Unicystic ameloblastoma of mural variant crossing the midline.

Unicystic ameloblastoma (UCA) refers to cystic lesions that show gross features of a jaw cyst but on histologic examination show a typical ameloblastomatous epithelium lining part of the cyst cavity, with or without luminal and/or mural tumor growth. Even though the lesion is not as aggressive as the solid ameloblastoma, an accurate histopathologic diagnosis is essential for the treatment and prognosis. This case report illustrates a case of UCA of mural variant in the anterior region of the mandible crossing the midline, which is usually an unusual site of occurrence.

Relationship between ABO blood group and Rh factor with oral potentially malignant disorder.

Introduction: Oral cancer is the most life threatening of all oral diseases. It has a prolonged natural history with oral potentially malignant disorders (OPMD) as the precursor. Recognition and diagnosis of OPMD will help in early treatment, patient survival and in reducing morbidity related to treatment of oral cancer. OPMDs has multifactorial etiologies and is significantly associated with risk factors of the individual's lifestyle, particularly, chronic use of tobacco, spicy food, alcohol and smoking. Genetic factors also play an important role in the etiology of OPMDs. It is proven by many studies like Dermatoglyphics, Salivary miRNA, micronuclei in buccal mucosa etc., one of such kind is ABO blood group and Rh factor. OBJECTIVE: Aim of our study is to evaluate if any of the ABO blood group and Rh factor is associated with an increased risk for OPMDs. Methodology: A cross sectional study was conducted in Sri Rajiv Gandhi College of Dental Sciences included 55 patients with clinical and histopathologically proven OPMD's. Blood grouping was determined for all the patients using standardised agglutination method. Result: This study showed that people with blood group B+ are 1.46 times at a greater risk to develop OPMDs. Conclusion: Our study concludes that subjects with B+ blood group and habit of tobacco chewing and smoking are at higher risk to develop OPMDs than subjects with other blood groups.

Intra-observer and inter-observer variability in two grading systems for oral epithelial dysplasia: A multi-centre study in India.

BACKGROUND: The presence and grading of oral epithelial dysplasia (OED) are considered the gold standard for predicting the malignant risk of oral potentially malignant disorders. However, inter-observer and intra-observer agreement in the context of reporting on OED grading has been reputedly considered unreliable. METHODS: We undertook a multi-centre study of six Indian oral pathologists to assess variations in reporting OED using the World Health Organization (WHO; 2005) system and also the recently introduced binary system. The observer variability was assessed with the use of kappa statistics. RESULTS: The weighted kappa intra-observer agreement scores improved (κw  = 0.5012) on grouping by two grades as no and mild dysplasia versus moderate and severe dysplasia compared to binary grading system (κ = 0.1563) and WHO grading system (κw  = 0.4297). Poor to fair inter-observer agreement scores were seen between the principal investigator (PI) and the other five observers using the WHO grading system (κ = 0.051-0.231; κw  = 0.145 to 0.361; 35% to 46%) and binary grading system (κ = 0.049 to 0.326; 50 to 65%). CONCLUSIONS: There is considerable room for improvement in the assessment of OED using either system to help in standardised reporting. The professional pathology organisations in India should take steps to provide external quality assessment in reporting OED among oral and general pathologists who are engaged in routine reporting of head and neck specimens.

The correlation between micronuclei count and smoking behavior: a hospital-based study / Correlación entre recuento de micronúcleos y hábito tabáquico: un estudio hospitalario

Background: Micronucleus is a microscopically visible cyto-plasmic chromatin mass in the extranuclear vicinity, originating from aberrant mitosis, which consists of eccentric chromosomes that have failed to reach spindle poles during mitosis. The present study was designed to evaluate and compare cytogenetic changes in the buccal mucosa of smokers and non-smokers based on the occurrence of micronuclei. The study aimed to determine the correlation between the micronuclei count and the frequency and duration of smoking habit. Materials and Methods: Two groups (smokers and non-smokers) of 34 individuals each were examined. Cytological buccal smears were taken from participants using a moistened wooden spatula and stained with standard Papanicolaou stain. Presence of micronuclei was assessed at 40X magnification using a light microscope and a count per 500 cells was determined. The results of the study were analyzed statistically using Mann-Whitney U test, Spearman's rank correlation coefficient and Student t-test. Result: Smears from smokers showed a significant increase in the total number of micronuclei per 500 cell count compared to non-smokers. There was a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. A age-related increase in older age groups was also observed. Conclusion: The study reveals a strong positive correlation between the occurrence of micronuclei and the frequency and duration of smoking. This observation is vital in the utilization of the micronuclei detection in smears as a prognostic, educational and interventional tool in the management of patients with smoking habits.

Antecedentes: El micronúcleo es una masa de cromatina citoplasmática microscópicamente visible en el área extranuclear, que se origina a partir de la mitosis aberrante, y que consiste en cromosomas excéntricos que no han podido alcanzar los polos del huso durante la mitosis. El presente estudio fue diseñado para evaluar y comparar los cambios citogenéticos en la mucosa bucal de fumadores y no fumadores en función de la aparición de micronúcleos. El estudio tuvo como objetivo determinar la correlación entre el recuento de micronúcleos y la frecuencia y duración del hábito de fumar. Materiales and Métodos: Se examinaron dos grupos (fumadores y no fumadores) de 34 individuos cada uno. Se tomaron frotis bucales citológicos de todos los participantes con una espátula de madera humedecida y se tiñeron con la tinción estándar de Papanicolaou. La presencia de micronúcleos se evaluó al microscopio óptico con un aumento de 40X y se determinó un recuento por 500 células. Los resultados del estudio se analizaron estadísticamente utilizando la prueba U de Mann-Whitney, el coeficiente de correlación de rango de Spearman y la prueba t de Student. Resultados: Los frotis de fumadores mostraron un aumento significativo en el número total de micronúcleos por 500 células en comparación con los no fumadores. Hubo una fuerte correlación positiva entre la aparición de micronúcleos y la frecuencia y duración del tabaquismo. También se observó un aumento relacionado con la edad en los grupos de mayor edad. Conclusión: el estudio revela una fuerte correlación positiva entre la aparición de micronúcleos y la frecuencia y duración del tabaquismo. Esta observación es vital en la utilización de la detección de micronúcleos en frotis como una herramienta pronostica, educativa e intervencionista en el manejo de pacientes con hábitos de fumar.

Expression of hTERT in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma - an Immunohistochemical Analysis.

Human telomerase reverse transcriptase enzyme, the catalytic subunit of telomerase are seen to be frequently reactivated in cancers including Oral squamous cell carcinoma (OSCC). Increased hTERT expression have been seen in potentially malignant conditions including Oral submucous fibrosis (OSMF). The aim of the study was to evaluate the expression levels in OSMF, OSCC in the background of OSMF and OSCC using immunohistochemistry and also to correlate hTERT expression with clinicopathologic parameters. A total of 50 histopathologically diagnosed cases of 20 OSMF, 20 OSCC wherein 5 were OSCC in the background of OSMF and 10 Normal oral mucosae were retrieved from the departmental archives and subjected to immunohistochemical analysis of hTERT. The expression of hTERT increased from normal, OSMF, to OSCC with statistically significant differences in mean labelling score (LS). We also found a shift in cellular localization of stain where, normal mucosal tissues showed a nuclear stain unlike OSMF, where combined nuclear and cytoplasmic staining as noted. The tumor cells in OSCC showed predominant cytoplasmic staining. There was no correlation between hTERT expression and clinicopathological parameters of OSMF. However, a significant increase of hTERT expression was seen with increasing histological grading of OSCC. These results suggest the role of hTERT in the early event of malignant transformation of OSMF. Telomerase could be used as a potent diagnostic marker to identify high-risk group of OSMF.

Comparison and Clinical Evaluation of Two Pit and Fissure Sealants on Permanent Mandibular First Molars: An In Vivo Study.

AIM: The aim of the study was to compare and evaluate the clinical efficacy of a microfilled pit and fissure sealant and a nanofilled pit and fissure sealant at 3, 6, and 12 months of interval. MATERIALS AND METHODS: Samples consisting of 55 healthy 8- to 12-year-old children with deep pits and fissures in mandibular first permanent molars were selected for the study. It was a split mouth design and randomized clinical trial. A total of 110 mandibular first molars were divided into two groups of 55 each: group I Fissurit FX sealant and group II Grandioseal nanofilled fissure sealant. The sealed teeth were clinically evaluated at 3, 6, and 12 months of interval to assess marginal adaptation, sealant retention, fissure caries development, roughness of sealant surface, and change of color around the sealant. RESULTS: The results showed that both Fissurit FX and Grandioseal pit and fissure sealants were effective in preventing dental caries. Marginal adaptation was significantly better with Fissurit FX when compared to Grandioseal pit and fissure sealant. There was no difference in sealant retention between the two groups. The surface roughness of Fissurit FX was high when compared to that of Grandioseal. Statistical analysis was done using the Chi-squared test for intra-group comparison and Fisher's exact test for inter-group comparison. Results were considered statistically significant if p ≤ 0.05. CONCLUSION: Fissurit FX and Grandioseal pit and fissure sealants provided similar caries preventive effects and there was no difference in retention of sealants over a period of 1 year. However, surface roughness was better with Grandioseal fissure sealants. CLINICAL SIGNIFICANCE: This study is significant because there is limited evidence about the efficacy of nanofilled pit and fissure sealants in vivo. It will also provide dental practitioners an insight into the clinical efficacy of nanofilled pits and fissure sealant when compared to micro-filled sealant enabling them to make the right choice for the betterment of their dental practice. How to cite this article: Smitha M, Paul ST, Nagaraj T, et al. Comparison and Clinical Evaluation of Two Pit and Fissure Sealants on Permanent Mandibular First Molars: An In Vivo Study. J Contemp Dent Pract 2019;20(10):1151-1158.

Verrucous carcinoma: A clinicopathological study.

OBJECTIVE: The purpose of this study is to identify a co-relation between clinical and histopathological features of verrucous carcinoma. MATERIALS AND METHODS: This study was conducted based on Knowledge Attitude and Practice (KAP) questionnaire comprising of 3 sets of questions covering clinical and histopathological aspects of the oral verrucous carcinoma. The target subjects were specialists in the field of Oral Medicine and Radiology, Oral and Maxillofacial Surgery and Oral Pathology. RESULTS AND CONCLUSION: Verrucous carcinoma is a low grade variant of squamous cell carcinoma and the clinical features of both are very similar. The treatment of both differs widely; we fail to diagnose it correctly. This study correlates the clinic-pathologic features of oral verrucous carcinoma by means of statistically analyzing the varied clinical features and pathological impressions. This is helpful in eliminating the diagnostic dilemma and thus channelizing the data to present a clear treatment planning.

Linear Dimensional Changes of Five Interocclusal Recording Materials When Immersed in Two Disinfectants for Different Time Intervals.

AIM: In this study, we intend to compare the linear dimensional changes of interocclusal recording media by immersing them in disinfectant solutions at different time intervals. MATERIALS AND METHODS: Five interocclusal recording materials were used for this study and were grouped according to material types, namely wax, zinc oxide eugenol impression paste, polyether, polyvinyl siloxane, and bisacryl bite registration material. Each material was manipulated and injected into a stainless steel die. The materials were divided into 5 groups with 5 subgroups of 10 samples with a total of 250 samples. The samples were subjected to immersion in 2% glutaraldehyde and 0.5% sodium hypochlorite each for 30 and 60 minutes. Linear dimensional changes of the samples were tested by measuring the distance between points A and B at different time intervals by means of a stereomicroscope and compared with the control group. RESULTS: Bisacryl showed the least linear dimensional change when immersed in both the solutions. CONCLUSION: Bisacryl (Luxabite) presented no linear dimensional change at both time intervals as opposed to the other materials, hence, it is most accurate.

Estimation of serum hepcidin in oral submucous fibrosis before and after supplementation with oral iron: A randomized control clinical trial.

BACKGROUND: Iron-deficiency anemia is synonymous with oral submucous fibrosis (OSMF). The cause for the same has not been ascertained yet. OSMF by way of anemia of chronic disease could be a probable cause of iron deficiency. AIM AND OBJECTIVE: This study was intended to evaluate the level of hemoglobin (Hb) in OSMF and to establish a relationship between serum hepcidin and Hb with OSMF, before and after oral supplementation of iron. MATERIALS AND METHODS: The clinical trial was registered with the Clinical Trial Registry of India (CTRI/2016/03/006761). Eighty participants were selected. Based on the hematocrit values, they were divided into equal number of case (Group I) and control (Group II). Serum hepcidin was evaluated in these eighty participants with clinically established OSMF. Participants in the case group with low hematocrit values indicative of iron-deficiency anemia were supplemented with oral iron capsules twice daily for 3 months. After an interval of 3 months, serum hepcidin and hematocrit were evaluated. STATISTICS: Statistical analysis was done using SPSS software version 11.5 (IBM, New York, USA). One-way ANOVA test was done to assess the correlation between Hb% and serum hepcidin. Unpaired t-test was done to correlate Hb% and hepcidin before and after oral supplementation of iron. Clinical significance was established by calculating the effect size. RESULTS: There was a significant correlation between the values of serum hepcidin and Hb (P < 0.001) before and after oral supplementation of elemental iron. After oral supplementation of iron, hematocrit improved in Group I along with reduction in serum hepcidin. CONCLUSION: It can be concluded that reduction of serum hepcidin is indicative of improvement in iron stores of body. Hence, serum hepcidin can be utilized as a diagnostic marker to assess iron stores in OSMF.

Transmigration of mandibular canines.

The purpose of this paper is to present the first case of unusual reverse oblique (110 degrees to midsagittal plane) migration of mandibular right canine crossing the jaw midline and piercing the lower border of the mandible at the level of the opposite canine and also to report two more cases of transmigrated mandibular canine and one case of transmigrating mandibular canine. Mandibular canines are "cornerstone" of dental arch; their importance is manifested by their efficiency in masticatory function, stability of dental arch, and aid in maintaining natural facial expression. Early detection of this anomaly can help preserving these canines by orthodontic intervention or by surgical transplantation. This developmental anomaly is properly diagnosed by radiographic evaluation, which is primarily based on the panoramic radiograph. In patients with overretained deciduous canines or missing permanent canines, an intraoral radiograph should be supplemented with panoramic radiograph. This paper discusses the importance of early diagnosis of canine transmigration in treatment planning and reviews the various possible treatment options.

The antimicrobial activity of the three commercially available intense sweeteners against common periodontal pathogens: an in vitro study.

AIM: To evaluate the in vitro antimicrobial activity of three commercially available intense sweeteners against two common periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. MATERIALS AND METHODS: Three commercially available intense sweeteners namely saccharin, aspartame and sucralose were obtained and powdered. Necessary concentrations of the sweeteners were prepared by mixing them with an inert solvent. The antimicrobial efficacy was assessed using agar well diffusion technique. Statistical analysis was done using one-way ANOVA followed by Tukey's post hoc test. p-value < 0.05 was considered statistically significant. RESULTS: All the three sweeteners showed significant antimicrobial activity against the periodontal pathogens tested. Sucralose containing sucralose showed maximum zone of inhibition, against Aggregatibacter actinomycetemcomitans. Saccharin and aspartame containing saccharin and aspartame respectively, showed maximum zone of inhibition, against Porphyromonas gingivalis. CONCLUSION: All the sweeteners used in this study have demonstrated significant antimicrobial activity. Therefore, these sweeteners could be recommended as an ideal alternative to sucrose. CLINICAL SIGNIFICANCE: Dental caries and periodontal diseases are ubiquitous diseases of mankind caused by microorganisms. Dental caries is caused by sucrose. By altering the source like intense sweetener we can combat caries as well as with its antimicrobial properties against periodontopathic bacteria, we can reduce prevalence of periodontal diseases.