Unveiling the In Vitro Anti-Biofilm Potential of Lactobacillus rhamnosus Against Saliva-Based Pathogens: A Gender-Age-Area Specific Study.

Probiotics, like lactobacilli and bifidobacteria, benefit health by populating the digestive system, which houses numerous microbial species. Studies demonstrate their ability to inhibit biofilm formation, crucial in preventing oral conditions like dental caries. Our research evaluated a probiotic strain's anti-biofilm efficacy against oral pathogens in 45 individuals' saliva, alongside its biofilm-forming potential. Analysis revealed significant biofilm inhibition in 36 samples. Comparisons based on age, gender, and geography further supported these findings. We propose further exploration of probiotics tailored to specific demographics to enhance oral health outcomes, suggesting a promising avenue for preventing oral microbial diseases.

Expression of CD44 and SALL4 in Leukoplakia and Oral Squamous Cell Carcinoma.

CD44 and SALL4 are markers of stemness and expressed in cancer stem cells (CSCs). Their deregulated expression was seen in various tumors and has been correlated with clinical severity. We evaluated immunohistochemical expression of CD44 and SALL4 in leukoplakia and oral squamous cell carcinoma (OSCC). CD44 was expressed in all the cases of leukoplakia and Its expression correlated with severity of the dysplasia in leukoplakia but varied with differentiation in OSCC. SALL4 did not express in leukoplakia. Its expression was varied in OSCC cases. We opine that CD44 expression is consistent with the progression of dysplasia in leukoplakia and differentiation in OSCC.

A rare case of undifferentiated pleomorphic sarcoma affecting the mandible - A case report.

Undifferentiated pleomorphic sarcoma (UPS) is a rare entity found in the oral cavity which involves the mandible in only 3% of all UPS bone lesions. The correlation of the clinical presentation of the neoplasm with the histopathological and immunohistochemistry findings is very important for appropriate diagnosis. Its incidence in membranous bone like mandible is rare. According to our literature search in the PubMed database, there are only four reported cases from India some of which does not have any immunohistochemistry findings to confirm the diagnosis. We present a rare case of UPS of mandible which was clinically mimicking squamous cell carcinoma. Upon immunohistochemical analysis, we found vimentin, KI67, CD68 positive and desmin, Melan A, LCA, S100 and myogenin negative, which lead us to the diagnosis of UPS.

Correction: Carcinoma Ex Ameloblastoma of the Mandible: A Rare Case Report.

[This corrects the article DOI: 10.7759/cureus.49536.].

Carcinoma Ex Ameloblastoma of the Mandible: A Rare Case Report.

Ameloblastoma is a benign yet locally aggressive tumor of the jaw bones and is most commonly found in the lower mandibular region. Histologically, it shows benign characteristics. However, ameloblastoma can turn malignant to show a more aggressive clinical course. Carcinoma ex ameloblastoma is an extremely rare malignancy arising from a pre-existing long-standing ameloblastoma or a recurrence of an ameloblastoma. According to the literature search, six to seven cases have so far been documented, and the majority of the lesions had a propensity to metastasize. Here, we present a case of carcinoma ex ameloblastoma implicating a 19-year-old male patient manifesting in the mandible, which arises from pre-existing ameloblastoma.

Comparative immunohistochemical analysis of WT-1, Syndecan and Snail in Ameloblastoma and odontogenic keratocyst: A retrospective study.

Background: The purpose of this experimental study was to evaluate and compare the degree of expression of Wilm's Tumor Gene-1 (WT-1), Syndecan (CD 138) and Snail in Ameloblastoma and odontogenic keratocyst (OKC) and to analyse their potential role in pathogenesis. Methods and Material: Immunohistochemical analysis was performed to evaluate WT-1, Syndecan and Snail expression in Ameloblastoma (n = 20) and OKC (n = 20). Topographical immunoexpression pattern of Ameloblast-like cells, Stellate Reticulum-like cells in Ameloblastoma and basal layer as well as suprabasal layer of cells of OKC were also compared. The results obtained were subjected to ANOVA test and Tukey HSD test through SPSS software 20.0 for Microsoft Windows. Results: WT-1 and Snail overexpression was seen in both Ameloblastoma and OKCs. Syndecan, responsible for maintaining normal cellular morphology, cell-cell adhesion and differentiation was significantly downregulated in both the lesions. The Ameloblasts-like cells and the basal cells showed significantly higher immunopositivity for WT-1 and Syndecan as compared to that of basal cells. An inverse relation was noted for Snail protein. The ANOVA test predicted a statistically significant difference of expression across the lesions with a P value <0.0001 for Syndecan and Snail. Conclusions: The under-expression of epithelial membrane protein Syndecan-1 and upregulation of EMT transcription factor Snail can promote local invasion and is indicative of poor prognosis of these lesions. The overexpression of WT-1 results in tumorigenesis, proliferation and localized aggressiveness of Ameloblastoma and intrabony growth of OKC. Further investigation on the biologic behaviour of OKC is still recommended to arrive at more specific conclusions regarding its nature.

The Study of Expression of Hypoxia-Inducible Factor-1 Alpha (HIF-1 Alpha) and Hypoxia-Inducible Factor-2 Alpha (HIF-2 Alpha) in Oral Squamous Cell Carcinoma: An Immunohistochemical Study.

CONTEXT: Oral cancer is the major cause of mortality and morbidity worldwide. There are many factors that influence the tumor microenvironment that promotes tumorigenesis. Hypoxia is one of the factors that affects the process of angiogenesis by inducing proangiogenic factors to maintain the blood supply which in turn enhances the aggressiveness of the tumor and prognosis of solid tumors such as oral squamous cell carcinoma. AIM AND OBJECTIVE: The aim of the study was to compare the expression of hypoxia-inducible factor 1α (HIF-1α) and hypoxia-inducible factor 2α (HIF-2α) in various histological grades of oral squamous cell carcinoma immunohistochemically. METHODOLOGY: Immunohistochemical evaluation of HIF-1α and HIF-2α was done in 90 samples of oral squamous cell carcinoma which were graded histologically into 30 samples each of well, moderately and poorly differentiated squamous cell carcinoma. Statistical evaluation: Statistical analysis was done to study the prognostic significance of the biomarkers. RESULTS: All the cases showed positivity for expression of HIF-1α and HIF-2α. The number of positive staining in both markers reduced as the tumor severity increased from well to poorly differentiated. The expression of MIL of HIF-2α was higher than HIF 1α and HIF 2α expression was mostly seen in cytoplasmic in well-differentiated and nuclear in both moderately and poorly differentiated OSCC suggestive that HIF-2α is a more specific marker to hypoxia. CONCLUSION: Hypoxia is an essential factor that triggers other angiogenic switch and inflammatory factors which facilitates the process of tumorigenesis. This is also important for predicting the treatment outcome and prognosis of the patients. HIF-2α is a more sensitive marker that appears to be correlated and could perhaps serve as a good surrogate marker of hypoxia.

Recognition of Oral Pathology as a Subject among Dental Undergraduates: Addressing their Concerns.

Oral and Maxillofacial Pathology is a speciality department of dentistry which deals with identification of diseases affecting oral and maxillofacial regions and investigates the cause, processes and effect of these diseases. Books, internet, lectures have made great progress but there is still a gap between students' understanding and interest in the subject. The aim of this study was to evaluate and analyse the challenges faced by undergraduate students in understanding oral pathology theory & practical and modify the teaching process accordingly. A descriptive cross-sectional study of 300 BDS third year students was conducted in our college. The results stated that 83% of the participants attended classes, 90% found the topics covered to be useful, 97% reported that the classes were taken to provide an in depth view of the subject, 71% faced difficulties in understanding the topics in theory classes. 46% attended seminars, 68% viewed more than 4 slides on an average in one practical class, and 80% faced difficulties in identifying the slide. Our data concluded, that if certain measures will be taken so as to engage the students' interests, then this subject would prove to be a much better scope of learning for the budding dentists.

Awareness and Attitude of Dental Practitioners on Impact of Music Therapy on Patients Anxiety Level during Various Types of Dental Treatments.

Music therapy plays an important role in reducing the anxiety of patients during various procedures of dental treatments. Dental practitioners should also be aware of the employment of music therapy on patients before various dental treatments to reduce dental anxiety and the feasibility of its implementation in regular dental practice. A questionnaire study was conducted regarding the awareness and attitude of dental practitioners on the impact of music therapy on dental patients, to which 305 participants responded. A comparison was made between the Undergraduates, Postgraduates, Faculties, Interns, and Private practitioners. They were also asked about the drawbacks associated with music therapy. There was a level of agreement amongst participants regarding the awareness of music therapy. But there was a statistically significant difference (p = 0.011) noted across groups. The majority of the participants agreed that it could be incorporated into a regular dental practice as a stress management procedure.

Lactate Dehydrogenase as a Biomarker in Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis was planned with the objective of evaluating the level of Lactate Dehydrogenase (LDH) in oral submucous fibrosis patients and in controls and comparing them. For this meta-analysis, we searched Google Scholar, PubMed, Scopus, and Directory of Open Access Journals (DOAJ) databases using a search methodology that included combinations of MeSH terms and keywords and included cross-sectional studies to evaluate the levels of LDH in patients with Oral Submucous Fibrosis (OSMF), Oral Squamous Cell Carcinoma (OSCC) and compared it with the controls. The total number of records identified through database searching was 4161 (n). Analysis of the quality of the studies was done using the National Heart, Lungs and Blood Institute (NHLBI) tool for case-control studies. Twelve case-control studies which matched the inclusion criteria were included after the literature search. The meta-analysis was carried out using R Studio (version 4.1.3, 2022; The R Foundation for Statistical Computing, Vienna, Austria). The pooled estimate that has been calculated from the salivary LDH course for OSMF was 15.35% and from the serum LDH course for OSMF was 6.82%. There was a visual observation of the funnel's plot asymmetry suggesting publication bias. After adjusting the publication bias, the t2 values for salivary and serum LDH were 41% and 14.71%, respectively, which was less than 50%, indicating that the meta-analysis was statistically significant. The evaluation of salivary and serum LDH can be a useful method for early diagnosis of OSMF as well as OSCC. To infer that individuals may have OPMD or OSCC, specific values for salivary and serum LDH must be found in further investigations.

Is Epithelial-Mesenchymal Transition a New Roadway in the Pathogenesis of Oral Submucous Fibrosis: A Comprehensive Review.

Epithelial-mesenchymal transition (EMT) collectively refers to a series of episodes that reshape polarized, intact epithelial cells into discrete motile cells that can conquer the extracellular matrix (ECM). It performs a pivotal role in embryonic development, wound healing, and tissue repair. Surprisingly, the exact mechanism can also lead to the onset of malignancy and organ fibrosis contributing to scar formation and loss of function. transforming growth factor signaling, WNT signaling, Notch signaling, Hedgehog signaling, and receptor tyrosine kinase signaling, as well as non-transcriptional changes in response to extracellular cues, such as growth factors and cytokines, hypoxia, and contact with the surrounding ECM, are responsible for the initiation of EMT. Although the pathogenesis of oral submucous fibrosis (OSMF) is multifactorial, compelling evidence suggests that it results from collagen deregulation. EMT is one of the spotlight events in the pathogenesis of OSMF, with myofibroblasts and keratinocytes being the victim cells. EMT is an essential step in both physiological and pathological events. The importance of EMT in the malignant development of OSMF and the inflammatory reaction preceding fibrosis implies a new upcoming area of research. This review aims to focus on the EMT events that function as a double-edged sword between wound healing and fibrosis and further discuss the mechanisms along with the molecular pathways that direct changes in gene expression essential for the same in the oral cavity. As OSMF involves a risk of malignant transformation, understanding the cellular and molecular events will open more avenues for therapeutic breakthroughs targeting EMT.

An Exquisite Case Report of Follicular Variant of Acinic Cell Carcinoma of the Parotid Gland With Review of Literature.

Acinic cell carcinoma (ACC), previously called acinic cell tumor, is an uncommon malignant neoplasm that tends to recur locally without proper treatment measures. This low-grade neoplasm has four histological subtypes. We hereby report a case of a follicular variant of ACC, which is a rare subtype. A 20-year literature search encompassing this variant of ACC of the parotid region was also performed, which showed four reported cases. A 60-year-old woman reported to our college, Kalinga Institute of Dental Sciences, with the chief complaint of pain and swelling in her upper right back tooth region for the past three months. Upon incisional biopsy, histopathological examination revealed a follicular variant of ACC. Further, immunohistochemistry was also performed using markers such as DOG-1, CK7, S-100, and thyroglobulin, which showed CK7 marker positivity. Subtotal parotidectomy was performed and the tissue was sent for histopathological analysis. Although ACCs are slow-growing and indolent in character, they can frequently recur locally decades later and spread to distant organs. Long-term follow-up is necessary following therapy as ACC has a noticeably high propensity to relapse and create latent metastases.

A Cheiloscopy Study among Students of Different Regional States in Eastern India: An Institutional Study.

Introduction: India is one of the largest countries which is inhabited by diverse populations of different tribes, castes, religious, and migrant groups. In forensic investigation, personal identification plays the greatest importance. Lip prints are considered as one such tool for personal identification. Study of lip prints is referred to as cheiloscopy and they are considered as unique in every individual just like fingerprints. Materials and Methods: Three hundred randomly selected specimens were taken in our study comprising of both the genders and of various regions from Odisha, West Bengal (WB) and Bihar was considered in the study. The age selected in our study ranged from 18 to 25 years comprising of 151 males and 149 females. Lip impression was made and viewed for different lip prints pattern under a magnifying glass of 10X. Results: There was a total of six lip print type identified in the present study. The type of lip print pattern found more in males was Type 2 and in females was Type 1. The type of lip print pattern found more in Bihar and WB was Type 2 and Odisha was Type 1. Conclusion: As the lip print is unique for every individual, Cheiloscopy is considered as a useful method of identification in forensic odontology. The study showed statistically significant difference in gender with a variation in geographical location.

A Case Report of Carcinosarcoma of the Tongue Mimicking a Fibroma: An Enigmatic Lesion With a Diagnostic Dilemma.

Carcinosarcoma of the tongue is a rare biphasic tumor composed of squamous cell carcinoma (SCC), either in situ and/or in invasive form, and a mesenchymal component but of epithelial origin. It is important to diagnose this variant because of its aggressive nature and tendency to metastasize early. The present report describes the case of a carcinosarcoma of the tongue in a 48-year-old male with a short history of 30 days, the clinical feature of which resembles that of an irritational fibroma. The diagnosis often represents a clinicopathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. We here present a case report of this rare tumor, with an unusual presentation, to contribute in part to better understanding and awareness of this rare malignancy.

Immunohistochemical Expression of the Epithelial to Mesenchymal Transition Proteins E-cadherin and ß-catenin in Grades of Oral Squamous Cell Carcinoma.

BACKGROUND: E-Cadherin/ß-Catenin protein complexes play a major role in epithelial to mesenchymal transition (EMT) and vice versa. Such types of EMT are implicated physiologically during embryonic development and pathologically in tissue fibrosis and tumorigenesis. AIMS: The aim was the evaluation of E-Cadherin and ß-Catenin immunoreactivity in various grades of oral squamous cell carcinoma (OSCC) and to correlate their pattern of expression. MATERIALS AND METHODS: Immunohistochemical expression of E-Cadherin/ß-Catenin was evaluated in a total n = 30 tissue samples comprising of n = 10 well-differentiated squamous cell carcinoma (WDSCC), n = 10 moderately differentiated squamous cell carcinoma (MDSCC), and n = 10 poorly differentiated squamous cell carcinoma (PDSCC). Based on the intensity of staining, an immunoreactivity scoring was calculated. STATISTICAL ANALYSIS: The scorings obtained were subjected to independent t-test, paired t-test, Chi-square test, and ANOVA test using SPSS version 20.0 statistical analysis software. P < 0.05 was considered statistically significant. RESULTS: A significant difference was observed in the expression of ß-Catenin between normal mucosa and WDSCC; normal mucosa and MDSCC. A gradual decrease in the immunoreactivity score of E-Cadherin is seen in WDSCC, MDSCC, and PDSCC. CONCLUSION: Therefore, dysregulation of these proteins can lead to tumor progression, invasion, and metastasis. Further studies are warranted to specify the role of these EMT proteins as prognostic/therapeutic markers in patients suffering from OSCC.

Microwave-Based Rapid Tissue Processing Technique: A Novel Aid in Histopathologic Laboratory.

INTRODUCTION: Conventional tissue processing takes a lot of time, but microwave processing method though rapid, its quality of tissue texture and staining properties is still questionable. Therefore, we conducted this study to find out the reliability of histological sections in the microwave method. AIM AND OBJECTIVES: The aim is to assess whether microwave tissue processing, which is a rapid technique, is comparable to conventional tissue processing in terms of quality and reliability of histological sections. MATERIALS AND METHODS: A total of 80 formalin-fixed tissue samples were taken and were divided into two pieces. One subjected to conventional tissue processing and the other subjected to microwave tissue processing. The slides were coded and evaluated by three independent observers using various parameters. All the data were subjected to Chi-square test. RESULTS: Both the process did not differ in their efficiency in overall nuclear details, overall cytoplasmic detail, occurrence of artifact and tissue architecture, nuclear staining, cytoplasmic staining, and red blood cell staining. Although the other observers did not find any statistical significance, according to observer 3, conventional processing proved to have marginally significantly better epithelial connective tissue interface than microwave processing (P = 0.047). CONCLUSION: The microwave method of tissue processing is an economical procedure which reduces the obnoxious chemicals as well as the turnaround time.

Evaluation of the Efficacy of Loricrin as a Diagnostic Marker in Patients with Oral Submucous Fibrosis.

INTRODUCTION: Loricrin is usually observed in abundance in keratinizing epithelium in response to mechanical stress, which may be associated with development and malignant transformations in conditions such as oral submucous fibrosis (OSMF). Therefore, understanding of various molecular mechanisms associated with difference in gene expressions between OSMF and that of normal oral tissue is important. AIM: The aim of this study was to evaluate of the efficacy of loricrin as a diagnostic marker in patients with OSMF. MATERIALS AND METHODS: Fifty formalin-fixed paraffin-embedded tissue blocks were obtained from the archives of the department. The study sample was grouped into two groups of normal mucosa (group I; n = 20) and OSMF (group II; n = 30) specimens. The study tissues were immunohistochemically stained with loricrin antibody and were further graded on basis of staining intensity. RESULTS: Loricrin immunostaining was observed significantly more in OSMF cases and even in stratum granulosum in comparison to normal mucosa. CONCLUSION: Loricrin can act as an early indicator and a prognostic marker for detection of deleterious changes within epithelium in OSMF.

An Immunohistochemical Study Showing Ki-67 as an Analytical Marker in Oral Malignant and Premalignant Lesions.

INTRODUCTION: Ki-67 is a nuclear protein. It is a proliferation marker that has an essential function in tumorigenesis due to its positive connection with tumor expansion. AIM: The aim of this study was to evaluate the articulation of Ki­67 as prognostic marker in various grades of oral epithelial dysplasia (OED) and in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: A total of 100 histologically affirmed samples of normal oral mucosa (NOM), OED, and OSCC were divided into three groups-Group I (10 samples of normal oral mucosa), Group II (45 samples of OED), Group III (45 samples of OSCC). Routine hematoxylin and eosin and immunohistochemical staining with Ki-67 monoclonal antibody were carried out in all the samples. RESULTS: Within Group I, articulation of Ki-67 was constrained to the basal layers. In Group II, cells showing positive expression of Ki-67 were available in the basal, suprabasal, and spinous layers. Cells showing positive expression of Ki-67 among well-differentiated OSCC were presented mainly in the periphery of the tumor nests; in moderately differentiated OSCC, cells were located in both peripheral and part of a center of the tumor nests; and in most cases of poorly differentiated OSCC, cells were diffused. Statistically significant difference in positive expression of Ki-67 was appreciated between three groups. CONCLUSION: Ki-67 antigen may perhaps be used as a marker for the histological reviewing of OED and OSCC. With the increase in the severity of OED, cells showing positive expression of Ki-67 also increased.

Assessment of lactate dehydrogenase enzyme levels in saliva and serum of oral submucous fibrosis and leukoplakia patients.

BACKGROUND: Pathology involving the oral epithelium may alter the level of salivary concentration of LDH. Thus its estimation can be used as a non invasive screening tool for the early detection of OPMDs and also to predict its malignant transformation especially in high risk population. AIMS AND OBJECTIVES: To evaluate the salivary and serum levels of lactate dehydrogenase (LDH) in patients having of oral submucous fibrosis (OSMF) and leukoplakia and compare it with healthy individuals. MATERIALS AND METHODS: A total of 120 subjects were selected and divided into three groups comprising clinically diagnosed cases of OSMF and leukoplakia and healthy subjects as controls. Unstimulated whole saliva and blood samples were collected under aseptic conditions for biochemical estimation of LDH by Semiautomatic Analyzer using LDH kit utilizing enzymatic UV-Kinetic method. The values obtained were statistically analyzed using the SPSS software version 20.0. P-value < 0.05 was considered significant. RESULTS: The mean salivary LDH level in Group I (OSMF) was 631.67 + 7.67, Group II (Leukoplakia) was 492.28 + 16.17 and Group III (Healthy Control) was 140.62 + 8.87. There was a statistically significant difference between the Serum and salivary LDH levels among the various groups of study population. A positive correlation between salivary LDH and serum LDH level was seen and the regression equation for OSMF and leukoplakia was computed. CONCLUSION: A significant difference was found between mean salivary LDH Levels and serum LDH levels in patients with leukoplakia, OSMF and health controls. A positive correlation was also established between salivary and serum LDH levels in patients with OSMF and leukoplakia patients making saliva a potent non invasive tool for early prediction and detection of PMOD and its malignant transformation.

A rare presentation of benign fibrous histiocytoma in the maxilla.

Fibrous histiocytoma is a soft-tissue tumor that may present as a fibrous mass anywhere in the human body. The involvement of the oral cavity is rare. We here report a case of benign fibrous histiocytoma localized in the maxilla. A 25-year-old male presented with a slowly increasing large painless mass over the left side of the upper jaw for 5 months. The swelling was of gradual onset, slowly progressive and was not associated with pain, tenderness, or discharge. The radiographic appearance showed a multilocular mixed radiodense, radiolucent lesion in the left posterior maxilla. The histopathological report showed connective tissue component having streaming fascicles of spindle-shaped cells showing a storiform pattern. Many areas showed foamy histiocytes along with few multinucleated giant cells. The cells were appearing benign without any appearance of atypia. The tumor cells were positive for CD-68 and vimentin and negative for CD-34 and S100. The lesion was excised under general anesthesia.