Association of matrix metalloproteinase 2 and matrix metalloproteinase 9 gene polymorphism in aggressive and nonaggressive odontogenic lesions: A pilot study.

CONTEXT: The exact factors that determine the biological behavior of odontogenic lesions have not been thoroughly established yet. The influence of the matrix metalloproteinases (MMPs) on the clinical behavior of these lesions was recently brought to light. AIMS: We did a pioneer study to investigate the association of MMP9 (rs3918242 [-1562 C/T] and rs17576) and MMP2 (rs243865 [-1306 C/T] and rs865094) gene polymorphisms and aggressiveness of ameloblastomas, keratocystic odontogenic tumors (KCOT) and dentigerous cysts (DC). SETTINGS AND DESIGN: A case-control study conducted in the Department of Oral Pathology and Microbiology, Government Dental College, Trivandrum and Human Molecular Genetics Laboratory, Rajiv Gandhi Institute of Biotechnology and Poojappura, Trivandrum, Kerala. SUBJECTS AND METHODS: DNA from the blood samples of histopathologically proven ameloblastoma (n = 15), KCOT (n = 11) and DC (n = 13) patients were extracted using standard protocols. Primers were designed based on the functionality and relevance for polymerase chain reaction (PCR). PCR products were analyzed by PCR-restriction fragment length polymorphism and sequencing. STATISTICAL ANALYSIS USED: Chi-square analysis was done to assess the association of gene polymorphisms among the cases and controls. RESULTS: Ameloblastomas showed a higher frequency of mutant allele (T = 0.43; P = 0.05) of MMP9 rs3918242 (-1562C/T) compared to the control population. All the cases showed a statistically significant difference in the distribution of genotype (P = 0.046) and allele (P = 0.03; odds ratio [OR] = 2.06 [1.08-3.95]) frequency of MMP2 rs2438659 (-1306C/T). KCOT samples also showed a significant association in distribution of both genotype (P = 0.01) and allele (P = 0.01 with an OR at 3.42 [1.31-8.92]) frequency, on comparison with control population. CONCLUSIONS: MMP2 rs243865 polymorphism has a plausible role in increasing the aggressiveness of ameloblastomas and KCOT compared to that of the control population. Furthermore, MMP9 rs3918242 polymorphism may contribute to the aggressive behavior of ameloblastomas.

Evaluation of salivary DNA obtained from dental prosthesis and its applicability in forensic investigations.

AIM: This study evaluated the salivary DNA obtained from dental prosthesis after a period of storage and its applicability in human identification. MATERIAL AND METHODS: In first phase, DNA was extracted after a span of 1 week and 1 month from the dental prosthesis dipped in whole saliva for 15 min. It was followed by PCR and electrophoresis. In second phase, from extracted DNA samples 15 STRs (short tandem repeats) of human genomic DNA were amplified via polymerase chain reaction. RESULTS & CONCLUSION: DNA isolated from saliva stained dental prosthesis after a period of storage and the techniques employed are adequate for further forensic analysis.

A study of 1177 odontogenic lesions in a South Kerala population.

CONTEXT: A study on odontogenic cysts and tumors. AIMS: The aim of this study is to determine the frequency of odontogenic cysts and tumors and their distribution according to age, gender, site and histopathologic types of those reported over a period of 1998-2012 in a Tertiary Health Care Center at South Kerala. SETTINGS AND DESIGN: The archives of Department of Oral Pathology and Microbiology, were retrospectively analyzed. SUBJECTS AND METHODS: Archival records were reviewed and all the cases of odontogenic cysts and tumors were retrieved from 1998 to 2012. STATISTICAL ANALYSIS USED: Descriptive statistical analysis was performed using the computer software, Statistical Package for Social Sciences (SPSS) IBM SPSS Software version 16. RESULTS: Of 7117 oral biopsies, 4.29% were odontogenic tumors. Ameloblastoma was the most common odontogenic tumor comprising 50.2% of cases, followed by keratocystic odontogenic tumor (24.3%). These tumors showed a male predilection (1.19: 1). Odontogenic tumors occurred in a mean age of 33.7 ± 16.8 years. Mandible was the most common jaw affected (76.07%). Odontogenic cysts constituted 12.25% of all oral biopsies. Radicular cyst comprised 75.11% of odontogenic cysts followed by dentigerous cyst (17.2%). CONCLUSIONS: This study showed similar as well as contradictory results compared to other studies, probably due to geographical and ethnic variations which is yet to be corroborated.

Evaluation of serum beta 2-microglobulin in premalignant and malignant lesions of the oral cavity.

Serum beta-2-microglobulin was estimated in patients with oral leukoplakia, oral submucous fibrosis, and oral cancer. The results were compared with that of an equal number of age- and sex-matched healthy controls. A definite increase in the level of beta 2-microglobulin was observed in patients with oral submucous fibrosis and oral cancer. Though the level of beta 2-microglobulin was found to be high in oral leukoplakia, it was not statistically significant. Further studies will validate the role of beta 2-microglobulin estimation to predict the malignant potential of oral submucous fibrosis.

Chondrosarcoma of the maxilla. Case report.

Chondrosarcoma is a rare malignant neoplasm of the jaws. The diagnosis of this lesion is mainly based on the histopathological appearance. A case of chondrosarcoma of the maxilla is reported. The origin of this rare tumor in the maxilla, a bone with exclusive membranous ossification, is discussed.

Gingival enlargement as a diagnostic indicator in leukaemia. Case report.

The acute leukaemias are a group of neoplastic diseases that are characterized by proliferation of immature white cells in the bone marrow and/or blood and are often associated with severe leukopenia, anaemia and thrombocytopenia. Oral manifestations are more common in patients with acute leukaemia. Oral bleeding, gingival enlargement, ulceration and infection in patients with leukaemia have been described. Leukaemic infiltrates in the gingivae are commonly seen in acute monocytic leukaemia. A case of acute monocytic leukaemia in a 34-year-old female who reported with gingival enlargement is presented here. The role of oral lesions as a diagnostic indicator is discussed.

Mandibulofacial dysostosis. Case report.

A case of mandibulofacial dysostosis (Treacher Collins syndrome) is presented. Clinical features and skull radiographs revealed typical anomalies associated with the syndrome. Cleft of the soft palate and unerupted multiple supernumerary teeth were present in this case. No haematological, biochemical or immunological abnormalities could be detected in the patient. Pedigree analysis showed an autosomal dominant mode of transmission of the disease. Chromosomal studies did not reveal any structural or numerical discrepancies.

Metastasis of thyroid carcinoma to the mandible. Case report.

Metastatic tumours to the jaw bones are uncommon. The incidence of jaw bone metastasis is difficult to assess accurately since the usual method to determine the distribution of a metastatic tumour has been by a radiographic skeletal survey in which the jaws are rarely included. At times, metastatic lesions of the orofacial region may be the first evidence of dissemination of a known tumour from its primary site. A case of metastatic follicular carcinoma of the thyroid to the mandible is presented. The present case emphasizes the importance of considering metastasis in the differential diagnosis of a radiolucent lesion in the mandible in a patient with a history of any malignant disease.

Oral submucous fibrosis in a 12-year-old girl: case report.

A case of oral submucous fibrosis in a 12-year-old girl discusses its etiopathogenesis, clinical features, and histopathologic findings of the condition and highlights strong association of areca nut chewing as the potential factor in the etiology of this condition. Cessation of the areca nut chewing habit and submucosal administration of aqueous extract of healthy human placental extract (Placentrex) showed marked improvement of the condition. (Pediatr Dent 15:120-22, 1993).

Tuberculous ulcer of the tongue as presenting feature of pulmonary tuberculosis and HIV infection.

Tuberculosis (TB), once a lethal disease, has shown a decrease in incidence with improved public health measures and availability of antituberculous drugs. But with the advent of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), it has re-emerged alarmingly as an opportunistic infection in immunocompromised patients. Lungs are the most commonly affected organs and involvement of the oropharyngeal region in TB is very rare. Two cases of TB manifesting as ulcer of the tongue are reported here. Interestingly, both of these cases were reported within a span of six months and both of the patients were in their early thirties. A primary diagnosis of both pulmonary TB and HIV sero-positivity was made after the diagnosis of the oral TB ulcer.

Squamous cell carcinoma of the gingiva in an HIV-positive patient: a case report.

This article presents a case of gingival squamous cell carcinoma in a patient who was HIV positive but who had no history of pan chewing, smoking, alcohol consumption or nutritional deficiency. Investigations also revealed the presence of superimposed pseudomembranous candidiasis. The case reported reveals that squamous cell carcinoma of the gingiva may occur as an oral manifestation of AIDS.

Immunology of chronic generalized periodontitis. 2. Estimation of total hemolytic complement (CH 50) and its fractions C3 and C4.

The total hemolytic complement activity (CH50) and its fractions C3 and C4 were determined in forty patients with chronic generalized periodontitis (CGP). The values were compared with an equal number of age and sex matched periodontally healthy controls. Total hemolytic complement activity was expressed as number of CH50 units per ml of blood, while C3 and C4 levels were assessed by radial immunodiffusion and expressed as mg%. The observations showed a significant increase in CH50, C3 and C4 levels in the sera of patients with CGP. The study reveals the role of complement system in the pathogenesis of chronic generalized periodontitis.

Expression of lectin binding in oral submucous fibrosis.

Lectins are a group of specific glycoproteins present in cells, particularly cell membrane. Recently, lectin binding studies have been used as a diagnostic as well as prognostic indicator of neoplasm's. Oral submucous fibrosis (OSMF) is a potential premalignant condition predominantly seen in Indian subcontinent. A comparison of expression of lectin binding was studied in normal tissue, OSMF cases and oral squamous cell carcinoma. The OSMF cases were grouped into early and advanced conditions as per the histopathologic criteria. Patterns of lectin binding observed with advanced OSMF cases were comparable with that of Oral squamous cell carcinoma. The role of lectin binding studies in assessing the malignant potential of a pre-malignant condition is discussed.

Detection of HIV antibodies in saliva and its implications.

Human immunodeficiency virus has been detected in almost all body fluids. With a silent disease such as HIV infection, testing for HIV antibodies currently is the most cost effective means for determining the incidence and prevalence of HIV infection in the community and for identifying HIV infection in the individuals. HIV antibodies are found in human saliva and can be detected by sensitive ELISA. Saliva collection is easy to perform, non-invasive, safe to use and thus provides alternative method to blood collection. Research is underway to develop a low-cost saliva assay, thus saliva could become the HIV antibody testing medium of choice for much of the developing countries.

Total hemolytic complement (CH50) and its fractions C3 and C4 in the sera of patients with localized juvenile periodontitis.

The total hemolytic complement activity (CH50) and its fractions C3 and C4 levels were determined in the sera of 21 subjects with localized juvenile periodontitis (LJP). Total hemolytic complement activity was expressed as number of CH50 units per ml of blood, while C3 and C4 levels were assessed by radial immunodiffusion and expressed as mg%. The values were compared with an equal number of age- and sex-matched periodontally healthy controls. The results indicate a significant increase in CH50, C3, and C4 levels in the sera of patients with LJP. The study reveals the participation of complement system in the pathogenesis of LJP, and its assessment may assist in understanding the relative importance of complement activities in the disease process.

Oral squamous cell carcinoma in a case of dyskeratosis congenita.

Oral manifestations of dyskeratosis congenita (DCG) have received little attention in dental literature. This report is a case of dyskeratosis congenita in a 17-year-old female which was associated with oral lesions such as leukoplakia, superimposed candidal infection, desquamative gingivitis, and severe periodontitis. Histopathologic examination of the granular lesion on the right lateral border of the dorsum of the tongue showed well-differentiated squamous cell carcinoma. Etiopathogenesis, clinical features, and laboratory findings of this disease are discussed.

Immunoglobulins in the saliva of diabetic patients with periodontitis.

The study was conducted to estimate the concentration of immunoglobulins in the saliva of diabetic and nondiabetic patients with periodontitis. The salivary immunoglobulins G, A and M (IgG, IgA, IgM) were determined in 50 patients with type II or noninsulin dependent diabetes mellitus (NIDDM) and 50 non diabetic patients with periodontitis. The values were compared with that of 50 age and sex matched controls. IgG, IgA were found to be significantly increased in diabetic patients with periodontitis, compared to nondiabetic patients and controls. Though an increase in IgM was found in diabetic patients it was not significant. The altered immune response observed may be due to the response to a greater antigenic challenge which in turn may be responsible for the increased incidence of periodontitis in diabetic patients. Further studies in this field may help to establish this association.

Sialoblastoma: A literature review from 1966-2011.

Sialoblastoma is a rare congenital tumour of the salivary glands arising mainly from the parotid gland. It is usually diagnosed at birth or shortly thereafter with a significant variability in histological appearance and clinical course. In extensive search of PubMed indexed journals, we got 46 cases of "sialobalstoma/embryoma/congenital basal adenoma", with one case was of German literature and three additional cases of adult sialobalstoma. This article has extensively reviewed the clinical, histopathological and immunohistochemical features, Magnetic resonance imaging (MRI) and Computerized Tomography (CT) findings, treatment and prognosis.

Association of cytokine gene polymorphisms with oral lichen planus in Malayalam-speaking ethnicity from South India (Kerala).

Oral lichen planus (OLP) is a chronic mucocutaneous condition that affects the oral mucous membrane as well as skin. It is a chronic cell-mediated autoimmune condition where the T-cell-mediated immune response plays an important part in the pathogenesis by causing damage to basal keratinocytes in oral mucosa. Cytokine gene polymorphisms have an unquestionable role in the orchestration of the immune response, leading to different functional scenarios, which in turn influence the outcome of the disease establishment and evolution. The purpose of this study was to understand the role of these cytokine gene polymorphisms in the tumor necrosis factor-alpha (TNF-α), interleukin-1ß (IL-1ß), and IL-6 genes with OLP in 101 individuals of Malayalam-speaking ethnicity from South India (Kerala). We further investigated the role of these polymorphisms in patients suffering from OLP with other comorbid factors. Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism. The results demonstrate that the A allele in the TNF-α -308 polymorphism could play an important role in the susceptibility to OLP. IL-1ß +3954 in OLP was associated with other comorbid factors in both allelic and genotypic combinations. However, when patients suffering from OLP were stratified to understand the involvement of other comorbid factors, we observed that the T and C alleles were independent risk factors for chronic periodontitits and diabetes mellitus. On the other hand, IL-6 -597 did not show any disease association with OLP in the study population. This study indicates that proinflammatory cytokines are an important factor in understanding the disease burden of OLP and their comorbid factors.

Cemento-ossifying fibroma in a patient with end-stage renal disease.

The presence of chronic renal disease (CRD) is a predisposing factor for the occurrence of soft and hard tissue lesions in the oral cavity. The cemento-ossifying fibroma (COF) is an uncommon benign fibroosseous lesion composed of fibrocellular component and calcified materials like cementum and woven bone. A 37-year-old female patient undergoing chronic haemodialysis reported to our institution with a complaint of slow growing, nontender swelling of mandible of 6-month duration. Computed tomography disclosed an ill-defined lesion showing thinning and expansion of buccal as well as lingual cortical plate with flecks of radiopacity in centre. Incision biopsy revealed histological characteristics consistent with cemento-ossifying fibroma. The lesion was excised under local anesthesia. The histopathological examination revealed irregularly shaped bone and cementum-like hard tissue calcifications contained within hypercellular fibrous tissue stroma, leading to a confirmation of the diagnosis of cemento-ossifying fibroma. This paper aims to provide light to the fact that the soft and hard tissues of the oral region may become susceptible to the development of pathological growths in case of some particular systemic conditions.