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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists
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   2020| May-August  | Volume 24 | Issue 2  
    Online since September 9, 2020

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Whither oral pathology?
TV Narayan
May-August 2020, 24(2):193-194
  530 93 -
Multiple oral ulcerations – An initial manifestation of COVID 19 infection: A personal experience!!
Sudip Indu
May-August 2020, 24(2):227-229
  509 68 -
From the Editor's Desk
T Smitha
May-August 2020, 24(2):191-192
  475 72 -
The effect of Vitamin C on melanin pigmentation – A systematic review
Rizwan M Sanadi, Revati S Deshmukh
May-August 2020, 24(2):374-382
Vitamin C, also known as ascorbic acid, is used as a treatment modality in depigmentation of hyperpigmented spots on the skin and gingiva. This systematic review discusses the studies conducted to assess the effect of Vitamin C on melanin pigmentation. The primary objective was to evaluate the effect of Vitamin C on melanin pigmentation. The secondary objective was to analyze the effect of Vitamin C administration on melanin pigmentation. An electronic database search was conducted from the following databases: PubMed, EBSCOhost, ScienceOpen, EMBASE and Google Scholar. Randomized controlled trials, experimental studies, case–control studies and cohort studies published in peer-reviewed journals in English language were included. Case reports, case series, animal model studies, in vitro studies, studies where Vitamin C was used along with other agents and unpublished research were excluded. Out of 22,580 studies, only 7 studies satisfied the selection criteria. Data extraction sheet was prepared, and the studies were analyzed. Out of the 7 studies analyzed, 1 was a randomized controlled trial and 6 were experimental studies. Vitamin C has been used widely as a depigmenting agent in dermatology. However, there are limited studies conducted on the use of Vitamin C for gingival depigmentation.
  462 53 -
Diagnosis of malignant lymphoma – An overview
R Madhavan Nirmal
May-August 2020, 24(2):195-199
  410 88 -
“Single file” pattern in histopathology
Deepak Pandiar, T Smitha
May-August 2020, 24(2):204-205
  380 75 -
Oral microbiome and oral cancer – The probable nexus
Priya Nimish Deo, Revati Deshmukh
May-August 2020, 24(2):361-367
Oral squamous cell carcinoma is one of the most common malignancies and is the leading cause of morbidity and mortality. The known risk factors for oral cancer are tobacco, alcohol consumption and betel quid chewing. Nutritional deficiencies and certain microorganisms are also associated with oral cancer. Oral cavity is a host to numerous microorganisms, majority of which are bacterial communities along with fungi and viruses. A possibility of the dysregulation of the oral microbiome cannot be ignored. Oral microbiome is defined as the collective genome of microorganisms that reside in the oral cavity. With the development of culture-independent techniques, the detection and identification of the bacteria which cannot be cultured has become possible. Revolution in technology has led to increased research in this area in an attempt to find the role of microbiome in health and disease. Before identifying the exact role the microbiome plays in the development of oral cancer, it is essential to profile the microbiome in healthy individuals and patients with oral cancer. It is essential to note that oral cancer may sometimes occur without any habit too!! This article is an attempt to review the role of oral microbiome in oral cancer with a focus on the bacteriome, its related studies and in brief about the omics technologies in understanding the microbiome.
  360 66 -
Osteodystrophies of jaws
N Santana, S Mehazabin, K Sangeetha, M Kumari
May-August 2020, 24(2):405-405
Bone is a dense, semi rigid, porous, calcified connective tissue forming the major portion of the skeleton of most vertebrates. It consists of a dense organic matrix and an inorganic mineral component. Bone remodelling is a complex process by which old bone is continuously replaced by new tissue, which requires interaction between different cell phenotypes and is regulated by a variety of biochemical and mechanical factors. In a homeostatic equilibrium, the process of resorption and formation are balanced so that old bone is continuously replaced by new tissue and it adapts to mechanical load and strain. Several local and systematic factors which cause disturbances in bone resorption and deposition leads to abnormal or defective development of bone commonly termed as osteodystrophy - A defective ossification of bone usually is associated with disturbed calcium and phosphorus metabolism. The better understanding of molecular cellular biology and pathogenic mechanism aids to define the abnormalities in osteoblastic and osteoclastic lineages and to develop new therapeutic approaches.
  337 39 -
ABO blood grouping and COVID 19: Is there any correlation in suspectibility?
Sushma Bommanavar, T Smitha
May-August 2020, 24(2):212-216
The pandemic outbreak of COVID 19 in the present century has provoked an emergency all over the globe. Recent reports highlighting the zoonotic cross over link and susceptibility in certain blood group individuals has created interest among researchers to explore more on it. This review is aimed to focus on the correlation of ABO blood grouping with COVID 19 susceptibility with compilation on its structure, pathophysiology, and current updates.
  330 43 -
A brief outlook on the current emerging trends of COVID 19 vaccines
T Smitha, Anela Thomas
May-August 2020, 24(2):206-211
  334 38 -
Dr. V. Ipe Varghese
TT Sivakumar
May-August 2020, 24(2):200-201
  319 49 -
Transforming B cell lymphoma: A diagnostic dilemma
Asha Karadwal, Shailja Chatterjee
May-August 2020, 24(2):202-203
  299 62 -
Proposal for safe oral pathology laboratory practices in COVID-19 pandemic
Deepika Mishra, Harpreet Kaur, Aanchal Kakkar
May-August 2020, 24(2):217-221
  304 49 -
Idiopathic first bite syndrome – A rare case report with review of literature
Ramakant S Nayak, S Rakendu, Vijayalakshmi S Kotrashetti, Ranganath Nayak
May-August 2020, 24(2):403-403
First bite syndrome (FBS) is a condition that classically presents as severe pain in the preauricular region, initiated on the first bite of a meal. In most of the cases reported, it is associated with a history of upper neck surgery or tumor of the parotid salivary gland or parapharyngeal space (PPS). Some propose that FBS arises due to damage to the cervical sympathetic trunk leading to the loss of sympathetic innervations to the parotid salivary gland. Literature also showed occurrence of this syndrome in individuals who had no history of parotid tumor, PPS tumor or surgery of the upper neck, and such cases are referred to as idiopathic FBS (IFBS). There are very few case reports reported on IFBS. We report the one such rare case of IFBS in a 35-year-old male, referred to the outpatient department, with a 5-month history of severe, sharp pain and bilateral swelling in the parotid region occurring only on the first bite of eating and would diminish over few minutes.
  329 18 -
Sulforaphane in broccoli: The green chemoprevention!! Role in cancer prevention and therapy
DB Nandini, Roopa S Rao, BS Deepak, Praveen B Reddy
May-August 2020, 24(2):405-405
Isothicyanates present in cruciferous vegetables are known to exhibit chemoprevention by various mechanisms. Presently, there is growing evidence that a phytochemical compound known as sulforaphane in these green leafy vegetables is found to be effective in preventing and treating various cancers such as prostate cancer, breast cancer, colon cancer, skin, urinary bladder and oral cancers. This component is naturally present in the broccoli sprouts, kale, cabbage, cauliflower and garden cress and is available as a commercial supplementary pill called Broccoli extract. Availability of many bioactive substances such as vitamins, polyphenols, sulfides, glucosinolates and antioxidants makes broccoli consumption important in daily diet regularly. Researchers have named it as “Green chemoprevention.” It is easily affordable and more cost-effective than the traditional chemopreventive drugs. Results from the epidemiological and experimental studies have emphasized the role of sulforophane as a complementary or alternative chemopreventive agent.
  304 19 -
Analysis of expression of p53, p63 and proliferating cell nuclear antigen proteins in odontogenic keratocyst: An immunohistochemical study
Vidya Kadashetti, Nanda Patil, Kailas Datkhile, Sujata Kanetakar, KM Shivakumar
May-August 2020, 24(2):273-278
Background: Odontogenic keratocyst (OKC) is a benign intraosseous lesions (within the jaw bone) of odontogenic origin that account for about 10% of jaw cysts. They are characterized by an aggressive behavior with a relatively high recurrence rate. Early diagnosis and follow-up of the patient with OKC is important because the possibility of such patient there is develop to other features of Nevoid basal cell carcinoma syndrome in future. Considering the roles and effects of p53, p63 and proliferating cell nuclear antigen (PCNA) in cells proliferation, this study was designed. Objectives: To understand the behavior of epithelial cells in pathogenesis and biological aspects of OKC in diagnosis. Materials and Methods: Immunohistochemical (IHC)technique was performed in 21 cases of OKCs. Results: Immunological stained p53 cells were mainly located in the suprabasal layers. p63 and PCNA-positive cells were found throughout the lining epithelium including basal and suprabasal cell layers. The intensity of staining was more in p63 and PCNA than the p53 expression of the cystic epithelial lining. Conclusions: It is possible that the biological behavior of OKCs may be related to the suprabasal proliferative compartment in the cystic epithelium as observed. These proteins may participate in the regulation of epithelial cell differentiation. Taken together, these data may favor tumerigenesis on OKCs.
  262 44 -
Evaluating the expression of GLUT-1 in oral leukoplakia
Daffney Mano Doss, Madhava Nirmal, Veeravarmal , R Saravanan, A Venkatesh
May-August 2020, 24(2):308-314
Aim: The aim of the present study is to analyze the role of GLUT-1 in detection of early alterations occurring in oral leukoplakia. This study was to evaluate the expression of GLUT-1 in normal oral epithelium, the expression of GLUT-1 levels in the tissue samples of oral leukoplakia and to statistically compare the expression of GLUT-1 in normal epithelium and oral leukoplakia. Materials and Methods: The study sample comprised formalin-fixed and paraffin-embedded tissue specimens from 23 cases of histopathologically diagnosed oral leukoplakia and formalin-fixed paraffin-embedded tissue specimens from 10 cases of normal oral mucosa. Sections were mounted on glass slide coated with Aminopropyltriethoxysilane (APES; Sigma chemical co., USA) and processed for subsequent immunohistochemical study to demonstrate GLUT-1. Results: GLUT-1 expression in normal oral mucosa revealed weak positivity in all 10 cases (100%). The oral leukoplakia cases showed immunopositivity in all 23 cases (100%) of which 10 cases (39.14%) demonstrated focal positivity and 13 cases (60.86%) of diffuse positivity. The results were compared statistically using ANOVA test was significant at P = 0.002. Conclusion: The present study shows expression of GLUT-1 in leukoplakia may be used as a reliable marker to identify the high risk group for malignant transformation.
  231 39 -
Non-Hodgkins lymphoma – A case report and review of literature
Sasidhar Singaraju, Shubham Patel, Ashish Sharma, Medhini Singaraju
May-August 2020, 24(2):322-326
Lymphomas are solid tumors of the immune system and include 14% of all head and neck malignancies. Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of lymphoproliferative disorders originating in B-, T-, or natural killer T-cells. They have a wide range of histological appearances and clinical features at presentation, which can make diagnosis difficult. A 58-year-old male patient presented with a 1-month history of swelling in the upper right back tooth region, which developed after extraction. On intraoral examination, there was small nodular lesion proliferation from the extracted socket. Biopsy specimen on histological examination revealed sheets of small round cells with hyperchromatic nucleus resembling lymphoblast. Immunohistochemistry (IHC) confirms the NHL of T-cell origin. This article is an attempt to correlate the clinical presentation and histological importance of small round cell tumors of the jaw and to discuss the differential diagnosis of small round cell tumors. Typically, a multimodal approach is employed, and the principal ancillary technique that have been found to be useful in classification is IHC.
  243 26 -
Primary oral tuberculosis: A case series of a rare disease
Rizwan Hamid, Prenika Sharma, Rayees Ahmad Sheikh, Muzafar Bhat
May-August 2020, 24(2):332-338
Tuberculosis (TB) is still one of the most life-threatening infectious diseases, resulting in high mortality in adults and is commonly found in developing countries. Lung is primarily affected while extrapulmonary TB is rarely encountered. Oral lesions, although rare, can be seen in both primary and secondary stages of TB. Primary oral TB may present a diagnostic challenge as its clinical features can be nonspecific that mimics other diseases and is usually misdiagnosed. Thus, it is very important to be aware and be highly suspicious of oral TB especially in endemic area. We share 4 such cases of primary oral TB with uncommon presentations (two on the gingiva, one on the palate and one on the tongue) The diagnosis was made by histopathological examination, polymerase chain reaction analysis and Mantoux test. They were successfully treated with antituberculous treatment. In secondary TB, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes or in any other part of the body and can be detected by a systemic examination.
  206 63 -
Dental age estimation using Willems method: A cross-sectional study on children in a North Indian city
Joe Mathew Cherian, Abi M Thomas, Shekhar Kapoor, Rajesh Kumar
May-August 2020, 24(2):383-388
Background: Numerous methods of age estimation have been proposed. The Demirjian method which was first applied in a French-Canadian population in 1972 is the most frequently used dental age estimation method. However, a constant over estimation using this method has been reported by numerous researchers. The Willems method is a modification of the above and was first applied in a Belgian Caucasian population in 2002. Several studies in the recent years found Willems method to be more accurate than the original Demirjians method. Objectives: The objective of this study was to evaluate the applicability of Willems method for dental age estimation in 6 -15-year-old North Indian children. Methods: The sample for this cross sectional study consisted of 390 OPGs of (215 boys and 175 girls) randomly selected from the patient records of a post graduate training dental college in North India. Exact chronological age of the subjects (in years and months) was calculated. The OPGs were used to score the seven mandibular teeth and dental age was estimated using the tables proposed in Willems method. Results: Significant correlation between the chronological age and dental age estimated using Willems method was observed in both males (r = 0.90) and females (r = 0.87). The mean difference between estimated DA and CA for males was 0.004 ± 1.08 years (P = 0.94). While for females, it was 0.031 ± 1.18 years (P = 0.72). The results showed no statistically significant difference between chronological age and dental age estimated using Willems method in the study population. Conclusion: Willems dental age estimation method without any modification can predict the chronological age of 6-15 year old North Indian children with good accuracy.
  240 29 -
Application of Milan system for reporting of salivary gland pathology and risk stratification: An institutional experience
Sneha Singh, Prem Singh, Ridhima Auplish, Shiv Pankaj Khanna, Karan Verma, Sukhpreet Kaur Aulakh
May-August 2020, 24(2):266-272
Background: Fine-needle aspiration cytology (FNAC) is a sensitive technique for diagnosing salivary gland pathologies. Milan system of reporting salivary gland cytopathology (MSRSGC) is an evidence-based system of reporting which has been introduced to improve reporting and communication between cytopathologist and clinician by introducing standardized categories with specified treatment protocols. Aims and Objectives: The aim of the present study is to find the diagnostic accuracy and risk of malignancy (ROM) in various categories when MSRSGC is applied. Materials and Methods: A single-institute-based 3-year retrospective study was done. All salivary gland lesions were reclassified according to MSRSGC. ROM, diagnostic specificity, sensitivity and accuracy of FNAC of salivary gland lesions were calculated. Results: A total of 133 cases were included in the study. Overall, the most common diagnosis was found to be pleomorphic adenoma comprising 61 (42.8%) of all cases. Adenoid cystic carcinoma was the most commonly diagnosed malignancy comprising of 6 (4.5%) of all lesions. Cases were further divided into Milan categories, namely nondiagnostic, nonneoplastic, atypia of undetermined significance, benign neoplasm, neoplasm of undetermined malignant potential, suspicious of malignancy and malignancy comprising 5 (3.7%), 29 (21.8%), 77 (57.8%), 4 (3%), 3 (2.2%), 1 (0.7%) and 14 (10.5%) cases, respectively, with ROM of 0, 14.28%, 33.33%, 5.71%, 66.66%, 100% and 80%, respectively. Sensitivity, specificity and diagnostic accuracy to separate benign from malignant lesions were 80%, 89.80% and 87.50%, respectively. Conclusion: FNAC of the salivary gland lesions is a safe and reliable diagnostic procedure. The Milan system of reporting is a risk stratification system which can improve the overall effectiveness of reporting and care of patients.
  226 33 -
Genetic predisposition and prediction protocol for epithelial neoplasms in disease-free individuals: A systematic review
J Gowthami, N Gururaj, V Mahalakshmi, R Sathya, TR Sabarinath, Daffney Mano Doss
May-August 2020, 24(2):293-307
Background: Epithelial neoplasm is an important global health-care problem, with high morbidity and mortality rates. Early diagnosis and appropriate treatment are essential for increased life survival. Prediction of occurrence of malignancy in a disease-free individual by any means will be a great breakthrough for healthy living. Aims and Objectives: The aims and objectives were to predict the genetic predisposition and propose a prediction protocol for epithelial malignancy of various systems in our body, in a disease-free individual. Methods: We have searched databases both manually and electronically, published in English language in Cochrane group, Google search, MEDLINE and PubMed from 2000 to 2019. We have included all the published, peer-reviewed, narrative reviews; randomized controlled trials; case–control studies; and cohort studies and excluded the abstract-only articles and duplicates. Specific words such as “etiological factors,” “pathology and mutations,” “signs and symptoms,” “genetics and IHC marker,” and “treatment outcome” were used for the search. A total of 1032 citations were taken, and only 141 citations met the inclusion criteria and were analyzed. Results: After analyzing various articles, the etiological factors, clinical signs and symptoms, genes and the pathology involved and the commonly used blood and tissue markers were analyzed. A basic investigation strategy using immunohistochemistry markers was established. Conclusion: The set of proposed biomarkers should be studied in future to predict genetic predisposition in disease-free individuals.
  219 30 -
SOX2, OCT4 and NANOG: The core embryonic stem cell pluripotency regulators in oral carcinogenesis
Niharika Swain, Mansee Thakur, Jigna Pathak, Biswaranjan Swain
May-August 2020, 24(2):368-373
Embryonic stem cells provide their major contribution to embryogenesis through formation of germ layers as they have pluripotency potential and capacity for self-renewal. Retention of pluripotency of these stem cells depends on expression/level of transcription factors, i.e., SOX2, OCT4 and NANOG. During organogenesis, the altered expression of the molecules also influences these stem cells to lose their pluripotency and turn toward the lineage selection. As the differentiation progresses, the maintenance of the somatic cells including the oral squamous cells also depends on differential expression of the transcription factors to some extent. Recently, many experimental and observational studies documented the significant contribution in carcinogenesis of various human cancers. In this review, we have attempted to summarize the evidences indicating about the putative role of these master pluripotency regulators in various phases of oral carcinogenesis i.e. initiation , progression and prognosis of oral squamous cell carcinoma.
  220 22 -
Studying the multiple faces of nevoid basal-cell carcinoma syndrome: A case series
Shikha Saxena, Krishna Sireesha Sundaragiri, Akshay Bhargava, Bharat Sankhla
May-August 2020, 24(2):315-321
Nevoid basal-cell carcinoma syndrome (NBCCS) or Gorlin–Goltz syndrome is an autosomal dominant-inherited condition that exhibits high penetrance and variable expressivity; however, this disorder can arise spontaneously. In 1960, Gorlin and Goltz described the syndrome as a condition, comprising the principle triad of multiple basal cell carcinoma, odontogenic keratocysts, and skeletal anomalies. The diagnostic findings of NBCCS in four patients were studied and compared with other reports in the Indian population. Early diagnosis of this syndrome is important for counseling of patients to prevent the life-long complications of this syndrome which includes the malignancy, oro-maxillofacial deformation, and destruction; this may be reduced if the diagnosis and treatment are made feasible at the earliest.
  211 28 -
Assessment of cervical lymph node metastasis based on total RNA from saliva and tumor tissue in patients with oral squamous cell carcinoma: An observational study
Kiran B Jadhav, Vandana Shah, Ghansham Parmar, Nirali Chauhan, Naveen Shah, Nidhi Gupta
May-August 2020, 24(2):230-236
Background: In case of oral squamous cell carcinoma (OSCC) most patients die within first 2 years due to metastasis. To overcome the limitations and drawbacks of the present available methods of assessment of lymph nodes metastasis, the search for alternative method is needed. Aim: The aim of the study is to evaluate the sensitivity, specificity and diagnostic accuracy of salivary and tumor tissue RNA for assessment of lymph node metastasis in patients with OSCC. Methodology: Patients histologically diagnosed with OSCC were included as participants. The unstimulated saliva and tumor tissue were collected and stored at deep freeze before surgical therapy. The pretreatment lymph node metastasis assessment was done by radioimaging investigation. The posttreatment histopathological status of cervical lymph nodes was noted. The RNA was isolated and quantified from stored saliva sample and tumor tissue. The collected data were statistically analyzed for specificity and sensitivity and significance. Results: The area under curve for salivary RNA level is 0.647 and for tumor tissue RNA level is 0.628 with moderate predictability at 95% confidence interval. It was observed that the sensitivity was 63.50% and 71.40% and specificity was 62.70% and 58.80% for saliva and tumor tissue respectively with diagnostic accuracy of 63%–65%. The Kappa statistics showed moderate degree of agreement with high statistical significance (P ≤ 0.05). Conclusion: Saliva and tumor tissue RNA can be a good marker for pretreatment assessment of lymph node metastasis in patients with OSCC. Although the diagnostic accuracy which range from 63% to 65%, further characterization and study of specific mRNA, siRNA and miRNA may come out with high diagnostic accuracy.
  197 39 -
Retraction: Coronavirus disease-2019: A brief compilation of facts

May-August 2020, 24(2):407-407
  189 43 -
Therapeutic effectiveness of alternative medications in oral lichen planus: A systematic review
Jayanth Kumar Vadivel, Devaraj Ezhilarasan, Meera Govindarajan, Elangovan Somasundaram
May-August 2020, 24(2):344-351
Lichen planus is a chronic inflammatory condition affecting the skin and mucosa. The etiology is unknown but the pathogenesis appears to be an immune-mediated reaction. The mainstay drugs used in the treatment are immunomodulators. The aim of this paper is to report on the therapeutic effectiveness of the alternate medications used in the management of oral lichen planus (OLP). A systematic search of PubMed, Web of Science and Cochrane Controlled Clinical trials were done for all the papers published until December 2019. The search resulted in a total of 20 studies that were found suitable for the review. The results showed that the reduction in pain, treatment effectiveness was comparable between the steroids and alternative medications. However, the alternative medications had a therapeutic advantage in studies that had used placebo as controls and the results were statistically significant (P < 0.05). No major adverse effects were reported with the usage of alternative medications. There is definitely a therapeutic potential in the usage of alternative medications in the management of OLP. In terms of therapeutic effectiveness, they are on par with the immunomodulators. These alternative medications offer us a new therapeutic option in the management of OLP without any adverse effects.
  190 42 -
Coronal pulp: An age biomarker – A cross-sectional radiographic study in children
Raghavendra Havale, Dhanu G Rao, Athira Mohan Latha, Manasa Nagaraj, Namira Mohammad Karobari, Namratha Tharay
May-August 2020, 24(2):389-394
Background: Age plays an important role in personal identification, treatment planning, forensic dentistry, and legal issues. It is one of the key identification tools for distinguishing one person from another and one population from another. An intraoral radiographic technique for age estimation is an easier approach. The widely accepted age estimation method in children is the Demirjian system. Tooth coronal index is another method that gained popularity for adult age estimation. Aim: This study aims to estimate the tooth coronal index (TCI) of mandibular right and left second deciduous molar and its correlation with chronological age to derive a regression equation. Settings and Design: The present study is a cross-sectional radiographical study which is conducted in AME's Dental College and Hospital, Raichur, Karnataka, India. Materials and Methods: A total of 100 children aged 5–10 years were selected. Digital intraoral periapical radiographs were taken for right and left deciduous mandibular second molar. The length of the tooth crown and the coronal pulp cavity were measured. Statistical Analysis: Further, the data are subjected to student's unpaired t-test and ANOVA test for the statistical analysis and simple linear regression to derive the regression equation. Results: TCI showed a statistically significant reduction with increasing age in both right and left mandibular deciduous second molar (P ≤ 0.05), and the strength of the correlation is moderate (r = −0.59) if age is correlated with TCI using simple linear regression. Conclusion: The tooth coronal index method is found as a simple, noninvasive, nondestructive and cost-effective method for age assessment in children.
  201 30 -
Extracellular matrix degradation by host matrix metalloproteinases in restorative dentistry and endodontics: An overview
VP Anshida, R Anitha Kumari, Chethana S Murthy, Anoop Samuel
May-August 2020, 24(2):352-360
Matrix metalloproteinases (MMPs) are a group of over 25 secreted and membrane-bound enzymes responsible for pericellular substrate degeneration. In response to injury, they play key roles in morphogenesis, wound healing, tissue repair and remodeling. They have been isolated from dentin, odontoblasts, pulp and periapical tissue. They play a major role in the formation of dentin matrix and secondary and tertiary dentin. These are also responsible for releasing dentinal growth factors. MMP family proteins elicit a dual role in the pathogenesis of inflammation, stimulating protective innate and/or adaptive immune functions, as well as tissue destruction. The main organic component of tooth structure is collagen, and MMPs that degrade collagen and the extracellular matrix have been implicated in the progression of dental caries, dental erosion as well as degradation of the hybrid layer. MMPs have also been shown to be active in pulpitis, and studies have shown that they can be used as diagnostic markers of pulpal and periapical inflammation. This review describes the role of MMPs in dental caries, dental erosion, bond stability as well as in pulpal and periapical inflammation.
  215 12 -
Solitary median maxillary central incisor syndrome: A rare entity
Anurag Negi, Amita Negi, Megha Mohanan
May-August 2020, 24(2):402-402
Solitary median maxillary central incisor (SMMCI) syndrome is a complex disorder and a rare dental anomaly, which is estimated to occur in approximately 1:50,000 live births. It is a unique developmental abnormality which involves the central incisor tooth germs, occurring with or without systemic involvement; hence, its early diagnosis is of great importance. The objective of this study was to discuss a case of SMMCI syndrome and various dental treatment alternatives available in management of such cases. Due to the possible association of this syndrome with other developmental problems, an early diagnosis and management becomes important. Moreover, when it is associated with other developmental malformation and defects, the management becomes multidisciplinary.
  199 27 -
Cyclin D1 in oral premalignant lesions and oral squamous cell carcinoma: An immunohistochemical study
Rohit Balwant Moharil, Shubhangi Khandekar, Alka Dive, Ashish Bodhade
May-August 2020, 24(2):397-398
Background: Cyclin D1 is derived from PRAD1 or CCND1 gene located on chromosome 11q13 and it acts as a positive regulator of the cell cycle. In normal cells, cyclin D1 promotes progression through the G1 phase of the cell cycle. Over expression of cyclin D1 may lead to shortening of G1 phase, increased cell proliferation and reduced dependency on growth factors. Over expression of cyclin D1 has been reported in various tumors like esophageal carcinoma, hepatocellular carcinoma, lung carcinoma, and head and neck carcinoma. Aims and Objectives: The study was carried out to evaluate and compare the expression of Cyclin D1 in premalignant lesion and different grades of oral squamous cell carcinoma. Materials and Methods: A total 75 histopathologically diagnosed cases of oral squamous cell carcinoma and oral premalignant lesions cases were evaluated immunohistochemically for cyclin D1 expression. Results: We found that cyclin D1 protein expression was significantly altered from epithelial dysplasia to oral squamous cell carcinomas. Conclusion: Thus we can conclude that cyclin D1 may be a useful marker in the cases of oral precancer and cancer. It can also act as a potential target for molecular intervention studies in future. Cyclin D1 is derived from PRAD1 or CCND1 gene located on chromosome 11q13, and it acts as a positive regulator of the cell cycle. In normal cells, cyclin D1 promotes the progression through the G1 phase of the cell cycle. Over expression of cyclin D1 may lead to the shortening of G1 phase, increased cell proliferation and reduced dependency on growth factors. Over expression of cyclin D1 has been reported in various tumors such as esophageal carcinoma, hepatocellular carcinoma, lung carcinoma and head and neck carcinoma. This study was carried out to find the alteration of cyclin D1 in oral cancer. A total 75 histopathologically diagnosed cases of oral squamous cell carcinoma (OSCC) and oral premalignant lesions cases were evaluated immunohistochemically for cyclin D1 expression. We found that cyclin D1 protein expression was significantly altered from epithelial dysplasia to OSCCs. Thus, we can conclude that cyclin D1 may be a useful marker in the cases of oral precancer and cancer. It can also act as a potential target for molecular intervention studies in future.
  191 34 -
A quantitative and qualitative comparative analysis of collagen fibers to determine the role of connective tissue stroma in oral squamous cell carcinoma using special stains and polarized microscopy
Bharadwaj Bordoloi, Safia Siddiqui, Rohit Jaiswal, Aanchal Tandon, Amol Jain, Rashmi Chaturvedi
May-August 2020, 24(2):398-399
Background: Solid tumors such as oral squamous cell carcinoma (OSCC) are composed of malignant epithelial cells and the stroma in which these cells are dispersed. As the tumor progresses, the extracellular matrix undergoes dramatic morphological and architectural changes. Special stains make analysis easy and less erroneous by highlighting the area of interest and can be used to study these changes. Aim: The aim of the study was to analyze morphological changes in collagen fibers in various histological grades of OSCC using Masson's trichrome (MT) and Picrosirius red (PSR). Study Design: The study comprised 74 tissue samples, divided into two groups: Group I consisted of 63 cases of histologically proven OSCC (39 cases of well-differentiated squamous cell carcinoma [WDSCC], 17 moderately differentiated squamous cell carcinoma [MDSCC] and 7 poorly differentiated squamous cell carcinoma [PDSCC]) and Group II consisted of 11 cases of normal mucosa as controls. Materials and Methods: Sections were stained with hematoxylin and eosin, MT and PSR and observed under light and polarizing microscope, respectively. Statistical Analysis: ANOVA, Tukey's honestly significant difference post hoc multiple comparison test, Chi-square test and paired t-test were used for the statistical analysis. Results: As the grade of OSCC progressed, collagen fibers became thin, loosely packed and haphazard. The mean area fraction also decreased. They exhibited orange–red hue and strong birefringence in WDSCC, yellowish-orange hue and strong birefringence in MDSCC and greenish-yellow hue and weak birefringence in PDSCC. Conclusion: Initially, there is a reorganization of the collagen fibers in an attempt to prevent the invasion of tumor cells, but as cancer progresses, the stromal change enhances movement of the tumor cells within it, leading to metastasis.
  189 36 -
Curbing COVID-19: Kerala model
R Heera, R Rajeev
May-August 2020, 24(2):222-226
The success of Kerala's war against COVID-19 has three factors to thank: strong public health system, clear risk communication and community participation. The state's early preparedness, focused health-care interventions led by the public health system, effective lockdown measures assisted by law enforcement agencies, special economic package well in advance, timely assistance for migrant laborers, decentralized initiatives through the local self-governments especially in taking care of those under quarantine and inter-departmental coordination, and so on have served as pillars of the Kerala model against this pandemic. Home quarantining of suspect cases, contact tracing of positive cases, adequate testing and specialized treatment have all ensured that positive cases have been treated effectively and cured. Kerala has the lowest mortality rate as well as the highest recovery rate with respect to corona virus infections. The initial statistical projection of cases and deaths became redundant due to the organic method adopted by Kerala.
  203 21 -
Assessment of serum and salivary adiponectin levels in newly diagnosed Type II diabetes mellitus patients
R Suma Kalyani, Vandana Raghunath
May-August 2020, 24(2):245-250
Background: Adiponectin, an adipocytokine, plays an important role in the development of Type 2 Diabetes Mellitus (T2DM) in obese and cardiovascular disease patients, with few studies having observed low plasma concentrations. Persistent low-grade inflammation, an important feature in T2DM and obesity, bears an indirect influence on insulin resistance and insulin secretion and is reflected by increased plasma levels of C-reactive protein (CRP). Thus, low levels of anti-inflammatory cytokine, adiponectin, depicts that inflammation could be the link between T2DM, obesity and adiponectin. Since these factors need to be explored to prevent or adequately treat T2DM, especially among Indian diabetics, this study was undertaken. Also of interest was to assess its salivary concentrations. Aim: This study aimed to assess serum and salivary adiponectin levels in newly diagnosed T2DM individuals along with postprandial blood sugar (PPBS) and glycosylated hemoglobin (HbA1C) and high-sensitivity-CRP (hs-CRP). Materials and Methods: Serum and salivary levels of adiponectin, PPBS, HbA1cand hs-CRP were assessed in 30 newly diagnosed T2DM (Group I) individuals and compared with 30 healthy individuals (Group II, healthy control). Glucose oxidase peroxidase, automatic analyzer, turbidimetric immunoassay and ELISA methods were adopted for PPBS, HbA1c, hs-CRP and adiponectin estimation. Results: Statistically significant decrease in mean serum (16.93 ± 3.86) and salivary (24.96 ± 8.21) adiponectin levels, were observed in Group I compared to Group II individuals with a p value of 0.00 and 0.04 respectively. In Group I individuals a significant p value of 0.02 was noted only between salivary adiponectin and PPBS. None of the other parameters correlated significantly with serum adiponectin levels. Conclusion: Decreased serum and salivary adiponectin levels in T2DM furthered the importance of its role in Indian T2DM. Decreased salivary adiponectin levels probably reflected salivary hypofunction. This being the preliminary study in saliva, more studies are required to emphasize its role both as a diagnostic marker and as an anti-inflammatory cytokine in T2DM.
  198 22 -
Rare phenomena of tacrolimus-induced gingival hyperplasia
K Nivethitha, Amitha Ramesh, Avaneendra Talwar, Nina Shenoy
May-August 2020, 24(2):403-403
In the modern world, men and women are very much concerned about their esthetic appearance. The gingival perspective of esthetics is more often concerned with the soft tissue envelope surrounding the teeth. Gingival enlargement/overgrowth is numerous in nature and often poses a clinical challenge by altering the function, resulting in poor oral health of an individual. Tacrolimus, an immunosuppressive drug, has been broadly used for organ-transplant rejection. It results in much less severe hypertension, hypertrichosis and gingival overgrowth compared to cyclosporine and calcium channel blocker-induced gingival enlargements. However, there is scanty literature available regarding the tacrolimus-induced gingival enlargements. Therefore, the present case report with a 6-month follow-up period describes the execution of the proper treatment plan and surgical protocol for the management of a severe case of generalized gingival enlargement attributed to tacrolimus-induced therapy following renal transplant.
  193 25 -
Proliferative and anti-apoptotic indices of unicystic ameloblastoma, odontogenic keratocyst, dentigerous cyst and radicular cyst
Efetobo Victor Orikpete, Osawe Felix Omoregie, Michael Akin Ojo
May-August 2020, 24(2):399-399
Objective: The aim of this study is to compare the proliferative capacity and antiapoptotic capacity of unicystic ameloblastoma (UA), odontogenic keratocyst (OKC), dentigerous cyst (DC) and radicular cyst (RC) by assessing the Ki-67 labeling index (LI) and Bcl-2 LI, respectively. Materials and Methods: Formalin-fixed, paraffin-embedded tissue blocks of twenty-three histopathologically diagnosed UAs, 6 OKCs, 8 DCs and 10 RCs were selected from the archival specimens. Five micrometer thick sections of tissue blocks of the lesions were processed for immunohistochemical staining with Ki-67 and Bcl-2. The Ki-67 LI and Bcl-2 LI were determined for the cases with a positive reaction. Results: Ki-67 expression was seen in 6 (26.1%) cases of UA, 4 (66.7%) OKC, 1 (12.5%) DC and 1 (10.0%) RC. There was a statistically significant difference between the mean Ki-67 LI of UA and OKC (P = 0.024). Bcl-2 expression was seen in 16 (69.6%) UA, 5 (83.3%) OKC, 5 (62.5%) DC and 5 (50.0%) RC. The mean Bcl-2 LI of UA was significantly higher than that of DC (P = 0.048). Furthermore, cases of OKC had significantly higher mean Bcl-2 LI compared to DC (P = 0.026) and RC (P = 0.049). Conclusion: This study suggests that the Ki-67 LI may help in differentiating OKC from UA. The Bcl-2 LI may be useful in differentiating UA from DCs, and differentiating OKC from DC and RC.
  188 29 -
Comparative analysis of nucleomorphometric parameters in methyl green-pyronin-stained sections of oral epithelial dysplasia, oral submucous fibrosis and oral squamous cell carcinoma
Esha Singh
May-August 2020, 24(2):401-401
Context: The diagnosis and grading of epithelial dysplasia is based on a combination of architectural and cytological changes. A gradual increase in quantitative DNA aberrations has been found to correlate with increasing degree of dysplasia in oral mucous membranes. Aims: The aim of this study is to assess nuclear parameters in potentially malignant and malignant lesions of the oral cavity and to assess cytomorphometric changes in the nucleus and nucleolus in oral epithelial dysplasia (OED), oral submucous fibrosis (OSMF), oral squamous cell carcinoma (OSCC) and normal oral mucosa using methyl green-pyronin staining to determine its suitability for detecting potentially malignant lesions and the stage of carcinogenesis. Methods: Forty-five archival sections of OED, OSMF and OSCC and 5 cases of normal oral mucosa as the control group were stained according to methyl green-pyronin-staining protocol. Cytomorphometric parameters such as nuclear diameter, nucleolar diameter, number of nucleoli and cytoplasmic RNA were assessed. Statistical Analysis Used: The study was subjected to statistical analysis to evaluate the association between morphometric parameters using analysis of variance test, followed by Bonferroni's post hoc analysis. Results: A progressive increase in the nuclear parameters as well as cytoplasmic RNA content was observed between normal mucosa through dysplasia and OSMF to OSCC. Conclusion: This study serves as an effective diagnostic aid in assessing nuclear parameters in potentially malignant and malignant epithelial lesions affecting oral cavity.
  194 21 -
Atypical presentation of tuberculosis
Ashwini Deshpande, Prashant Gupta, A Vikram Simha Reddy, GV Ramachandra Reddy
May-August 2020, 24(2):404-404
Developing countries such as India face an intense situation with communicable diseases such as tuberculosis (TB). It is an inflammatory infectious granulomatous disease commonly affecting the lungs. Extrapulmonary TB presentations have been documented, with the orofacial region also being involved. TB usually presents as an ulcer in the oral cavity with tongue and lip being the favored sites. TB presenting as a lip swelling is unusual even if it is a secondary lesion with a primary pulmonary involvement. We present a lip swelling and discuss the differential diagnosis. Investigation of ultrasonography revealed a vascular lesion which was disproved, suggesting an increase in vascularity even in diseases such as TB. We present a case of a lip swelling which led to the diagnosis of recurrent pulmonary TB which the patient was unaware of. Findings of histopathology revealing the absence of bacilli are also discussed. Monetary constraints frequently cause a neglect of dangerous diseases such as TB.
  185 29 -
Well-armed is well started: A population-based study to assess risk stratification in potentially premalignant oral epithelial lesions
Reshma Venugopal, Radhika Manoj Bavle, Sudhakara Muniswamappa, Soumya Makarla, Sreelatha S Hosthor, Punith Shetty
May-August 2020, 24(2):237-244
Background: The association between potentially premalignant oral epithelial lesions (PPOEL), oral squamous cell carcinoma and its higher incidence in South-East Asian population due to the use of arecanut, pan, slaked lime and tobacco is well known. The study was carried out in urban and rural population of Bengaluru, Karnataka, to assess and correlate the pattern of habit, clinical presentation and cytological grading of PPOELs, attempting at identifying the main arms associated with risk of malignant transformation. Aims: Assessment of history, clinical presentation of PPOELs, co-relate with cytological grades and escalate to binary risk assessment. Materials and Methods: One hundred and fourteen cytological smears received at the Department from screening camps were stained with Papanicolaou and hematoxylin-eosin stains and correlated with the clinical data. Results/Statistics: Descriptive and inferential statistics were performed. 38% lie between 21 and 30 years, 76.3% males, 81 cases involved buccal mucosa with 51.1% Grade II cytosmear, 53.5% chewing tobacco habit, 10 cases involved multiple sites with 60% Grade II cytosmear and 6 cases showed Grade III cytosmear. Based on clinical risk factors and cytological grading, 15.3% were grouped under high risk lesions as against 5.4% when only cytological grading was considered. Conclusion: The incidence of PPOELs is increasing in young males with chewing tobacco mainly in buccal mucosa associated with habit. Biopsy and definitive treatment is necessary when the lesions are red, nonhomogeneous, seen in multiple sites and concomitant lesions with higher grades of dysplasia. The use of cytosmears in screening camps helps to assess, affirm and stress on biopsy on higher dysplasia grades as biopsy is not an acceptable norm in camps.
  180 23 -
Evaluation of immunomorphological patterns of cervical lymph nodes in oral squamous cell carcinoma
Hyandavi Balla, Divya Uppala, Sumit Majumdar, Sreekanth Kotina, Sravya Kodati, Madhurya Namana
May-August 2020, 24(2):285-292
Background: The Immunomorphological patterns of Lymph Nodes indirectly assess the host immune response facing a malignant tumor. These patterns also help us predict the susceptibility of the patient to Lymph Node Metastasis. Aims and Objectives: To evaluate the Immunomorphological patterns of Lymph Nodes in Oral Squamous Cell Carcinoma and to correlate them with the histopathological subtype of Oral Squamous Cell Carcinoma, TNM staging and the degree of tumor involvement within the Lymph Nodes. Methodology: A total of 40 subjects were taken for the study. Individuals who were clinically and histopathologically diagnosed as cases of Squamous Cell Carcinoma, who had undergone Radical or Elective Neck dissection were considered. The excised Lymph Nodes along with the primary tumor were collected stained with Hematoxylin and Eosin. The Lymph Nodes were assessed for Metastasis and Immunomorphological patterns. Statistical Correlation was done between the Immunomorphological pattern of Lymph Nodes and (a) Size of the tumor, (b) TNM stage of the tumor, (c) Histopathological Grade of the primary tumor, (d) Metastasis of the Lymph Node and (e) Grade of the Metastasis of Lymph Node. Statistical Correlation was done between the Metastasis of the Lymph Node and (a) Size of the tumor and (b) TNM stage of the tumor. Results and Conclusion: Statistically, a significant association was observed between TNM staging and Immunomorphological patterns of Lymph Node (P < 0.01). The relationship between histopathological grade of primary tumor of Squamous Cell Carcinoma and the Immunomorphological patterns was statistically significant (P < 0.01). Statistically, a significant association was observed between Sinus Histiocytosis pattern and decreased occurrence of nodal metastasis (P < 0.01).
  177 25 -
Oral leishmaniasis: Report of two cases
Rennan Luiz Oliveira Dos Santos, Jefferson Rocha Tenorio, Ligia Gonzaga Fernandes, Ana Isabel Moreira Ribeiro, Sabrina Araujo Pinho Costa, Marilia Trierveiler, Celso Augusto Lemos, Norberto Nobou Sugaya
May-August 2020, 24(2):402-402
Leishmaniasis is a chronic inflammatory disease caused by several species of the parasite Leishmania that is transmitted by insects of the genus Phlebotomus spp. or Lutzomyia spp. This disease can affect skin, mucous membranes and viscera being classified as cutaneous, mucocutaneous and visceral leishmaniasis, depending on the spectrum of clinical manifestations. Diagnosis can be achieved through biopsy, microscopical analysis, Montenegro intradermoreaction and/or ELISA. The dentist plays an important role in the diagnosis of this disease due to frequent involvement of oral mucosa. This article reports two clinical cases of leishmaniasis with oral mucosa involvement, their diagnosis workup and treatment.
  181 19 -
Molecular identification of Capnocytophaga species from the oral cavity of patients with chronic periodontitis and healthy individuals
Ulka Idate, Kishore Bhat, Vijayalakshmi Kotrashetti, Manohar Kugaji, Vijay Kumbar
May-August 2020, 24(2):397-398
Introduction: Capnocytophaga species are recognized as part of human oral microbiota and implicated as periodontal pathogens associated with various periodontal diseases. The three original Capnocytophaga species - Capnocytophaga ochracea, Capnocytophaga sputigena and Capnocytophaga gingivalis were initially isolated from periodontitis in adults, but subsequent studies demonstrated their presence also at periodontally healthy sites in both children and adults. Their association with periodontal disease is a matter of controversy. Considering the differing virulence features of the respective isolate, it is crucial to identify these isolates to species level. Aims: The aim of this study is to investigate the prevalence of Capnocytophaga species by polymerase chain reaction (PCR) through restriction fragment length polymorphism in healthy individuals and patients with periodontal disease. Material and Methods: The study included a total of 300 individuals, 100 each with Gingivitis, Chronic periodontitis, and Healthy individuals. The plaque samples were collected using sterile curette in reduced transport fluid. DNA extraction was carried out for PCR analysis. Results: Of 300 individuals, Capnocytophaga species were identified from 237 (79%) participants in all groups. The prevalence was statistically analyzed using Chi-square test. The prevalence was more in males in gingivitis and healthy individuals (42% and 49% respectively), and females in periodontitis (40%). C. ochracea was observed in a higher proportion (36.33%), followed by C. granulosa (32.66%) and C. gingivalis (10%). They were identified more in the age group of 30–40 years in gingivitis and periodontitis, (30 and 21 individuals, respectively) and 39 individuals in 18–29 years in healthy individuals. They were present in 87% in healthy individuals, 77% in gingivitis and 73% in periodontitis. Conclusion: Capnocytophaga species are commonly present in healthy individuals and may be associated with periodontal disease. There is a need for further study to know the prevalence of other species of Capnocytophaga in health and disease.
  169 27 -
8-Isoprostane: A salivary oxidative stress biomarker for oral submucous fibrosis and oral squamous cell carcinoma
S Meera, R Sarangarajan, K Rajkumar
May-August 2020, 24(2):279-284
Background: 8-isoprostane is one of the stable oxidative stress marker formed by the lipid peroxidation of arachidonic acid. It is present in detectable quantities in all biological fluids. Elevation of 8-Isoprostane has been reported in various neurological, cardiological disorders, and periodontal diseases. Aim: The present study was conducted to estimate and compare the level of 8-isoprostane in plasma and saliva in patients with oral squamous cell carcinoma (OSCC), oral submucous fibrosis (OSMF), and in controls. The study also aimed to find out if 8-isoprostane can be used as an effective oxidative stress marker in evaluating the disease progression in OSCC. Materials and Methods: Plasma and salivary samples were taken from 10 cases each of clinically diagnosed OSMF, clinically and hisotpathologically diagnosed cases of OSCC and controls. The samples were subjected to 8-Isoprostane ELISA procedure and analyzed. Statistical analysis was performed using the SPSS software. Results: The levels of 8-isoprostane in plasma showed an average increase from normal to OSMF to OSCC but was not statistically significant. The variations in the level of salivary 8-isoprostane were found to be statistically significant (P = 0.037) suggesting that there is a gradual increase in levels of isoprostane from controls to OSMF to OSCC. Conclusion: The results showed that the concentration of isoprostane in saliva showed a progressive and steady increase from control through OSMF to OSCC indicating that saliva could be used as an effective diagnostic tool in estimating tumor markers. Large scale studies correlating with other potentially malignant oral disorders are required to ascertain the role of 8-Isoprostane as an ideal tumor marker.
  166 26 -
Carcinosarcoma: A rare case report of a recurrent mass in the neck region
Dinshaw Hormuzdi, Sharad Desai, Sushma Bommanavar, Dipti Patil
May-August 2020, 24(2):327-331
Carcinosarcoma, a biphasic malignant mixed tumor, is an extremely rare neoplasm with >1% incidence. This aggressive malignancy is characterized by the presence of two components admixed with each other, i.e., the epithelial component and the mesenchymal component arising from a monoclonal/multiclonal origin or de novo. Most patients usually present between 60 and 65 years of age with no sex predilection. The authors present a case of carcinosarcoma arising as a mass in the neck region of a 14-year-old male. The case is been presented for its rarity of occurrence in the younger age group.
  159 30 -
Basal cell adenoma of sublingual salivary gland: A rare entity
Reena Sirohi, Sanjeev Malhotra, Vijay Wadhwan, Sangeeta Malik
May-August 2020, 24(2):404-404
Monomorphic adenoma or Basal cell adenoma (BCA) is a benign epithelial tumor of glandular origin. It has very unique histological characteristic and its diagnosis is mainly established by histological examination. Most common occurrence is in parotid gland and rarely reported in submandibular and sublingual salivary glands. In this case report, we are presenting a case of basal cell adenoma of sublingual gland.
  152 30 -
Anticancer and antiproliferative efficacy of a standardized extract of Vaccinium macrocarpon on the highly differentiating oral cancer KB cell line athwart the cytotoxicity evaluation of the same on the normal fibroblast L929 cell line
Anil V Ankola, Vaibhav Kumar, Simran Thakur, Richa Singhal, T Smitha, Roopali Sankeshwari
May-August 2020, 24(2):258-265
Background and Objectives: The perpetual search is on to find botanical complementary adjuncts to the conventional therapies used that is not only cost-effective but also reduces side effects associated with conventional synthetic drugs that are available in the market. The aim of this study was to assess the in vitro anticancer efficacy of hydroalcoholic fruit extract of cranberry against oral cancer KB cell line by Di-Methyl Thiazoldiphenyl Tetrazolium bromide assay (MTT) assay and its cytotoxicity on normal fibroblast cells. Materials and Methods: Vaccinium macrocarpon extract was prepared using a hydroethanolic solvent (water – 30%:ethanol – 70%) using the standardized maceration protocol. Standard KB and normal fibroblast (L929) cell lines were used. The minimum lethal effect of the extract was calculated using the MTT cytotoxicity assay. Results: The extract shows a satisfactory antiproliferative effect on the KB cell line and a higher cell viability percentage of the normal fibroblast cell line. Conclusion: V. macrocarpon can prove to be an adjunct to the existing anticancer drug therapy against oral cancer KB cell line.
  162 17 -
Analysis of octamer-binding transcription factor-4 expression in oral leukoplakia
Anand Siddappa Tegginamani, Vanishree Halasagundhi Shivakumar, Thomas George Kallarakkal, Siti Mazlipah Ismail, Mannil Thomas Abraham, Ahmad Termizi Bin Zamzuri
May-August 2020, 24(2):400-400
Background: Oral potentially malignant disorders have a risk for malignant transformation but are difficult to reliably identify and predict which patients are at the risk for malignant transformation. OCT4 has been hypothesized to play a key oncogenic driver in a variety of solid tumors. A deeper understanding of the aberrant molecular pathways which lead to carcinogenesis needs to be identified by the potential markers. Aims: To assess the OCT4 stemness factor in oral leukoplakia for its potential risk to malignant transformation. Settings and Design: 20 cases of oral leukoplakia were obtained from archives at Oral Cancer Research & Coordinating center (OCRCC) Malaysia Subjects and Methods: 20 cases of oral leukoplakia were assessed by OCT4 immunohistochemically. Oral squamous cell carcinoma was used as a control. Result: no expression of OCT 4 was observed in any cases of oral leukoplakia. Conclusion: The molecular mechanisms of Oct4 regulation and in particular of its switch on and off in tissues depends upon its microenvironment, which makes it challenging in fundamental and applied research fields of regenerative medicine and cancer therapy. It's better that patients should undergo multiple biopsies for the early detection of malignant transformation with close follow-up during the first two to three years, a large amount of work remains to be done with multi-marker panel investigation, as cure rates have remained constant over three decades.
  160 14 -
Comparison of cluster analysis of Porphyromonas gingivalis by arbitrarily primed-polymerase chain reaction between healthy and chronic periodontitis subjects
Preeti Ingalagi, Vijayalakshmi Kotrashetti, Kishore Bhat, Manohar Kugaji
May-August 2020, 24(2):251-257
Introduction: Periodontitis is a chronic destructive inflammatory disease of the oral cavity. The main causative agent is presence of biofilm formed due to different micro-organisms. Among different micro- organisms “red complex” bacteria is known to be the main causative agent in progression of periodontitis. Porphyromonas gingivalis out of the red the complex organism plays a major role in progression of periodontitis. P. gingivalisis present in both in healthy and diseased individuals. The difference in the strains will determine the virulence factor of the organism and also progression of disease. Only few studies have been done showing variation in strains present between healthy and diseased. Aims: To check the difference in heterogeneity of P. gingivalis in chronic periodontitis and healthy individuals through Arbitrarily Primed-PCR (AP-PCR). Materials and Methods: A total of 400 subjects (200 each of chronic periodontitisandhealthy individuals) were included. Sub-gingival plaque was collected in the Reduced transport fluid (RTF) medium and processed at the institutional central research laboratory. Presence of P. gingivalis was, confirmed by culture andphenotypical analysis. Further confirmed cases were processed for PCR after DNA extraction using 16S rRNA. Positive cases of P. gingivalis were subjected for AP-PCR for clonal analysis using the specific 272 primer. Results: In 152(76%) and 98(49%) were confirmed for P. gingivalis in chronic periodontitis and healthy individual respectively by PCR. AP-PCR analysis showed 6 clusters with similarity index in CP and 3 clusters with similarity index in Healthy individuals. Conclusion: The present study showed difference in clusters between chronic periodontitis and healthy individual'sthussuggestive variantin genetic heterogeneity of P. gingivalis strain between healthy and chronic periodontitis. AP- PCR appears to be a promising tool for clonal analysis of P. gingivalis.
  150 16 -
Multiple endocrine neoplasia type 2B: A report of a rare case
Deepak Singh Ningombam, Potsangbam Aparnadevi, Doddabasavaiah Basavapur Nandini, Tulsidas Singh Wahengbam
May-August 2020, 24(2):339-343
Multiple endocrine neoplasia type 2 (MEN2) is caused by RET proto-oncogene mutations and characterized by the presence of medullary carcinoma of the thyroid, pheochromocytoma, marfanoid features and mucosal neuromas of the tongue, lips, inner cheeks and inner eyelids. MEN type 2B is also known as mucosal neuroma syndrome. Oral presentations are sometimes the earliest signs of this condition. Early identification of this syndrome is important because affected patients often develop medullary thyroid carcinoma and pheochromocytoma. This article reports a 43-year-old male patient with mucosal neuromas and previous history of thyroidectomy due to medullary carcinoma.
  148 17 -
Floret-like giant cells in intra-osseous schwannoma
Sudeendra Prabhu, Roshan Athikari, Maji Jose, Mohitha Shetty
May-August 2020, 24(2):395-396
Floret-like giant cells are very commonly seen in neurofibroma and as an indication to be associated with neurofibromatosis type 1 gene. This particular case of intraosseous schwannoma of mandible showing such giant cells, which is rarely reported.
  138 20 -
The efficiency of propranolol on occurrence and development of 4-nitroquinoline 1-oxide-induced squamous cell carcinoma of the tongue in rats
Secil Cubuk, Sina Uckan, Handan Ozdemir, Zeynep Firdevs Taslica, Didem Bacanli
May-August 2020, 24(2):400-401
Aims: The aim of this study to investigate the efficiency of propranolol on occurrence and development of 4-nitroquinoline 1-oxide (4NQO)-induced squamous cell carcinogenesis of the tongue in rats. Subjects and Methods: The sample was composed of 27 male Sprague Dawley rats that received 50 ppm 4NQO for 20 weeks in drinking water. Group 1 (n = 9) was treated with 50 mg/kg/day propranolol for 20 weeks, Group 2 (n = 9), after carcinogenesis inducement for 20 weeks, received propranolol (50 mg/kg/day) for 2 weeks and Group 3 (n = 9) received no treatment. At the end of the experimental stage, the tongue specimens were evaluated under a light microscope and categorized as low- or high-risk lesions according to a binary system. Statistical Analysis Used: The statistical comparison was performed with a likelihood ratio test. Results: Histopathological analysis revealed the risk of malignant transformation rates as 33.3% in Group 1, 55.5% in Group 2 and 77.8% in Group 3; however, the difference between the groups was not statistically significant (P > 0.05). Conclusion: The results of the study suggest that propranolol has a tendency to preventive effect against carcinogenesis.
  125 14 -
Erratum: Malocclusion: An adjunctive aid in individual identification

May-August 2020, 24(2):406-406
  98 7 -
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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007