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    Table of Contents - Current issue
September-December 2018
Volume 22 | Issue 3
Page Nos. 289-451

Online since Friday, December 14, 2018

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From the Editor's Desk Highly accessed article p. 289
T Smitha
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Private practice of oral and maxillofacial pathology: A career option Highly accessed article p. 290
Kabita Chatterjee
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Dr. Purshotam P. Nainani p. 292
Leela S Poonja
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Microarray-based gene expression profiling for early detection of oral squamous cell carcinoma p. 293
Shwetha Hulimavu Ramaswamyreddy, T Smitha
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Physaliphorous cells p. 296
Deepak Pandiar, Smitha Thammaiah
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Assessment of oral mucosal conditions among beedi workers residing in beedi workers colonies in Karnataka, India p. 298
Padma K Bhat, Amit Kumar, CN Aruna, Bhumika Kamal Badiyani, MY Jayachandra
Background and Objectives: Beedi workers are an important part of our society. Due to their occupation of beedi making, they face different types of health hazards. This study was undertaken to assess the oral mucosal conditions among beedi workers residing in beedi workers' colonies in Karnataka. Methodology: A cross-sectional study was carried out among 700 beedi workers in the age group of 18–60 years residing in five beedi workers' colonies in Karnataka. The information was recorded regarding personal history by personal interview by the investigator. The clinical examination was done using WHO 1997 “Oral Health Assessment Form.” Significance is assessed at 5% level of significance. Results: It was found that 26.9% of study population had different oral mucosal lesions. Interpretation and Conclusion: The present study showed that oral mucosal conditions of beedi workers residing in beedi workers' colonies in Karnataka were relatively poor.
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Estimation of serum hepcidin in oral submucous fibrosis before and after supplementation with oral iron: A randomized control clinical trial p. 303
Tejavathi Nagaraj, HN Santosh
Background: Iron-deficiency anemia is synonymous with oral submucous fibrosis (OSMF). The cause for the same has not been ascertained yet. OSMF by way of anemia of chronic disease could be a probable cause of iron deficiency. Aim and Objective: This study was intended to evaluate the level of hemoglobin (Hb) in OSMF and to establish a relationship between serum hepcidin and Hb with OSMF, before and after oral supplementation of iron. Materials and Methods: The clinical trial was registered with the Clinical Trial Registry of India (CTRI/2016/03/006761). Eighty participants were selected. Based on the hematocrit values, they were divided into equal number of case (Group I) and control (Group II). Serum hepcidin was evaluated in these eighty participants with clinically established OSMF. Participants in the case group with low hematocrit values indicative of iron-deficiency anemia were supplemented with oral iron capsules twice daily for 3 months. After an interval of 3 months, serum hepcidin and hematocrit were evaluated. Statistics: Statistical analysis was done using SPSS software version 11.5 (IBM, New York, USA). One-way ANOVA test was done to assess the correlation between Hb% and serum hepcidin. Unpaired t-test was done to correlate Hb% and hepcidin before and after oral supplementation of iron. Clinical significance was established by calculating the effect size. Results: There was a significant correlation between the values of serum hepcidin and Hb (P < 0.001) before and after oral supplementation of elemental iron. After oral supplementation of iron, hematocrit improved in Group I along with reduction in serum hepcidin. Conclusion: It can be concluded that reduction of serum hepcidin is indicative of improvement in iron stores of body. Hence, serum hepcidin can be utilized as a diagnostic marker to assess iron stores in OSMF.
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Detection of salivary heat shock protein 27 by enzyme-linked immunosorbent assay and its correlation with histopathology of oral leukoplakia p. 307
V Soumya Bhavana, MG Madhura, B Veerendra Kumar, S Suma, Y Sarita
Context: Salivary analytes may be used as biomarkers for translational and clinical applications. Heat shock proteins (Hsps) are ubiquitous, highly conserved proteins found in all prokaryotic and eukaryotic species. Hsp27, a low molecular weight protein, may act as a salivary biomarker. Leukoplakia is the most common oral potentially malignant disorder and various salivary biomarkers such as interleukin-6, 8, tumor necrosis factor-α and MMPs have been detected in it. Oral leukoplakia presents clinically as homogenous and nonhomogenous forms; the microscopic pattern ranges from simple epithelial hyperplasia to carcinoma in situ. Aims: This study aims to detect salivary Hsp27 in oral leukoplakia by enzyme-linked immunosorbent assay (ELISA) and to correlate its expression pattern with histopathology. Materials and Methods: A total of 45 cases had constituted the study group. Salivary Hsp27 levels were assessed by ELISA in histopathologically confirmed cases of oral leukoplakia and were compared with that of healthy volunteers. Statistical Analysis: Mann–Whitney U-test and Spearman's correlation coefficient were used for the detection of Hsp27 and its correlation with mean absorbance levels. Results: The mean absorbance values had shown elevated expression of Hsp27 in oral leukoplakia when compared to that in healthy volunteers. Conclusions: The present study had shown elevated expression of salivary Hsp27 in oral leukoplakia which could be attributed to altered redox potential.
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Stress recognition in dental students using smartphone sensor and a software: A pilot study p. 314
Santosh Hunasgi, Anila Koneru, Amrutha Rudraraju, Vardendra Manvikar, M Vanishree
Aims and Objectives: A dental student in his/her life goes through several academic stresses. Mild stress may be beneficial in cognitive tasks and performance, while persistently high stress may lead to anxiety and depression. Thus, the aim is to compare the stress levels in students appearing for previva and postviva during university examinations. Materials and Methods: The study was carried out on 70 3rd year Bachelor of Dental Surgery students who were appearing for their university practical examination. Heart rate, oxygen saturation and stress levels were measured using Android S-HEALTH software. The data were compared and tabulated. Results obtained were statistically analyzed using paired “t”-test. Results: Heart rate, oxygen saturation and stress levels were statistically high in previva of all the students. Conclusion: It can be concluded that examination is a situational stress resulting in anxiety due to increased levels of plasma cortisol reflected by an increased heart rate, oxygen saturation and stress levels. It is important for students to use stress-reducing measures or to reduce them as much as possible to avoid factors that can affect themselves and their patients in stressful way.
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Detection of human papilloma virus-E6/E7 proteins of high-risk human papilloma virus in saliva and lesional tissue of oral squamous cell carcinoma patients using nested multiplex polymerase chain reaction: A comparative study p. 318
Rajbir Kaur Grewal, Keya Sircar, Kishore G Bhat, Dilpreet Singh Grewal, Krishan Kumar Tyagi, Simon David
Introduction: Human papilloma virus (HPV)-associated oral squamous cell carcinoma (OSCC) shows different biological behavior as compared to tobacco-induced OSCC. Mere presence of HPV in OSCC is of no clinical significance; however, the integration of HPV-DNA through E6/E7 gene into the host genome is important as it affects the development and progression of OSCC. Aim: The aim of this study was to determine the presence of E6/E7 proteins of high-risk (HR) HPV (HPV16 and HPV18) in saliva as well as lesional tissue of OSCC patients and to determine the use of saliva as an alternative to tissue for E6 and E7 proteins in OSCC. Materials and Methods: Histopathologically confirmed 47 cases of OSCC were taken up for the study. The tumor tissue and saliva sample of each patient were obtained to detect the presence of HPV16 and HPV18 along with E6/E7 proteins in both samples by nested multiplex polymerase chain reaction (NMPCR). The data were analyzed using Student t-test (2 tailed) and Wilcoxon signed-ranks test. Results: In tumor tissue, 40.42% of cases showed HPV16 (19/47) positivity while 34.04% were HPV18 (16/47) positive; whereas, in salivary sample, 31.91% showed HPV16 (15/47) positivity while 25.53% of cases were HPV18 positive (12/47). Mean age of participants was 46.7 years, males showed no significant difference from females in the prevalence of HPV 16/18 with tongue being the most common site for the occurrence. There was no statistically significant difference for HPV16/18 presence in tissue and saliva sample of OSCC. Taking lesional tissue sample as standard, sensitivity and specificity for HPV16 and HPV18 in saliva by NMPCR was estimated at 68.42% and 92.86%, respectively. The accuracy level of NMPCR detection for HPV16 was 82.98% and HPV18 was 65.96%. Conclusion: The study revealed no significant difference in the prevalence of HPV (16/18) among tissue and saliva of OSCC patients in Indian population. The study also found no difference in the level of DNA content of HPV in saliva and tissue indicating that saliva can be used as an alternative predictor of HPV positivity in OSCC.
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Bcl-2 and c-Myc expression in oral dysplasia and oral squamous cell carcinoma: An immunohistochemical study to assess tumor progression p. 325
N Pallavi, Govind Raj K Nalabolu, Santhosh Kumar S Hiremath
Introduction: Oral cancer is a multistep process involving foul play of proto-oncogenes that induce cell proliferation, inactivation of tumor suppressor gene and cessation of programmed cell death. Among various proto-oncogenes, the nature and behavior of Bcl-2 and c-Myc in oral precancerous/cancerous lesions were obscured which require further assessment for better understanding of etiology, treatment and prognosis. Aim: The aim of the study is to assess the expression of Bcl-2 and c-Myc in oral epithelial dysplasia and oral squamous cell carcinoma (OSCC). Materials and Methods: This retrospective study of 70 (oral dysplasia [30], OSCC [30] and normal gingiva [10]) is immunohistochemically assessed for Bcl-2 and c-Myc for distribution, intensity, percentage of positive cells, localization and immunoreactive scores using ImageJ software. Results: Bcl-2 showed 60% and 37% positivity within dysplasia and OSCC, respectively (P = 0.03); c-Myc showed 87% and 90% positivity within dysplasia and OSCC, respectively. In OSCC, c-Myc showed moderate intensity (P = 0.04). Average percentage of positive cells expressing c-Myc and Bcl-2 increased proportionally within grades of dysplasia (P = 0.000 and P = 0.008, respectively), whereas in OSCC, only c-Myc showed significant expression (P = 0.021). Localization of c-Myc was seen in the nucleus among OSCC (P = 0.01). c-Myc and Bcl-2 showed moderate immunoreactivity in dysplasia (P = 0.005 and P = 0.013, respectively), whereas in OSCC, moderate immunoreactivity of c-Myc (P = 0.05) was observed. Conclusion: Variable expression of c-Myc and Bcl-2 reveals that these proteins act in synergism in early phases of carcinogenesis, whereas in later stages, due to the diminished activity of Bcl-2, c-Myc interacts incoordination with other oncogenes contributing to tumor progression.
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Comparison of the efficacy of herbal mouth rinse with commercially available mouth rinses: A clinical trial p. 332
Nadeem Jeddy, Shivani Ravi, T Radhika, LJ Sai Lakshmi
Aim: The aim of the study was to compare the efficacy of an herbal mouthwash containing red ginseng extract with different brands of commercially available chemical mouthwashes. Objective: The objective of the study was to evaluate the effectiveness of herbal mouthwash (Dr. Dental care liquid) in reducing the oral bacterial count and compare it with the efficacy of commercially available mouthwashes such as Rexidine, Listerine and Colgate Plax. Materials and Methods: The study includes sixty normal individuals (aged 18–24 years) who were divided into four groups of 15 individuals each. The participants of each group were given four different mouthwashes (Dr. Dental Care liquid, Colgate Plax, Listerine and Rexidine) and asked to use it twice daily for 5 days. Saliva samples were collected before the use of mouthwash and also after 5 days of using the mouthwashes. Culture and microscopic examination of salivary samples was done, and oral bacterial load present in the saliva samples was counted before and after the mouth rinse use. Results: The results were compared using Wilcoxon sign-rank test. Among the four mouthwashes, the herbal mouthwash, Dr. Dental care liquid exhibited maximum efficacy in reducing the amount of bacteria followed by Colgate Plax, Listerine and Rexidine. Conclusion: The herbal mouthwash, Dr. Dental care liquid, contains red ginseng extract, a herb with immense medicinal values. In this study, the herbal mouth rinse exhibited increased antibacterial action compared with other commercially available chemical mouth rinses. Hence, we conclude that the ginseng-containing herbal mouthwash can be considered as a safe and effective oral hygiene aid.
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Cytogenetic and micronuclei study of human papillomavirus-related oral squamous cell carcinoma p. 335
Pritha Pal, Ranjan Raychowdhury, Subhasis Basu, Prasanta Kumar Gure, Suman Das, Ajanta Halder
Background: The association of human papilloma viral infection in oral squamous cell carcinoma is well studied in the Western countries, but its correlation with DNA damage in the form of micronuclei (MN) formation, ceased apoptosis or presence of chromosomal abnormalities has not yet been studied. Aim: The aim of this study is to find any possible correlation between human papillomavirus (HPV) infection and cytogenetic damage in the oral malignant and premalignant population of West Bengal. Settings and Design: A total of 104 malignant and 103 premalignant cases were selected along with 200 controls. Methods: The buccal smear samples were Pap stained for the detection of MN, apoptosis frequency and koilocytes. The buccal swab samples were processed for DNA extraction followed by polymerase chain reaction for the detection of HPV DNA. The peripheral venous blood samples were processed for the detection of any chromosomal abnormality, by the method of human leukocyte culture followed by Giemsa staining. Statistical Analysis Used: Correlation analysis using GraphPad Prism software was used in this study. Results: About 34.6%, 42.3% and 6.73% of malignant and 6.79%, 3.88% and 20.38% of premalignant cases showed the presence of HPV DNA, koilocytes and apoptosis, respectively. The difference between the MN frequencies of premalignant and malignant oral lesions with the control group is significant with respect to various risk factors (P < 0.05). One percentage of malignant cases showed the presence of chromosomal break. Conclusion: A considerable percentage of malignant cases showing the presence of koilocytes and viral DNA may indicate the effect of HPV infection leading to the malignancy, which can be correlated with the MN and apoptosis frequency.
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Estimation of salivary Candida albicans counts in asthmatic adult patients taking anti-asthmatic medication for 3–5 years p. 341
Kumari Alka, Vikram S Amberkar, KP Mohan Kumar, DB Nandini, B Vidyasagar
Background: Bronchial asthma is a chronic inflammatory disease of airways. The disease itself along with the principal medication used makes the oral cavity susceptible to most common opportunistic infection, i.e., oral candidiasis. There are many species of Candida causing oral candidiasis, but the most prevalent among them is Candida albicans. Hence, assessing C. albicans count in response to disease and its treatment is necessary. This enables us to educate asthma patients about side effects of medication and highlight the necessity for oral health care, thereby improving their quality of life. Aims: The present study aims to evaluate the effects of asthma and its medication on C. albicans count in saliva samples of asthmatic adult patients taking medication for 3–5 years and compare C. albicans count in saliva samples among cases and controls. Materials and Methods: Thirty asthmatic adults taking medication for asthma since 3–5 years' age ranging from 20 to 50 years and equal number of age- and sex-matched healthy participants were included in the study. In both groups, saliva was collected and inoculated on Sabouraud Dextrose Agar culture plates for estimation of C. albicans counts. C. albicans counts were assessed in colony-forming unit/milliliter. Statistical Analysis: Mann–Whitney U-test and Fisher's exact t-test were used. Results: The C. albicans count is significantly higher among asthmatics than healthy individuals. Conclusions: The present study concludes that there is increased candidal growth among asthmatics as compared to their normal healthy counterpart.
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A study to assess expression of human papillomavirus types 16 and 18 in oral squamous cell carcinoma using polymerase chain reaction p. 347
S Deepika Chowdary, P Chandra Sekhar, Kiran Kumar Kattapagari, CH Mani Deepthi, Dasari Neelima, Baddam Venkat Ramana Reddy
Objective: The diverse subset of oral squamous cell carcinoma (OSCC) with different clinical appearance and outcome, independent of traditional risk factors has led to increasing attention in human papillomavirus (HPV) infection. Materials and Methods: The investigation followed a case–control design. Information pertaining to the subjects was retrieved from hospital records. Twenty cases of OSCC and twenty age-matched controls were analyzed to ascertain the prevalence of HPV types 16 and 18. DNA was extracted from the blocks of formalin-fixed paraffin embedded tissues, and HPV-DNA was amplified using HPV type-specific primers by polymerase chain reaction (PCR) method. Data analysis was carried out using Chi-square test. Results: HPV-DNA was detected in 55% of cases (11/20; HPV 16 = 6, HPV 18 = 3 and HPV 16 and 18 = 2) and 30% of controls (6/20; HPV 16 = 3, HPV 18 = 1 and HPV 16 and 18 = 2) indicating higher percentage of HPV presence among OSCC cases. No significant association was found between the presence of HPV and gender, age, site and grade of differentiation of OSCC. Conclusion: Although the presence of HPV was higher in cases compared to controls, none of these differences were statistically significant. HPV 16 and 18 are commonly found in normal oral mucosa mandating the need for distinguishing clinical, subclinical and latent HPV infections.
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Low frequency of BRAF V600E immunoexpression in mandibular ameloblastomas: An institutional study p. 353
Pankaj M Shirsat, Shivani Bansal, Pooja Prasad, Rajiv S Desai
Background: Ameloblastoma is an uncommon, benign neoplasm of odontogenic epithelium commonly affecting the posterior mandible (almost 80%) particularly in the molar/ramus region, with occasional tumors involving the maxilla. Recently, there has been much interest generated after the reports of BRAF V600E mutations in ameloblastomas with a frequency of 46%–80% using both molecular as well as immunohistochemical (IHC) techniques. We sought to assess the presence of BRAF V600E expression in ameloblastomas in Indian patients and correlate the same with clinical behavior and histological variants by performing IHC analysis with anti-BRAF V600E antibody. Materials and Methods: Thirty formalin-fixed paraffin-embedded tissues of mandibular ameloblastomas were examined by anti-BRAF V600E antibody and correlated with clinicopathologic and histological parameters. Cytoplasmic staining of neoplastic epithelium was considered positive for BRAF V600E expression. Statistical Analysis: Data analysis was performed using Chi-square test and Student's t-test with statistical software IBM SPSS statistics 20.0. Results: BRAF V600E antibody showed positive expression only in 33.3% (10/30) cases. About 66.7% (4/6) recurrent cases and 63.6% (7/11) plexiform cases showed statistically significant association of P = 0.05 and P = 0.021, respectively, among cases with positive BRAF V600E immunoexpression. Conclusion: We report the lowest frequency (33.3%) of BRAF V600E immunoexpression in mandibular ameloblastomas in Indian population. However, a significant association of BRAF V600E-positive immunoexpression with recurrence and plexiform pattern could underline its role as a therapeutic marker for ameloblastoma.
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Dermatoglyphic findings in dental caries and their correlation with salivary levels of Streptococcus mutans and Lactobacillus in school-going children in and around Moradabad p. 360
Ritika Sharma, Narendra Nath Singh, Gadiputi Sreedhar
Introduction: Dental caries is the disease of the calcified tissues of the teeth resulting from the action of microorganisms on carbohydrates characterized by a decalcification of inorganic portion of the tooth and accomplished or followed by disintegration of organic portion. Genetic susceptibility to dental caries is dependent on certain factors, which, if evaluated, can help in estimating disease situation prematurely. Dermatoglyphics are the genetically determined dermal ridge configurations on the digits, palms and soles, influenced by environmental forces that are operating before birth. Hence, the study was undertaken to establish a possible link between dental caries and dermatoglyphics and to determine whether specific dermatoglyphic patterns exist which help in predicting the occurrence of dental caries. Subjects and Methods: The dermatoglyphics of 50 caries free (CF) and 50 individuals with dental caries (WDC) were taken and compared with the microbial levels of Streptococcus mutans and lactobacilli, and results were evaluated qualitatively and quantitatively. Statistical Analysis: Analysis was done using P value, Chi-square test and Student's t-test. Results and Conclusion: (1) Whorl pattern was more common in individuals WDC (P < 0.0001) as compared to the CF individuals who exhibited more loop pattern (P = 0.002). (2) Whorl pattern had significant association with the microbial counts of S. mutans (P = 0.383) and Lactobacillus (P = 0.015) with no such statistically significant correlation with loop pattern in the disease group. (3) ≤6 loops was a good predictor of caries. ≥4 whorls was a moderate predictor of caries.
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Stem-cell therapy and platelet-rich plasma in regenerative medicines: A review on pros and cons of the technologies p. 367
Shwetha Hulimavu Ramaswamy Reddy, Roopa Reddy, N Chaitanya Babu, GN Ashok
Regenerative medicine encompasses new emerging branch of medical sciences that involves the functional restoration of tissues or organs caused by severe injuries or chronic diseases. Currently, there are two contending technologies that can repair and restore the damaged tissues, namely platelet-rich plasma (PRP)- and stem cell (SC)-based therapies. PRP is a component of blood that contains platelet concentrations above the normal level and includes platelet-related growth factors and plasma-derived fibrinogen. Platelets are the frontline healing response to injuries as they release growth factors for tissue repair. SCs, on the other hand, are the unspecialized, undifferentiated, immature cells that based on specific stimuli can divide and differentiate into specific type of cells and tissues. Differentiated SCs can divide and replace the worn out or damaged tissues to become tissue- or organ-specific cells with specialized functions. Despite these differences, both approaches rely on rejuvenating the damaged tissue. This review is focused on delineating the preparation procedures, similarities and disparities and advantages and disadvantages of PRP- and SC-based therapies.
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Salivaomics: The current scenario p. 375
Sonalee Shah
For generations, blood has been the medium of choice for diagnosing most diseases and conditions. The reason for this is mainly the limitations of technology. The concept of oral diagnostics is preferred to more invasive methods. In recent years, it has become evident that the salivary constituents become detectably altered in response to certain disease states. Even so, what is most impressive is that salivary biomarkers not only arise in correlation with oral disorders but also those of distal tissues and organs. This suggests that oral fluids may represent a substantial reservoir of molecular and microbial information capable of communicating the onset or presence of disease throughout the body. An initiative of the National Institute of Dental and Craniofacial Research created a roadmap to achieve these goals whereby, with the use of oral fluids as the diagnostic medium, it would become possible to scrutinize the health and/or disease status of patients. The real promise of salivary analysis use is the ability of the patient or clinician to directly and continuously assess disease status, progression and therapeutic efficacy. The sensitive analysis may even allow presymptomatic diagnosis. There are five major diagnostic alphabets available in saliva namely, proteins, messenger RNAs, micro-RNAs (mi-RNAs), metabolic compounds and microbes which offer substantial advantages for salivary diagnostics because, the state of the disease may be associated with detectable changes in one, but not all, dimensions. Recently, the Salivaomics Knowledge Base (SKB) has been established by aligning the salivary biomarker discovery. The SKB constitutes data repository, management system and web resource fabricated to support human salivary proteomics, transcriptomics, miRNA, metabolomics and microbiome research.
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A novel clinical protocol for therapeutic intervention in oral submucous fibrosis: An evidence based approach Highly accessed article p. 382
Chandramani Bhagwan More, Nishma Gavli, Youbai Chen, Naman Rajeshkumar Rao
Oral submucous fibrosis (OSMF) is a chronic, progressive, debilitating, scarring and crippling disorder of the oral cavity. It is a potentially malignant oral disease which predominantly affects people of South and Southeast Asia, especially Indian subcontinent, where chewing of areca nut and its commercial preparation is rampant. However, due to increase in immigration of people from the Indian subcontinent, the health professionals in many developed countries do come across this disease very often. Since decades, many treatment modalities are suggested and studied using medicines, surgery and physiotherapy, with varying degrees of benefit, but none have been able to cure this disease completely, and hence, it has become a challenging condition. The present article emphasizes on various therapeutic interventions used till date to curb the menace of this disease and the principal author with his vast academic research and clinical experience in treating this disease has proposed the stage-wise treatment regimen for OSMF. The current article is an attempt to compile the available treatment, its current status and future perspectives, so as to assist early intervention of the disease with evidence-based approach. This article will ignite the research minds of dental clinician, oral medicine specialist, otolaryngologist and general physician in treating OSMF.
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Clear cell odontogenic carcinoma of mandible: An unclarified entity p. 392
NS Priya, AG Annaji, R Keerthi, HS Umadevi
Morphological tampering of cellular architecture is a frequent phenomenon, leading to a spectrum of histological melange at light microscopic level. One such group of tumors which exhibit diagnostic and therapeutic dilemmas are the Clear cell tumors. Clear Cell Odontogenic Carcinoma (CCOC) is an infrequent tumor, which is aggressive by nature among the odontogenic tumors. A case of CCOC of mandible in a denture wearer is presented with the emphasis on diagnostic work up and clarified and unclarified facts of the tumor.
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Peripheral ameloblastoma with neoplastic osseous invasion versus peripheral intraosseous ameloblastoma: A challenging diagnosis p. 396
Mahija Janardhanan, S Rakesh, Vindhya Savithri, Thara Aravind
Peripheral ameloblastoma, a soft-tissue analogue of intraosseous ameloblastoma, is a rare odontogenic tumor with histologic characteristics of ameloblastoma. In contrast to conventional ameloblastoma, peripheral ameloblastomas are considered as innocuous lesions which usually do not show invasion of the underlying structures. Rarely, intraosseous ameloblastoma which penetrates the alveolar bone can fuse with the overlying oral epithelium and eventually manifest as an exophytic peripheral lesion. Such lesions which mimic peripheral ameloblastoma both clinically and microscopically are termed as peripheral intraosseous ameloblastoma. As per the existing criteria, soft-tissue ameloblastomas showing bone invasion are strictly excluded from the category of peripheral ameloblastoma and are considered as peripheral intraosseous ameloblastoma. We report a rare case of extraosseous ameloblastoma with clear origin from the superficial epithelium showing the presence of a few odontogenic islands in the underlying bone suggestive of a neoplastic osseous invasion. This paper discusses the diagnostic challenges associated with peripherally occurring ameloblastomas and stresses the need for accurate diagnosis in deciding the treatment modalities.
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Benign chondroid syringoma affecting the upper lip: Report of a rare case and review of literature p. 401
Praveen B Reddy, DB Nandini, Reddy Sreedevi, BS Deepak
Chondroid syringoma (CS) (mixed tumor of the skin) is a rare neoplasm of the sweat glands, which presents itself as a slow-growing, painless, nonulcerated, subcutaneous or intracutaneous mass often occurring in the head and neck region. The clinician may miss the diagnosis of this lesion due to its rarity. CS should be considered in the differential diagnosis of any subcutaneous nodules, especially in the head and neck region. The diagnosis of CS is mainly based on the histopathologic examination. This article presents a 35-year-old male with a mass on the upper lip that was histopathologically diagnosed as an apocrine variant of benign CS with squamous metaplasia after surgical excision. No sign of recurrence is evident till date during the follow-up. We report this case because of its rarity. A brief literature review and all the reported cases in the lip have been listed.
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A rare case report of craniofacial fibrous dysplasia p. 406
Vidyadevi Chandavarkar, Pavan Manohar Patil, Deepak Bhargava, Mithilesh N Mishra
Fibrous dysplasia (FD) is a fibro-osseous lesion of the osseous structures of the body. The exact cause is unknown; however, recently, the cause has been reported to be postzygomatic somatic mutation in guanine nucleotide-binding protein, alpha stimulating 1 gene located at chromosome 20q13.2. The three subtypes of FD are monostotic, polyostotic and craniofacial. The term craniofacial FD (CFD) is used to describe FD where the lesions are confined to contiguous bones of the craniofacial skeleton. This report describes the case of CFD of a 20-year-old male patient who had unusual presentation involving right maxilla and frontal bone of the left side of the face. The clinical features, radiological findings and treatment have been discussed.
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A rare case of oral melanoacanthoma p. 410
Aanchal Tandon, Abhinav Srivastava, Rohit Jaiswal, Bharadwaj Bordoloi
Oral melanoacanthoma is a rare, pigmented lesion which brings suspicion of a malignancy with its sudden appearance and rapid growth. It is characterized clinically as a brown-black lesion and histologically it shows acanthosis of the superficial epithelium and proliferation of dendritic melanocytes. Due to their unusual clinical pattern, biopsy is mandatory to rule out malignancy.
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Prevalence of oral potentially malignant disorders and oral malignant lesions: A population-based study in a municipal town of southern Kerala p. 413
TT Sivakumar, Nisha Sam, Anna P Joseph
Oral cancer burden poses a major challenge in India. Oral cancer in the majority of instances arises from preexisting oral potentially malignant disorders (OPMDs). Early detection of OPMD and elimination of primary risk factors such as smokeless and smoking tobacco help in reduction of oral cancer. A study was conducted to find the prevalence and associated risk factors of OPMDs and oral malignant lesions (OMLs) in Punalur township of South Kerala. A total of 2368 patients were screened, out of which 156 were identified with OPMD and 5 with OML. A male predominance was noted for both OPMD and OML. Strong association with smokeless tobacco and smoking tobacco habits was seen with patients having OPMD and OML.
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Eccrine poroma: Insights of its occurrence and differentials in the maxillofacial region p. 415
Arpan K Shah, Amrish N Shah, Sandeep B Patil
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The cusp of Carabelli: Frequency, distribution and type in the Bengaluru population p. 418
T Smitha, Deepak Venkatesh, M Veeresh, KN Hema, HS Sheethal, MA Vidya
Aims: Detailed description and study of teeth traits could provide valuable information regarding phylogeny of man and distinctions between races and subraces. But morphological variations of the human dentition have not been utilized to their full potential by anthropologists concerned with patterns of human biological variation in Indian population. The aim of the present study is to detect the frequency and degree of expression of Carabelli's trait in Bengaluru population, this helps to develop a probabilistic model to distinguish individuals from specific human populations, particularly for forensic purposes. Materials and Methods: A total number 400of age and sex matched individuals from four different ethnic groups – Hindu, Islam, Christian and Iranians were examined clinically and study casts were made. Permanent maxillary first molars were examined for the expression of Carabelli's trait, Dahlberg classification system was used to score the trait on the teeth. The scores were recorded on Osteoware Dental Morphology software. The cast were examined by 2 observers independently to eliminate intra observer variation in interpretation and mean of 2 was taken for analysis. The data so obtained was statistically analysed especially emphasizing on differences between above mentioned 4 ethnic groups. Results: Cusp of Carabelli was present in 87% of the study population in maxillary first permanent molar. Type 3 was the most frequently expressed and Type 6 was the least frequently expressed and both type being expressed in Islamic groups. The expression of trait was bilateral in 90% of the surveyed groups. Conclusions: It was concluded that the prevalence of cusp of Carabelli in the small population from Bengaluru considered in the present study was found to possess a high degree of Carabelli trait expression.
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Sexual dimorphism of enamel area, coronal dentin area, bicervical diameter and dentinoenamel junction scallop area in longitudinal ground section p. 423
Wakambam Monalisa, Ganganna Kokila, Hidangmayum Denish Sharma, Pillai Arun Gopinathan, Okram Manoranjan Singh, Shubha Kumaraswamy
Introduction: Sex determination plays an important role in forensics; several studies done using radiographs, model cast and animal teeth have shown that males possess larger tooth crown and more dentin than that of the females. As physical sectioning of tooth provides more accurate measurement of enamel thickness when compared with other methods, the present study was done to evaluate and compare enamel area (EA), coronal dentin area (CDA), bi-cervical diameter (BCD), average enamel thickness (AET) and dentinoenamel junction scallop area (DEJ-SA) in longitudinal ground sections of first premolars between males and females. Materials and Methods: A total of 60 extracted first premolar teeth were used for the study, of which 30 were from male and 30 were from female. A longitudinal ground section of 15 maxillary and 15 mandibular premolars of approximately 50 μm was prepared buccolingually at the center of each tooth and mounted on the slide. Multiple photomicrographs were captured with the help of Image Analysis System Software-Progres, Speed XT core 3. EA, CDA, length of the dentinoenamel junction and BCD were measured. Average DEJ-SA and AET were also calculated. Results: Mann–Whitney U- test was used for statistical analysis. It was found that EA and AET were significantly greater in females than in males. On the contrary, it was found that CDA was significantly greater in males than in females. However, no significant difference was found in BCD and DEJ-SA between males and females. Conclusion: Permanent first premolar can be reliably used in the field of forensic in establishing gender of individuals by measuring its EA, CDA and AET.
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Assessment of palatal rugae pattern and its significance in orthodontics and forensic odontology p. 430
AM Shailaja, IR Umme Romana, Goutham Narayanappa, T Smitha, Nishitha C Gowda, HK Vedavathi
Background: Palatal rugae are nonidentical mucosal elevations seen on anterior third of palate. They are arranged in transverse direction on either side of the mid-palatine raphe. Although they are the most stable anatomical structures in the oral cavity, certain conditions such as expansion in orthodontic treatment contribute to some amount of variations in their pattern qualitatively. The aim of this study was to compare the shape of rugae and its positional changes before and after rapid maxillary expansion. Materials and Methods: Fifteen pairs of pre- and post-maxillary expansion casts showing finer details of palatal rugae from seven males to eight females in the age group of 10 ± 2.5 years were selected for this study with transverse maxillary deficiency reporting to Department of Orthodontics, VS Dental College and Hospital. The shape of rugae and the distance between the median points and lateral points of the first and the last two rugae on either side of the mid-palatal raphe were noted and marked. The data collected was statistically analyzed using SPSS program. Results: There was statistically significant difference in the distance between medial and lateral points of first two and last two rugae. Conclusion: During maxillary expansion, there is stability of palatal rugae with respect to its shape, number but not with respect to its position. Clinically, the orthodontist can quantify the palatal separation after expansion of the maxillary arch using the interruga distance.
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Proceedings of JOMFP panel discussion on publication, ethics and research, held in XVII National IAOMP PG Convention 2018 p. 436
T Smitha, B Sivapathasundaram, Raghu Radhakrishnan, Rooban Thavarajah, Aravinda Babu, P Jayanthi
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The importance of ctokeratins in the early detection of oral squamous cell carcinoma p. 441
Aiman A Ali, Badr A Al-Jandan, CS Suresh
Background: Oral cancer is usually diagnosed at advanced stages. The pattern of keratin expression in normal epithelia and the change in their expression in premalignant lesions and carcinomas have suggested the possibilities of improving diagnosis. The aim of this study is to determine the use of acidic cytokeratins (CKs) as biomarkers of histopathological progression in oral carcinogenesis. Materials and Methods: A total of 50 paraffin blocks of histological specimens diagnosed as hyperplastic epithelium, dysplastic epithelium, well-differentiated squamous cell carcinoma (SCC) and poorly-differentiated SCC (10 specimens each) were included in this study, in addition to 10 normal oral mucosal samples. All samples were stained immunohistochemically with CKs (10-ab1, 14, 16-ab1, 18-dc10 and 19-abs10) using Ventana Medical Systems (Arizona-USA). The expression of CKs antigen was evaluated as absent, mild, moderate and severe. Results: CK10-ab1 was found to be positive in the suprabasal layers of all specimens in normal and hyperplastic epithelium, while it was moderate in dysplastic epithelium and mild in well-differentiated SCC. CK10-ab1 was negative in all samples with poorly-differentiated SCC (P < 0.005). CK14 was positive in all specimens of all groups whereas CK16-ab1 was negative in all specimens of all groups. The stain of CKs 18-dc10 and 19-abs10 was restricted to the basal cells only in normal, hyperplastic and dysplastic epithelium, while it was mild in well-differentiated and poorly-differentiated SCC (P < 0.01). Conclusion: CK10-ab1 disappeared gradually with the progression of malignant changes of squamous cells whereas CKs 18-dc10 and 19-abs10 increased gradually at the same time. Such changes in the protein mapping of squamous cells need more investigation for a better understanding of oral SCC.
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Comparative efficacy of chemiluminescence and toluidine blue in the detection of potentially malignant and malignant disorders of the oral cavity p. 442
Abhilasha Shukla, Narendra Nath Singh, Sangeeta Adsul, Sulabh Kumar, Deepika Shukla, Anubhuti Sood
Context: Early detection of oral cancer is of paramount importance in determining the prognosis of oral cancer. Literature suggests that several diagnostic modalities have been proposed to aid a clinician in early detection of oral cancer without much conclusive evidence. Aims: The present study aims to compare toluidine blue and chemiluminescence screening methods in early detection of carcinoma in North Indian population and also to evaluate these methods with histopathological diagnosis. Methods: In this prospective study, 42 patients with clinically visible premalignant lesions were included. Demographic data were collected, and suspicious lesions were examined by chemiluminescence light (Vizilite) and followed by local application of toluidine blue (Mashberg's recommendation). Findings were recorded for each lesion under standard incandescent light as positive or negative. Biopsy and histopathological analysis of the tissues were performed. Statistical Analysis: Sensitivity, specificity and positive and negative predictive values for the chemiluminescence technique and toluidine blue were calculated for diagnostic tests. Results and Conclusions: In the present study, toluidine blue test was found to be moderately sensitive (63.33%) whereas chemiluminescence test (Vizilite) was found to be highly sensitive (90%); however, the test has limited specificity (50%). Thus, the study concluded that both toluidine blue and Vizilite can be used as an adjunct to simple, conventional visual examination and in screening procedure for oral potentially malignant disorders.
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Dentition status and treatment needs and its correlation with oral health-related quality of life among men having sex with men and transgenders in Pune city: A cross-sectional study p. 443
Shrikanth Muralidharan, Arunkumar Acharya, Ajit V Koshy, Judy Annie Koshy, TL Yogesh, Bindumadhav Khire
Introduction: Dental diseases are universal in nature. Their presence and severity may vary from one individual to another and is also affected by multiple factors such as gender, knowledge, attitude and the affordability of dental/oral care. Gay, bisexual and transgender community is one among the socially disadvantaged community in our country. The present study was carried out in the city of Pune, India, to evaluate the prevalence of dentition status and the treatment needs among the men who have sex with men (MSMs) and transgenders (TGs) and its correlation with the oral health-related quality of life. Materials and Methods: The sample size was 270. Convenience sampling was followed. The WHO oral health assessment for 1997 was used to record dentition status and treatment needs. Oral Health Impact Profile-14 was used to record the oral health-related quality of life. SPSS 22.0 (Chicago, IL, USA) was used for statistical analysis. All P < 0.05 were considered to be statistically significant. Results: There was no statistically significant difference seen across the various domains in the overall impact of the oral quality of life. There was a significant correlation between the decayed teeth, missing teeth and overall decayed, missing and filled teeth scores with respect to the seven domains. Problems arising due to past dental experience (dental caries), lost natural tooth structures replaced with restorative material and a cumulative impact significantly affected the outcome of the oral health-related quality of life of the participants. Conclusion: There was an alteration in quality of life of the MSMs and TGS with respect to dental caries. This calls for an intervention that is tailor-made to meet the needs of this group.
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Rapid tissue processing technique: A novel method using methyl salicylate p. 443
Shyamala Karnam, HC Girish, Sanjay Murgod, Vaidhehi Narayan Nayak, VK Varsha, Sarita Yanduri
Introduction: Tissue processing involves transition of the biopsy tissue in graded concentration of various chemicals to make the tissue amiable for sectioning. The entire process takes 2–3 working days before a microscopic slide is ready for diagnosis. In order to shorten the turnaround time, rapid tissue processing method using methyl salicylate was developed. Aim: The aim of this study is to develop a rapid tissue processing technique using methyl salicylate as a clearing agent and to compare it with routine tissue processing technique. Materials and Methods: A total of 70 tissue specimens were cut into two equal halves. One each was processed by routine processing technique (RoPT) and rapid processing technique (RaPT). Tissue specimens were measured before and after processing. Quality of staining and cellular-level shrinkage were observed and scored for specimens. Statistical analysis using Welch's unequal variances t-test was performed. Costs of chemicals in both the techniques were compared to see the cost-effectiveness of RaPT. Results and Conclusion: Outcomes of both the processing techniques were comparable with statistically not significant P values for all the parameters. Hence, the results of RaPT technique are satisfactory, and the use of this technique may prove beneficial to pathology laboratories.
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Experimental model of oral ulcer in mice: Comparing wound healing in three immunologically distinct animal lines p. 444
Paulo Goberlânio de Barros Silva, Érian Bezerra Belo de Codes, Milena Oliveira Freitas, Joyce Ohana de Lima Martins, Ana Paula Negreiros Nunes Alves, Fabrício Bitu Sousa
Background: The oral wound healing is dependent of immune participation and the absence or augment of one specific immune profile can delayed wound healing. Objectives: So, the objective of this study was t evaluate the wound healing of oral traumatic ulcer (OTU) in cheek mucosa of swiss, balb/c and c57bl6J mice. Materials and Methods: A total of 144 mice (25-30g) were distributed in three groups: swiss (n = 48), balb/c (n = 48) and c57bl/6j (n = 48). An OTU was performed using a dermatological punch in left cheek mucosa. The animals were euthanized daily (n = 6/group/day by 8 days) for evaluation of the ulcer area, weight loss and histological analysis. Results: There are no differences between ulcer area in three groups; however only swiss group showed total wound healing. Swiss group showed weight loss in 2nd and 3rd days recovering the body mass in 4th day (P < 0.01). Balb/c group showed the greater weight loss (P < 0.05) and c57bl/6j did not show body mass variation (P = 0.258). Histologically swiss group was the only group that showed total reepithelization (P < 0.001). Balb/c (P = 0.022) and c57bl/6j (P < 0.001) showed decrease in histological scores, chronic inflammation on the 8th day. Actinomyces was significantly more observed in surface of OTU of balb/c. Conclusion: Balb/c mice showed high infection of OTU surface delaying wound healing, and greater weight loss. C57bl/6J mice showed low infection of OTU, but not healing along the eight days. Only the Swiss mice showed wound healing of OTU.
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Estimation of salivary and serum alkaline phosphatase level as a diagnostic marker in type-2 diabetes mellitus with periodontal health and disease: A clinico-biochemical study p. 445
Amit De, Rekha Puttannavar, Faizia Rahman, Anwesha Adak, Rahul Sahoo, BS Ravi Prakash
Introduction: Chronic periodontitis is a multifactorial disease resulting in the inflammation and destruction of the supporting structures around the teeth, leading to tooth mobility and subsequent loss of tooth. Metabolic disorders, such as diabetes mellitus, play a crucial role in the progression of periodontal inflammatory conditions. Alkaline phosphatase (ALP) enzyme plays a key role in gingival inflammation and bone resorption. Hence, the aim of the present study is to compare the serum and salivary alkaline phosphatase levels in chronic periodontitis patients with or without type-2 diabetes mellitus. Materials and Methods: A total of 45 individuals were included in the study and divided into three groups: Group I (healthy individual), Group II (Chronic periodontitis without diabetes mellitus type-2) and Group III (Chronic periodontitis with type-2 diabetes mellitus) on the basis of clinical, radiographic and blood sugar examination. The serum and unstimulated saliva were collected from all patients in aseptic condition and samples were analyzed for alkaline phosphatase level using AVANTOR™ Benesphera ALP Kit by fully automated analyzer. Results: The result showed that the concentration of serum and salivary alkaline phosphatase increases significantly in patients with chronic periodontitis with type-2 diabetes mellitus than chronic periodontitis without diabetes mellitus and healthy patients. Conclusion: We can conclude that alkaline phosphatase can be used as a key inflammatory diagnostic biomarker in periodontal diseases.
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Study of salivary arecoline in areca nut chewers p. 446
Deepak Venkatesh, RS Puranik, SS Vanaki, Surekha R Puranik
Aims: Arecoline, a predominant alkaloid present in arecanut, has been implicated in the pathogenesis of several oral diseases because of its mutagenic and carcinogenic potential. The response of cultured cells to arecoline is highly dependent on its concentration; arecoline stimulates cultured cells above 0.1 μg/ml and is cytotoxic above 10 μg/ ml. Although this alkaloid seems important for areca nut induced oral diseases and carcinogenesis, little is known of the levels achieved before, during and after chewing. Also, it is prudent to understand its effects in arecanut chewers for a comprehensive understanding of its pathogenesis. Accordingly, the present study quantified the salivary arecoline levels in arecanut chewers. Materials and Methods: The study participants were divided into Study Group A & B and Control Group C; unstimulated whole saliva was collected by spitting method for a period of 5 min. Then, participants in Group A and C chewed 0.5 g of areca nut without any other additives while in Group B were asked to chew 0.5 g of inert rubber base impression material. Stimulated whole saliva from all three groups was collected into graduated tubes during chewing at time intervals of 1, 3, 5, 10, 15, 20 and 25 min. Then, all participants were asked to remove nut particles or inert rubber base material from the mouth, and saliva samples were collected further up to 20 min, changing tubes at 5 min interval. Salivary arecoline was quantitated by HPLC-MS. The tabulation and descriptive statistics of the study were carried out. Results: In the present study, baseline levels of arecoline were zero in all three groups, whereas mean salivary arecoline levels during chewing were 76.93 ng/ml, 129.83 ng/ml and 64.83 ng/ml and after chewing were 196.17 ng/ml, 321.12 ng/ml and 43.75 ng/ml in Groups A, B and Control respectively, which were significantly higher than reported threshold levels. Conclusions: The data from this study reveals that a significant amount of arecoline would be trapped in oral cavity, or being re-circulated between blood and saliva might have resulted in surprisingly high levels of arecoline even 10 mins after chewing in both groups after which the levels started declining. The higher levels of salivary arecoline achieved during and after chewing are enough to cause cytotoxic and genotoxic effects on oral tissues over a period of time in chronic chewers. The great differences in salivary arecoline levels achieved during chewing, may contribute to the variable response to areca nut seen in communities where this habit is widespread. Areca nut users have persistent background salivary arecoline levels long after chewing, whereas concentrations achieved are highly variable and consistent with a role in oral pre-malignancy and malignancy..
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Immunohistochemical expression of osteonectin, matrix metalloproteinases-9 and Ki-67 in ameloblastoma p. 446
K Indirapriyadarsini, Vandana Raghunath, B Venu Naidu, Botu Badari Ramakrishna, Archana Tangudu, KV Lokesh
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.
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Evaluation of glutathione peroxidase in the blood and tumor tissue of oral squamous cell carcinoma patients p. 447
Kshipra Chandrakant Deshpande, Mina Milind Kulkarni, Dinesh V Rajput
Aims and Objectives: The lowered antioxidant capacity and the oxidant–antioxidant imbalance have been considered to play a role in multistage carcinogenesis. The deleterious effects produced by reactive oxygen species depend on the imbalance between oxidant and antioxidant status in the body, so this study is aimed to evaluate the levels of antioxidant enzyme, glutathione peroxidase (GPx), in the blood and tumor tissues of oral squamous cell carcinoma (OSCC) patients in comparison with healthy controls. Materials and Methods: The study comprised of 38 participants divided into two groups. Group 1 comprised of 20 patients with OSCC and Group 2 comprised of age- and sex-matched 18 healthy individuals free of any habits and systemic illness. The levels of GPx were estimated in the blood and tissue samples in both groups by Paglia and Valentine method using a Commercial Biochemical assay kit (RANDOX), by ultraviolet-visible spectrophotometer. Results: The GPx levels were elevated in the whole blood and the tissue samples of OSCC cases as compared to the control group. It was also found that the GPx levels were increased in the tumor tissue with respect to the histopathological grading of the OSCC cases. Conclusion: Detection of antioxidant status may be useful to choose correct radiotherapy or chemotherapy, to monitor the effectiveness of the therapeutic strategy and to determine tumor resistance to therapy. Hence, the evaluation of GPx enzyme level can be used as a prognostic marker in patients with OSCC.
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Significance of micronuclei in buccal smears of mobile phone users: A comparative study p. 448
M Vanishree, Vardendra Manvikar, Amrutha Rudraraju, KM Parveen Reddy, NH Praveen Kumar, Syed Jaffar M Quadri
Aims and Objectives: The present study was designed to evaluate the frequency of micronuclei (MN) in the buccal exfoliated cells of mobile phone users. In addition, comparison of MN frequency between high and low mobile phone users was also done. Materials and Methods: A total of 30 male and 30 female participants between the age group of 20–28 years were selected from the Outpatient Department of Navodaya Dental College and Hospital, Raichur, Karnataka. The participants were divided into two groups: Group A – low mobile phone users and Group B – high mobile phone users. Cell sampling and preparation was done on the slide. All the slides were observed for a total of 1000 cells for the presence and number of MN in each cell. Results: There was a significant increase in the mean MN count in Group B in comparison to the Group A. There was highly significant difference in the mean MN count of participants using (code division multiple access) CDMA than (global system for mobiles) GSM mobile phones. The MN mean count was found to be significantly increased in nonheadphone users in comparison to headphone users. In Group B, the MN count on the side of mobile phone use was found to be statistically significantly elevated in comparison to the opposite side. Conclusion: Mobile phone radiation even in the permissible range when used for longer duration can cause significant genotoxicity. The genotoxicity accentuates when mobile phones are frequently used on the same side which may be due to more amount of radiation and increase in the temperature. Headphone usage reduces the genotoxicity of mobile phone radiation to some extent.
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Demystifying the nature of hard tissues in odontogenic tumors using Modified Gallego's stain: A preliminary study p. 448
Syeda Neelam Afroze, Surekha Ramulu, Guttikonda Venkateswara Rao, Sravya Taneeru, Rithika Bashamalla, Purnima Vadla
Introduction: Histological stains are dyes that bind to a variety of tissues. Modified Gallego's (MG) stain is a modification of Lille's stain that can be used as a differential stain for identification of hard tissues in oral pathological lesions. Objectives: The objective of this study was to identify the presence of hard tissues such as enamel, dentin and cementum in normal extracted teeth and odontogenic tumors using MG stain and to compare the efficacy of MG stain with hematoxylin and eosin (H&E) stain. Methods: A total of fifty samples, twenty decalcified sections of teeth and thirty cases of odontogenic tumors, were included in the present study. Two sections were cut from the above cases and stained with H&E stain and MG stain, respectively, and assessed for the nature of hard tissue. Results: In H&E staining, enamel, dentine, cementum and bone stained pink. Whereas, in MG stain, enamel stained pink, dentin and bone stained green, while cementum stained red. The shade of color differs with the degree of mineralization of the hard tissues in MG stain. Conclusion: MG stain can be used as a differential stain for different hard-tissue structures when compared to routine H and E staining.
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An insight into the cannibalistic behavior of giant cell granulomas of the jaws p. 449
Aadithya B Urs, Punyo Yaming, Rewa Malhotra
Background: Cellular cannibalism is defined as a large cell engulfing a smaller one within its cytoplasm. It is predominantly a feature of aggressive malignancies but has recently been demonstrated in giant cell (GC) lesions such as GC tumor of tendon sheath, central GC granuloma (CGCG) and peripheral GC granuloma (PGCG). Aim: The aim of the study is to assess the cannibalistic GCs in CGCG and PGCG and correlate with aggressiveness of the lesion. Settings and Design: Archival data of histopathologically confirmed cases of CGCG (n = 40) and PGCG (n = 25) were studied in the Department of Oral Pathology, Maulana Azad Institute of Dental Sciences. Materials and Methods: Quantification of cannibalistic cells was performed using H&E stain on microscopic sections. One hundred GCs were examined in each slide, and the number of cannibalistic cells was expressed in percentage. Results: GC cannibalism was observed in all cases. The mean number of cannibalistic GCs in CGCG was 44.67 which was significantly higher (P = 0.028) than PGCG (mean 28.04). In aggressive (n = 18) CGCG, the mean number of cannibalistic GCs was 51.27 which was significantly higher (P = 0.019) than cannibalistic GCs in nonaggressive (n = 22) CGCG (mean 39.27). No significant difference was observed between the number of cannibalistic cells in recurrent (mean = 52.9) and nonrecurrent (mean = 49.2) cases of CGCG (P > 0.05). Two of the nine cases treated initially by steroid showed fewer and smaller cannibalistic GCs with vesicular nuclei. Conclusion: There was a clear distinction in the mean cannibalistic count between aggressive and nonaggressive CGCG. Hence, the aggressiveness of the lesion could be assessed following which appropriate treatment modality can be constituted.
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Evaluation of canine sexual dimorphism in deciduous and permanent dentition p. 450
Pramod Ingaleshwar, Vina Vaswani, Satish Subrao Bhosale, V Deepak, Pramod Redder, T Smitha
Introduction: Teeth are an excellent material in living and nonliving populations for anthropological, genetic, odontologic and forensic investigations. Among the various calcified structures in the human body, teeth have gained lot of popularity in estimating the sex of an individual as they are highly resistant to destruction and decomposition. The present study aims to assess the importance of canines in sexual dimorphism in both primary and permanent dentition as well as to describe the dimensional characteristics of canines among the population of Bagalkot district of Karnataka, India. Materials and Methods: One hundred and fifty participants belonging to Bagalkot district of Karnataka population, 100 adults (50 males and 50 females) in the age group of 17–30 years and 50 children (25 boys and 25 girls) in the age group of 3–6 years were included in the study. Impressions were made using alginate and study models were prepared using dental stone. Clinical crown height (CCH), maximum mesiodistal diameter (MMD) and maximum buccolingual width (MBL) of maxillary and mandibular canines of both dentitions were measured using digital vernier caliper. Results: In deciduous dentition, significant differences were noted between maxillary and mandibular deciduous canines in male and female children using three dimensions, except mandibular canine, i.e., CCH did not show a significant difference. In permanent dentition, CCH and MMD showed significant differences except mandibular canines not showing significant differences in MBL (P < 0.05). Conclusion: Thus, canines can act as a valuable tool in gender determination as there is significant sexual dimorphism in maxillary and mandibular deciduous and permanent dentition.
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Heritability and correlation of lip print, palm print, fingerprint pattern and blood group in twin population p. 451
Fakir Mohan Debta, Priyanka Debta, Ruchi Bhuyan, Santosh Kumar Swain, Mahesh Chandra Sahu, Saswati Siddhartha
Background: Twins are similar in many ways owing to the genetical and environmental factors. However, still, there are certain things that are not similar among them, and this is the challenge for personal identification among the twins. Objectives: Our present study aimed to know and assess the similarities and differences present between the monozygotic (identical) and dizygotic (fraternal) twins in relation to lip prints, palm prints, fingerprints and blood group and to evaluate their heritability among parents and their offspring. Materials and Methods: The study group comprised 30 twins and their parents – 15 identical and 15 nonidentical twins. The age of twins ranged from 15 years to 40 years. Lip print, palm print, fingerprint and blood group were statistically analyzed. Results: All the data were subjected to statistical analysis. The identical twins showed more percentage of similarities in comparison to the non identical twins. The inheritance pattern was significant for twins in case of their lip prints while palm prints and finger prints showed no such significance in inheritance pattern whereas there was significant association seen in case of blood groups of identical twins and their parents. Conclusion: Lip prints, palm prints, fingerprints and blood groups are the important parameters in forensic science for individual identification. Many studies have been done till now in individual but very few studies done in twin population. To the best of knowledge, ours is the first study of its kind with multiple parameters and its heritability in twins. We have observed that heritability in twins with relation to lip print was statistically significant and all the parameters can be used independently to identify the twins.
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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007