Assessment of serum and salivary visfatin levels in newly diagnosed patients of type-II DM.

Background: Type II diabetes mellitus (T2DM) is a metabolic disorder. It is thought to be an autoinflammatory disease, as inflammatory mediators are associated with the progression of the disease. Visfatin, an adipokine, is linked to insulin resistance. Aims: We aimed to study serum and salivary visfatin levels, at the time of diagnosis of T2DM, in middle-aged individuals, in the context of other diagnostic parameters like fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated haemoglobin A1c (HbA1c). Materials and Methods: Thirty newly diagnosed T2DM (Group-I, T2DM) patients and 30 healthy nondiabetic individuals (Group-II, health controls [HC]) matched for age and sex were studied. In both the groups, we assessed serum and salivary visfatin levels, and serum high-sensitivity C-reactive protein (hs-CRP) levels. We also compared serum and salivary visfatin levels and serum hs-CRP levels between Group-I and Group-II individuals. Statistical Analysis: The correlation between the groups was tested using Pearson's correlation. A P- value < 0.001 was considered to be statistically significant. The data was tabulated using software MS Excel and analysed using IBM Statistical Package for the Social Sciences (SPSS) Version 22.0. Results: A positive correlation with a value of 0.8836 and a P value of 0.001 was noted between serum and salivary visfatin of Group-I. Conclusion: This is the first study in the Indian scenario to study the serum and salivary visfatin in newly diagnosed T2DM individuals. Serum visfatin and hs-CRP levels increased in T2DM, thus defining the link between visfatin, inflammation and T2DM, but we failed to notice a positive correlation.

Evaluation of immunohistochemical expression of E-cadherin in pleomorphic adenoma and adenoid cystic carcinoma.

Background: Pleomorphic adenoma (PA) and adenoid cystic carcinoma (ADCC) are benign and malignant salivary gland tumors, respectively, with distinct behavior. They have similar origins and cell components. E-cadherins are the main homophilic cell adhesion molecules, which play a central role in maintaining epithelial integrity, functioning in intercellular adhesion and differentiation. Hence, changes in E-cadherin function are reflected in the morphologic events associated with the cellular arrangement, movement and wound healing. Aim: To study and compare the expression of E-cadherin immunostaining in PA and ADCC. Materials and Methods: Fifteen cases of each PA and ADCC were immunohistochemically stained with E-cadherin. Five cases of normal salivary gland tissues were taken as the positive control.Mann-Whitney U-test was used for statistical analysis. Results: About 86.6% of PA cases showed homogeneous staining. 66.6% of cases of ADCC showed heterogeneous staining. PA, cribriform and tubular patterns of ADCC predominantly showed moderate immune-staining and solid patterns of ADCC exhibited predominantly mild immunostaining. Depending on the intensity of staining, we found a significant P value between PA and the solid variant of ADCC. Conclusion: E-cadherin proved to be a better marker for epithelial phenotypes in PAs. In ADCC difference in staining intensity between different histological subtypes suggests that further studies should be done to assess the usefulness of an immuno-marker to know the aggressive behavior of ADCC.

Peels as an alternative to ground sections - An in vitro microscopic study.

BACKGROUND: The routine approach to delve into the organization of mineralized and nonmineralized structures of teeth is by studying whole tooth or slices of it by making thin section which requires laborious grinding or employing specialized equipment and also leads to specimen wastage. Peels hitherto utilized for fossil studies hold promise in overcoming the aforesaid shortcomings. Although the acetate peel technique has been modified for the study of tooth structure, the field remains largely unexplored. AIM: The current study was taken up to explore the usefulness of cellulose acetate peels in reproducing microscopic structures of teeth as seen in routine ground sections and further if they could supplement or replace the same. MATERIALS AND METHODS: Extracted human teeth were embedded in plaster blocks in longitudinal and transverse orientation, ground and polished with silicon carbide paper. Following etching, washing and drying, the polished surface was wet with acetone and precut cellulose acetate film was placed over it and allowed to dry. As the acetate polymer dissolved in acetone and subsequently re-polymerized after setting into the micro reliefs produced by tooth etching, it registered the microscopic tooth details on its surface. The peels were mounted and secured on a glass slide and subjected to routine light and phase contrast microscopy for observing captured details of the tooth structure. RESULTS AND CONCLUSION: Acetate peels successfully reproduced most of the microscopic tooth details which were better than those observed in ground tooth sections. Hence, this technique could be considered as a quick, durable and inexpensive alternative or supplement to routine thin ground sections of dental hard tissues.

Assessment of serum and salivary adiponectin levels in newly diagnosed Type II diabetes mellitus patients.

BACKGROUND: Adiponectin, an adipocytokine, plays an important role in the development of Type 2 Diabetes Mellitus (T2DM) in obese and cardiovascular disease patients, with few studies having observed low plasma concentrations. Persistent low-grade inflammation, an important feature in T2DM and obesity, bears an indirect influence on insulin resistance and insulin secretion and is reflected by increased plasma levels of C-reactive protein (CRP). Thus, low levels of anti-inflammatory cytokine, adiponectin, depicts that inflammation could be the link between T2DM, obesity and adiponectin. Since these factors need to be explored to prevent or adequately treat T2DM, especially among Indian diabetics, this study was undertaken. Also of interest was to assess its salivary concentrations. AIM: This study aimed to assess serum and salivary adiponectin levels in newly diagnosed T2DM individuals along with postprandial blood sugar (PPBS) and glycosylated hemoglobin (HbA1C) and high-sensitivity-CRP (hs-CRP). MATERIALS AND METHODS: Serum and salivary levels of adiponectin, PPBS, HbA1c and hs-CRP were assessed in 30 newly diagnosed T2DM (Group I) individuals and compared with 30 healthy individuals (Group II, healthy control). Glucose oxidase peroxidase, automatic analyzer, turbidimetric immunoassay and ELISA methods were adopted for PPBS, HbA1c, hs-CRP and adiponectin estimation. RESULTS: Statistically significant decrease in mean serum (16.93 ± 3.86) and salivary (24.96 ± 8.21) adiponectin levels, were observed in Group I compared to Group II individuals with a p value of 0.00 and 0.04 respectively. In Group I individuals a significant p value of 0.02 was noted only between salivary adiponectin and PPBS. None of the other parameters correlated significantly with serum adiponectin levels. CONCLUSION: Decreased serum and salivary adiponectin levels in T2DM furthered the importance of its role in Indian T2DM. Decreased salivary adiponectin levels probably reflected salivary hypofunction. This being the preliminary study in saliva, more studies are required to emphasize its role both as a diagnostic marker and as an anti-inflammatory cytokine in T2DM.

Immunohistochemical expression of osteonectin, matrix metalloproteinases-9 and Ki-67 in ameloblastoma.

BACKGROUND: Ameloblastoma (AM) is a benign odontogenic neoplasm characterized by local invasiveness and recurrence. We have evaluated the immunohistochemical expressions of osteonectin (ON), matrix metalloproteinase-9 (MMP-9) and Ki-67 in AM to understand the biologic behavior of this neoplasm. AIM: The aim of this study is to evaluate the expression of ON, MMP-9 and Ki-67 in AM. MATERIALS AND METHODS: The study sample included archival tissues embedded in paraffin blocks histopathologically diagnosed as AM (20 cases). Three serial sections of each tissue specimen were stained separately with ON, MMP-9 and Ki-67 (immunohistochemistry stain) and evaluated. The data were analyzed using Spearman rank correlation test. RESULTS: All AM cases 20/20 (100%) exhibited positive immunostaining for ON, MMP-9 and Ki-67. CONCLUSION: Increased expression of ON, MMP-9 and Ki-67 in AM indicates that these molecules might play a role in the regulation and aggressive nature of this neoplasm.

Gingival leiomyomatous hamartoma of the maxilla: a rare entity.

Hamartoma is a tumour-like malformation appearing as a focal overgrowth of normal cells. Leiomyomatous hamartomas (LHs) are rare in the oral cavity and commonly seen in the Japanese and less than 40 cases have been reported in the Japanese and English literature. The clinical differential diagnoses are irritational (traumatic) fibroma and congenital epulis. It has to be differentiated histopathologically from its neoplastic counterparts and mesenchymomas. Hence, we report such a case of LHs, which presented as a sessile gingival growth occurring in the midline in a 15-year-old girl. The final diagnosis was based on the histopathological appearance which was confirmed by immunohistochemical staining of various markers. A review of the literature of previous cases was also carried out.

Clinicopathologic Correlation of White, Non scrapable Oral Mucosal Surface Lesions: A Study of 100 Cases.

INTRODUCTION: White, non scrapable lesions are commonly seen in the oral cavity. Based on their history and clinical appearance, most of these lesions can be easily diagnosed, but sometimes diagnosis may go wrong. In order to arrive to a confirmative diagnosis, histopathological assessment is needed in many cases, if not all. AIMS: 1) To find out the prevalence of clinically diagnosed oral white, non scrapable lesions. 2) To find out the prevalence of histopathologically diagnosed oral white, non scrapable lesions. 3) To correlate the clinical and histopathological diagnosis in the above lesions. MATERIALS AND METHODS: A total of 100 cases of oral white, non scrapable lesions were included in the study. Based on their history and clinical presentation, clinical provisional diagnosis was made. Then biopsy was done and confirmatory histopathological diagnosis was given and both were correlated. In order to correlate clinical and histopathological diagnosis Discrepancy Index (DI) was calculated for all the cases. RESULTS: Based on clinical diagnosis, there were 59 cases (59%) of leukoplakia, 29 cases (29%) of lichen planus and six cases (6%) of lichenoid reaction; whereas, based on histopathological diagnosis, there were 66 cases (66%) of leukoplakia epithelial hyperplasia and hyperkeratosis (leukoplakia) and 30 cases (30%) of lichen planus. Seventy eight clinically diagnosed cases (78%) correlated with the histopathological diagnosis and 22 cases (22%) did not correlate. The total discrepancy index was 22%. CONCLUSION: A clinician needs to be aware of oral white, non scrapable lesions. Due to the overlapping of many clinical features in some of these lesions and also due to their malignant potential, a histopathological confirmative diagnosis is recommended.

Osteolipoma of floor of the mouth.

Lipomas are benign soft tissue tumours composed mainly of mature adipose tissue. Histological variants of lipomas have been named according to the type of tissue present and they include fibrolipoma, angiolipoma, osteolipoma, chondrolipoma and others. Osteolipoma, a classic lipoma with osseous metaplasia, is a very rare histological variant. Owing to the rarity of oral osteolipomas, we report an uncommon case of osteolipoma located on the floor of the mouth of a 20-year-old female patient and include a review of the literature.

Massive granular cell ameloblastoma with dural extension and atypical morphology.

Ameloblastomas are rare histologically benign, locally aggressive tumors arising from the oral ectoderm that occasionally reach a gigantic size. Giant ameloblastomas are a rarity these days with the advent of panoramic radiography in routine dental practice. Furthermore, the granular cell variant is an uncommon histological subtype of ameloblastoma where the central stellate reticulum like cells in tumor follicles is replaced by granular cells. Although granular cell ameloblastoma (GCA) is considered to be a destructive tumor with a high recurrence rate, the significance of granular cells in predicting its biologic behavior is debatable. However, we present a rare case of giant GCA of remarkable histomorphology showing extensive craniofacial involvement and dural extension that rendered a good prognosis following treatment.

A clinicopathological study of ossifying fibromas and comparison between central and peripheral ossifying fibromas.

AIMS AND OBJECTIVES: To study the clinical, histological features of peripheral and central ossifying fibromas and also to compare between them. MATERIALS AND METHODS: The sample comprised a total 50 cases of ossifying fibromas [25 central ossifying fibromas (COF) and 25 peripheral ossifying fibromas (POF)] inclusive of cemento-ossifying fibromas. RESULTS: The mean age is 28.2 years in POF and 24.7 years in COF. The male: female ratio was 1:1.5 in POF and 1:1.8 in COF. The size of the lesions varied from 0.45 to 2.75 cm in cases of POF and in COF, it ranged from 1.25 to 13.5 cm. COF showed more duration (1-8 years) when compared with POF (1-3). Majority of cases of COF showed radiolucent, mixed radiolucent and radiopaque unilocular lesions. The predominant cell type in both POF and COF was a combination of both ovoid and spindle cells. Regarding vascularity it showed mild, moderate and intense vascularity. On comparison of all stromal changes between POF and COF showed no statistically significant difference. CONCLUSION: The clinical parameters and radiographic changes of POF and COF in our study were similar to the previous studies. Histopathological features like type of cells, cellularity and vascularity in POF and COF were similar to previous studies. However, when clinical and histopathological features were compared between POF and COF showed no statistical significance except for site of the lesion. These features signify the behavior of two lesions. Further research on larger sample might give more insights into these lesions.

Intraosseous polymorphous low-grade adenocarcinoma of mandible: A rare entity.

Polymorphous low-grade adenocarcinoma is a rare type of minor salivary gland malignancy. The characteristic features of these tumors are the varied histomorphology and the malignant, albeit indolent behavior. It occurs commonly in the minor salivary glands, with the palate (58.5%) being the most common intra oral site. Maxillary area (2%), mandibular mucosal area (1.5%) and posterior trigone region (0.5%) are the least affected areas. An occasional case has been reported arising from an intraosseous location i.e the maxilla, and only two cases have been reported in the English literature originating from the mandible. One such very rare case of polymorphous low-grade adenocarcinoma of the mandible, which radiographically has a soap bubble appearance, is reported here.

Immunohistochemical expression of Bcl-2 in benign and malignant salivary gland tumors.

OBJECTIVES: The present study was undertaken to assess and compare the immunohistochemical expression of Bcl-2 in selected benign and malignant salivary gland tumors. STUDY DESIGN: A total of 50 cases of buffered formalin-fixed, paraffin embedded tissues of previously diagnosed cases of benign and malignant salivary gland tumors from the archives of Department of Oral and Maxillofacial Pathology and Microbiology, SDM College of Dental Sciences and Hospital, Dharwad, India, were taken for the study. The immunohistochemical staining procedure was performed using monoclonal anti Bcl-2 antibody, as directed by the manufacturer. RESULTS: Thirty six cases (72%) out of 50 cases showed a positive expression for Bcl-2. Benign salivary gland tumors showed a positive expression in 8 out of 14 cases (~57%) and malignant salivary gland tumors in 28 out of 36 cases (~78%). The staining was intense in the normal lymph node, which is used as a positive control. Bcl-2 expression was seen in both benign and in malignant salivary gland tumors taken for the study except in "canalicular adenoma". CONCLUSION: The immunohistochemical expression of Bcl-2 was greater and more intense in malignant salivary gland neoplasms, suggesting a high survival rate of tumor cells in malignant neoplasms.

Developmental defects of enamel in children of Davangere District and their relationship to fluoride levels in drinking water.

To assess the prevalence and severity of developmental defects and their relationship to fluoride levels in drinking water. 739 (406 male and 333 female) schoolchildren aged 13 years formed the study population. We used the ion selective electrode method to estimate the fluoride concentration in drinking water. A modified developmental defects of enamel index was used for recording the developmental defects. The Karl Pearson coefficient for correlation and the chi-square test were used for statistical estimation. The fluoride concentration ranged from 0.64 to 2.64 ppm. The prevalence of developmental defects was 88.5%. The most common type of defect was diffuse opacity in 61.2% of the children. There was a significant positive correlation between the type (r=0.85; P<.001) and extent (r=0.92; P<.001) of developmental defects in relation to fluoride levels in drinking water. The observed prevalence demonstrates the need to ascertain factors other than fluoride levels in drinking water that could contribute to its occurrence.

Histochemical and polarization microscopic study of two cases of vegetable/pulse granuloma.

Vegetable granuloma (VG) or pulse granuloma (PG) results from the implantation of food particles of plant or vegetable origin. It is usually seen in the periapical or in the sulcus areas. These lesions have been described as a distinct entity and classified into central and peripheral lesions according to the location. Central lesions are asymptomatic, whereas peripheral lesions present as painless sub-mucosal swellings. Many authors have postulated that food particles in VG or PG get implanted and are rapidly digested, and sometimes partly get altered by host responses. The cellulose part of plant foods being indigestible persists in the form of hyaline material, whereas the starch matter gets digested. This cellulose moiety invokes chronic granulomatous response.

Permanent maxillary central incisor impaction: report of two cases.

Impaction of the permanent maxillary central incisor is rare. Trauma to the primary maxillary anterior teeth is the most common cause. Two case reports of impacted permanent maxillary central incisors with a history of trauma to the primary maxillary anterior teeth are presented. In one case there was radiographic evidence of complete arrest of root formation, and in the other case the root was dilacerated from the cervical third and the enamel surface was rough.