analogues showed promising cytotoxic effects against multiple human carcinoma cell lines. The most potent analogue exhibited a ∼37-fold enhancement in cytotoxicity compared to bacilotetrin C in a triple-negative breast cancer (MDA-MB-231) cell line at submicromolar doses. The study further revealed that some of the analogues induced autophagy in cancer cells to the point of their demise at doses much lower than those of known autophagy-inducing peptides. The results demonstrated that the chemical synthesis of bacilotetrin C with suitable improvisation plays an important role in the development of novel anticancer chemotherapeutics, which would allow future rational design of novel autophagy inducers on this template.

2'-O-Alkyl-N 3-Methyluridine Functionalized Passenger Strand Improves RNAi Activity by Modulating the Thermal Stability.

Herein, we have demonstrated that the siRNA activity could be enhanced by incorporating the guide strand in the RISC complex through thermodynamic asymmetry caused by m3U-based destabilizing modifications. A nuclease stability study revealed that 2'-OMe-m3U and 2'-OEt-m3U modifications slightly improved the half-lives of siRNA strands in human serum. In the in vitro gene silencing assay, 2'-OMe-m3U modification at the 3'-overhang and cleavage site of the passenger strand in anti-renilla and anti-Bcl-2 siRNA duplexes were well-tolerated and exhibited improved gene silencing activity. However, gene silencing activity was attenuated when these modifications were incorporated at position 3 in the seed region of the antisense strand. The molecular modeling studies using these modifications at the seed region with the MID domain of hAGO2 explained that the 2'-alkoxy group makes steric interactions with the amino acid residues of the hAGO2 protein.

Idiopathic Lympho-Plasma Cellular Mucositis; A Diagnostic Predicament.

The term "idiopathic lymphoplasmacellular mucositis" (ILPM) refers to a set of conditions marked by extensive lymphocyte and plasma cell infiltrates in the submucosa which can involve the oral cavity, upper respiratory tract and the genital epithelium. There is no recognized cause of ILPM, and the diagnosis is mostly done on an exclusion basis. Herein, we report a 32-year-old man presented with an erosive ulcerated lesion on the hard palate and review the literature regarding the possible differential diagnosis including squamous cell carcinoma. We also reviewed the previously reported cases of ILPM with palatal involvement to summarise clinical presentation, treatment, and outcome of the entity to date.

Giant Cell Tumor of the Mandible: A Case Report with an Argument on a Possible Diagnostic Tool.

Giant cell tumor (GCT) is a benign, locally aggressive neoplasm with a high recurrence rate with common occurrence in the long bone and the cases in the maxillofacial region bone are very rare. Due to the paucity of the cases, there is not enough information available regarding the behavior of the tumor. Also, the differentiation of this aggressive lesion with the commonly occurring reactive giant cell lesions is crucial and needs more research. This study is pertaining to the review of literature of the cases of GCT in the oral cavity with their clinicopathological, radiographic, and biochemical analyses. Although there are no available studies regarding the immunohistochemical characteristics of this lesion, this study is the first step in this direction to differentiate this tumor better and identify the possible pathogenesis.

Rev-erbα regulate neurogenesis through suppression of Sox2 in neuronal cells to regenerate dopaminergic neurons and abates MPP+ induced neuroinflammation.

Parkinson's disease is a progressive neurodegenerative disease that affects the motor and non-motor circuits of the brain. Currently, there are no promising therapeutic measures for Parkinson's disease, and most strategies designed to alleviate the Parkinson's disease are palliative. The dearth of therapeutic interventions in Parkinson's disease has driven attention in the search for targets that may augment dopamine secretion, promote differentiation towards dopaminergic neuronal lineage, or aid in neuroprotection from neuronal stress and inflammation, and prevent Parkinson's disease associated motor impairment and behavioural chaos. The study first reports that Rev-erbα plays an important role in regulating the differentiation of undifferentiated neuronal cells towards dopaminergic neurons through abating Sox2 expression in human SH-SY5Y cells. Rev-erbα directly binds to the human Sox2 promoter region and represses their expression to promote differentiation towards dopaminergic neurons. We have reported a novel mechanism of Rev-erbα which effectively abrogates 1-methyl-4-phenylpyridinium induced cytotoxicity, inflammation, and oxidative stress, exerted a beneficial effect on transmembrane potential, and suppressed apoptosis in the neuronal in vitro model of Parkinson's disease. Rev-erbα ligand SR9011 was observed to ease the disease severity in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine induced mouse model of Parkinson's disease. Rev-erbα alleviates the locomotor behavioural impairment, prevents cognitive decline and promotes motor coordination in mice. Administration of Rev-erbα ligand also helps in replenishing the dopaminergic neurons and abrogating the neurotoxin mediated toxicity in an in vitro and in vivo Parkinson's disease model. We conclude that Rev-erbα emerges as a moonlighting nuclear receptor that could be targeted in the treatment and alleviation of Parkinson disease.

How predominant cell and stroma types harmonize to predict head and neck adenoid cystic carcinoma outcomes?

Adenoid cystic carcinoma (ACC) is an uncommon tumor that usually appears in the major salivary glands of the head and neck region, including the minor glands in the oral cavity, sinonasal tract, and other sites. ACC of the head and neck may have a low-grade histological appearance. This malignant tumor has unusual clinical characteristics such as occasional regional lymph node metastases and a prolonged yet continuously advancing clinical course. Additionally, it is an invasive tumor with perineural invasion, difficult-to-clear margins, metastasis, and localized recurrence. The cribriform and tubular proliferation of basaloid cells, which mostly display a myoepithelial cellular phenotype, are ACC's distinct histologic characteristics. The degree of genetic alterations and aneuploidy observed in tumor genomes are linked to the severity of histologic grade, which correlates with clinical prognosis. The three predominant cell types (PCTs) i.e., conventional ACC (C-ACC), myoepithelial-predominant ACC (M-ACC), and epithelial-predominant ACC (E-ACC)-and their respective applications will be reviewed. The function of extracellular matrix (ECM) components such as laminin, type IV collagen, fibronectin, and tenascin are also emphasized. An attempt has been made to explore the recent molecular diversity, regulatory pathways prevalent in PCT, ECM with its genetic changes, and translational utility with targeted therapies for ACC.

Cone-beam computed tomography-based descriptive classification for transverse root fracture.

Transverse root fracture (TRF) is classified as a cervical, middle or apical third root fracture on a periapical radiograph. The International Association of Dental Traumatology (IADT) suggests that cone-beam computed tomography (CBCT) should be considered, when conventional radiographs provide 'insufficient' information for diagnosis and treatment planning. Considering that CBCT can divulge additional information, it would be beneficial to have a clinically pertinent three-dimensional classification for TRF. The proposed alphanumeric classification includes the traumatised tooth number, describes the number of TRF, the facial and lingual location of each fracture line on the anatomic root, and its position relative to the crest of the alveolar bone. Further, diastasis, displacement of the coronal fragment and status of the alveolar bone at the site of TRF are also documented. This comprehensive classification system would provide a standard format for reporting, aid in referral communication and can be applied for future outcome studies on TRF.

p16, p53 and EGFR expression in head and neck squamous cell carcinoma and their correlation with clinicopathological parameters.

INTRODUCTION: Oral squamous cell carcinoma is a major cause of death throughout the developed world. Human papillomavirus (HPV) type 16 has also been suggested to play a role in etiology of head and neck squamous cell carcinoma (HNSCC). p16 expression is now being used as a surrogate marker of HPV infection in squamous cell carcinoma. Dysfunction in the p53 tumor suppressor gene is implicated in many cancers, including head and neck cancer. Overexpression or mutation of EGFR is found in 80%-100% of the patients with HNSCC, and is associated with poor prognosis and decreased survival. MATERIALS AND METHODS: In this cross-sectional observation study, total of 100 cases of HNSCC were taken. p16, p53, and EGFR expression was determined by immunohistochemical staining and correlated with clinicopathological parameters. p16 expression was also correlated with expression of p53 and EGFR. The obtained results were analyzed and evaluated using Chi-square test, value of P < 0.05 was taken significant. RESULTS: p16, p53, and EGFR were positive in 60%, 44%, and 58% cases, respectively. A statistically significant association was observed between p16 with age, site of the tumor, abnormal sexual habits and lymph node involvement. Significant expression also seen between p53 with age and abnormal sexual habits and immunohistochemical expression of p16 with p53 and EGFR. CONCLUSION: Immunohistochemical expression of p16 can be used as a surrogate marker of HPV. Study of p16, p53, and EGFR expression may provide clinicians with more exact information in order to evaluate tumor aggressiveness and treatment modalities.

Corrigendum: Translatability of findings from cynomolgus monkey to human suggests a mechanistic role for IL-21 in promoting immunogenicity to an anti-PD-1/IL-21 mutein fusion protein.

[This corrects the article DOI: 10.3389/fimmu.2024.1345473.].