Immunohistochemical expression of E-Cadherin and Cyclin D1 in different grades of oral squamous cell carcinoma.

Background: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, representing up to 80-90% of all malignant neoplasms of the oral cavity. It results from the multistep accumulation of heterogeneous genetic changes. Important risk factors for OSCC include the use of tobacco or betel quid chewing, alcohol consumption, human papillomavirus and poor nutrition. E-Cadherin as a tumour suppressor gene sets a threshold for Wnt/ß-catenin signalling. When expression of E-Cadherin is lost, potentiation of Wnt signalling pathway occurs leading to loss of cell-cell adhesion. The cyclin D1 gene (CCND1) located on chromosome 11q13 encodes a nuclear protein that is the regulatory subunit of Cdk-4 and Cdk-6. Cyclin D1 plays a major role in cell cycle transition from G1 to S phase by contributing to inactivation of the retinoblastoma gene product, and overexpression of CCND1 has been reported in 35-40% cases of OSCC. Aim: Considering this, we decided to evaluate and compare the expression of CE-Cadherin and Cyclin D1 in different grades of OSCC. Materials and Methods: A retrospective study was carried out on 60 formalin-fixed paraffin embedded tissue blocks comprising of 20 cases of well-differentiated OSCC, 20 cases of moderately differentiated OSCC and 20 cases of poorly differentiated OSCC. Diagnosed (using H and E), with oral mucosa taken as control. Results: There was downregulation of E-Cadherin and overexpression of Cyclin D1 in increasing grades of OSCC and the difference was statistically significant. E-Cadherin was localised to membranous and shifted to cytoplasm as the grade worsened. Cyclin D1 was localised to nuclei of cells and the expression was seen more at the peripheral portions of tumour islands depicting the proliferative activity of tumour front. Conclusion: The study revealed a good prognostic role of both E-Cadherin and Cyclin D1 in OSCC. The markers can be used for prognostic as well as therapeutic purposes.

Evaluation of histomorphometric changes in tissue architecture due to fixation delay.

INTRODUCTION: All good tissue specimen preparations require complete fixation. The process of tissue handling and processing from patient to paraffin block is too frequently invisible to the pathologists. Many times due to certain emergencies or unavailability of a proper fixative, tissues are kept in different carrying media such as normal saline (NS) or local anesthetic till the availability of a proper fixative solution. This fixation delay can lead to various tissue architectural changes which can affect its diagnostic value. AIMS: The aim of this study was to assess sectioning ability, staining intensity and microscopic details of tissues kept in different carrying media at different time intervals followed by standard fixation. MATERIALS AND METHODS: Fresh tissue specimen, i.e., goat tongue was collected and its middle portion was retained and was used for study purpose. The tissue was grossed and kept in various carrying media for five different time intervals. Standard formaldehyde fixation was then carried out followed by sectioning and staining. The sections were evaluated histologically under light microscope. STATISTICAL ANALYSIS: For sectioning parameter, Fisher's exact test and for staining and microscopic details, Mann-Whitney U-test was used. RESULTS: According to the study, NS is considered as a best carrying media followed by 10% honey and local anesthetic. Two percent hydrogen peroxide cannot be used as a carrying media. CONCLUSION: It was concluded that NS should be given first preference as a carrying media till the availability of a suitable fixative. Clinicians and Pathologists should have to familiarize themselves with the advantages and disadvantages of using various carrying media and the histomorphometric changes associated with delayed fixation which may lead to incorrect diagnosis.

Prevalence of Traumatic Dental Injuries to Anterior Teeth of 12-Year-Old School Children in Kashmir, India.

BACKGROUND: Traumatic dental injuries to anterior teeth are a significant public health problem, not only because their prevalence is relatively high, but also because they have considerable impact on children's daily lives. Traumatic dental injuries (TDIs) cause physical and psychological discomfort, pain and other negative impacts, such as tendency to avoid laughing or smiling, which can affect social relationships. OBJECTIVES: This study aimed to assess the prevalence of traumatic dental injuries to anterior teeth among 12-year-old school children in Kashmir, India. PATIENTS AND METHODS: A cross-sectional study was conducted in private and government schools of India among 1600 schoolchildren aged 12 years. In addition to recording of the type of trauma (using Ellis and Davey classification of fractures, 1970), over jet, Angle's molar relation and lip competence were also recorded. The socioeconomic status and academic performance of the study subjects were registered. The data obtained were compiled systematically and then statistically analyzed. The statistical significance for the association between the traumatic injury and the variables was analyzed using the chi-square test. Logistic regression was used to identify potential risk predictors of TDIs. RESULTS: The overall prevalence of TDI to anterior teeth was found to be 9.3%. The TDI to anterior teeth in male was more than female, but the difference was statistically nonsignificant (P < 0.01). Falls and sports were the most common causes of trauma in the present study. The highest potential risk factor for the occurrence of trauma was over jet. Academic performance was found to be significantly associated to TDI to anterior teeth, when analyzed in a multiple regression model. CONCLUSIONS: It was concluded that the prevalence of traumatic dental injuries was 9.3%. Traumatic dental injuries among children exhibit complex interaction between the victims' oral conditions and their behavior. Therefore, prevention should consider a number of characteristics such as oral predisposing factors, environmental determinants and human behavior. It is recommended that specific and proper public places for leisure and sports activities, with impact-absorbing surfaces around the items on which children are most likely to fall, should be provided.

Root and canal morphology of maxillary first premolar teeth in north Indian population using clearing technique: An in vitro study.

AIM: The purpose of this study was to determine the root form and canal configuration in maxillary first premolars. MATERIALS AND METHODS: A total of 250 extracted human adult maxillary first premolar teeth from North Indian population were collected. Access cavities were prepared and the coronal pulp tissue was extirpated. The samples were stored in 5% nitric acid solution for 5 days. They were then rinsed, dried, and dehydrated using increasing concentrations of ethanol (70, 80, and 95%) successively for 1 day. Teeth were rendered transparent by immersing in methyl salicylate. India ink was then injected. The root canal morphology was examined under stereomicroscope. RESULT: 53.6% were single rooted followed by fused root form followed by two root form. 0.4% had three rooted maxillary first premolar. Variable root canal configurations were also found. Type IV configuration was most prevalent (33.2%). Two teeth showed an additional configuration. Lateral canals were present in 34.8% of the samples and intercanal communications in 16%. CONCLUSION: Within the limitations of this study, it was concluded that in North Indian population, there was an increased propensity for types IV, I, II, and III canal morphologies in maxillary first premolars. Single root form was most common.

Attitude of Dental Practitioners Towards their Colleagues: A Justifiable Criticism.

AIM: A cross-sectional, questionnaire based study was conducted in Moradabad, U.P., India to assess the attitude of dental practitioners towards their colleagues. Materials and Methods : Eleven-item, close-ended, validated questionnaire was formulated. The responses of 60 registered dental practitioners were recorded. RESULTS: Majority of the respondents were well versed with ethical obligations towards their colleagues but only few of them were aware of all the principles mentioned in Codes of dental ethics, DCI, India. CONCLUSION: Dentists face ethical problems/dilemmas while dealing with their duties towards colleagues and their patients. Adopting of ethical ways in practice was independent of gender, qualification and experience of practice. It is recommended that dental ethics should be emphasized upon during the formative years of dental education.

Exploring trends in forensic odontology.

BACKGROUND: Forensic odontology nowadays has become a developing science and is of great importance to society. It is important that dental practitioners should have a proper knowledge of forensics as the need has increased greatly over the last decades due to the unprecedented demand from the criminal justice including terrorism in Kashmir valley (J&K India). MATERIALS AND METHODS: Data was collected based on questionnaire survey among qualified dental practitioners related to their awareness of forensic odontology. RESULTS: A total number of 235 dental practitioners responded to the questionnaire. RESULTS showed that there was a low confidence, in handling of forensic odontology related cases among dental practitioners and majority of dental practitioners were not having any formal training in forensic odontology. CONCLUSION: Each dental practitioner has a responsibility to understand the forensic implications associated with the practice of his profession and thus he should work sincerely enough so to ensure his contribution in the field of forensic odontology.

Effect of academic stress on plaque and gingival health among dental students of Moradabad, India.

OBJECTIVE: Stress has an adverse effect on oral health and is a risk factor for plaque-associated diseases. The present study aims to assess the effect of academic stress on plaque and gingival health among dental students of Moradabad, India. METHODS: Fifty eligible dental students (age 18 - 22 years) undergoing university examinations participated in the study. Students were examined for plaque index (PII) and gingival index (GI) scores during and after their examinations. Stress levels (using the DASS 21 questionnaire) and oral hygiene behavior were also assessed during and after university examinations and the data were subjected to statistical analysis. RESULTS: The average PII and GI were 1.213 and 0.944, respectively, during examinations and 0.845 and 0.467, respectively, after examinations. The average stress scores were 15.66 and 9.94 during and after examinations, respectively. Eighty-eight percent of the students brushed once and 12% of the students brushed twice during the university examinations, whereas 76% brushed once and 24% of the students brushed twice after their examinations. Thirty-four percent of the subjects rated their thoroughness of brushing as good during university examinations whereas the percentage increased to 80% after the examinations. All the differences were found to be statistically significant. CONCLUSION: Students appearing for the university examinations showed increased stress levels. Moreover, under conditions of stress, the students generally neglected their oral health care and adverse effects on their plaque and gingival scores were observed. Thus, it might be concluded that academic stress has an adverse effect on plaque levels and gingival status in students.