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Biomedical waste management
Veda Hegde, RD Kulkarni, GS Ajantha
January-June 2007, 11(1):5-9
Proper handling, treatment and disposal of biomedical wastes are important elements of health care office infection control programme. Correct procedure will help protect health care workers, patients and the local community. If properly designed and applied, waste management can be a relatively effective and an efficient compliance-related practice. This review article discusses about the various types of waste, its management and the hazards of indiscriminate disposal of hospital waste and in brief about dental waste management.
  55,405 2,291 1
Oral lichen planus: An update on pathogenesis and treatment
N Lavanya, P Jayanthi, Umadevi K Rao, K Ranganathan
May-August 2011, 15(2):127-132
Oral lichen planus (OLP) is a chronic inflammatory disease that affects the mucus membrane of the oral cavity. It is a T-cell mediated autoimmune disease in which the cytotoxic CD8+ T cells trigger apoptosis of the basal cells of the oral epithelium. Several antigen-specific and nonspecific inflammatory mechanisms have been put forward to explain the accumulation and homing of CD8+ T cells subepithelially and the subsequent keratinocyte apoptosis. A wide spectrum of treatment modalities is available, from topical corticosteroids to laser ablation of the lesion. In this review, we discuss the various concepts in the pathogenesis and current treatment modalities of OLP.
  17,488 2,856 20
Comparison of three different methods of tissue processing
Pritam Panja, G Sriram, TR Saraswathi, B Sivapathasundharam
January-June 2007, 11(1):15-17
Biopsied tissue is cut into thin slices and stained suitably for microscopical examination. Enabling the tissue for sectioning by paraffin embedding is known as tissue processing. The three most commonly employed means of tissue processing are routine manual method, rapid manual method and the microwave method. In this study, sections obtained from the same site of the same tissue were processed by these three methods and stained by hematoxylin and eosin. These sections were then microscopically evaluated by various parameters to compare the three methods. The results that were obtained, after subjecting to statistical analysis, showed no significant differences between the three different processes in terms of quality of staining, clarity of nucleo-cytoplasmic differentiation in various cells and the presence of artifacts. Tissue shrinkage was less in microwave-processed tissue as compared to the other methods. Microwave tissue processing was also found to be more cost-effective than other methods.
  17,768 1,457 2
Oral leukoplakia (leukokeratosis): Compilation of facts and figures
R Rajendran
July-December 2004, 8(2):58-68
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Oral manifestations of human immunodeficiency virus in children: An institutional study at highly active antiretroviral therapy centre in India
Srinivas Rao Ponnam, Gautam Srivastava, Kotaih Theruru
May-August 2012, 16(2):195-202
Context: More than 1000 children are newly infected with Human immunodefi ciency virus (HIV) every day, and of these more than half will die as a result of AIDS due to lack of access to HIV treatment. HIV disease varies considerably in children. Among those infected prenatally, some experience few or no symptoms for years, whereas in others the disease progresses rapidly. The risk factors that influence the development of such oral manifestations include, low CD4+ T cell count, xerostomia and lack of highly active antiretroviral therapy (HAART). Aims: To identify the oral manifestations of HIV in children receiving HAART. Materials and Methods: The study comprised 95 children receiving HAART. 95 HIV +ve children not receiving HAART and 95 HIV -ve children were also included for comparing the manifestations of HIV. Statistical Analysis Used: Statistical analysis was done using Fisher's Chi-square test. Probability value (P value) was obtained for the three groups. Results: The manifestations of HIV that were observed in children receiving HAART include dental caries (26%), periodontal diseases (23%), candidiasis (19%), hyperpigmentation (17%), ulcerative stomatitis (9%) and one case of mucocele. These manifestations were compared with HIV +ve children not receiving HAART and HIV -ve children to find manifestations with statistical significance. Conclusions: We conclude that HAART had increased the disease-free states in HIV +ve children on HAART promising them better life span. The incidence of oral lesions can further come down with adequate oral hygiene measures in HIV-infected children.
  13,192 476 -
Recurrent aphthous stomatitis
L Preeti, KT Magesh, K Rajkumar, Raghavendhar Karthik
September-December 2011, 15(3):252-256
Recurrent aphthous ulcers are common painful mucosal conditions affecting the oral cavity. Despite their high prevalence, etiopathogenesis remains unclear. This review article summarizes the clinical presentation, diagnostic criteria, and recent trends in the management of recurrent apthous stomatitis.
  10,910 1,851 17
Xylene: An overview of its health hazards and preventive measures
Reena Kandyala, Sumanth Phani C Raghavendra, Saraswathi T Rajasekharan
January-June 2010, 14(1):1-5
DOI:10.4103/0973-029X.64299  PMID:21180450
Xylene is an aromatic hydrocarbon known for its wide usage in tissue processing, staining and cover slipping in the histology laboratory. The hazards of xylene are well documented, making it a potential occupational hazard for the histopathological technicians. As every other profession became cautious of the occupational hazards, the very speciality that identifies the illnesses became one of the last to become aware and remedy its own hazards. This review article aims to discuss the toxicity of xylene and safety measures to counteract the hazards and enlists the pros and cons of using various substitutes that claim to be much safer, better and faster.
  11,028 1,315 6
Amelogenesis imperfecta: Report of a case and review of literature
Mayur Chaudhary, Shweta Dixit, Asha Singh, Sanket Kunte
July-December 2009, 13(2):70-77
DOI:10.4103/0973-029X.57673  PMID:21887005
Amelogenesis imperfecta (AI) is a diverse collection of inherited diseases that exhibit quantitative or qualitative tooth enamel defects in the absence of systemic manifestations. Also known by varied names such as Hereditary enamel dysplasia, Hereditary brown enamel, Hereditary brown opalescent teeth, this defect is entirely ectodermal, since mesodermal components of the teeth are basically normal. The AI trait can be transmitted by either autosomal dominant, autosomal recessive, or X-linked modes of inheritance. Genes implicated in autosomal forms are genes encoding enamel matrix proteins, namely: enamelin and ameloblastin, tuftelin, MMP-20 and kallikrein - 4. This article presents a case reported to Dr. D. Y. Patil, Dental College and Hospital, Pune, India, along with a review of this often seen clinical entity.
  9,572 1,450 2
An estimation of serum malondialdehyde, superoxide dismutase and vitamin A in oral submucous fibrosis and its clinicopathologic correlation
Suryakant B Metkari, JV Tupkari, SR Barpande
January-June 2007, 11(1):23-27
Recently, there has been growing interest in studies that concern with reactive oxygen species in various diseases. Several studies have shown the role of oxidant-antioxidants system in the causation and progression of various types of cancer including oral cancer. However, considering its high prevalence in India and the potential to undergo malignant transformation oral submucous fibrosis (OSF) has not been widely investigated with respect to lipid peroxidation and antioxidants. This definitely has developed a responsibility over the oral pathologists to find out the exact role of lipid peroxidation and antioxidants in OSF. With this view in mind, the present study was undertaken and an attempt was made to correlate the serum levels of lipid peroxidation product malondialdehyde (MDA), antioxidants superoxide dismutase (SOD) and vitamin A in relation to clinical and histopathological grading of OSF. The progressively increased MDA and progressively decreased SOD and vitamin A levels has positive correlation with clinical grades of OSF.
  9,626 1,373 1
Oral lichen planus
R Rajendran
January-June 2005, 9(1):3-5
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Oral submucous fibrosis
R Rajendran
January-June 2003, 7(1):1-4
Oral submucous fibrosis (OSF) is a chronic, progressive, scarring disease, that predominantly affects people of South-East Asian origin. This review article discusses the etiology, clinical features, epidemiology, pathology and management of oral submucous fibrosis in detail.
  10,705 0 -
Evaluation and comparison of decalcification agents on the human teeth
Karpagaselvi Sanjai, Jayalakshmi Kumarswamy, Archana Patil, Lokesh Papaiah, Srinivas Jayaram, Lakshmi Krishnan
May-August 2012, 16(2):222-227
Context: In routine histopathology, decalcification of bone and teeth is often an essential and important step during tissue processing. Various decalcifying agents have been used in the past. The rate of decalcification and the effect of decalcifying agents on the tissue and its staining characteristics are two important parameters which influence the selection of decalcifying solutions. Though some agents remove the calcium ions completely and rapidly, they adversely affect the staining characteristics and may also damage the organic components. There have been very few studies which have systematically evaluated the efficacy of these agents in decalcifying dental hard tissues. Aims: The present study was done to evaluate the rate of decalcification of six different decalcifying agents and also their effect on staining characteristics on dental hard tissues. Materials and Methods: Six decalcifying agents namely, neutral ethylene diamine tetra acetic acid (EDTA) decalcifying solution, 5% nitric acid, Perenyi's fluid, formalin-nitric acid, 5% trichloracetic acid, and 10% formic acid were used to decalcify 24 natural teeth (four in each solution). The endpoint of decalcification was evaluated by radiographic and chemical methods. The decalcified teeth were then routinely processed, sectioned, and stained with hematoxylin and eosin stains. Results: Neutral EDTA was the most considerate to the soft and hard tissues and 5% nitric acid was the least considerate to the tooth structure. Conclusions: Neutral EDTA, though being the slowest decalcifying agent among the six agents used in the study, gave excellent results for soft-tissue integrity, and best quality of both soft-tissue and hard-tissue stainings.
  9,431 954 4
Neutrophils in health and disease: An overview
SM Rashmi, DK Alka, SN Ramakant
January-June 2006, 10(1):3-8
Neutrophils are granulocytes, which form an essential component of the cellular innate system involved in killing bacteria and fungi. They play critical role in host defence by phagocytizing and digesting microorganisms and inappropriate activation of neutrophils may result in damage to normal host tissues. The structure, functions of neutrophils, mechanism of controlling periodontal bacteria, and neutrophilic abnormalities with oral manifestations are discussed in this article.
  10,206 0 2
Chemical and physical basics of routine formaldehyde fixation
Rooban Thavarajah, Vidya Kazhiyur Mudimbaimannar, Joshua Elizabeth, Umadevi Krishnamohan Rao, Kannan Ranganathan
September-December 2012, 16(3):400-405
DOI:10.4103/0973-029X.102496  PMID:23248474
Formaldehyde is the widely employed fixative that has been studied for decades. The chemistry of fixation has been studied widely since the early 20 th century. However, very few studies have been focused on the actual physics/chemistry aspect of process of this fixation. This article attempts to explain the chemistry of formaldehyde fixation and also to study the physical aspects involved in the fixation. The factors involved in the fixation process are discussed using well documented mathematical and physical formulae. The deeper understanding of these factors will enable pathologist to optimize the factors and use them in their favor.
  9,277 879 4
Mast cells are increased in leukoplakia, oral submucous fibrosis, oral lichen planus and oral squamous cell carcinoma
Madhuri R Ankle, Alka D Kale, Ramakant Nayak
January-June 2007, 11(1):18-22
Introduction: Oral leukoplakia, submucous fibrosis (OSMF), oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC) are the commonly occurring oral diseases, with characteristic clinical and histological features. These diseases at some stage are associated with chronic inflammation in adjacent connective tissue. Mast cells are the local residents of the connective tissue, and are said to be pro-inflammatory, immunoamplifying in action and producing mitogenic cytokines. These functions of mast cells may play a significant role in the pathogenesis of other oral diseases. Aims: This study was done to histologically evaluate the number of mast cells in tissue sections of oral leukoplakia, submucous fibrosis, lichen planus and squamous cell carcinoma. Materials and Methods: Five cases each of normal oral mucosa, oral leukoplakia, oral submucous fibrosis, lichen planus and squamous cell carcinoma were studied for mast cell number using 1% Toluidine blue. Results: Increase in mast cell number were seen in all the four above mentioned oral diseases, with the highest mast cell count obtained in oral lichen planus. The mast cell number/sq.mm in oral leukoplakia, submucous fibrosis, lichen planus, squamous cell carcinoma were; 59.50, 48.25, 59.75 and 56.75 respectively. Conclusion: As compared to normal oral mucosa, increase in the mast cell number was noted in all the four conditions. Mast cell hyperplasia in oral leukoplakia, OSMF, OLP, OSCC suggests their probable role in the pathogenesis of these diseases.
  8,271 1,665 2
Extensive gingival myiasis - Diagnosis, treatment, and prevention
LK Surej Kumar, Suvy Manuel, Thomas V John, Madhu P Sivan
September-December 2011, 15(3):340-343
Myiasis is a rare disease primarily caused by infestation of tissue by larvae of houseflies. Oral myiasis is still more "rare" and "unique" owing to the fact that oral cavity rarely provides the necessary habitat conducive for a larval lifecycle. Here we report a case of extensive gingival myiasis, in an 81-year-old female patient, diagnosed and treated successfully in our department. The case is discussed in relation to its clinical presentation, etiopathogenesis, management, and prognosis.
  9,658 246 4
Natal teeth: Case report and review of literature
Roopa S Rao, Sudha V Mathad
January-June 2009, 13(1):41-46
DOI:10.4103/0973-029X.44574  PMID:21886998
The presence of teeth at birth or within a month post-delivery is a rare condition. A newborn, a 2 days old female, with two mandibular incisor natal teeth was examined. The teeth were mobile and were extracted because of the fear of aspiration and refusal to feed. The purpose of this report is to review the literature related to natal teeth epidemiology and discuss their possible etiology and treatment.
  8,665 1,085 4
Shafer's textbook of oral pathology
TR Saraswathi
January-June 2009, 13(1):46-46
  8,487 857 -
Maxillary double lip and cheilitis glandularis: An unusual occurence
Raghu Dhanapal, S Nalin Kumar, TR Saraswathi, M Uma Devi, Elizabeth Joshua, M Veerabahu, K Ranganathan
January-June 2007, 11(1):35-37
Double lip is an uncommon oral anomaly, which occurs mostly in the upper lip. It may be congenital or acquired and occurs as an isolated case or in association with other lesions. Cheilitis glandularis is a rare inflammatory disease that affects minor salivary glands and their ducts, predominantly those of the lower lip. In this article, we report a case of double lip and cheilitis glandularis in the upper lip of a 14-year-old female patient. An overview of the etiology, clinical presentation, histopathologic features and treatment are discussed.
  8,467 601 -
Keratoameloblastoma of the mandible
BF Adeyemi, AO Adisa, AO Fasola, EE Akang
July-December 2010, 14(2):77-79
DOI:10.4103/0973-029X.72507  PMID:21731268
Keratoameloblastoma is a very rare ameloblastoma variant defined by extensive squamous metaplasia and keratinization. There are 13 previously reported cases in the literature, with a male predilection of 3:1. A 38-year-old male presented with a painless mandibular swelling which had been progressively increasing in size for 18 months. The incisional biopsy was misdiagnosed as basaloid squamous carcinoma. Owing to financial constraints, the patient had mandibular resection a decade after first noticing the growth, during which the clinical course was essentially benign, thus casting doubt on the initial diagnosis. The final histological diagnosis for both the incisional and resection biopsy specimens was keratoameloblastoma.
  8,509 546 1
Oral pyogenic granuloma: Various concepts of etiopathogenesis
Reet Kamal, Parveen Dahiya, Abhiney Puri
January-April 2012, 16(1):79-82
Pyogenic granuloma or granuloma pyogenicum is a well-known oral lesion. The name pyogenic granuloma is a misnomer since the condition is not associated with pus and does not represent a granuloma histologically. Pyogenic granuloma of the oral cavity is known to involve the gingiva commonly. Extragingivally, it can occur on the lips, tongue, buccal mucosa, palate, and the like. A history of trauma is common in such sites. The etiology of the lesion is not known, though it was originally believed to be a botryomycotic infection. It is theorized that pyogenic granuloma possibly originates as a response of tissues to minor trauma and/or chronic irritation, thus opening a pathway for invasion of nonspecific microorganisms, although microorganisms are seldom demonstrated within the lesion. Pathogenesis of pyogenic granuloma is still debatable. Medline and PubMed databases were searched under the following key terms: Pathogenesis of oral pyogenic granuloma, pyogenic granuloma, and oral pyogenic granuloma. This search was limited to articles on human/animal studies which were published in English language. After reviewing the searched articles, the relevant articles were selected for the present review. Through this article, we have tried to summarize and present all the concepts of pathogenesis related to this most common and most mysterious oral lesion.
  7,255 1,775 12
Toluidine blue: A review of its chemistry and clinical utility
Gokul Sridharan, Akhil A Shankar
May-August 2012, 16(2):251-255
Toluidine blue is a basic thiazine metachromatic dye with high affinity for acidic tissue components, thereby staining tissues rich in DNA and RNA. It has found wide applications both as vital staining in living tissues and as a special stain owing to its metachromatic property. Toluidine blue has been used in vivo to identify dysplasia and carcinoma of the oral cavity. Use of toluidine blue in tissue sections is done with the aim to highlight components, such as mast cells granules, mucins, and cartilage. This article provides an overview on chemistry, technique, and the various applications of toluidine blue.
  7,574 1,312 6
A study on histological grading of oral squamous cell carcinoma and its co-relationship with regional metastasis
M Akhter, S Hossain, Quazi B Rahman, Motiur R Molla
May-August 2011, 15(2):168-176
Background: Histological grading is an important diagnostic tool to predict the clinical and biological behaviour of cancer. Cervical lymph node metastasis indicate poor prognosis of oral cancer. Considering economical status of a third world country, Anneroth's grading system is less expensive, more informative than TNM staging and Broder's grading system. Anneroth's grading system also shows co-relationship with lymph node metastasis. So we are trying to evaluate the Anneroth's grading as a standard one among these three system. Objective: To study the grading of histological malignancy according to Anneroth's classification of biopsy specimens in relation to metastasis in the cervical lymph nodes and comparing the Anneroth's with the other two recognized classifications. Materials and Methods: Fifty(50) patients with oral squamous cell carcinoma was included in the study. Specimen of 35 non-metastatic tumors were compared with 15 metastatic cases. All of the patients were graded to TNM, Broder's and Anneroth's system. TNM is clinical assessment and Broder's is based on only differentiation of cells. On the other hand, six parameters of Anneroth's gives a detail about the morphology of the tumor, invasion criteria in the host tissue and show its correlation with lymph node metastasis. Scoring system of Annearoth's grading indicates demarcation points of worseness of tumor and signifies the possibility of lymph node metastasis. Results: Both Anneroth's(P=0.002) and Broder's grading(P=0.012) have been significant but Anneroth's one is more significant then Broder's. Conclusion: Anneroth's classification can be taken as a standerd diagnostic factor and predictive factor of lymph node metastasis.
  7,398 1,219 1
Aneurysmal bone cyst of the mandible: Report of a case and review of the literature
Srinivasa Prasad, Ashok M Raghaviah, Nitin Sharma, A Einstein, TR Saraswathi
January-June 2007, 11(1):38-41
Aneurysmal bone cyst (ABC) is an uncommon non-neoplastic lesion of the bones, usually affecting the long bones and spine. The rare jaw lesions are encountered in the body and ramus of the mandible. Commonly reported in the second and third decades of life, ABC's are characterized by a rapid growth pattern with resultant bony expansion and facial asymmetry. Surgical management usually consists of surgical curettage or resection. This paper describes a case of ABC in a 21-year-old female, that presented as an expansile bony mass in the parasymphyseal region. A brief review of existing literature on ABC is also made.
  7,648 887 -
Clinico-pathological correlation of micronuclei in oral squamous cell carcinoma by exfoliative cytology
Devendra H Palve, Jagdish V Tupkari
January-June 2008, 12(1):2-7
Oral squamous cell carcinoma accounts for 90% to 95% of all oral malignancies. Though its diagnosis seldom presents difficulty, it is the cancer staging and histopathological grading that are important to prognostication; and micronuclei are good prognostic indicators. Micronucleus frequencies in oral exfoliated cells stained with papanicolaou stain were counted and correlated with the histopathological grades and clinical stages of squamous cell carcinoma patients. They were also compared with healthy control subjects. Micronuclei (MN) frequencies were found higher in squamous cell carcinoma patients than in control subjects. MN frequencies were also found to be raised with increasing histological grades of squamous cell carcinoma.
  6,699 1,774 2
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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007