Micrometastasis detection using modified papanicolaou stain in nodal tissues of oral squamous cell carcinoma - A histological study.

CONTEXT: Cervical lymph node metastasis is the most important prognostic factor in Squamous Cell Carcinoma of Head and Neck (SCCHN). Detection and evaluation of micro-metastasis forms the basis for diagnosis, staging, treatment options and prognosis. Lymph node prognostic factors are extremely important for the survival and recurrence in the patient. Assessing lymph node metastasis in the absence of clinical enlargement is challenging. AIM: To evaluate micrometastasis and individual tumor cells (ITC) in regional lymph nodes of oral squamous cell carcinoma (OSCC) by modified papanicolaou (PAP) stain and re-evaluate the tumor staging. SETTINGS AND DESIGN: The retrospective study was executed at MS Ramaiah University of Applied Sciences. METHODS AND MATERIALS: The current study constituted a total of 40 lymph nodes from OSCC patients, metastatic (n=20) and non-metastatic lymph nodes (n=20). All sections were stained with H & E followed by modified PAP stain. Modified PAP was used for identification of micrometastasis deposits. STATISTICAL ANALYSIS USED: The Chi square test was employed to analyze significance. RESULTS: Modified PAP stain proved to be more accurate (p = 0.006) than H and E stain in detecting micrometastasis which accounted for 15% of non-metastatic lymph node sections used in our study. CONCLUSION: Special stain like modified PAP stain is valuable and sensitive in detecting micro-metastasis over H and E stain. Detection of micrometastasis in OSCC patients is advantageous for the patient as it influences staging, it modifies the treatment plan in terms of both radiotherapy and chemotherapy.

Knowledge, attitude and preparedness to combat COVID-19 infection among dental professionals: A student-centric pilot study.

Background: In the COVID-19 age, attempts are being made to raise student awareness and improve best practices to contain the outbreak. Methodology: The target population was interns and 3rdyear undergraduate students from JSS Dental College and Hospital, Mysuru. COVID-19 knowledge, awareness and attitude of the students and interns and the preparedness to tackle the current COVID 19 pandemic were assessed. Results: 120 respondents responded via a contented validated self-administered questionnaire with regard to knowledge, attitude and practices and preparedness to address the COVID 19 pandemic by undergraduates and interns. The student participants irrespective of their years into practice were aware of the guidelines being issued by Health care authorities and to address the COVID 19 pandemic. Among the respondents, 57.5% were 3rd year dental students and 42.5% were interns. Regarding knowledge about COVID infection, 42.9% (3rd year students) and 57.1% of the interns were aware of the recent developments, 34.1% of the III year students were aware of the safe distance to be maintained between patients, 42.4% of the students and 57.6% of interns were aware of the authority to be contacted with suspected COVID 19 infections. The participants were also aware of the vaccine trial which was conducted. Most of the respondents (64.3% of the students and 78.6% of the interns) were aware of fumigation in clinical or high-contact areas on a daily basis and biweekly in nonclinical areas. Conclusions: The results suggest a strong need to encourage the current training program among students in health care-related fields.

Classification staging systems on clinical and radiographic features of inverted sinonasal papilloma: A case report.

Inverted sinonasal papilloma is an infrequent tumor that mostly affects the elder group of 40-50 yr. This tumor is distinguished from other sinonasal tumors by three characteristics: a high rate of recurrence, carcinomatous changes, and a high potential for local destruction. In 40% of cases of inverted sinonasal papilloma showed an association with the human papillomavirus and considered as the main etiological agent. Here, we present a case of a 36-year-old male presented with pus discharge from the right upper back teeth region in the past 1 year. Correlating with clinical, radiographical features, a diagnosis of the Inverted sinonasal papilloma.

Melanin and odontogenic cysts: An ambiguous yet imperative relation.

Pigmentation in the head-and-neck lesions is an uncommon feature. The presence of it is fascinating, but its relevance is unknown. Various odontogenic and nonodontogenic lesions show the presence of melanin pigment. Although the presence of melanin is normal in the epithelium and connective tissue, the role of melanin pigmentation in odontogenic cysts is unclear. Apart from maintaining the skin balance, varying other functions of melanin is being researched. However, not much study has been done regarding it in odontogenic lesions. As the literature regarding such cases are scanty, here, we present a case of pigmented dentigerous cyst and an attempt to understand their relationship.

Cephalic index, facial index and dental parameters: A correlative study to evaluate their significance in facial reconstruction.

Background: It becomes extremely challenging for forensic artists to reconstruct the highly decomposed faces, especially during mass disasters. It would be of great help for the identifying team of experts if there was a method to determine the facial and cephalic dimensions. This study aims to provide a method to generate a simplified method to calculate the facial and cephalic indices of an individual based on the dentition since human dentition remains almost intact in most scenarios. Materials and Methods: The sample consisted of 200 participants with the age range of 18-23 years belonging to Kerala. The cephalic and facial indices were measured using a caliper. The interincisal, intercanine, interpremolar and intermolar widths of maxillary dentition were measured on study models using a digital vernier caliper. The mean cranial and facial index were calculated and were correlated with interdental measurements. Results: It was concluded that dominant head types in Kerala males were dolichocephalic (50.2%) followed by mesocephalic (29.8%). In females, the dominant head types were dolichocephalic (42.7%) followed by mesocephalic (42.2%). In the facial types, majority of individuals were found to be leptoprosopic. A good correlation was found between the intercanine width with facial width and cranial width and a simplified formula were derived to estimate the cranial and facial index for this population. Conclusion: The results of the study suggest that the facial index and cranial index of a particular population can be evaluated from interdental measurements of the maxillary cast, especially the intercanine width.

Pigmented calcifying cystic odontogenic tumor associated with compound odontoma: Report of a rare case and review.

Calcifying cystic odontogenic tumor (CCOT) is a rare lesion accounting for only 2% of all odontogenic cysts and tumors. CCOTs can occur alone or in association with other odontogenic tumors such as odontomas. Pigmented intraosseous odontogenic lesions are rare. Among them, pigmented CCOT is known to occur with greater frequency. Only six cases of combination of pigmentation CCOT associated with odontoma have been reported in the literature. We herein present such a rare case occurring in the maxillary anterior region in a 13-year-old female patient.

Chondroid Tenosynovial Giant Cell Tumor of Temporomandibular Joint.

Tenosynovial giant cell tumor (TGCT), a benign proliferative lesion arising from the synovial membrane of the joints, is rarely seen in the temporomandibular joint. It frequently presents as a painful, preauricular swelling and affects the jaw functions. Two types of TGCT seen are diffuse TGCT (TGCT-D) and localized TGCT. A case of TGCT-D is described here, the highlight of the case being extensive areas of chondroid metaplasia which mimicked chondroid lesions, but was ruled out based on negative immunohistochemical findings within the tumor cells.