Histo-Blood Group Antigens in Oral Cancer and Potentially Malignant Disorders.

BACKGROUND: Early detection of oral cancer is of critical importance because survival rates markedly improve when oral lesions are identified at an early stage. Aim of the present study is to investigate the expression of ABO (H) antigens in tissue specimens of oral cancer and potentially malignant disorders and to determine the role of ABO (H) antigens in tumour staging. MATERIALS AND METHODS: A prospective study was conducted on 60 cases of oral cancer and potentially malignant diseases. Specific red cell adherence test (SRCA-test) was used for studying A, B and O (H) antigens in tissue specimens and iso-antigenicity of epithelium was graded according to degree of adherence of indicator red blood cells. RESULTS: Among OSMF group, grade II adherence was seen in 53.3% cases, grade III in 33.3% cases, grade IV in 13.3% cases. In leukoplakia group, grade II adherence was seen in 26.7% cases, grade III adherence in 53.3% cases, grade IV adherence in 20% cases. Within the leukoplakia group, cases with dysplasia showed decreased adherence, compared with cases without dysplasia. Oral cancer group, negative adherence was seen in 13.3% cases, grade I adherence in 46.7% cases, grade II in 40% cases. In oral cancer group, antigen reactivity was less in poorly and moderately differentiated carcinoma, compared to well differentiated carcinoma. CONCLUSIONS: Antigen adherence and degree of loss of ABO (H) antigens in tissue specimens can be used for staging of the tumour.

Association of Diabetes with Oral Cancer- an Enigmatic Correlation.

INTRODUCTION: Association of diabetes mellitus (DM) with head and neck cancers (HNC) is still controversial. In some studies, diabetic patients had an increased risk of cancer at some HNC subsites like oral cancer, while in other studies this risk was decreased. So, the present study aims to evaluate the association of diabetes mellitus, oral cancer with and without metformin and the role of habits in association with DM and metformin in the etiology of oral cancer. MATERIALS AND METHODS: This study was undertaken in the Kamineni Institute of Dental Sciences in collaboration with MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad. The study includes 2 main groups, they are 500 Oral cancer patients and Control group includes 500 age and gender-matched patients with habits without any oral precancerous lesion/conditions. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using unconditional logistic regression. RESULTS: Out of 1000 subjects inverse relation of DM with oral cancer was observed. On comparison between oral cancer, diabetes and habits in study group and control group, decreased risk was observed with smokers (OR: 1.131and 95%CI: 0.68 -1.86) and non-chewers (OR: 2.43 and 95% CI: 1.31 - 4.49) and non-alcoholics (OR: 1.78 and 95% C.I:1.18 - 2.68). Metformin use among diabetic participants was associated with a decreased risk of oral cancer (OR: 0.51 and 95% C.I: 0.33 - 0.77). A negative association was observed in smokers (OR: 0.19 and 95% C.I.: 0.078 - 0.459), non-chewers (OR: 0.24 and 95% C.I : 0.11- 0.53) and non-alcoholics (OR: 0.46 and 95% C.I. : 0.29 - 0.727). CONCLUSION: Thus the present population based study results suggest an inverse association of DM and oral cancer with metformin and negative association of habits with DM and Metformin in etiology of oral cancer.

Evaluation of Gustatory Function in Oral Submucous Fibrosis Patients and Gutka Chewers

Aim: The aim of the study is to assess and compare taste perception among Oral submucous fibrosis (OSMF) patients, Gutka chewers without OSMF and healthy subjects. Materials and methods: Ninety subjects (30 OSMF, 30 Gutka chewers without OSMF and 30 controls) were enrolled in the study for assessing taste perception by filter paper strips impregnated with different taste qualities. Taste perception assessment was also done in stage I, II and III OSMF subjects. The obtained data were analyzed using SPSS 20.0 software. Results: The gustatory defect was related to sweet, sour, bitter and salt, with significant changes in sour (33.3% showed hypoguesia) taste in OSMF subjects and 13.3%showed hypoguesia to all tastants in gutka chewers and hypoguesia to salt, sour and bitter to grade III compared in grade I and II. Conclusion: This study proved that there is significant alterations to taste perception with sour, salt, and bitter and then to sweet in OSMF subjects.

Sonographic imaging of fibrosis of oral mucosa and its correlation with clinical staging in oral submucous fibrosis.

BACKGROUND AND OBJECTIVES: To evaluate the efficacy of ultrasonography (USG) as a noninvasive tool in assessing the severity of oral submucous fibrosis (OSMF) by measuring the submucosal thickness and also to correlate the sonographic changes with clinical staging. MATERIALS AND METHODS: The submucosal thickness of the upper and lower labial mucosa, anterior and posterior portions of the right and left buccal mucosa were measured using ultrasound in 64 patients comprising of 32 OSMF patients and 32 controls. Among the controls, 16 were with a habit of chewing gutkha and 16 were without any habit history. RESULTS: In OSMF group, four patients were with Stage I, 13 were with Stage II, 11 were with Stage III, and four with Stage IV. Results were analyzed by one-way analysis of variance for the significance of difference among the groups in submucosal thickness. As the stages of OSMF advanced, there was an increase in submucosal thickness of the buccal mucosa in the study group when compared with controls (P< 0.005). CONCLUSION: USG is an effective noninvasive zero radiation tool for assessing the progression of OSMF.

3D Evaluation of Maxillary Sinus Using Computed Tomography: A Sexual Dimorphic Study.

Purpose. Gender determination is considered to be an important step in the reconstruction of the biological profile in forensic medicine. Maxillary sinus can be used for identification of sex when other methods are indecisive. Computed tomography (CT) provides an excellent method for examining maxillary sinuses. Hence the aim of the study was to determine the accuracy of gender determination using maxillary sinus with CT. Materials and Methods. CT images were used to measure the mediolateral, superoinferior, and anteroposterior dimensions and the volume of the maxillary sinuses in 100 patients (50 males and 50 females) to determine the gender of an individual for forensic identification. Discriminative analysis was done using the values derived and the t-test for independent samples was used to compare these values in males and females. Results. The accuracy rate was found to be 84% in males and 92% in females with the mean accuracy of 88%. Conclusion. Our study concludes that gender determination can be done using measurements of maxillary sinus through CT when other methods are unavailable. The prediction rate can be increased by including volume of the maxillary sinus.

Eosinophilic Granuloma Presenting as Palatal Swelling.

Swellings involving palate can be challenging to diagnose for the clinician as they have wide range of origin which can result from developmental, inflammatory, reactive or a neoplastic process. The clinical presentation of these swellings is similar and difficult to differentiate from each other. So it is important to take proper history from the patient and subject the patient to appropriate laboratory and radiographic investigations and finally biopsy is mandatory for accurate diagnosis. Thus, this article highlights on various common palatal swellings, their clinical presentation, and differential diagnosis helpful for proper diagnosis of swellings associated with palate.

Identification of gender using radiomorphometric measurements of canine by discriminant function analysis.

PURPOSE: Human teeth are the most stable and durable tissues in the body. Teeth can be identified even after complete decomposition, thus making them invaluable for identification of sex and age from fragmentary adult skeleton. This study aimed to compare the morphological and radiological measurements of canine and investigate its accuracy in sex determination. MATERIALS AND METHODS: This study involved 60 males and 60 females between the age group of 20 and 30 years. Mesiodistal (MD) widths of mandibular left canines and mandibular inter-canine distance (ICD) were measured and compared both clinically and on digital intraoral periapical and occlusal radiographs. Discriminant function analysis was carried out for gender determination. Discriminant equation and cutoff point were used in determining the gender and the percentage accuracy. Kappa statistics were carried out to assess intra-observer agreement. RESULTS: A definite statistically significant difference in the MD width and ICD was found between males and females. Clinical and radiological measurements were almost equally efficacious in gender determination with an accuracy of 55-75% in both males and females. When all the variables were used, the accuracy of gender determination increased substantially to 94%. k-values suggested a high intra-observer agreement. CONCLUSION: It can be concluded that both the clinical and radiographic measurements of MD width of canine and ICD are quick and easy methods for determining sex and in identification of an unknown individual with a substantial accuracy.

Invitro Antifungal Evaluation of Denture Soft Liner Incorporated with Tea Tree Oil: A New Therapeutic Approach Towards Denture Stomatitis.

AIM: Adherence and colonization of candida on denture soft liners is the most important contributing factor in development of denture stomatitis. This invitro study is undertaken to investigate whether the incorporation of tea tree oil into denture soft liners would inhibit the growth of candida albicans. MATERIALS AND METHODS: Each 10 specimen disks incorporated with tea tree oil into soft liners (St) and without tea tree oil (S) were prepared. Both the tea tree oil daily. These disks were inoculated with candida albicans suspension for assessment of fungal growth and were rinsed with sterile water to remove loosely attached surface organisms. The attached yeasts were measured by inoculating them on saboraud's agar. Treated and control disks were stored in distilled water for 1, 30, 60 days and washed daily with wet cotton. Data between treated and control disks were compared by applying t-test. RESULTS: The mean colony forming units (CFU) per mm(2) for specimens without tea tree oil after water storage and wash with wet cotton for 1, 30 and 60 days was 7.1 × 10(6), 6.5 × 10(6), 6.8 × 10(6), respectively and for specimens with tea tree oil CFU decreased significantly to 2.1 × 10(6), 2.8 × 10(6), 3.1 × 10(6) after 1, 30 and 60 days. Treated disks were effective in controlling the growth of C.albicans for two months following water storage. CONCLUSION: Addition of tea tree oil to denture soft liner significantly reduced growth of C.albicans suggesting a new form of intra oral effective antifungal management for denture stomatitis.

Relationship of salivary cortisol and anxiety in recurrent aphthous stomatitis.

BACKGROUND AND OBJECTIVES: Recurrent aphthous stomatitis (RAS) is one of the most frequently encountered oral mucosal disorders. Despite extensive amount of research, the etiology of RAS remains unclear. Psychological-emotional factors were considered as one of the major predisposing factors. The aim of the study was to assess the levels of anxiety and salivary cortisol levels in patients with RAS and also to determine the association and relationship of salivary cortisol levels to variations of stress. MATERIALS AND METHODS: A total of 30 patients suffering with RAS, along with the same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects at 9.00 am to avoid diurnal variations of cortisol levels. Salivary cortisol levels were measured by competitive enzyme linked immunosorbent assay. Anxiety levels of both groups were measured by using Hamilton's anxiety scale. Student's t-test was used to compare the anxiety and salivary cortisol levels between both groups. RESULTS: The mean salivary cortisol level of the RAS group showed a very highly significant difference (P = 0.000) from the controls. The mean anxiety scores of the RAS group showed a very highly significant difference (P = 0.000) from the controls. The values of Pearson correlation coefficient between anxiety and salivary cortisol was 0.980 and one with a P value of 0.000 showing that there is a highly positive correlation between anxiety and salivary cortisol. CONCLUSION: Results suggest that anxiety may be involved in the pathogenesis of RAS. Thus besides traditional treatment of RAS patients, our findings suggest that psychological support is also needed.

Morphometric analysis of canine in gender determination: revisited in India.

BACKGROUND AND AIM: Teeth are excellent material for anthropological, genetic and odontologic investigations in both living and dead population. Canines are the ideal teeth for identification of sex, due to its sexual dimorphism and durability in the oral cavity. This study tests the effectiveness of the canine tooth in predicting sex of an individual. MATERIALS AND METHODS: This study involved 60 males and 60 females between the age group of 20-30 years. Mesio-distal (MD) widths of maxillary and mandibular right and left canines and inter-canine distance of both arches were measured clinically and on cast for all patients. Standard canine indices were derived from these dimensions and tested for sexual dimorphism and reliability of canine teeth in gender determination by comparison with the known gender of the population under investigation. RESULTS: All measurements showed significant sexual dimorphism. Standard mandibular canine index (CI) was found to be more reliable in gender estimation than the MD width of canine and CI values. INTERPRETATION AND CONCLUSION: Use of the standard mandibular CI in gender determination is recommended for forensic procedures as it was found to have an acceptable accuracy. MD width of canine may be used in a setup when only the single tooth or a fragment of a jaw is available for analysis, with due consideration to its relatively low accuracy.

Evaluation of salivary cortisol and anxiety levels in myofascial pain dysfunction syndrome.

BACKGROUND: Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. METHODS: Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. RESULTS: The mean serum cortisol level of the MPDS group showed a highly significant difference (p < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (p < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. CONCLUSIONS: These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.

Association of salivary cortisol and anxiety levels in lichen planus patients.

BACKGROUND: Oral lichen planus (OLP) is a frequently encountered chronic inflammatory disease of oral mucosa and skin, where the patients often relate the onset and aggravation of oral symptoms to increased levels of stress. Cortisol, also called as "stress hormone" has been used as an indicator in various stress evaluation studies. AIM: The aim of this cross-sectional study was to determine any association between anxiety and salivary cortisol levels in OLP patients. MATERIALS AND METHODS: A total of 20 OLP patients along with same number of age and sex matched healthy controls were included in the study. Saliva was collected from all the subjects between 9.00 to 9.15 am to avoid diurnal variations of cortisol levels. The saliva samples were analysed for cortisol levels by competitive enzyme-linked immunosorbent assay (ELISA) method. Anxiety levels of 40 patients were measured by using Hamilton's anxiety scale. Student's t-test was used to compare the anxiety and salivary cortisol levels between both groups. RESULTS: The mean salivary cortisol level of the OLP group showed highly significant difference (p<0.001) from the controls. The mean anxiety scores of the OLP group showed highly significant difference (p<0.001) from the controls. A positive correlation was found between anxiety and salivary cortisol levels in the OLP patients. CONCLUSION: These findings suggest that anxiety play a vital role in the pathogenesis of OLP, thus besides traditional treatment, psychological support is also needed.

Hereditary hypohidrotic ectodermal dysplasia: report of a rare case.

Hereditary Hypohidrotic Ectodermal Dysplasia (HHED), an X-linked, recessive, Mendelian character, is seen usually in males and it is inherited through female carriers. It is characterised by congenital dysplasia of one or more ectodermal structures and it is manifested by hypohidrosis, hypotrichosis and hypodontia. It results from abnormal morphogenesis of cutaneous and oral embryonic ectoderm. Here, we are presenting a rare case of HHED in a 19 year female with classic features of this condition.

Imaging characteristics of diffuse large cell extra nodal non-Hodgkin's lymphoma involving the palate and maxillary sinus: a case report.

Non-Hodgkin's lymphomas are a group of highly diverse malignancies and have a strong tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. Primary extra nodal lymphoma of the hard palate is rare. Here, we present a case of diffuse large B cell lymphoma in a 60-year-old male patient that manifested as slightly painful ulcerated growth on the edentulous right maxillary alveolar ridge extending onto the palate, closely resembling carcinoma of the alveolar ridge. Computed tomography images showed the involvement of the maxillary sinus and right nasal cavity, along with destruction of hard palate, superiorly extending into the orbit. This case report highlights the importance of imaging to evaluate the exact extent of such large malignant lesions, which is essential for treatment planning.

Unusual imaging appearance of unicystic ameloblastoma.

Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histologic examination show a typical ameloblastous epithelium lining part of the cystic cavity, with or without luminal and/or mural tumor growth. It accounts for 5-15% of all intraosseous ameloblastomas. We report a case of UA in a 35-year-old female with an unusual large multilocular (tennis racket) appearance on the right body of mandible and illustrate the importance and complexity of differential diagnosis with a brief review of recent literature.