Central Telangiectatic Osteosarcoma of the Mandible in a Paediatric Patient: A Rarity

Osteosarcoma (OS) involving the head and neck region is rare and is a diagnostic challenge due to its aggressive nature and varied presentations. Although OS constitute 40% to 60% of all bone tumours, only 10% of these occur in the head and neck region, most commonly in the maxilla and mandible. OS of the jaw bone has a different pattern and behaviour when compared to OS at other anatomic location. It occurs in a more elderly population, less aggressive and usually spreads locally rather than distant metastases. Telangiectatic Osteosarcoma (TOS) of jaws in a paediatric patient is still a very rare variant and till date only two cases have been reported in literature. Radiographic evaluation plays an important role as the clinical symptoms are not specific to the condition. Conventional radiography should always be supplemented by advanced imaging modalities for the diagnosis, which gives a three dimensional assessment and also prevents superimposition of surrounding structures. Early diagnosis and radical surgery are the keys to high survival rates. Herein, we present a third ever reported case of TOS occurring in mandible of a nine-year-old male patient.

Evaluation of different Diagnostic Modalities for Diagnosis of Dental Caries: An in vivo Study

AIM

The aim of this study was to compare and evaluate the efficacy of different diagnostic aids for diagnosis of dental caries and to compare the validity in terms of sensitivity and specificity of all four diagnostic modalities for diagnosis of caries.

MATERIALS AND METHODS

Occlusal surfaces of 100 primary and permanent molars were examined using the four diagnostic systems (visual, intraoral camera, DIAGNOdent, and DIAGNOdent with dye). These results were compared with operative intervention gold standard. Sensitivity and specificity were calculated for each diagnostic system for both enamel and dentin caries. Interrater agreement was calculated for each diagnostic system using kappa statistics.

RESULTS

For both enamel and dentin caries, the highest sensitivity values were provided by DIAGNOdent (0.91 and 0.72) and lowest for visual examination on wet surface (0.60 and 0.50). For both enamel and dentin caries, the specificity was found to be highest for intraoral camera on dry surface and lowest for visual examination. The DIAGNOdent gave the highest value of interrater agreement (kappa), i.e., 0.816 as compared with 0.03 for visual examination.

CONCLUSION

The study clearly demonstrated that DIAGNO-dent was the most accurate and valid system tested for the detection of occlusal caries. It has the advantage of quantifying the mineral content, helping to improve the diagnostic efficacy and treatment and accurate assessment of fissures where the visual examination alone is not adequate, thus complementing the traditional dental examination.

HOW TO CITE THIS ARTICLE

Zaidi I, Somani R, Jaidka S, Nishad M, Singh S, Tomar D. Evaluation of different Diagnostic Modalities for Diagnosis of Dental Caries: An in vivo Study. Int J Clin Pediatr Dent 2016;9(4):320-325.

Endocardial Thickening in the Sprague-Dawley Rat

Thickening of the endocardium is sometimes observed in rats and other animals as a spontaneous or experimentally induced lesion. However, its nature, pathogenesis, and significance are not well understood.

In this study, 480 Sprague-Dawley CD outbred albino rats between the ages of 6 and 25 months were examined grossly and microscopically. Endocardial thickening was observed in six cases. It was diffuse and was caused by proliforation of fibroblast-like cells, most frequently involving the left ventricle.

Endocardial thickening in Sprague-Dawley rats appears to be primarily due to endomyocardial fibrosis. It may represent repair of damage to subendocardial myocardium occurring spontaneously or as a consequence of exposure to chemicals or other agents.

Preterm Birth: A Primary Etiological Factor for Delayed Oral Growth and Development

Preterm and low birthweight children comprise approximately 6% of all live births. It is now a well-known fact that premature children experience many oral complications associated with their preterm births. Prematurely born infants have a short prenatal development period and they are prone to many serious medical problems during the neonatal period, which may affect the development of oral tissues. Adverse perinatal factors, premature birth and exceptional early adaptation to extra-uterine life and functional activity may influence dental occlusal development and symmetry in the jaws. Thus, the goal of the present paper is to elucidate further the effect of preterm birth on the development of the dentition.

How to cite this article: Zaidi I, Thayath MN, Singh S, Sinha A. Preterm Birth: A Primary Etiological Factor for Delayed Oral Growth and Development. Int J Clin Pediatr Dent 2015;8(3): 215-219.

Expression of p63 in potentially malignant and malignant oral lesions

BACKGROUND

p63, a member of p53 family, known to be expressed in embryonic tissues and basal regenerative layers of many epithelial tissues in the adult, is also expressed in various benign and malignant lesions of body including lesions of oral cavity. To evaluate the expression of p63 and compare the expression qualitatively and quantitatively in normal buccal mucosa, epithelial dysplasia, oral submucous fibrosis (OSMF), and oral squamous cell carcinoma (OSCC).

METHODS

The study material consisted of 45 archival cases which were divided into Group I with 5 cases of normal buccal mucosa, Group II with 15 cases of epithelial dysplasia, and Group III with 10 cases of OSMF and 15 cases of OSCC. Immunohistochemical expression of p63 was assessed by using mean, standard deviation, and analysis of variance.

RESULTS

Overexpression of p63 was seen in epithelial dysplasia, OSMF, and squamous cell carcinoma with an increased suprabasal expression in cases of epithelial dysplasia. The mean labeling index (LI) of p63 was found to be in increasing order from normal oral mucosa (33.75%), OSMF (57.37%), epithelial dysplasia (63.87%) to squamous cell carcinoma (69.76%).

CONCLUSION

The results suggest a possible role of p63 in oral carcinogenesis, and an increased LI as well as increased suprabasal expression of this gene in dysplastic lesions may have a potential to be utilized as a marker for premalignancy.

Saliva as a prediction tool for dental caries: An in vivo study

INTRODUCTION

The present study was undertaken to assess the caries activity by comparing the pH, buffering capacity, calcium, phosphorous, amylase along with the association of mutans in saliva for caries-free and caries-active children and to find out the interrelationship amongst the two groups.

METHODOLOGY

The study sample of 80 children, aged between 4 and 8 years were included in the study. Caries status of each child was recorded using DMFS. They were divided into two groups: (i) caries-free group (40) and (ii) caries-active group (40). After collecting the salivary samples, mutans were determined using Saliva-Check mutans kit and buffering capacity by Saliva-Check Buffer kit. The remaining samples were sent to laboratory for analyzing pH by electrode pH meter, calcium by OCPC(o-cresolphthalein complexone) photometric method, phosphorous by phosphomolybdate/UV method, amylase by CNP-G3(2chloro-4-nitrophenyl-alpha-maltotrioside) method using semi-autoanalyzer.

RESULTS

The results obtained were tabulated and subjected to statistical analysis. The pH, buffering capacity, calcium and phosphorous level were found to be increased with the decrease in the caries activity of the children whereas amylase activity was increased with the increase in caries activity. It was observed that 77.5% children were tested positive and 22.5% were tested negative for mutans in caries-active group whereas 100% children were tested negative for mutans in caries-free group.

CONCLUSION

The physicochemical properties of saliva, such as pH, buffering capacity, calcium, phosphorous, amylase and Streptococcus mutans has a definite relationship with caries activity.

Platelet Rich Plasma-A Healing Aid and Perfect Enhancement Factor: Review and Case Report

Platelet rich plasma (PRP) has been a breakthrough in the stimulation and acceleration of tissue healing. It represents a relatively new approach in regenerative procedures and is a developing area in pediatric dentistry. It is an autologous source of growth factors obtained by sequestrating and concentrating platelets by gradient density centrifugation. This novel and potentially promising technique enhances body’s natural wound healing mechanism. This article goes on to describe preparation and clinical benefits of PRP in pediatric dentistry.

Elevated serum CCL2 concomitant with a reduced mycobacterium-induced response leads to disease dissemination in leprosy

Mycobacterium leprae and Mycobacterium tuberculosis are successful intracellular pathogens which down regulate host immune responses. T-cell interferon-gamma (IFNgamma) and macrophage tumour necrosis factor-alpha (TNFalpha) activate chemokines such as, C-C chemokine ligand-2 (CCL2) and CCL5, which play a role in granuloma formation. Lepromatous leprosy is characterized by defective granulomas with lowered T-cell- and macrophage-mediated responses. Tuberculosis (TB) can be localized to the lung, whereby discreet granulomas are formed. The role of chemokines in leprosy infections is as yet unclear. We compared chemokine responses in lepromatous leprosy and pulmonary tuberculosis patients. Circulating serum CCL2 was raised while CCL5 was lowered in leprosy, as compared with TB patients and healthy controls. However, both Mycobacterium bovis BCG- (P=0.08) and M. leprae-induced (P=0.05) CCL2 secretion was reduced in leprosy. In leprosy, BCG induced greater CCL2 (P=0.01), TNFalpha (P=0.02) and somewhat greater CCL5 (P=0.08) than M. leprae, while CXCL8 induction was comparable. Overall levels of Mycobacterium-induced CCL2, TNFalpha and CXCL8 were two to threefold lower, and CCL5 was 10-fold lower in leprosy as compared with TB. Reduced inducible CCL2 combined with a lowered TNFalpha response in lepromatous leprosy may contribute to the unrestricted growth and dissemination of mycobacteria found in the disease.

Tapetal changes in beagle dogs following oral administration of CGS 14796C, a potential aromatase inhibitor

CGS 14796C, cis-1-[(4-[(1-imidazolyl)methyl]-cyclohexyl)methyl)imidazole succinate, has been evaluated as a potential aromatase inhibitor. As part of the safety evaluation program, a 3-month oral toxicity study was performed in which beagle dogs were administered CGS 14796C by gavage at 5, 15, or 50 mg/kg/day. Ophthalmoscopically, changes in the tapetum lucidum affecting dogs from the 15 and 50 mg/kg dose levels were diffuse areas of pigmentation varying in appearance from a brownish peppered or mottled to a more uniform brown similar to that of the nontapetal area of the fundus. Tapetal reflectivity was absent or markedly reduced. Within the pigmented area, multiple islets (yellow, green, or orange) of tapetal cells were visible, suggestive of destruction of the tapetum. In no instance was retinal destruction, edema, vascular changes, or detachment observed. Ophthalmoscopic examinations performed during recovery revealed changes of slight increase in tapetal islets, suggestive of a slight progression and organization within the tapetum followed by an arrest of the toxic insult within the tapetal tissue. At light and electron microscopic examination of the ocular tissues, the lesions were tapetal cell degeneration/atrophy. These results demonstrated that the taptetum lucidum was a target tissue of toxicity for CGS 14796C, and indicated that the findings are without toxicological significance in atapetal species, including man, whose globes do not have this structure.

Effects of chronic treatment with captopril (SQ 14,225), an orally active inhibitor of angiotensin I-converting enzyme, in spontaneously hypertensive rats

The effects of hydralazine (3 mg/kg) and the angiotensin I-converting enzyme (ACE) inhibitor captopril (SQ 14,225) (100 mg/kg) on mean arterial blood pressure, plasma renin activity, urinary volume and urinary Na+,K+, and aldosterone concentrations were examined in spontaneously hypertensive rats of the Okamoto and Aoki strain (SHR) after oral daily dosing for 2 weeks, 3 or 6 months. Captopril caused progressive cumulative reductions in blood pressure resulting in normalization of pressure after 6 months of dosing. Hydralazine also significantly reduced blood pressure but not to the level of normotensive rats of the Wistar-Kyoto strain (WKY). Reductions in heart size paralleled the changes in blood pressure, normalization of cardiac hypertrophy occurring after captopril but not hydralazine. Plasma renin activity increased approximately 2-3 fold after hydralazine and 15-fold after captopril. Neither hydralazine nor captopril had any consistent effects on 24-hr urine volume, urinary Na+,K+ or aldosterone excretion. These results indicate that chronic inhibition of ACE with captopril induces normalization of blood pressure in SHR, a normal-renin model of hypertension.