Calcifying odontogenic cyst associated with compound odontoma - A rare entity.

Calcifying odontogenic cyst (COC) or Gorlin's cyst categorized as a distinct entity by Gorlin et al. in 1962. It is a rare benign developmental cystic lesion that accounts for less than 1% of all odontogenic cysts. It can occur in association with various types of odontogenic tumors such as odontomas. COC is a hybrid lesion of the jaw presenting a manifold variety of clinical behaviors and histopathological characteristics including cystic, solid (neoplastic), and aggressive forms. COC exhibits diversity in terms of its clinical presentations, histopathologic features, and biological behavior. Normally, it presents as asymptomatic, slow developing lesion affecting the maxilla and mandible equally with strong predilection for the anterior segment. Radiographically, these lesions usually present as a unilocular, well-defined radiolucency with radiopaque structures within the lesion, either as irregular calcifications or tooth-like densities. The distinct features of COC as solid or cystic lesions presents with an ameloblastomous component admixed with varying proportions of ghost cells and spherical calcifications. Here, we report an article of calcifying odontogenic cyst associated with compound odontoma in a young patient with lesion in the anterior mandible with review of the various terminologies and classification and histopathology.

Sexual dimorphism using permanent maxillary and mandibular incisors, canines and molars: An odontometric analysis.

INTRODUCTION: Sex identification of skeletal remains is one of the prime factors employed in identification of an individual. Teeth, the most hard and stable human tissue, which is resistant to physical insults, serve as a valuable material for forensic, anthropological, odontologic and genetics. Among the four main attributes of biological identity, gender determination is usually the first step in the human identification process. Hence, the main objective of the present study was to assess the dimorphic status of mesiodistal (MD) width, labiolingual (LL) width as well as cervicoincisal (CI) length of the crown in both maxillary and mandibular permanent incisors, canines and first molars. MATERIALS AND METHODS: The present study comprised a set of 100 casts (50 males and 50 females) between the age group of 20-50 years of age. Impressions were made using alginate impression and study models were prepared using dental stone. The CI length of the crown, maximum MD width and maximum LL width of both maxillary and mandibular permanent incisors, canines and first molars were evaluated using digital Vernier calipers. The obtained data were analyzed using linear discriminant analysis and logistic regression method. RESULTS: This study concludes that MD dimension of maxillary canine and CI dimension of mandibular first molar as reliable indicators for gender determination than mandibular canine, maxillary and mandibular central incisors and maxillary first molar dimensions. CONCLUSION: This study concludes that MD dimension of maxillary canine and CI dimension of mandibular first molar as reliable indicators for gender determination than mandibular canine, maxillary and mandibular central incisors and maxillary first molar dimensions.

Immunohistochemical evaluation of inducible nitric oxide synthase in the epithelial lining of odontogenic cysts: A qualitative and quantitative analysis.

INTRODUCTION: The three common odontogenic cysts include radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs). Among these 3 cysts, OKC is recently been classified as benign keratocystic odontogenic tumor attributing to its aggressive behavior, recurrence rate, and malignant potential. The present study involved qualitative and quantitative analysis of inducible nitric oxide synthase (iNOS) expression in epithelial lining of RCs, DCs, and OKCs, compare iNOS expression in epithelial linings of all the 3 cysts and determined overexpression of iNOS in OKCs which might contribute to its aggressive behavior and malignant potential. AIMS: The present study is to investigate the role of iNOS in the pathogenesis of OKCs, DCs, and RCs by evaluating the iNOS expression in the epithelial lining of these cysts. SUBJECTS AND METHODS: Analysis of iNOS expression in epithelial lining cells of 20 RCs, 20 DCs, and 20 OKCs using immunohistochemistry done. STATISTICAL ANALYSIS USED: The percentage of positive cells and intensity of stain was assessed and compared among all the 3 cysts using contingency coefficient. Kappa statistics for the two observers were computed for finding interobserver agreement. RESULTS: The percentage of iNOS-positive cells was found to be remarkably high in OKCs (12/20) -57.1% as compared to RCs (6/20) - 28.6% and DCs (3/20) - 14.3%. The interobserver agreement for iNOS-positive percentage cells was arrived with kappa values with OKCs → Statistically significant (P > 0.000), RCs → statistically significant (P > 0.001) with no significant values for DCs. No statistical difference exists among 3 study samples in regard to the intensity of staining with iNOS. CONCLUSIONS: Increased iNOS expression in OKCs may contribute to bone resorption and accumulation of wild-type p53, hence, making OKCs more aggressive.

Role of micronucleus in oral exfoliative cytology.

In the last few years, the interest for oral cytology as a diagnostic and prognostic methodology, for monitoring patients in oral potentially malignant disorders and oral cancer has re-emerged substantially. In 1983, buccal mucosal micronuclei assay was first proposed to evaluate genetic instability. There are biomarkers that predict if a potentially malignant disorder is likely to develop into an aggressive tumor. These genotoxic and carcinogenic chemicals have been reported to be potent clastogenic and mutagenic agents which are thought to be responsible for the induction of chromatid/chromosomal aberrations resulting in the production of micronuclei. Various studies have concluded that the gradual increase in micronucleus (MN) counts from normal oral mucosa to potentially malignant disorders to oral carcinoma suggested a link of this biomarker with neoplastic progression. MN scoring can be used as a biomarker to identify different preneoplastic conditions much earlier than the manifestations of clinical features and might specifically be exploited in the screening of high-risk population for a specific cancer. Hence, it can be used as a screening prognostic and educational tool in community centers of oral cancer.