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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists
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   2014| January-April  | Volume 18 | Issue 1  
    Online since May 6, 2014

 
 
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CASE REPORTS
Abrikossoff's tumor of tongue: Report of an uncommon lesion
G Suchitra, Kaustubh N Tambekar, Kango Prasad Gopal
January-April 2014, 18(1):134-136
DOI:10.4103/0973-029X.131943  PMID:24959055
Granular cell tumor, an uncommon neoplasm, can occur at any site in the body, but they are more commonly observed in the head and neck region, especially the oral cavity. A lesion of controversial origin, this entity has to be considered in the differential diagnosis of swellings of the tongue. Immunohistochemical findings obtained in the present case also render support for the neural histogenetic origin for this tumor. Though commonly observed in the fourth to sixth decades of life, we present this case in a 9-year-old female patient.
  1 1,864 247
Multiple vascular malformations in head and neck - Rare case report
Yogesh T Lakkasetty, Sangeeta Malik, Akshay Shetty, Kourosh Nakhaei
January-April 2014, 18(1):137-142
DOI:10.4103/0973-029X.131944  PMID:24959056
Multiple venous malformations (VMs) pose some of the most difficult challenges in the practice of medicine today. Clinical manifestations of these lesions are extremely protean. Because of the rarity of these lesions, experience in their diagnosis and management by most clinicians is limited. This augments the enormity of the problem and can lead to misdiagnoses, inadequate treatment, high complication rates and poor patient outcomes. Because these lesions can recur, removal of the nidus is the main priority. Vascular malformations are best treated in medical centers where patients with these maladies are seen regularly and the team approach is utilized. The presence of intralesional nerve in arteriovenous malformation (AVM) and sometimes in VMs, as reported in this study, provides an additional diagnostic criterion that is simple and reliable and can be readily used to differentiate VMs from hemangiomas.
  - 3,618 271
Chondromyxoid fibroma of zygoma: A rare case report
M Sudhakara, Radhika M Bavle, N Srinath, K Paremala
January-April 2014, 18(1):93-96
DOI:10.4103/0973-029X.131924  PMID:24959045
Chondromyxoid fibroma (CMF) is a rare benign mesenchymal tumor of the bone. Clinically, it is characterized by a lobular growth pattern and histologically by chondroid and myxoid differentiation. The tumor is rare in the craniofacial bones with only 2% of all reported cases. Extragnathic location in the facial skeleton is extremely rare. Most of the cases reported either originate from gnathic sites or in the cranium. A case of CMF in a 3΍-year-old male is presented here, which arose from the root of zygomatic arch. A detailed clinical history and histopathological picture of one more case is added to the literature. It is important to document such cases so that better light can be shed on future reviews and conclusions. This shall facilitate better treatment approaches and prognosis. This case is the first reported case of involvement of the zygomatic arch in a pediatric patient.
  - 2,015 201
Acinic cell carcinoma of minor salivary gland showing features of high-grade transformation
Vadivel Ilayaraja, H Prasad, Krishnamurthy Anuthama, Ranganath Sruthi
January-April 2014, 18(1):97-101
DOI:10.4103/0973-029X.131925  PMID:24959046
Introduction: Acinic cell carcinoma (AciCC) of salivary gland is a relatively infrequent tumor. Though known for its low-grade behavior, its unpredictable element of recurrence and malignancy should never be ignored. Case Report: A male patient with complaints of pain and swelling in the left jaw region since a year was operated based on the computed tomography (CT) and incisional biopsy report. Histopathology (routine staining, special staining, immunostaining and electron microscopy) of the excised specimen revealed it to be a variant of AciCC from minor salivary gland. Discussion: To the best of our knowledge, this is the first case of AciCC showing propensity for high-grade transformation (HGT), arising from minor salivary gland, being reported. The rarity of such variants and the importance of various investigative techniques in the diagnosis of such cases are discussed.
  - 2,652 251
Primary biphasic synovial sarcoma of gingiva: Report of a rare case
Guttikonda Venkateswara Rao, Taneeru Sravya, Yeluri Sivaranjani, Vidya Rani Bhat
January-April 2014, 18(1):77-80
DOI:10.4103/0973-029X.131916  PMID:24959041
Synovial sarcoma is a mesenchymal spindle cell tumor with variable epithelial differentiation. It is unrelated to the synovium as the name might suggest but arises in the soft tissues of the extremities around the knee joints and tendon sheaths. The tumor cells are thought to resemble normal synovial tissue histopathologically, hence named "synovial sarcoma" (SS). Head and neck lesions are less common and oral cavity involvement is extremely rare. Few cases in tongue, soft palate, mandible, buccal mucosa and floor of mouth have been described in the literature. Here, we probably report the first case of primary biphasic SS (BSS) involving gingiva in the retromolar area of the mandible in a 21-year-old male patient.
  - 1,866 280
Aggressive extranodal peripheral T-cell non-Hodgkin's lymphoma: A rare case report and review
Pacha Venkat Bagirath, Jogishetty Vijay Kumar, Uttara Dasharatha Arvind, Gangula Shailaja
January-April 2014, 18(1):80-83
DOI:10.4103/0973-029X.131918  PMID:24959042
Non-Hodgkin's lymphoma (NHL) is primarily a disorder of lymph nodes, when limited primarily to extranodal sites it is referred to as primary extranodal lymphoma and accounts for 24-48% of all cases of NHL. The development of peripheral T-cell lymphoma is poorly understood and is thought to be associated with effector T cells involving chromosomal translocations. It has been suggested by few authors that the continued increased risk for NHL among highly active antiretroviral therapy (HAART)-treated human immunodeficiency virus (HIV)-infected persons may be a reflection of incomplete immune reconstitution and possibly a chronic state of B-cell hyperactivation. Here, we present one such rare case of extranodal NHL in a known HIV patient.
  - 1,446 174
Non-hereditary cherubism
Babita Niranjan, ND Shashikiran, Shilpy Singla, Sowmya Kasetty
January-April 2014, 18(1):84-88
DOI:10.4103/0973-029X.131920  PMID:24959043
Cherubism is a self-limiting non-neoplastic autosomal dominant fibro-osseous disorder of the jaw usually found in children between 2-5 years of age. It occurs predominantly in boys and is characterized clinically by bilateral swelling of cheeks due to bony enlargement of the jaw that gives the patient a typical cherubic look. Cherubism may occur as solitary cases or in many members of family, often in multiple lesions. Radiographically the lesions appear as multilocular bilateral radiolucent areas. The present case report describes a 13-year-old female cherubic child with progressive swelling of cheeks.
  - 2,346 301
Glandular odontogenic cyst: A rare entity
Monali Shah, Hemant Kale, Amena Ranginwala, Govind Patel
January-April 2014, 18(1):89-92
DOI:10.4103/0973-029X.131922  PMID:24959044
Glandular odontogenic cyst (GOC) is an uncommon developmental odontogenic cyst of jaws with a relative frequency between 0.012 and 1.3%. GOC is very rare and only 111 cases have been documented in the English literature so far. Generally, this cyst is encountered in the anterior areas of the mandible and is more common with a wide age range, the mean age being 49.5 years and has a tendency to recur. GOC is often misdiagnosed because of its overlapping histopathological features with that of other odontogenic cysts such as lateral periodontal cyst (LPC) or botryoid cyst and central low-grade Mucoepidermoid carcinoma. Histopathological diagnosis and differential diagnosis of GOC is challenging for pathologist. Here, we present a case of GOC in a 40 year old male patient in left mandibular region that crossed the midline.
  - 4,314 515
Primary diffuse large B-cell lymphoma in the anterior hard palate: A rare case report with review of literature
Sujit Ranjan Sahoo, Satya Ranjan Misra, Lora Mishra, Sobhan Mishra
January-April 2014, 18(1):102-106
DOI:10.4103/0973-029X.131927  PMID:24959047
Diffuse large B-cell lymphomas (DLBCLs) are defined as neoplasms of large transformed B cells, i.e. with nuclear diameter more than twice that of a normal lymphocyte. These account for 30-40% of all adult non-Hodgkin's lymphomas (NHL). Intraoral lymphomas are relatively rare and often difficult to diagnose in clinical settings. In this case report, we describe a case of primary DLBCL affecting the anterior part of the hard palate of an elderly male patient. DLBCL of anterior part of hard palate is yet to be reported in the English literature, even though DLBCL cases involving the posterior palate have been recorded, thus making the present case to be first of its kind. Emphasis has also been given on the subclassification, differential diagnosis and prognostic antibody factors determining the outcome of DLBCL.
  - 2,110 217
Gingival angioleiomyoma-infrequent lesion of oral cavity at a rare site
Shashi Ranjan, Kumar Tathagat Singh
January-April 2014, 18(1):107-110
DOI:10.4103/0973-029X.131928  PMID:24959048
Gingival angioleiomyoma are rarely encountered lesions and most of these lesions are excised in toto in view of reactive gingival epulitic lesions. However, due to the vascular nature of these lesions, many a times surgeons experience unexpected hemorrhage and require extensive hemostatic management. A preoperative diagnosis is a must for these lesions and at least color imaging techniques can be utilized to know its vascular nature and preoperative tumor embolization can be done to be on the safer side. Also histopathological dilemma can occur due to the varied types of vascular arrangement in angioleiomyoma or due to simulation of other vascular lesion like hemangiomas, as well as due to similarity with other spindle cell neoplasms. We advocate the use of immunohistochemistry (IHC) to establish the exact diagnosis in such cases. Also due to infrequent reports of angioleiomyoma in such unusual location, we want to record this case for further reference in future.
  - 1,699 231
Mandibular arteriovenous malformation: A rare life- threatening condition depicted on multidetector CT angiography
Amit Nandan Dhar Dwivedi, Anubha Pandey, Ishan Kumar, Arjit Agarwal
January-April 2014, 18(1):111-113
DOI:10.4103/0973-029X.131930  PMID:24959049
Arteriovenous malformation (AVM) of the mandible is a rare and potentially life-threatening condition which can lead to massive hemorrhage. The following is a description where a large mandibular AVM presented with torrential bleeding following tooth extraction for caries. An orthopantomogram (OPG) was performed which was suggestive of aneurysmal bone cyst or ameloblastoma. A computed tomography (CT) angiography revealed a large mandibular AVM with submandibular extension. It is important for both clinicians and radiologist to be aware of this type of lesion that can have life-threatening complications. It is important to define the anatomical location and the feeder vessels of the entity in detail preoperatively. This communication highlights the common differential and use of multidetector CT (MDCT) angiography along with other imaging modalities to prevent a fatal hemorrhage and arrive at a correct diagnosis.
  - 2,483 232
Plexiform neurofibromatosis involving face and oral cavity
Dorairaj Jayachandran, Selvaraj Sunantha, Hema Gopalaiah, Gajendra Veeraraghavan
January-April 2014, 18(1):114-117
DOI:10.4103/0973-029X.131932  PMID:24959050
Plexiform neurofibromas (PNFs) are one of the most common and debilitating complications of neurofibromatosis type I (NF-I). They account for substantial morbidity, disfigurement, functional impairment and are life threatening. PNFs can also be subjected to transformation into malignant peripheral nerve sheath tumor (MPNST). This complication is refractory to treat due to paucity of effective therapies for malignant soft tissue sarcomas in general and also the delay in diagnosis from a preexisting tumor. We report a case of PNF of face involving oral cavity with literature review.
  - 2,428 236
An unusual case of epithelial-myoepithelial carcinoma of the parotid gland radiologically simulating a benign lesion
Shubhra Sharma, Sangeeta Patankar
January-April 2014, 18(1):118-120
DOI:10.4103/0973-029X.131935  PMID:24959051
Epithelialmyoepithelial carcinoma (EMEC) is a rare low-grade malignant salivary gland neoplasm that most commonly occurs in the parotid gland but can also arise in minor salivary glands. Here, we present a case of EMEC in a 60-year-old male patient with a huge swelling in the left parotid gland region. Clinically and radiologically, it simulated a benign salivary gland neoplasm. However, fine-needle aspiration cytology and histologic examination revealed atypical myoepithelial cells in solid sheets or nests suggestive of epithelial-myoepithelial carcinoma. Diagnosis was further confirmed by positive immunohistochemical staining with calponin (CALP) and periodic acid-Schiff (PAS) for glycogen.
  - 4,276 173
A fatal case of rapid gingival enlargement: Case report with brief review
Srinivas Rao Ponnam, Gautam Srivastava, Narendradev Jampani, VV Kamath
January-April 2014, 18(1):121-126
DOI:10.4103/0973-029X.131938  PMID:24959052
Myeloid sarcoma (MS) is a rare extramedullary tumor composed of primitive granulocytic cells. These lesions are commonly associated with other hematologic disorders such as myeloid leukemia and other myeloproliferative neoplasms. Although extremely rare in the oral cavity, this lesion was reported in gingiva, palate, buccal mucosa and extraction sockets. MS is an aggressive lesion associated with poor prognosis. Early identification and prompt treatment holds the key for increasing the disease-free period in these patients. In this context, we report a rare and aggressive case of MS, which ran a fatal course in a 45-year-old female patient.
  - 2,067 279
Oncocytoma of minor salivary gland involving the retromolar region: A rare entity
Suhasini Gotur Palakshappa, Vishal Bansal, Vandana Reddy, Nagaraju Kamarthi
January-April 2014, 18(1):127-130
DOI:10.4103/0973-029X.131941  PMID:24959053
Oncocytic neoplasms comprise a group of rare tumors of salivary glands. Histologically, World Health Organization (WHO) (1991) classified them into three distinct types: Oncocytosis, oncocytoma and oncocytic carcinoma. Oncocytoma is also known by the more descriptive and less confusing terms of oxyphilic adenoma and oxyphilic granular cell adenoma. Oncocytoma is a rare benign salivary gland neoplasm composed of large epithelial cells with characteristic bright eosinophilic granular cytoplasm (oncocytic cells). It accounts for approximately 0.4-1% of all salivary gland neoplasms, occurring primarily in parotid glands, with only a small percentage occurring in minor salivary glands of palate, tonsillar fossi, larynx, nasal cavity, maxillary sinus and the lacrimal gland. It occurs primarily in persons older than 50 years of age. According to some authors, the biologic behavior of oncocytomas arising from minor salivary glands is that of an aggressive nature and should be considered as low-grade malignancies. Only 17 cases of histologically verified oncocytoma of an intraoral minor salivary gland are reported in literature, , the current case being the 18th. Owing to the lack of large series, assiduous study of the cases reported in the literature may lead to better understanding of this rare entity. We herein describe a rare and probably the first case of minor salivary gland oncocytoma involving retromolar area in a 32-year-old female patient with a brief review of literature.
  - 2,320 269
Fine-needle aspiration findings in epithelioid myoepithelioma of the parotid gland: A diagnostic pitfall
BN Gayathri, R Kalyani, ML Harendra Kumar, SM Azeem Mohiyuddin
January-April 2014, 18(1):131-133
DOI:10.4103/0973-029X.131942  PMID:24959054
The cytological features of myoepithelioma of the parotid gland are documented in only a few case reports. We describe the fine-needle aspiration cytological findings in a case of epithelioid myoepithelioma of the parotid gland in a 43-year-old male. The differential diagnosis with other salivary gland neoplasms is discussed.
  - 1,941 173
EDITORIAL
From the Author's desk: Oral Pathology as a Dental Speciality in India
A Einstein
January-April 2014, 18(1):1-1
DOI:10.4103/0973-029X.131879  PMID:24959027
  - 1,658 353
ENIGMATIC MORPHO INSIGHT
Microcalcifications in Salivary Gland Tumors
Radhika M Bavle
January-April 2014, 18(1):2-3
DOI:10.4103/0973-029X.131880  PMID:24959028
  - 2,055 716
KNOW YOUR FIELD
Histopathological variants of oral squamous cell carcinoma-institutional case reports
Jigna Pathak, Niharika Swain, Shilpa Patel, LS Poonja
January-April 2014, 18(1):143-145
DOI:10.4103/0973-029X.131945  PMID:24959057
  - 4,638 700
Papillary squamous cell carcinoma of antrum-clear cell variant
Sangeeta R Patankar, V Poornima, Vineet Avdhani, Sanya Bhatia
January-April 2014, 18(1):146-148
DOI:10.4103/0973-029X.131946  PMID:24959058
  - 1,730 201
ONLINE ONLY - CASE REPORTS
Orodental findings in postaxial acrofacial dysostosis
Aadithya U Urs, Priya Kumar, Kalpana Nunia
January-April 2014, 18(1):149-149
DOI:10.4103/0973-029X.131947  PMID:24959059
We report a new case of postaxial acrofacial dysostosis (Miller) syndrome with expanded profi le. The patient presented with unusual orofacial and digital anomalies along with mental retardation. This report emphasizes the recognized features of the syndrome as well as describes intraoral fi ndings that could aid in the diagnosis and management of these patients.
  - 1,707 189
Lipoma of the submandibular space
DC Sathyaki, R Jyothi Swarup, M Mohan, Rekha Varghese
January-April 2014, 18(1):149-149
DOI:10.4103/0973-029X.131948  PMID:24959060
Lipomas in the submandibular space are uncommon. This report describes a case of lipoma in the submandibular space. The clinical features, imaging study, histopathological features and management of the tumor are described.
  - 1,860 218
Focal cemento-osseous dysplasia masquerading as benign cementoblastoma: A diagnostic dilemma
Gayathri S Rao, Muralidhar G Kamalapur, Swetha Acharya
January-April 2014, 18(1):150-150
DOI:10.4103/0973-029X.131949  PMID:24959061
Context: Focal cemento-osseous dysplasia (FCOD) is a fibro-osseous lesion that is a nonneoplastic reactive lesion. Case Report: A case of 47-year-old female patient presenting with a diagnostic dilemma to the clinician is reported. Methods to achieve definitive diagnosis are discussed. Conclusions: FCOD can present with features of periapical pathology or other osseous lesions. Hence, to arrive at a definitive diagnosis biopsy and histopathologic examination is imperative.
  - 2,159 346
Branchial cleft cyst: A case report and review of literature
Surekha Chavan, Revati Deshmukh, Prasad Karande, Yeshwant Ingale
January-April 2014, 18(1):150-150
DOI:10.4103/0973-029X.131950  PMID:24959062
First branchial cleft anomaly is a rare disease of the head and neck. Because of its rarity, first branchial cleft anomaly is often misdiagnosed and results in inappropriate management. In this article, we present a case of type II first branchial cleft anomaly. A middle-aged woman who had suffered from swelling on lower jaw visited our department with the chief complaint of a swelling. She underwent complete excision of the lesion with preservation of the facial nerve. The patient recovered well and had no recurrence at 1-year of follow up.
  - 3,516 293
ORIGINAL ARTICLES
Molecular detection and corelation of Helicobacter pylori in dental plaque and gastric biopsies of dyspeptic patients
T Sreenivasa Bharath, M Sesha Reddy, Raghu Dhanapal, N Govind Raj Kumar, PV Neeladri Raju, TR Saraswathi
January-April 2014, 18(1):19-24
DOI:10.4103/0973-029X.131885  PMID:24959032
Helicobacter pylori is a microaerophilic organism, which colonizes in the gastric mucosa. Its role in etiology and development of acute and chronic gastritis and peptic ulcer diseases is scientifically proved. Oral cavity especially supragingival, subgingival plaque and so forth simulate the same microaerophilic environment favorable for the growth of this bacterium. Aim: Detection of H. pylori simultaneously in the oral cavity and gastric mucosa of patients suffering from gastric pathologies. Objectives: To detect H. pylori in the oral cavity and gastric mucosa using endoscopy, urease test and real-time polymerase chain reaction (PCR) (urease A gene). Determining its association and corelation with patient demographics, oral hygiene maintenance and periodontal disease status. Materials and Methods: Endoscopic examination, oral findings oral hygiene index-simplified (OHI-S) and community periodontal index and treatment needs (CPITN) indices were recorded. Antral biopsies and supragingival plaque samples were taken from 56 dyspeptic adult patients. The collected samples were subjected to histological examination, urease broth test and urease A gene amplification using real-time PCR. Result: H. pylori was detected in the supragingival plaque of individuals with H. pylori-induced gastric diseases using rapid urease test and real-time PCR analysis. Occurrence of same strain of H. pylori simultaneously in plaque and gastric mucosa was observed. Positive correlation was obtained between the collected indices and quantity of H. pylori colonization.
  - 2,361 266
Attitude and knowledge of dental students of National Capital Region regarding HIV and AIDS
Neeraj Grover, Abhishek Prakash, Sanjeet Singh, Nishant Singh, Paramjit Singh, Jazib Nazeer
January-April 2014, 18(1):9-13
DOI:10.4103/0973-029X.131882  PMID:24959030
Background: India is estimated to have third highest number of Human Immunodeficiency Virus (HIV) infection in world with about 2.4 million people currently living with HIV/Acquired Immunodeficiency Syndrome (AIDS). There is a possibility of HIV transmission in the oral health care setting and thus adequate knowledge and proper attitude among dental students is vital to prevent the chances of transmission and for proper care of the patient. Aims and Objectives: The present study aimed to investigate the knowledge of dental students about HIV infection and their attitude toward treating HIV/AIDS patients and behaviour practiced. Materials and Methods: A cross-sectional survey was conducted among 600 dental students of different colleges present in National Capital Region (NCR). The students were from third and fourth year and they completed a predesigned questionnaire assessing the knowledge, attitude and willingness to treat HIV/AIDS patients. One-way analysis of variance (ANOVA) was applied to compare mean level of knowledge and attitude toward HIV/AIDS. Result: The results showed that only 28% students have excellent knowledge regarding HIV/AIDS. Certain misconceptions were prevalent regarding mode of transmission. It also shows that around 43% of the dental students have an overall negative attitude. Conclusion: The findings suggest that the students had adequate knowledge about HIV/AIDS and their attitude toward this group of people was significantly negative. There is need and scope to provide correct and detailed information on HIV/AIDS for dental students.
  - 2,193 313
Vinegar as a disinfectant of extracted human teeth for dental educational use
Manisha Tijare, D Smitha, Sowmya Kasetty, Shreenivas Kallianpur, Sandeep Gupta, HV Amith
January-April 2014, 18(1):14-18
DOI:10.4103/0973-029X.131883  PMID:24959031
Context: Extracted human teeth are routinely used in dentistry to learn technical and preclinical skills. Centers for Disease Control and Prevention (CDC) has adopted guidelines for infection control of extracted teeth used for research and teaching, requiring that teeth be sterilized before use. Many of the proposed disinfection methods starting from use of formalin, sodium hypochlorite and to autoclaving have their own drawbacks and may not be practical. Aim: To assess the effectiveness of vinegar for disinfection/sterilization of extracted human teeth. Materials and Methods: A total of 80 extracted non-carious human teeth were kept in seven disinfectant media-10% formalin, 3% hydrogen peroxide, 5.25% sodium hypochlorite, 70% alcohol, vinegar, neem extract and normal saline. Ten samples were placed in each disinfectant individually for a period of 7 days, at room temperature. In all, 10 teeth were treated with microwave irradiation at 650 W for 3 min. Later, teeth from each group were placed individually in separate test tubes containing 10 ml of tryptic soy broth at 37°C for 48 h to observe the evidence of growth of microorganisms. Semiquantitative analysis of all the samples was done in Clade agar at 37°C for 48 h. Statistical Analysis Used: The number of teeth disinfected in each group was compared using Chi square test. Results: 10% formalin, 3% hydrogen peroxide and vinegar were totally effective. The result was statistically significant with a Chi square value of 61.414 and P < 0.001. Conclusions: Vinegar can be used as an effective disinfectant medium for extracted human teeth.
  - 3,003 439
Expression of Mucin 4 in leukoplakia and oral squamous cell carcinoma: An immunohistochemical study
Sangeetha Narashiman, Malathi Narasimhan, Ganesh Venkatraman
January-April 2014, 18(1):25-31
DOI:10.4103/0973-029X.131887  PMID:24959033
Background: Mucins are large glycosylated proteins that act as a selective molecular barrier on the epithelial surface and engage themselves in morphogenetic signal transduction pathways. MUC4 (Mucin 4) is a transmembrane mucin, that protects and lubricates the mucous membranes of the human body and involves itself in various cellular functions like growth, differentiation and signaling. An aberrant expression of MUC4 has been demonstrated in various human cancers. A thorough literature survey shows very few studies about MUC4 expression in normal and cancerous oral mucosa. Aim: Our study aimed at investigating the expression pattern of MUC4 in normal oral mucosa, oral leukoplakia and oral squamous cell carcinoma (OSCC) in an attempt to analyze its role played in oral carcinogenesis. Materials and Methods: Formalin-fixed paraffin-embedded tissues of five cases of normal tissue, 15 cases of leukoplakia, 10 cases of well-differentiated squamous cell carcinoma and 10 cases of moderately differentiated squamous cell carcinoma were retrieved from the archives of the department and MUC4 antigen was immunohistochemically localized. Statistical Analysis: The result was subjected to statistical analysis using Pearson's Chi-square test and an intergroup analysis was performed using one-way analysis of (ANOVA). Results: A total of 46.7% of leukoplakia and 70% of OSCC were stained positive with MUC4 antigen. Maximum intensity of staining was noted in well-differentiated OSCC. A steady increase in MUC4 staining was noted from normal oral tissues to leukoplakia to OSCC. Conclusion : The findings of the study suggest that MUC 4 plays a vital role in the pathogenesis of OSCC and can be regarded as a useful marker for oral dysplasia and OSCC.
  - 2,006 405
Scanning electron microscopic analysis of incinerated teeth: An aid to forensic identification
Chetan A Pol, Suchitra R Gosavi
January-April 2014, 18(1):32-35
DOI:10.4103/0973-029X.131889  PMID:24959034
Background: Forensic dental identification of victims involved in fire accidents is often a complex and challenging endeavor. Knowledge of the charred human dentition and residues of restorative material can help in the recognition of bodies burned beyond recognition. Aim: To observe the effects of predetermined temperatures on healthy unrestored teeth and different restorative materials in restored teeth, by scanning electron microscope, for the purpose of identification. Materials and Methods: The study was conducted on 135 extracted teeth, which were divided into four groups. Group 1-healthy unrestored teeth, group 2-teeth restored with all ceramic crowns, group 3-teeth restored with class I composite resin and group 4-teeth restored with class I glass ionomer cement (GIC). Results: The scanning electron microscope is useful in the analysis of burned teeth, as it gives fine structural details, requires only a small sample and does not destroy the already fragile specimen. Conclusion: Scanning electron microscope can be a useful tool for the characterization and study of severely burnt teeth for victim identification.
  - 2,282 428
Immunohistochemical characterization of cyclin dependent kinase-4 in different histological grades of oral leukoplakia and oral squamous cell carcinoma
NDVN Shyam, Nirmala N Rao, Raman DS Narang, Jiji George, Sanjay R Bommu, G Kiran
January-April 2014, 18(1):36-41
DOI:10.4103/0973-029X.131896  PMID:24959035
Background: Cyclin dependent kinase-4 (CDK4) encoded by CDK gene, is a heterodimer protein of cell cycle in G1-S transition. This study aimed to characterize the CDK4 immunoreactivity in different histological grades of oral leukoplakias (OLs) and oral squamous cell carcinomas (OSCCs) and also aims to discuss its probable role in the tumor biogenesis. Materials and Methods: Expression of CDK4 was investigated in total of 52 samples including OL (15), OSCCs (30) and normal oral tissues (07). A labeled Streptavidin-Biotin immunohistochemistry assay was performed and staining intensity was evaluated. Results: The staining pattern was similar in all tissues and was located in both nuclei and cytoplasm. Dysplastic epithelium displayed a progressive increase in nuclear expression of CDK4 when compared to normal tissues. Also, positive staining cytoplasm was highly evident in OSCC with loss of differentiation. Conclusion: Our study indicated a progressive over expression of CDK4 from normal to leukoplakias (various histological grades of dysplasias) and OSCCs.
  - 1,475 250
Evaluation of serum and salivary lipid profile: A correlative study
Simranjit Singh, Venkatapathy Ramesh, Nirima Oza, Pennagaram Dhanasekaran Balamurali, Karthikshree Vishnu Prashad, Premalatha Balakrishnan
January-April 2014, 18(1):4-8
DOI:10.4103/0973-029X.131881  PMID:24959029
Context: The correlation of serum and salivary lipid profile has been poorly characterized. The most commonly used laboratory diagnostic procedures for lipid profile involve analysis of cellular and chemical constituents of blood/plasma. As a diagnostic aid, saliva offers many advantages over serum. Aims: To evaluate and compare the serum and salivary lipid profile levels in healthy individuals and to validate the role of saliva as a non-invasive diagnostic tool for assessing lipid profile. Settings and Design: The present study was a prospective study. Materials and Methods: A total of 100 healthy study subjects who had no complaint or any major illness in recent past were selected. The parameters assessed included serum and salivary: total cholesterol (TC), high-density lipoprotein-cholesterol (HDLC), low-density lipoprotein-cholesterol (LDLC), very low-density lipoprotein-cholesterol (VLDLC) and triglycerides (TGL). Statistical Analysis Used: Evaluation of results and statistical analysis was carried out using descriptive, correlation and regression analysis. Results: There was a moderate level of correlation between serum and salivary TC, TGL, HDLC and VLDLC and there was a low and quite small correlation between serum and salivary LDLC. For all the five parameters assessed as a part of lipid profile, the correlation coefficients were highly significant statistically and also, with an increase in the serum mean values, corresponding increase in the saliva mean values for all the five parameters was noted. Conclusions: From the present study we conclude that saliva can be used as a non-invasive diagnostic tool for assessing lipid profile.
  - 4,342 759
Histopathological analysis of apoptotic cell count and its role in oral lichen planus
Vidya G Doddawad
January-April 2014, 18(1):42-45
DOI:10.4103/0973-029X.131900  PMID:24959036
Apoptosis is a process of genetically programmed cell death by which senescent, DNA-damaged and diseased cells are eliminated from the body. Aim of the Study: To identify and count the number of apoptotic cells in oral lichen planus (OLP) and correlate with the degree of keratinization, thickness of epithelium and thickness of lymphocytic infiltration of OLP. Materials and Methods: The study comprised 40 diagnosed cases of OLP. Sections were stained with hematoxylin and eosin to identify and count the number of apoptotic cells. Measurement of other histopathological parameter of OLP such as degree of keratinization, thickness of epithelium and thickness of lymphocytic infiltration was done by using stage micrometer and eyepiece graticule. Statistical analysis was done to understand the correlation between apoptotic cells and histopathological features of OLP. Result: The result showed that the number of apoptotic cells increased, with an increase in thickness of lymphocytic infiltration and degree of keratinization, but there was a decrease in the epithelial thickness. Conclusion: Further immunological and molecular studies are required for a stronger evidence in correlating apoptotic cell and histological parameters of OLP.
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Quantitative analysis of serum levels of trace elements in patients with oral submucous fibrosis and oral squamous cell carcinoma: A randomized cross-sectional study
Sreelatha S Hosthor, Pushpalatha Mahesh, S Mahesh Priya, P Sharada, M Jyotsna, S Chitra
January-April 2014, 18(1):46-51
DOI:10.4103/0973-029X.131902  PMID:24959037
Background and Objectives: Metabolic disorders, oral precancerous conditions and oral cancer are accompanied by alterations in the concentration of one or more trace elements like copper, iron, zinc, magnesium etc., in some body fluids, especially blood serum or plasma, which can help not only in the early diagnosis and treatment but also in prognosis. The objective of the study is to evaluate the levels of circulating trace elements (copper, iron, magnesium, zinc and calcium) in serum of patients with Oral Submucous Fibrosis (OSF) and Oral Squamous Cell Carcinoma (OSCC), to analyze the alteration and identify the best predictors amongst these parameters for disease occurrence and progression and their association with areca nut and betel quid chewing habits. Materials and Method: Serum levels of trace elements (copper, iron, magnesium, zinc and calcium) were estimated using electronic absorption colorimetric method. These levels were compared with controls and statistically evaluated using ANOVA and POST-HOC TUKEY tests. Results: The data analysis revealed that serum copper levels increased gradually from precancer to cancer, as the duration of betel quid chewing habit increased. However, serum iron, magnesium, zinc levels were decreased significantly in both the groups. Serum calcium levels were increased in the cancer group owing to bone resorption in the later stages of the disease, whereas it was close to normal in OSF patients. Among all the trace elements, the best predictor for occurrence of both the lesions was copper. Conclusion: The present study shows that the above trace elements may be associated with the pathogenesis and progression of OSF and OSCC. Betel quid and areca nut chewing habits are frequently associated with both disease states and may play a role in altering the serum levels of these trace elements. Concerted efforts would, therefore, help in early detection, management and monitoring the efficacy of treatment.
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REVIEW ARTICLES
Myofibroblasts in oral lesions: A review
Soujanya Pinisetti, Ravikanth Manyam, Babburi Suresh, V Aparna
January-April 2014, 18(1):52-57
DOI:10.4103/0973-029X.131905  PMID:24959038
Myofibroblasts (MFs) are modified fibroblasts that express features of smooth muscle differentiation and were first observed in granulation tissue during wound healing. These cells play a key role in physiologic and pathologic processes like wound healing and tumorigenesis. The presence of MFs has been reported in normal oral tissues and pathologic conditions like reactive lesions, benign tumors, locally aggressive tumors and malignancies affecting the oral cavity. This article briefly reviews the important hallmarks related to the discovery, characterization and tissue distribution of MFs in oral health and disease.
  - 2,761 973
Histological patterns of head and neck tumors: An insight to tumor histology
Alka M Dive, Ashish S Bodhade, Minal S Mishra, Neha Upadhyaya
January-April 2014, 18(1):58-68
DOI:10.4103/0973-029X.131912  PMID:24959039
This article emphasizes the basis for origin and importance of tumor patterns in diagnosis of oral and maxillofacial tumors. In this article, histological patterns and subpatterns of head and neck tumors are enlisted. Although, undifferentiated tumors remain a challenge to the histopathologist, by describing the histological patterns and the subpatterns of the tumors, an attempt has been made for the diagnosis of the tumors and subsequently for implementation of precise treatment plan for the same.
  - 13,367 1,941
Biomarkers and chemopreventives in oral carcinogenesis and its prevention
Sonalee Shah, Manpreet Kaur
January-April 2014, 18(1):69-76
DOI:10.4103/0973-029X.131914  PMID:24959040
Squamous cell carcinoma is the predominant type of oral malignancy and is a result of oral carcinogenesis. Oral carcinogenesis is a mutifactorial and complex process related to the sequential occurrence of alterations in genetic structures, promoting inhibitory or excitatory effects of the tumor oncogenes and gene suppressors, compromising the histophysiology of the division, differentiation and cell death; and therefore, methods to prevent, detect, or treat it in the best way is constantly being searched for. Biomarkers reveal the genetic and molecular changes related to early, intermediate and late endpoints in the process of oral carcinogenesis.Thereby, they are likely to not only refine our ability to predict the biologic course of oral cancer and distinguish individuals at high and/or low risk of oral cancer development; but, also they will also reveal the genetic and molecular changes related to various endpoints of oral carcinogenesis. Chemopreventives are chemicals of natural or synthetic origin, which reduce the incidence of fatal diseases such as cancer before clinical symptoms occur. Chemopreventives are agents whose curative capacity is defined with help of biomarkers, as the later determine the effectiveness and safety of chemopreventives.
  - 2,355 707
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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007