Diagnostic challenges of superficial mucoceles: An update

A superficial mucocele is a unique variant of a mucocele of the oral cavity that was described by Eveson for the first time in 1988. It occurs due to subepithelial extravasation of sialomucin at the epithelial-connective tissue interface and is related to damage of the minor salivary gland ducts. Clinically, they appear as small, asymptomatic, clear, tense vesicles with a predilection for the soft palate, retromolar pads, and posterior buccal mucosa. They are reported to occur more frequently in women than in men. Before Eveson endeavoured to describe these rather peculiar lesions, they were often misdiagnosed as vesiculobullous lesions such as bullous lichen planus, mucous membrane pemphigoid, and the like. It is incumbent on the present-day pathologist to be cognizant of the presence of these entities as it could present a formidable diagnostic challenge otherwise. This review gives an updated account on the etiology, prevalence, clinical features, differential diagnosis, and management of superficial mucoceles.

Juvenile ossifying fibroma of maxilla: Concurrent presentation of psammomatoid and trabecular variant

Juvenile Ossifying Fibroma (JOF) is a type of ossifying fibroma which occurs in younger individuals and manifests as trabecular and psammomatoid variants. The nature and behaviour of these variants vary, and they exhibit characteristic histopathological appearance. The solitary presentation of these subtypes is reported in numbers, but co-occurrence of both these entities is very few. Here, we present a case of JOF with the co-occurrence of both trabecular and psammomatoid variants in relation to an incompletely healed extraction socket.

Role of dry ice in decoverslipping of microscopic slides: A new insight

Background

The process of decoverslipping is often required in a laboratory to review or examine an older slide which tends to fade over time, making it almost impossible to use it for research or study purposes. The sections then need to be re-stained which can only be done after removing the coverslip. The traditional method of decoverslipping using xylene is a time-consuming process. Various methods have been used in the past; however, none were found to be completely effective. Dry ice, the solid form of carbon dioxide, is an easily available, cheap cooling agent with a low freezing temperature (-78.5°C) which was evaluated for its efficacy in decoverslipping process, as an alternative to xylene.

Materials and Method

64 faded haematoxylin and eosin (H&E)-stained histopathology slides were randomly selected and segregated, according to duration of year, into eight major groups. Each group was further divided into four subgroups according to the time that the slides were subjected for decoverslipping. The slides were placed on dry ice and the time was set. Once the coverslip was removed, the slides were placed in xylene to remove any residual mountant. The tissue sections were evaluated for physical disfigurement followed by re-staining with H&E to check for any change in tissue morphology.

Result

The mean time taken for removal of coverslip using dry ice was 35 seconds.

Conclusion

This technique is easy, fast, and effective, with no tissue loss or compromise in staining quality, thereby preventing xylene toxicity and its effect on the environment.

Soft Bite Appliance for Teething Infants

Mother's milk is a biological secretion that provides the best nutritional source with numerous benefits to the infant, which include somatic growth, modulation of post-natal intestinal function, brain development, and immune ontogeny. As per WHO, exclusive breastfeeding is recommended for the first six months and continuation up to two years of age as both mother and the infant are mutually benefitted. Breast milk contains more nutritional, hormonal, and growth factors which are mandatory for the baby to attain the highest standards of health. Many mothers encounter bite injuries in their nipples and areola while feeding due to the teething process, which usually starts six months after birth. This may cause injury to the mother's skin causing inconvenience in feeding. This can be avoided by fabricating a "soft bite appliance" for the infant, which prevents bite injuries and makes both the baby and mother feel comfortable during feeding. This device can be used as a temporary device during the teething process, thereby enhancing nursing mothers to continue the feeding process without anxiety.

Accidental finding of COVID-associated mucormycosis (CAM) in a patient presenting as toothache: A case report and review of literature

Mucormycosis is an angio-invasive rapidly progressing fungal infection, usually reported in immunocompromised individuals. We present a case of COVID-associated mucormycosis in a patient with a presenting symptom of toothache in the maxilla with a possible mild case of COVID-19.

Abstract

Coronavirus-associated mucormycosis (CAM) had reached epidemic status, especially during the second wave of COVID-19. It was especially prevalent in India with a large mortality rate. Mucormycosis, particularly the rhinocerebral type is seen to be greatly associated with COVID-19, especially in patients with altered immunity. Uncontrolled diabetes, chronic kidney disease, immunocompromised patients, malignant hematological diseases, etc. are the major risk factors of CAM, precipitated by the injudicious use of corticosteroids for the treatment of COVID-19. CAM may often present in the maxillofacial region which warrants that dental clinicians be aware of the clinical presentation, diagnostic guidelines, and appropriate management measures for the disease. This report is one such case of CAM involving the posterior maxilla in a middle-aged individual with mild COVID-19 symptoms.

An article on "letter to the editor"

A 'Letter to the Editor' is an abbreviated form of communication where 'readers' can express their carefully considered scientific opinion about a recently published article in a journal. It is considered as 'post-publication peer review'. There are certain things that a letter writer and the 'editor' need to keep in mind while writing a 'Letter' for a journal. The 'editor' needs to curate the contents of the 'Letter' and make sure that there are no misinformation shared. The formatting, type, scope and the scientific quality of the 'Letter' depend on the journal that publishes them, and hence, different publications may require their 'letter writers' to present the information that they want in a certain way. The following article reflects an overview of the role of editors and writers, guidelines, scope, and format of the 'Letter to the Editor'.

Histopathological significance of necrosis in oral lesions: A review

Necrosis is a localized area of tissue death followed by degradation of tissue by hydrolytic enzymes released from the dead cells, resulting in swelling of organelles, rupture of the plasma membrane, eventual cell lysis, and leakage of intracellular contents into the surrounding tissue. It is always accompanied by an inflammatory reaction. Necrosis is caused by various factors such as hypoxia, physical factors, chemical agents, immunological agents, and microbial agents. Still now, there is no literature review regarding the necrotic lesions of the oral cavity. In this paper, the oral lesions associated with necrosis are categorized under the headings such as odontogenic cysts, odontogenic tumors, salivary gland pathology, and epithelial malignancies. In addition, the histopathological significance of necrosis in oral lesions has been discussed. By suggesting that spotting necrosis in the histopathology aids in determining the diagnosis, tumor behavior, and prognosis of oral lesions.

Spectrum of salivary gland diseases: A 24-year single-institution retrospective study

Introduction

Salivary glands are exocrine glands and are classified as major and minor salivary glands. Salivary gland pathologies are classified as neoplastic and non-neoplastic. The neoplasms of salivary glands can be benign or malignant.

Aim

The aim of the study was to describe the frequency of various salivary gland diseases reported in our institution from 1997 to 2021.

Methodology

This was a 24-year retrospective study of salivary gland lesions processed and reported by the Department of Oral Pathology and Microbiology. Data regarding age, gender, site, and diagnosis were obtained and studied.

Results

Amongst the total 5928 biopsied cases reported, 6% were salivary gland pathologies. Two hundred sixty-six were non-neoplastic lesions and 81 were neoplastic. The most common non-neoplastic lesion was mucous extravasation cyst. The most common neoplastic lesion was pleomorphic adenoma.

Conclusion

The frequency of occurrence of salivary gland lesions in the last 24 years of this institution is almost similar to that stated in other published studies.

Oral lesions and periodontal status in diabetics and non-diabetics: A hospital based study

Background

Diabetes mellitus, a chronic hyperglycemic disorder has been associated with several manifestations in the body including the oral cavity. The oral manifestations are of importance and may significantly contribute to the detection of undiagnosed diabetes.

Objective

To find out the prevalence of oral diseases in type 1 and type 2 diabetics, to evaluate and compare the periodontal status of diabetics and non-diabetics.

Materials and Methods

This was a cross sectional study conducted on 110 diabetic subjects of >5 years duration at the M.V. Hospital for Diabetes, Diabetes Research Centre, Chennai. One hundred apparently healthy non-diabetic subjects in the age group of 40-60 years were studied as control. The oral cavity was examined by using a mouth mirror and periodontal status was assessed by utilizing oral hygiene index - simplified (Greene and Vermillion), Miller's mobility index and Ramjford's periodontal disease index.

Results

Subjects with diabetes were found to have significant association with xerostomia (P < 0.003) and chronic periodontitis (P < 0.026). However, no significant association was found forleukoplakia, traumatic ulcer, frictional keratosis, smoker's melanosis, mucocele, aphthous ulcer, fissured tongue, lichen planus, parotid enlargement, parulis, chronic gingivitis, fibroma, and periodontal abscess.

Conclusion

The study reaffirmed higher prevalence of xerostomia and periodontal disease among diabetic subjects. However, contrary to previous studies, no significant differences were found in the prevalence of traumatic ulcer, fissured tongue, lichen planus, and parotid enlargement.

Effectiveness of Online Learning vs Traditional Learning during COVID-19 Pandemic in Chennai: A Questionnaire Study

BACKGROUND

Digitalization of education became a need of the hour when the COVID-19 pandemic affected the traditional modalities of learning, and it was widely implemented in various fields including dentistry.

AIMS

The aim of this study was to assess the effectiveness of online learning against traditional learning systems among dental students in Chennai.

METHODS AND MATERIALS

A Google Form questionnaire comprising 29 dental learning-based questions was designed and distributed to dental students across colleges in Chennai using online distribution platforms. The study responses were closed after the stipulated period of 1 month. The data were analyzed using SPSS software version 17.

RESULTS

The survey was answered by 834 participants comprising 76.9% females and 22.3% males. Of the total study population, 71.1% of them did not have previous online learning experiences. Approximately, 15.5% of the study population were not satisfied with the facilities provided by the online learning platforms. Also, one-third of the study population reported difficulty during the presentation. Three-fourths of the study participants did not prefer online learning over traditional learning and reported that the attention span and communication between the students and teachers were lower in online classes. Overall, 43% of the study participants rated the quality of online video-based learning to be good and 8.5% found it to be poor.

CONCLUSION

Online-based learning systems are evolving and can provide a wide array of knowledge from global experts. However, structured planning and technique may be needed for the dental curriculum.

Covid 19 – A Forensic Odontologist Perspective

Investigations related to forensic odontology involves handling of antemortem as well as postmortem dental records. In case of any identification process, forensic odontologists may end up in exposing these dental related records. Exposure to any biological remains, and its related surfaces or objects at the scene, during this pandemic situation, puts any forensic professional at risk towards COVID-19. A detailed description on the risk involved during dental identification and autopsy procedures, and the knowledge about the precautionary measures which have to be exercised, makes the forensic team to carry forth the work cautiously without any perplexity or doubt.

The diverse role of oral fibroblasts in normal and disease

Fibroblasts are the major cellular component of the connective tissue. They differ both structurally and functionally based on their location. The oral fibroblasts vary from the dermal fibroblasts in their origin, properties and also functions. These cells play an important role in wound healing, tumor progression and metastasis, allergic reactions. In this review, the various functions of the oral fibroblasts are discussed in detail.

Basaloid squamous cell carcinoma in the maxillary gingiva

Basaloid squamous cell carcinoma (BSCC) is a rare, unique, and aggressive variant of squamous cell carcinoma which mostly occurs in the upper aerodigestive tract. Histologically and immunologically different from conventional squamous cell carcinoma, it is mostly seen in men of the sixth and seventh decades and is commonly associated with tobacco and alcohol usage. BSCC usually presents as a high stage disease with distant metastasis, high recurrence rate, and poor prognosis. In the head-and-neck region, BSCC has a strong predilection for sites such as the base of the tongue, soft palate, and epiglottis. Less commonly, it may also occur on the floor of the mouth, gingiva, and tonsils. In the present article, we report a case of BSCC in the right maxillary anterior gingiva of a 57-year-old female for its rarity.

Tooth eruption clock: A novel learning aid

Chronology of tooth eruption is the most preliminary and crucial topic which is covered in the undergraduate syllabus of the dental curriculum. Eruption of permanent and primary teeth follows a particular time sequence. Both maxillary and mandibular arch has similar number of teeth, beginning from central incisors to molars. The pattern of eruption differs slightly between maxillary and mandibular arch. Remembering the years or months in a numerical manner is the usual way by which a student learns the eruption chronology. Eruption clock is a specially designed learning aid, which makes this teaching–learning process a lot easier, effective and practical.

Estimation and comparison of serum cotinine level among individuals with smoking and tobacco chewing habit

Aims and Objectives

The present study was aimed to estimate and compare tobacco exposure in smokers and chewers. The levels of cotinine, one of the constituents of tobacco were considered as indicative of tobacco exposure. Serum Cotinine levels in individuals with the habit of smoking and tobacco chewing were estimated and compared. Base line values of cotinine levels in normal subjects were established.

Materials and Methods

The study groups comprised about 30 individuals with the habit of smoking (Group A); these 30 individuals with the habit of tobacco chewing (Group B), and 20 individuals who were never exposed to any form of tobacco as control group (Group C). Serum cotinine levels were estimated using a commercially available enzyme-linked immunosorbent assay in both test and control groups and the difference in the levels were compared.

Results

: In individuals with the habit of smoking, cotinine levels ranged between 11 ng/ml and 215 ng/ml with a mean concentration of 87.56. In tobacco chewers, the levels ranged between 11 ng/ml and 128 ng/ml with a mean concentration of 73.66. In control group, the levels ranged between 0.34 ng/ml to 2.5 ng/ml with a mean concentration of 0.93. Cotinine levels between smokers and tobacco chewers were compared and there was no statistically significant difference.

Conclusion

Difference in serum cotinine levels between smokers and tobacco chewers is not significant. The fact that cotinine level is influenced by age of the individual, frequency and duration of the habit seems to be irrelevant from the results obtained from this study. Prospective studies considering all the factors and variables, with a preferable larger sample size can probably eradicate the chaos on the reliability of cotinine as a predictive biomarker for the amount of tobacco exposure.

Benign lymphoepithelial lesion of the minor salivary gland - A rare presentation as a palatal swelling

Benign lymphoepithelial lesion (BLEL) is characterized by extensive lymphocytic infiltration of the major salivary glands and may be associated with Sjogren's syndrome or HIV infection. The involvement of the palatal minor salivary glands is extremely rare. We report an isolated case of BLEL affecting the palatal minor salivary glands, presenting as a palatal swelling in a 37-year-old female patient. Serological tests ruled out potential comorbid conditions. Cone-beam computed tomography showed a palatal soft-tissue mass with thinning of the adjacent cortical plates. A histopathological examination revealed salivary gland tissue with significant acinar destruction, dense lymphocytic infiltration and focal myoepithelial islands. Therefore, BLEL may be considered as a rare differential diagnostic possibility of a palatal soft-tissue mass lesion.

Adenosquamous carcinoma of the tongue: A case report and an overview of histogenetic concepts

Adenosquamous carcinoma (ASC), a rare variant of squamous cell carcinoma, is an aggressive and highly infiltrating epithelial neoplasm, which has a distinct histomorphological features comprising simultaneous areas of squamous cell carcinoma and adenocarcinoma. Some researchers consider it as a controversial neoplasm, as it may arise from the ducts of the minor salivary gland or from the overlying surface epithelium. In the head-and-neck region, commonly affected sites include paranasal sinuses, larynx and oral cavity. Areas of occurrence in the oral cavity include palate, tonsillar pillar areas, tongue and floor of the mouth. The prognosis of the neoplasm is considered poor due to its early recurrence, local and distant metastasis and low survival rate. This article reports a case of ASC affecting the posterior part of the tongue in a 50-year-old male patient and an overview of its histogenetic concepts.

Salivary cortisol and dehydroepiandrosterone as oral biomarkers to determine stress in patients with recurrent aphthous stomatitis

Background

Recurrent aphthous stomatitis (RAS) is one of the most common oral ulcerative diseases with a multifactorial etiology. Although psychological stress is an exacerbating factor, the role of salivary stress hormones, cortisol, and dehydroepiandrosterone (DHEA) in this oral disease has not been extensively reported. The study aimed to estimate and compare the salivary cortisol and DHEA levels in RAS patients and healthy control group with the aid of ELISA microplate reader.

Subjects and Methods

Sixty patients were enrolled in our study, which included 30 patients with clinically diagnosed RAS and 30 healthy controls. Two mL of unstimulated whole saliva was collected and salivary cortisol and DHEA levels were measured using ELISA kit, and the values were read by microplate ELISA reader and recorded in both groups.

Results and Conclusion

The mean salivary cortisol and DHEA levels were elevated in the RAS patients compared to the healthy controls and were statistically significant. Salivary cortisol and DHEA can serve as oral biomarkers to determine stress in patients with RAS. However, the present study necessitates further studies with larger sample size and an improved protocol to ascertain the actual role of these presumed oral biomarkers as well as anxiety and stress as triggers in the pathogenesis of RAS.

The World Health Organization classification of odontogenic and maxillofacial bone tumors: An appraisal

Classification is the process of grouping similar entities under one category for the ease of their comprehension and better handling. Medical classification dates back to the days of William Farr who is credited with the development of a nosology, which later served as the forerunner for the modern-day disease classification by ICD. The WHO system of classification is a time-honoured system that has prevailed from decades together and is under constant evolution. The classification of odontogenic tumours was first formulated by Pierre Paul Broca and has undergone several transformations over years. Though the earlier classifications and their modifications by several authors and even by the WHO appeared to be fitting for their time, the latest edition of WHO classification of odontogenic and maxillofacial bone tumours neither seems to be complete nor perfect, even at the present context. It is unfortunate that even with the advancement of molecular biology, the present WHO classification on Odontogenic and Maxillofacial bone tumours, fails to serve as a 'reference standard' in the true sense of the term. This article highlights the limitations of the current classification with constructive criticism that may help in further improvement.

Carcinoma Cuniculatum of the Alveolar Mucosa: A Rare Variant of Squamous Cell Carcinoma

Carcinoma cuniculatum is one of the variants of squamous cell carcinoma. It is significantly rare with an incidence rate < 1% compared to other histological variants of squamous cell carcinoma. Various etiologic factors implicated are trauma, HPV, chronic inflammation and alcohol consumption but real causative agent still remains unclear. Initially it resembles plantar wart which slowly progress to bulky exophytic mass in the sole of the foot, where cases have been reported first. In the oral cavity it presents clinically as an exophytic growth and slowly invades the jaw and destroys the underlying bone. Microscopically it exhibits as both exophytic and endophytic epithelial masses along with well differentiated and pronounced hyperkeratosis. Treatment includes surgical resection alone unlike other variants which are treated by radiation with or without chemotherapy. Here we present a case of carcinoma cuniculatum occurred in alveolar mucosa of a 47 years old female. It presented as an exophytic growth in mandibular alveolar region, with histological features consistent with carcinoma cuniculatum.

Assessment of histological changes in antemortem gingival tissues fixed at various time intervals: A method of estimation of postmortem interval

Introduction:

Conventional methods to estimate the time of death are adequate, but a histological method is yet unavailable to assess postmortem interval (PMI). The autolytic changes that occur in an unfixed antemortem gingival tissue which reflects histologically at an early stage are similar to changes that occur in postmortem tissue. These histological changes can be used and applied in a postmortem tissue as a method to assess PMI.

Aims:

The aim of the study is to assess the histological changes in a gingival tissue left unfixed for various time intervals and to correlate the findings with duration.

Materials and Methods:

Sixty gingival tissues obtained from patients following therapeutic extractions, impactions, gingivectomy and crown lengthening procedures were used. Each tissue obtained was divided into two pieces and labeled as “A”, the control group and “ B” the study group. Tissues labeled “A” were fixed in 10% formalin immediately and tissues labeled“B” were placed in closed containers and fixed after 15, 30, 45 min, 1, 2, and 4 h time interval. Of the sixty tissues in the study group “ B”, ten tissues were used for each time interval under investigation. All the fixed tissues were processed, stained, assessed, and analyzed statistically using Pearson correlation and regression analysis.

Results:

Histological changes appear at 15 min in an unfixed antemortem tissue. At 2 h interval, all layers with few cells in basal cell layer are involved. At 4 h interval, loss of stratification and complete homogenization of cells in the superficial layers with prominent changes in basal layer is evident. There was a positive correlation (<1.0) between the time interval and the appearance of the histological changes.

Conclusion:

Histological changes such as complete homogenization of cells in superficial layers and loss of epithelial architecture at 4 h in unfixed antemortem tissue may be used as a criterion to estimate PMI, after further studies on postmortem tissues.

Evaluation of Salivary Nitric Oxide Levels in Smokers, Tobacco Chewers and Patients with Oral Lichenoid Reactions

INTRODUCTION

Nitric oxide (NO), a free radical, acts as a signalling molecule affecting numerous physiological and pathological processes. Role of nitric oxide as a mediator in tobacco related habits and the resultant oral lichenoid reactions was assessed.

AIM

The aim of the study is to evaluate and compare the salivary nitric oxide levels in normal patients with that of smokers, tobacco chewers and patients with oral lichenoid reactions.

MATERIALS AND METHODS

One hundred and twenty patients were enrolled in the study which included 30 healthy patients without any chronic inflammatory lesion and habit as controls (group I), 30 smokers without the habit of tobacco/betel nut chewing and any oral lesion (group II), 30 tobacco chewers without the habit of smoking and any oral lesion (group III) and 30 histologically confirmed cases of oral lichenoid reaction with the habit of tobacco usage (group IV). Saliva from these patients was collected and the nitrite concentration was assessed.

RESULTS

Our results concluded that there was highly significant increase in the nitric oxide levels in smokers, tobacco chewers and patients with oral lichenoid reactions compared to that of controls. Also, there was a significant increase in nitric oxide levels in patients with smoking associated oral lichenoid reactions in comparison with smokers and in patients with lichenoid reactions associated with tobacco chewing in comparison with tobacco chewers.

CONCLUSION

Estimation of salivary nitric oxide levels is a simple, non-invasive procedure and could be analysed to suggest the role of nitric oxide in the pathogenesis of these lesions. The increased activity of the enzyme may indicate that nitric oxide has a pathophysiological role in these lesions.

Histological appearance of postmortem pink teeth: Report of two cases

This article presents images and histological changes in the dentin of two cases involving posmortem pink teeth. Postmortem pink teeth were noted among two deceased male individuals. Pink teeth were noted during autopsy examination after twelve days in one corpse, and eight days following death in the second case. During the examination decomposition and putrefaction of the body was noted. Cause of death was drowning in one case and haemorrhages and shock in another. A central incisor tooth was obtained from each body. Both teeth exhibited a pink appearance and the intensity was more pronounced in the cervical region. Although pink teeth can be noted in death due to asphyxia, carbon monoxide poisoning and so on, it is necessary to study the exact role behind the appearance of pink teeth and try to incorporate the finding medico legally.

Evaluation of lactate dehydrogenase enzyme activity in saliva and serum of oral submucous fibrosis patients

BACKGROUND

Of all oral precancerous conditions, Oral Submucous Fibrosis is of greater concern because of its disabling nature and relative greater chances of malignant transformation. This malignant transformation involves glycolytic pathways that can alter lactate dehydrogenase levels. Therefore the aim of this study was to estimate the LDH levels in saliva and serum of subjects with OSMF and to compare them with healthy controls and to correlate the relationship between pathogenesis of OSMF and the LDH enzyme.

METHODS

Sixty Subjects were recruited for this study and divided into two groups, 30 subjects with OSMF (Group A) and 30 healthy controls (Group B). Venous blood and unstimulated whole saliva measuring 1 ml was collected from each of these evaluated for LDH levels using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software version 17.

RESULTS

The average salivary LDH value for Group A was 606.83 ± 60.09 U/l and for Group B was 80.73 ± 20.06 U/l. salivary LDH was greater in group A than Group B and this was statistically significant. On comparing the serum and salivary LDH in Group A with the clinical staging of OSMF, the results were not statistically significant. Similarly no statistically significant relationship was found on comparing the serum and salivary LDH in Group A (OSMF subjects) with duration of habit.

CONCLUSION

This study provides additional rationale for the role of salivary LDH in the early diagnosis and prognosis of oral submucous fibrosis.

Hormonal changes in exfoliated normal buccal mucosal cells

AIMS

The present study was undertaken as a baseline study to evaluate the nuclear diameter (ND), cell diameter (CD) and nuclear-cytoplasmic ratio (N:C) and their variation with age in normal buccal smears of female subjects.

MATERIALS AND METHODS

Buccal smears were collected from 400 apparently healthy individuals. After fixation in 95% alcohol, the smears were stained using the standard Papanicolaou laboratory procedure. The CD and ND were measured using a stage micrometer and an ocular micrometer. Statistical analysis of the data was performed using the one-way analysis of variance to evaluate the difference in the ND, CD and N:C with age in females. Multiple range tests by Tukey-honestly significant difference procedure were performed to evaluate the significance between various age groups.

RESULTS

The results showed an increase in ND and CD from the 5-10 age groups to 15-35 age groups. In the 15-35 age groups, there was a decline in ND and CD when comparing the first and the second half of the menstrual cycle, but the difference was not significant. There was further decline in ND and CD in the 45-60 age groups. Variations were also seen in ratio N: C. Pattern of exfoliation also varied in each age group.

CONCLUSION

Age-related alterations are observed in buccal smears.

Comparative study of Candida by conventional and CHROMagar method in non-denture and denture wearers by oral rinse technique

INTRODUCTION

Candidal species colonizes the oral cavities of healthy individuals without dentures and also of denture wearers. Soft liners and tissue conditioning materials have been found to support the growth of Candida albicans which may predispose to lesions. The most important and common candidal species are C. albicans, C. tropicalis, and C. glabrata. C albicans is usually isolated from both the fitting surface of the denture and the denture-bearing mucosa of the affected patients. The aim of this study was to isolate, quantify, and speciate candidal species in non-denture wearers (controls) and denture wearers (study group) by the oral rinse technique. Isolation was done using Sabouraud dextrose agar (SDA). Speciation was done using conventional methods like the germ tube test, carbohydrate fermentation test, urease test, as well as the CHROMagar method.

AIMS AND OBJECTIVE

1) To assess the prevalence of Candida in non-denture wearers and in denture wearers by oral rinse technique, with isolation on SDA; 2) to speciate and quantify Candida in non-denture wearers and denture wearers by using conventional methods (germ tube test, carbohydrate fermentation test, urease test) and the CHROMagar method; 3) to assess the influence of smoking and diabetes on candidal species among the denture wearers; and 4) to assess the sensitivity and specificity of SDA and CHRO Magar.

MATERIALS AND METHODS

Salivary samples for Candida evaluation were collected from the subjects in sterile sample containers, using the oral rinse technique.

RESULTS

C glabrata was the most commonly found species among denture wearers and non-denture wearers both by conventional and CHROMagar methods. In males, C. albicans was the predominant species, whereas C. glabrata was the predominant species in females. Candidal colonization was higher in denture wearers compared to non-denture wearers, especially among females. The CHROMagar method was more rapid compared to conventional methods. In the present study, CHROMagar Candida showed 100% specificity and 100% sensitivity when compared to SDA and conventional methods.

An erupted odontoma associated with pigmentation: a histogenetic and histological perspective

Odontomas are hamartomatous malformations of odontogenic origin composed of all the structures that form the tooth. Pigmentation associated with odontomas is rare, with only two cases reported in the literature. The genesis of this composite malformation is attributable to the organizational failure of the developing odontogenic apparatus leading to abnormal morphodifferentiation. Although some odontomas erupt into the oral cavity, it defies the existing views of normal physiologic tooth movement thus raising questions over the use of this term. Here, we review a case of large odontoma in a 23-year-old male surfacing into the oral cavity from its intraosseous location. The unusual occurrence of melanotic pigmentation in the odontogenic epithelial rests was demonstrated by Mason Fontana special stain. The histogenesis of this unusual entity and explanation to its possible occurrence is discussed.

Immunohistochemical evaluation of mast cells and vascular endothelial proliferation in oral precancerous lesion-leukoplakia

Background:

Oral leukoplakia is the best-known precursor lesion. Although a morphologic feature of oral epithelial dysplasia is well described, less is known about the pathobiologic changes within the cells and over the cell surfaces for malignant transformation.

Aims:

The present study is aimed at comparing and correlating the mast cell density (MCD) and micro vascular density (MVD) in Normal Mucosa (NM) and different grades of dysplasia and to analyze their role in disease progression.

Materials and Methods:

MCD was assessed using anti mast cell tryptase and MVD was assessed immunohistochemically using anti-Factor VIII related von Willibrand factor.

Results:

The Results of the present study showed an exponential increase in microvessel density as mast cell density increased.

Conclusion:

The role of mast cells in angiogenesis as it progresses from normal mucosa to dysplasia is in concordance with the study. The number of mast cells and microvessel can be used as indictors of disease progression.

Giant cell fibroma: A clinicopathological study

Objective:

Giant cell fibromas (GCF) of the oral cavity are found predominantly in Caucasians and rarely in other races. This retrospective study was done to evaluate the clinicopathological features of GCFs in a sample of Indian population.

Materials and Methods:

21 oral GCF cases were investigated from the year 1995 to 2010. Clinical data and microscopic features were reviewed and analyzed.

Results:

The mean age of patients at the time of diagnosis was 39years. Oral GCF occurred in patients between 6 and 67 years of age. The lesions were 4-17 mm in greatest dimension. GCF frequently has the provisional diagnosis of fibroma or papilloma. All tumors were treated by total surgical excision and no recurrence was reported. The consistent and diagnostic feature was the presence of large stellate giant cells, usually with one or two nuclei. Multinucleated giant cells were seen occasionally. These giant cells were most numerous in the connective tissue beneath the epithelium.

Conclusion:

Though there are distinct histopathologic features for GCF, its clinical presentation and prognosis are similar to the conventional fibroma/fibroepithelial polyp.

Idiopathic multiple impacted unerupted teeth: Case report and discussion

Multiple impacted permanent teeth are usually related to syndromes, metabolic and hormonal disorders. However, in some cases, impaction of multiple teeth is not associated with any syndrome. In this report, we present a case of 17-year-old male patient with missing teeth. Radiographs revealed multiple impacted permanent teeth, though medical and family history along with physical examination was not suggestive of any syndromes. If other investigations are negative, an idiopathic case of multiple impacted teeth is suggested to be the possible diagnosis. The objective of this report is to increase awareness of such cases especially in the absence of hereditary/genetic/metabolic factors usually inherent in such scenarios. The patient management in such cases needs to be planned specifically from a multidisciplinary standpoint.

Awareness of forensic odontology among dental practitioners in Chennai: A knowledge, attitude, practice study

Objective:

The aim of the study is to analyze the knowledge, attitude and practice of forensic odontology among dental practitioners in Chennai.

Materials and Methods:

A cross-sectional study was conducted in a sample of 322 dental practitioners in Chennai and data was collected by means of a questionnaire.

Results:

Twenty-one percent of the dental practitioners did not maintain dental records in their clinic/workplace, with only 12% of the practitioners maintaining complete records. Ninety-three percent of dental practitioners were not maintaining dental records for more than seven years. The significance of ante-mortem records in identifying deceased suspects was not known to 17% of the dental practitioners. Forty percent of the dental practitioners were not aware of child abuse and the actions to be taken. Dental age estimation was not known to 41% of the dental practitioners. Thirty-eight percent of the practitioners were unaware of the accurate method of individual identification. About 18% of the dental practitioners did not know the significance of bite mark patterns of the teeth. Ninety-three percent of the practitioners lacked formal training in collecting, evaluating and presenting dental evidence. Thirty percent of dental practitioners did not know they can testify as an expert witness in the court of law. Forty percent of the dental practitioners were unaware of identifying the age and gender of an individual in mass disasters.

Conclusion:

Our study revealed inadequate knowledge, poor attitude and lack of practice of forensic odontology prevailing among the dental practitioners in Chennai.

Efficacy of various materials in recording enamel rod endings on tooth surface for personal identification

AIM

To analyze efficacy of cellulose acetate film, cellophane tape, and light body impression material in recording enamel rod endings on tooth surface for personal identification.

MATERIALS AND METHODS

Surface enamel rod endings of 30 extracted teeth were recorded from the same area of the same tooth for two times using cellulose acetate film, cellophane tape, and light body impression material. Photomicrographs of enamel rod endings were taken and subjected to Verifinger standard SDK version 5.0 software for analysis. Minutiae scores of all enamel rod end patterns obtained using these three imprint materials were statistically analyzed.

RESULTS

Cellulose acetate film imprint showed complete enamel rod end patterns and the software was able to identify the particular tooth with the same previous identification number in subsequent recordings as well. Cellophane tape and light body rubber-base impression material imprint showed incomplete enamel rod end patterns and the software failed to identify the particular tooth with the same previous identification number in subsequent recordings. Statistical analysis revealed that cellulose acetate film recorded more number of minutiae points compared with the other imprint materials.

CONCLUSION

Cellulose acetate film is a reliable material for recording enamel rod endings on tooth surface for personal identification compared with cellophane tape and light body rubber-base impression material.

Plasma cell granuloma of lip

Plasma cells are medium-sized round-to-oval cells with eccentrically placed nuclei, usually found in the red pulp of the spleen, tonsils, medulla of the lymph nodes, nasal mucosa, upper airway, lamina propria of the gastrointestinal tract, and sites of inflammation. Plasma cell granuloma is a rare reactive tumor-like proliferation composed chiefly of plasmacytic infiltrate. Here, we present a case of plasma cell granuloma of lip in a female patient.

Isolation of epithelial cells from tooth brush and gender identification by amplification of SRY gene

Introduction:

This study determines the importance of tooth brush from which DNA can be isolated and used for sex determination in forensic analysis.

Materials and Methods:

A total of 30 samples were collected and stored at room temperature for different periods of time interval. The epithelial cells adhered to the bristles of tooth brush were collected and genomic DNA was extracted and quantified using Nanodrop 1000 spectrophotometer.

Results:

Gender identification was done by amplification of sex determining region on Y chromosome (SRY) gene using real-time polymerase chain reaction and minimal amount of DNA (in pico grams) with 100% sensitivity and 73.3% specificity, i.e., all male samples showed positive results and out of 15 female samples 4 showed false positive results, i.e wrongly identified as males.

Conclusion:

With this study, we conclude that PCR is a valuable and sensitive procedure where minute contamination may cause alteration in the result, i.e, 4 females showed false positive result. Minute amount of DNA in picograms, which was collected at different intervals is enough for amplification of SRY gene and tooth brush can be used as one of the very valuable sources of gender identification.

Immunohistochemical evaluation of mast cells and angiogenesis in oral squamous cell carcinoma

OBJECTIVES

Angiogenesis is a complex event mediated by angiogenic factors released from cancer cells and immune cells. It has been reported to be associated with progression, aggressiveness and metastases of various malignant tumors including oral squamous cell carcinoma (OSCC). Similarly, mast cells have also been reported to play a role in tumor progression and metastases by promoting angiogenesis. The present study aims at comparison of microvascular density (MVD) and mast cell density (MCD) in normal oral mucosa (NM) and among various grades of OSCC.

MATERIALS AND METHODS

MVD was assessed immunohistochemically using anti-Factor VIII related von Willebrand factor, and MCD using anti-mast cell tryptase in a study sample of 30 cases of OSCC and 10 cases of clinically normal oral mucosa.

RESULTS

The mast cells in normal oral mucosa and oral squamous cell carcinoma strongly expressed mast cell tryptase. The density of mast cells and micro vessels were significantly higher in OSCC compared to normal oral mucosa. The MCD and MVD were higher in moderately differentiated OSCC than in well differentiated OSCC ( P > 0.05) and normal oral mucosa ( P < 0.05). Pearson's correlation revealed a positive correlation between MCD and MVD ( r=0.33; P=0.077).

CONCLUSION

These findings indicate that mast cells may play a role in up regulation of tumor angiogenesis in OSCC probably through mast cell tryptase.

Role of genes in oro-dental diseases

In oral cavity, the spectrum of diseases due to genetic alterations ranges from developmental disturbances of teeth to the pre-cancerous and cancerous lesions. Of late, significant progress has been made in the molecular analysis of tumors. With molecular genetic testing emerging as diagnostic, prognostic, and therapeutic approach, a review of genetic alterations ranging from the development of oro-facial structures to the tumors in the head and neck region are addressed in this article. The functional regulatory aspect of genes in relation to oro-facial structures are discussed separately, i.e., in relation to tooth genesis, tooth agenesis (non-syndromic, syndromic), tooth structural alterations, syndromic oro-facial defects, bone diseases, skin diseases (genodermatoses), and malignant tumors. In this literature, various genes involved in the development of the oro-facial structures and tooth in particular are discussed. The genetic basis of disorders in the tooth development (agenesis, hypodontia), tooth structural defects like amelogenesis imperfecta (AI), dentinogenesis imperfecta (DI), and oro-facial structural alterations (various syndromes) are explained.