Analysis of collagen fibers in human gingival tissues using picrosirius red stain under polarized microscope.

BACKGROUND: Collagen fibers are the main element of gingival connective tissue and contribute a leading role in the preservation of structural integrity and tissue function. Hence, its degradation is regarded as the main marker of periodontal disease progression. AIM: The aim of this study is to analyze and compare collagen fibers, their birefringence pattern in healthy and in diseased gingival tissues stained using picrosirius red stain (PRS) and the polarizing microscope. MATERIALS AND METHODS: A total of 90 participants screened were divided into the control group (healthy gingiva) and experimental group (moderate periodontitis and severe periodontitis) based on the clinical parameters. Gingival tissue sections were stained with PRS and observed under the polarized microscope to assess the type of collagen fibers in healthy and diseased gingival tissue. Statistical analysis was performed using the one-way ANOVA and Tukey multiple comparison test. RESULTS: The healthy group revealed well-packed collagen in a parallel pattern with a strong birefringence, whereas in severe periodontitis group showed loosely packed collagen fibers in a haphazard pattern suggestive of severe destruction of the extracellular matrix. The moderate periodontitis group had a blended mixture of thick and thin fibers. CONCLUSIONS: Collagen fibers showed birefringence property when stained with PRS that helps in a better understanding of normal and pathological conditions.

Tetrad presentation of non-syndromic odontogenic keratocyst: An uphill diagnostic and therapeutic challenge.

Odontogenic keratocyst (OKC), in the last decade sceptically referred to as keratocystic odontogenic tumor (KCOT), is known for its subclinical extensive growth potential and significant rate of recurrences. Odontogenic keratocyst, being the third most common cystic lesion (10-20%) of the maxillofacial region, is often recognized as a sporadic lesion and is well-documented in the literature. Multiple presentation of these cysts over a lifetime is relatively uncommon and is usually seen in conjunction with nevoid basal cell carcinoma syndrome (NBCC), orofacial digital syndrome, Noonan syndrome, Ehlers-Danlos syndrome, Simpson-Golabi-Behmel syndrome, or other syndromes. The 'two-hit' hypothesis postulated by Knudson best explains this anomaly, wherein multiple OKCs associated with the syndromes arise as a consequence of the allelic loss in the patched (PTCH) gene, mapped to the long arm of chromosome 9q22.3-q31. A partial expression of the gene may result in multiple OKCs (5%) without any related syndromes. Though concurrent occurrence of non-syndromic multiple OKCs is a rare phenomenon, a handful of cases have been documented over the past few years. Adding to this, we report a case of multiple OKCs occurring synchronously and bilaterally in all 4 quadrants in non-syndromic, otherwise healthy persons, which could indicate a shift in trend.

A rare case of unicystic ameloblastoma with luminal, intraluminal, and intramural proliferation.

Unicystic ameloblastoma (UCA) is a cystic lesion that shows clinical, radiographic, or gross features of an odontogenic cyst, but reveals a typical ameloblastomatous epithelium lining in the cyst cavity, with or without luminal and/or mural tumor growth. This article reports the case of a 22-year-old man with dull intermittent pain and swelling in the mandible. Histopathological examination revealed a UCA of a luminal, intraluminal, and intramural histological subgroup, which has a high risk for recurrence.