bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the mechanism of commonly occurring COVID-19-associated oral lesions
Authors: Saxena Susmita , Kumar Sanjeev
Published: April 2023

Covid-19 pandemic is a novel disease with gradual emergence of its signs and symptoms. Oral healthcare providers had a setback in their dental practices due to the high rate of infectivity and the risk of contracting the disease through the patients carrying the virus. Once the dental practice resumed to its normalcy the dental surgeons came across a variety of oral manifestations in patients with a history of Covid and post recovery. An attempt is made to recognise the Covid-19 oral manifestations with plausible explanation of the mechanism of development of such oral signs.
Expression of matrix metalloproteinase-9 in histological grades of oral squamous cell carcinoma
Authors: Patil Rekha , Mahajan Aarti , Pradeep G L , Prakash Nilima , Patil Swapnil , Khan Sabiha Mohiddin
Published: April 2023

Context:

Oral squamous cell carcinoma (OSCC) is characterized by a high degree of local invasiveness and metastasis to cervical lymph nodes and distant sites. Degradation of extracellular matrix (ECM) requires the concerted action of several extracellular enzymes, the most prominent of which are matrix metalloproteinases (MMPs). Proteolytic degradation of ECM components by (MMP-9) facilitates carcinoma cell invasion, enhances angiogenesis and tumor progression.

Objective:

To assess and correlate the immunohistochemical expression of MMP-9 with clinicopathological parameters and histological grades of OSCC.

Settings and Design:

Thirty histopathologically diagnosed cases of OSCC including 12 cases of well-differentiated squamous cell carcinoma, 12 cases of moderately differentiated squamous cell carcinoma and 6 cases of poorly differentiated squamous cell carcinoma were included in the study group.

Materials and Methods:

The samples were subjected to staining using monoclonal antibodies against MMP-9 and visualized using the polymer-HRP detection system. Expression of MMP-9 was assessed in tumor epithelium/parenchyma and connective tissue stroma separately, and the mean of both was considered as average MMP-9 expression.

Statistical Analysis:

The parametric independent samples “t” test, one-way ANOVA test and Pearson's correlation test were used for the statistical analysis.

Results:

Immunoexpression of MMP-9 increased with advancing stage and histological grade of OSCC with statistically significant results.

Conclusion:

MMP-9 plays an important role in invasion and metastasis and can serve as an independent prognostic marker.
Immunohistochemical expression of stathmin in oral dysplasia
Authors: Vadla Purnima , Deepthi G , Kumar Chippalapally Arun , Bashamalla Rithika , Syeda Neelam , Naramala Srikanth
Published: April 2023

Background and Objectives:

Stathmin is a phosphoprotein, which in its phosphorylated/unphosphorylated states plays a major role in polymerization/depolymerization of microtubules, respectively. Assembly of microtubules is an important aspect of cell division called mitosis. Hinderance in the function of stathmin could lead to damage in the mitotic process resulting in aneuploidy which is common manifestation of malignancies. Hence, stathmin could be used as a tumor marker for oral dysplasias and cancers. The purpose of the study is to compare the expression of stathmin in normal subjects to the patients with oral leukoplakia and to correlate its expression with different histopathological grades of oral leukoplakia This is the first ever study conducted to examine the expression of stathmin in oral dysplasia.

Methodology:

Thirty histopathologically confirmed cases of oral dysplasia were selected for the study. These tissues were evaluated immunohistochemically for stathmin. To enumerate the stathmin stained cells, 300 cells were examined manually in at least 5 areas and a mean percentage of positive–stained slides were determined. Then, each sample was assigned to one of the following staining scores: (0) – (<10% of stained cells); (1) – (11%–25% of stained cells); (2) – (26%–50% of stained cells); (3) – (51%–75% of stained cells); (4) – (76%–90% of stained cells) and (5) – (91%–100% of stained cells). The results were analyzed statistically using ANNOVA test.

Results:

When comparison was made with respect to staining scores of stathmin between normal and dysplasia groups, the results were found to be statistically significant with a P = 0.0001. A statistically significant difference was observed between various histopathological grades of dysplasia with respect to stathmin immunohistochemistry scores with a P = 0.0001.

Conclusion:

These results suggest stathmin as a tumor marker and prognostic indicator.
Orofacial granulomatosis
Authors: Shetty Nisha , Subramanyam R Venkata , Srikanth Gadicherla , Solomon Monica Charlotte
Published: April 2023

Orofacial granulomatosis (OFG) is an uncommon chronic inflammatory disorder with multifactorial etiology and pathogenesis affecting the orofacial region which appears usually as a persistent and/or recurrent swelling that may involve one or both the lips and/or recurrent ulcers along with other orofacial features. The diagnosis of OFG is challenging and it should be ruled out from other conditions characterized by granulomatous inflammation. This article describes a case of a 30-year-old female patient with upper lip swelling as the main manifestation without any systemic involvement and we have also laid down a proposal of a diagnostic algorithm for differential diagnoses and treatment modalities for OFG which could be helpful for the clinician and dentists alike to rule out other granulomatous disorders thus in effective management of OFG.
A systematic review on the guidelines for nutritional assessment for head and neck cancer patients managed by surgery
Authors: Muralidharan Shrikanth , Acharya Arunkumar , Mallaiah Pramila , Babu B Anil
Published: April 2023

There are a number of guidelines to assess the nutrition status of cancer cases. None of these guidelines are specifically head and neck cancer related; except for the European guidelines. This article reviews the different guidelines in nutrition for cancer cases and also their drawbacks.
Imaging of Gorlin-Goltz syndrome
Authors: Rafiq Suhail , Manzoor Farzana , Dar Musaib Ahmad , Aslam Rassieq
Published: April 2023

Gorlin–Goltz syndrome (GGS) is a rare autosomal dominant disorder with multisystemic involvement. It is characterized by the triad of multiple baso-cellular epitheliomas, odontogenic keratocysts (OKC) in the jaws and skeletal anomalies. Later, it was found that calcification of falx is also highly specific. We present radiological findings in case series of two cases, one with multiple OKC, calcified falx, skin lesions, and fibrous dysplasia of sphenoid and second with multiple OKC, calcified falx, vertebral anomaly and medulloblastoma.
Osteosarcoma
Authors: Manchanda Adesh S , Narang Ramandeep Singh , Mahajan Sanah
Published: April 2023

Osteosarcoma (OS) comprises 2.1% of all malignant oral and maxillofacial tumors. OS arising from the jaw OS differs from OS of the long bones in its biological behavior, presenting a lower incidence of metastasis and a better prognosis. The morphologic and behavioral heterogeneity observed in OS and the perplexity of the varied histological features mimicking other primary and metastatic bone tumors has emphasized the need of advanced molecular techniques in its diagnosis. Hereby, we present a case of OS which was diagnosed by immunohistochemical analysis, aiding in establishing its histogenetic origin.
The present and future status of oral and maxillofacial pathology in Iran: A multicenter study
Authors: Tabatabaei Seyed Hosein , Razavi Seyed Mohammad , Saghravanian Nasrollah , Sadri Donia , Aminishakib Pouyan , Mahdavi Nazanin , Keshmiri Fatemeh , Shamloo Nafiseh
Published: April 2023

Background:

At present, the status of oral and maxillofacial pathology (OMFP) in the country is not properly good. This study aimed to investigate the current status and develop practical approaches to improve occupational condition of the specialty in the future from the viewpoint of the beneficiaries.

Materials and Methods:

This was a descriptive cross-sectional study. The participants were oral and maxillofacial pathologists of the country (200 individuals), OMFP residents (9 individuals), and final year dental students at six dentistry school of the country at 2020 (200 individuals) through multicenter design. At the first phase, the related questionnaires were developed and assessed psychometrically. Reliability of the questionnaires, internal consistency, and repeatability were computed and confirmed. At the second phase, the survey questionnaires on the current and future condition were sent electronically to the study groups. The data were analyzed using descriptive statistical tests (mean, standard deviation, percentage) and the Pearson test using SPSS.

Results:

At the first phase, after primary design of the study too, 23 variables with content validity ratio below 0.56 and content validity index (CVI) below 0.79 were omitted. The questionnaire for the specialists was confirmed with Cronbach's alpha of 0.75 and intraclass correlation coefficient (ICC) as 0.83, and the questionnaire for the students and the residents were confirmed with Cronbach's alpha of 0.95 and ICC of 0.80. Results of the second phase showed that score of tendency of students to select OMFP specialty to continue education was 1.58 ± 0.57 from 5. Satisfaction score of specialists on specialized activity of this specialty is 2.7 ± 1.52 from 5. The most important reason for the students to select this specialty was “interest in being faculty member,” and the “difficulty of the specialty” was the most probable reason for not selecting this specialty. The most important priority of the residents was “interest in specialty” and for the specialists was “being faculty member.” The most important reason to change attitude regarding the specialty by the specialists was mentioned as “high occupational and profession responsibility as well as low income” with the score of 1.38 ± 3.99. “Fundamental revision in the educational curriculum of the specialty” with a score of 4.60 ± 0.93 from 5 was considered as the most important revisionary approach from the viewpoint of specialists.

Conclusion:

At present, the main problem regarding the OMPF specialty in the country is “high number of graduates and lack of the present occupational opportunities.” Evaluation and validation of the relevant specialized departments, producing occupational opportunities, and fundamental revision in the educational curriculum to train well-powered specialists are necessary.
The effect of micro-osteoperforation on root resorption, pulp vitality, and biological changes of teeth subjected to orthodontic tooth movement: A systematic review study
Authors: Mosayebi Neda , Khademi Abbasali , Bagherieh Shervin , Abedi Niloufar , Kargarfard Mina , Tajmiri Golnaz , Kouhi Monireh
Published: April 2023

Background:

These days minimally invasive micro-osteoperforation (MOPs) has accelerated orthodontic tooth movement (OTM). However, there are some conflicting reports about their various impacts; hence, the present systematic review study aimed to evaluate the effect of MOP on root resorption, pulp vitality, and the biological changes of teeth subjected to OTM.

Materials and Methods:

Search in electronic databases of English literature including PubMed, Scopus, Web of sciences, Cochrane, and Google scholar as well as a manual search was performed from 2013 to 2022. Most of the studies included in this article were randomized controlled trials.

Results:

From the total number of 321 found articles, 31 duplicated and 268 irrelevant articles were excluded regarding the defined inclusion and exclusion criteria. Consequently, 22 articles were subjected to the quality assessment process, and finally, 18 articles were selected for the review phase. Root resorption during tooth movement using the MOP approach was reported only in one study. Besides, except for two animal studies, all of the relevant included articles showed that MOPs significantly increased the expression of some inflammatory biomarkers known to recruit osteoclast precursors and increase the number of osteoclast cells. On the other hand, two animal studies showed no differences in osteoclast counts by using MOPs in comparison to their control groups, which was consequently the result of biologic variability between animal and human and also probably the small sample sizes of these two studies.

Conclusion:

In this systematic review, according to the adverse effects of MOP on root resorption, one study showed higher levels of root resorption among patients undergoing MOP. However, this outcome was due to the different methods used to evaluate the effect of MOPs on root resorption. Moreover, a high certainty of evidence supports that MOP causes biological changes and an elevation in cytokines, chemokines, and other biomarkers that stimulates osteoclasts differentiation which in turn accelerate OTM. There was no change in pulp vitality status based on available evidence.
Negotiability of mesiobuccal canals in maxillary first molars using different path file systems
Authors: Gharechahi Maryam , Khajehpour Mandana , Hamedi Ali , Peighoun Maryam
Published: April 2023

Background:

In endodontics, glide path creation has been extensively considered a mandatory clinical step to improve the safety and efficiency of rotary nickel–titanium instruments. The high anatomic variations in the mesiobuccal (MB) root of the maxillary molars are observed in the form of canal configuration, number, and position. The aim of this study was to evaluate the negotiability of MB canals in maxillary molars using different pathfiling systems (ProGlider, R-pilot, HyFlex electrical discharge machining [EDM], WaveOne Gold Glider, and C-Pilot).

Materials and Methods:

This in vitro study included 125 maxillary first molars with closed apex. Before preparation, all teeth were scanned by periapical radiograph for review of the presence of second MB (MB2) canals, without any resorption or calcification, and moderate curve of MB root canal. Subsequently, the access cavity was prepared with a Diamond Fissure Bur. Then, the samples were divided into five groups (ProGlider, R-pilot, HyFlex EDM, WaveOne Gold Glider, and C-Pilot). Certain relevant indices were recorded for analysis, such as the negotiability of the glide path file in the MB canals, file fracture rate, and negotiation speed. The level of significance P value was set at 0.05.

Results:

In this study, HyFlex EDM was the only path file that could not reach the full working length (WL) in some cases. The highest frequency of file fracture in the MB2 was observed with HyFlex EDM (24%); nevertheless, R-Pilot presented an intermediate fracture rate (16%), and both ProGlider and WaveOne Gold Glider were the safest files (4%) in this regard. However, there were no significant differences between the groups (P = 0.065). The lowest and the highest average time of reaching full WL was observed with WaveOne Gold Glider and HyFlex EDM; nonetheless, there was no significant difference between the four rotary groups. The average number of pecks in HyFlex EDM was significantly higher in comparison to those reported for WaveOne Gold Glider and ProGlider.

Conclusion:

Path files used for glide path preparation in the MB2 canals of maxillary molars should be flexible with low taper. The use of HyFlex EDM in the MB2 canals is not recommended due to its high taper.
Response of stem cells derived from human exfoliated deciduous teeth to Bio-C Repair and Mineral Trioxide Aggregate Repair HP: Cytotoxicity and gene expression assessment
Authors: Maru Viral , Madkaikar Manisha , Gada Ashita , Pakhmode Vivek , Padawe Dimple , Bapat Salil
Published: April 2023

Background:

The aim of this study was to investigate and compare the cytotoxicity and gene expression of Bio-C Repair, Mineral Trioxide Aggregate (MTA) HP Repair, and Biodentine on stem cells derived from exfoliated deciduous teeth.

Materials and Methods:

In this in vitro study MTT assay was used to assess the cellular viability at three different dilutions. The gene expression of Runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), osteocalcin [OCN], and dentin matrix protein-1 (DMP-1) was measured with real-time polymerase chain reaction after 7 days, 14 days, and 21 days of incubation. One-way analysis of variance and Bonferroni posttest were used for statistical analysis (p=o.o5).

Results:

After 72 h of incubation at dilution 1:4, stem cells derived from human exfoliated deciduous teeth (SHEDs) cultivated in Biodentine, followed by Bio-C Repair and MTA Repair HP reported with highest cellular viability. The highest mRNA expression of Runx2, ALP, OCN, and DMP-1 was reported in SHEDs cultured in Biodentine (after 21 days of incubation).

Conclusion:

Bio-C Repair and MTA HP Repair are biocompatible and capable of odontogenic differentiation similar to Biodentine when cultured in stem cells derived from exfoliated primary teeth.
Thrombosis of the internal jugular vein, a rare entity
Authors: Esteban-Zubero Eduardo , García-Muro Cristina , Alatorre-Jiménez Moisés Alejandro , López-García Carlos Arturo , Marín-Medina Alejandro
Published: April 2023

Rationale:

Thrombosis of the internal jugular vein is an infrequent and underdiagnosed pathology due to the absence of symptoms. If present, the symptoms are frequently manifested as a sensation of pain and cervical tension. Its etiology is variable, including trauma, central catheterization, and hypercoagulable states, among others.

Patient’s Concern:

A 41-year-old female, previously healthy, was admitted to the emergency room for worsening pain in the left cervical area of 5 d. Previously, she was treated for suspected acute pharyngotonsillitis yet without improvement.

Diagnosis:

Physical examination revealed a 2 cm in length cervical mass of hard consistency that was painful on palpation and non-fluctuating. Ultrasound study showed thrombosis of the left internal jugular vein. A computed tomography scan revealed that the thrombosis occurred at the cervical portion of the left internal jugular vein as well as the left transverse sinus.

Interventions:

Hospital admission and treatment with low molecular weight heparin at a dose of 1.5 mg/kg every 24 h.

Outcomes:

The patient was discharged after 3 d of treatment with vitamin K antagonists.

Lessons:

Venous thrombosis at the level of the internal jugular vein is an infrequent entity. Clinical suspicion is necessary for the diagnosis given the possibility of absence of symptoms.
Recent public health concerns of the high-altitude tribal population of Lahaul and Spiti, Himachal Pradesh
Authors: Mishra Tanuja , Goswami Shweta , Deval Hirawati , Vaid Ranjit , Kant Rajni
Published: April 2023

ABSTRACT

Objective:

India has a tribal population of 8.6%. Health concerns of the high-altitude tribal population in India play a vital role in overall socio-economic development and health transformation of the country. Therefore, the aim of this study was to determine the current health problems among the tribal population of Lahaul and Spiti district of Himachal Pradesh.

Material and Methods:

The study area encompasses one regional hospital (RH) in Keylong (the district headquarters), three community health centers (CHCs), and 16 primary health care centers (PHCs). In addition, the district has 37 sub-centers (SCs) and 21 Ayurveda dispensaries to serve the district. The data for this study were gathered over a 4-year period from records of daily out-patient department registration from the various health centers (RH, CHCs, and PHCs) from 2017 to 2020.

Results:

In terms of communicable diseases, the population in the concerned region was more likely to have acute respiratory infection, enteric fever, tuberculosis, and typhoid. Hypertension, asthma, bronchitis, and diabetes mellitus type II were determined to be the most common non-communicable diseases.

Conclusion:

Acute respiratory disease, hypertension, diarrhea, accidental injuries, and eye problems were shown to be prevalent in the study area. The population’s position in relation to these five diseases indicates the community’s sensitivity to a variety of common conditions. There is a need to review the needs and priorities of the concerned population and create goals and targets to meet those needs using validated public health measures.
Outcome prediction using sequential organ failure assessment (SOFA) score and serum lactate levels in organophosphate poisoning
Authors: Balmuchu Govinda , Mohanty Manoj K. , Sahu Manas R. , Hansda Upendra , Naveen Alagarasan , Lenka Preetam K.
Published: April 2023

ABSTRACT

Background:

Organophosphorus compounds are widely used as pesticides in agriculture practicing countries like India. Since it is readily available and accessible, it is one of the most commonly used agents for suicidal poisoning. The current study was undertaken to evaluate the performance of the SOFA score (scoring system) and the serum lactate level (laboratory parameter) as a mortality predictor in organophosphorus poisoning.

Material and Methods:

This prospective observational study was conducted at AIIMS, Bhubaneswar, for 17 months. The study population included all patients with an alleged history of ingestion of organophosphorus (OP) compounds reporting to the casualty. The receiver operating characteristic (ROC) curve and the logistic regression analysis were used for the analysis.

Results:

In our study, 75 patients with OP poisoning were studied after satisfying the inclusion criteria. OP poisoning was commonly seen in married males aged 21–40 years. Twelve (16%) patients died during the process of treatment. There was a statistically significant difference in the mean SOFA score, serum lactate level, pH value, and mean duration of hospital stay between the discharged and the deceased patients. In the current study, the ROC curve analysis used to assess the predictor of the outcome of OP poisoning showed that the area under the curve for SOFA score and serum lactate level were 0.794 (95% CI 0.641–0.948) and 0.659 (95% CI 0.472–0.847), respectively.

Conclusion:

Sequential Organ Failure Assessment (SOFA) score is significantly associated with the outcome of organophosphate poisoning and can be utilized to predict mortality.
Carcinoma vulva: Ten years experience in a teaching institution of North India
Authors: Goyal Lajya Devi , Kaur Balpreet , Bhalla Shivali , Garg Pardeep
Published: April 2023

ABSTRACT

Introduction:

Vulvar carcinoma is primarily a disease of post-menopausal women. Surgery is a primary treatment strategy. Chemotherapy and radiotherapy are a part of multimodal therapy. Presently, there is a shift towards neoadjuvant chemotherapy or radiotherapy so as to decrease the surgical morbidities.

Objective:

To study the surgical outcome and prognostic factors in Ca vulva patients.

Methodology:

A retrospective analysis of 19 vulvar cancer patients, surgically treated at a teaching institution of Punjab (2009–2019).

Results:

Mean age of the patients was 60.95 years. Ulcerative swelling (89.5%) over labia majora (73.7%) was the main presenting symptom. Radical vulvectomy-bilateral IFLN dissection was performed in 74% patients, hemivulvectomy-unilateral IFLN dissection in 21% patients and wide local excision in one patient. Squamous cell carcinoma was detected in all, and one had verrucous carcinoma. Thirty-seven per cent patients had FIGO stage III disease, 31.5% - stage II and 31.5% - stage I. On HPE, 78.57% (11/14) patients had positive nodes and two had ECS. Only 5/9 (55.5%) cases could receive PORT. Seven patients defaulted follow-up. Two developed nodal metastasis, and seven women developed recurrence. One patient with regional recurrence faced demise during RT course. In 10/19 regular follow-up patients, four are alive and disease free, five patients are on palliative chemoradiation, and one is undergoing adjuvant radiotherapy for regional recurrence. Estimated 5-year overall survival is 83.33%.

Conclusion:

Tumour stage, nodal positivity and nodal ECS were poor prognostic factors. Radical surgery-extensive groin node dissection causes significant morbidity; hence, studies evaluating the role of neoadjuvant treatment are needed so as to modify current treatment practices. HPV vaccination as a preventive measure and a thorough and extensive evaluation of patients with suspicious signs in vulvar disease is needed.
Perception Towards Newborn Screening
Authors: Amalakanti Sridhar , Raman Arepalli Kesava Venkata , Suvvari Tarun Kumar , Jillella Jyothi Priya
Published: April 2023

Background:

Newborn screening (NBS) to identify various disorders has been running successfully across the world. But the public in many developing countries do not have access to this program.

Aims:

To assess the awareness of NBS in patients and clinicians. Patients and

Methods:

We assessed the awareness of NBS by oral questionnaire.

Results:

We found that, in the community the awareness regarding NBS was low [47.2%] and the knowledge of the availability of the test was less both in the community [65%] and amongst clinicians [11/28]. But all the subjects opined that the tests will have a high rate of acceptance if they are offered free of cost.

Conclusions:

The awareness regarding NBS is low but has potential for acceptance.
Gene Therapy and Its Applications
Authors: Bansal Alka , Prakash Ravi , Agarwal Swati , Advani Uma
Published: April 2023

Gene therapy is the treatment of abnormal or mutated genes present in cells through the addition of healthy genes or replacement/deletion/site-specific modification of faulty genes. Deoxyribonucleic acid, messenger ribonucleic acid (RNA), small interference RNA, microsomal RNA and antisense oligonucleotides are the genetic materials implicated in gene therapy. They are inserted into the diseased cells using viral or non-viral vectors through an in vivo or ex vivo transduction. Gamma retrovirus, lentivirus, herpesvirus, adenovirus and adeno-associated virus are common viral vectors, while transposons, cationic polymers, dendrimers and cell-penetrating peptides or liposomes are common non-viral vectors. Allologous or autologous T cells, haematopoietic stem cells and chimeric antigen receptor T cells are used for ex vivo gene transduction. Conventional gene therapy of inserting new genetic material shows toxicity such as off-target effects, altered immune responses, inflammatory reactions and possible oncogenic transformation in the recipient. Newer gene editing techniques such as zinc-finger nuclease, transcription activator-like effector nucleases and clustered regularly interspaced short palindromic repeats allow the site-specific correction or control of expression of mutated genes present in cells. Until August 2020, 23 gene-based medicines received approval from drug regulatory agencies in various countries and 362 were in development. Single-gene disorders have shown encouraging results, but evidence of using gene therapy in polygenic and common age-related diseases is still required. Recently, the horizon of gene therapy widened to include COVID vaccines and as an adjunct to chemotherapy. If we could overcome its limitations such as immunogenicity, mutagenicity and high costs, gene therapy can be the medicine of the next generation.
Leaving no stone unturned
Authors: James Amritha , Jayan Lekshmy , Ramadoss Ramya , Arunachalam Preethi
Published: April 2023

Introduction:

Understanding the molecular pathogenesis of an entity helps in devising the mode of progression as well as mode of therapy. Even with years of research to claim the understanding of the molecular pathogenesis of oral submucous fibrosis (OSMF) is limited. More deeper knowledge of the genes responsible for this will help in understanding and managing this disease better.

Materials and Methods:

The articles published during a time period of 1990–2020 were chosen in accordance with the inclusion and exclusion criteria according to the PRISMA guidelines.

Results:

From a total of 80 articles obtained from both electronic search of PUBMED, EMBASE, MEDLINE and Cochrane registry as well as the manual search only 21 articles were selected and analyzed.

Conclusion:

Careful analysis of the samples revealed that transforming growth factor-beta may be a potential biomarker or a candidate for targeted therapy in OSMF.
Digital microscopy
Authors: Sreeshyla Huchanahalli Sheshanna , Usha Hegde , Nitin Priyanka , Sowmya SV , Augustine Dominic , Haragannavar Vanishri C
Published: April 2023

The COVID-19 pandemic has brought out lot of changes among the way people and organisations function. It has also reduced social gatherings and hence social relations considerably, forcing people to adjust to new ways of work and life. An outstanding difference between the current COVID-19 pandemic and previous epidemics or pandemics is the increased availability and use of technology currently, which has been validated by various reports from across the globe. Thus, even with the ensuing pandemic, lockdown and decreased social gatherings, with the technology support we have devised ways to keep in contact with friends, family and work place, so as to continue our lives. Social distancing guidelines and regulations have put pressure on a great many organisations to find new ways of keeping employees and students connected while working remotely. For more deskbound occupations and roles, this can be relatively straightforward, but it is challenging if not impossible for lab-based quality control, research and study. The answer to this is digital remote microscopy which enables sharing of data online, carrying out collaborative work through multi-viewing in real time and facilitates remote training functions.
Giant Osteochondroma of the mandibular condyle and temporomandibular joint - A case report
Authors: Mahajan Amit , Patil Deepa J. , Shah Vandana , Mulay Mrudula
Published: April 2023

Osteochondroma is one of the common bone tumours but is rarely seen in the head and neck region. Osteochondroma of the mandibular condyle, extending to the temporomandibular joint (TMJ) is an infrequent occurrence. Patients commonly present with restricted mouth opening and malocclusion. Due to the significant overlap in features between chondromas and condylar hyperplasia, it is very likely to be misdiagnosed, resulting in treatment errors. In this report, an interesting case of a large osteochondroma of the mandibular condyle extending into the zygomatic and petrous part of the temporal bone involving the left TMJ in a 35-year-old female patient is described who presented with facial asymmetry and restricted mouth opening. This paper outlines the clinico-radiographic and histopathological features for diagnosis and appropriate treatment of osteochondroma.
Lipid profile in oral potentially malignant disorders and oral squamous cell carcinoma – A prognostic view
Authors: Sai Surapaneni K , Babburi Suresh , Deepthi G , K. Nandan S. R. K. , Reddy Shyam P. , Adusumilli Praveena
Published: April 2023

Introduction:

Lipids play an important role in the maintenance of cell integrity. Various tobacco-associated products are known to induce the generation of free radicals and reactive oxygen species, responsible for the high rate of oxidation/peroxidation of polyunsaturated fatty acids. These further release peroxide radicals, causing increased utilization of lipids leading to hypolipidemia.

Aim:

The aim of this study was to evaluate and compare the lipid profile pattern of patients with oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) with healthy controls.

Material and Methods:

The study included 90 subjects with 30 OPMDs, 30 OSCC and 30 healthy controls. Fasting blood samples were collected from subjects and were analysed for serum lipids, including the following: i) Total cholesterol (TC) ii) High-density lipoproteins (HDL) iii) Low-density lipoproteins (LDL) iv) Very low-density lipoproteins (VLDL) v) Triglycerides (TG) vi) CHO/HDL ratio by using semi auto analyser.

Statistical Analysis Used:

The statistical tests used were the independent t-test, ANOVA test. A P value of <0.05 and <0.01 was considered statistically significant.

Results:

A statistically significant decrease in serum TC, LDL and CHO/HDL ratio was observed among OPMD and OSCC groups than controls, whereas a significant decrease in serum VLDL and TG (p value <0.01) in poorly differentiated OSCC was seen.

Conclusion:

The study shows an association between lipid variations and OPMD and OSCC. Low levels of lipids could be due to the rapidly dividing cells in premalignancies and malignancies utilizing them for new membrane biogenesis. Thus, lower lipid status may be a useful indicator for initial changes happening in neoplastic cells.
Epidemiologic and histopathological evaluation of unclassified gingival papules in Urmia, Iran
Authors: Khashabi Ehsan , Taram Saman , Saatloo Maedeh Vakili , Farjah Gholam Hossein , Sharifi Parisa , Gobaran Zahra Mirzaei
Published: April 2023

Objectives:

Unclassified gingival papules might be mistaken with other malignant lesions as they resemble some other oral lesions. The present study demonstrates epidemiologic and histopathological characteristics of the gingival unclassified papules in the patients referred to Urmia Dental School, Iran.

Materials and Methods:

A cross sectional descriptive study design was conducted among 500 pateints in Urmai university of medical sciences, Iran. The participant's demographic data and medical history were obtained using clinical examinations and a questionnaire. Histopathological assessments were done in two specimens. The effect of the possible factors on the incidence of gingival papules was statistically assessed by Fisher's exact test.

Results:

Among 500 participants, 340 (68%) demonstrated unclassified gingival papules (40.9% males, 59.1% females; mean age of 34.9 years). No significant differences were found regarding the effect of gender, smoking, mouth breathing, history of skin disease or pregnancy on the incidence of gingival papules. However, the breastfeeding females (P < 0.004) or those using contraceptive pills (P < 0.02) showed lower frequency of papules' incidence. Among 340 papules, 332 (97.6%) were white in color, 337 (99.1%) were well defined and 331 (97.3%) were observed in the keratinized gingiva. 207 (60.9%) were multiple and 133 (39.1%) were single lesions. The papules showed healthy tissues similar to gingival tissue; however, abundant collagen bundles were irregular and close to the surface, which was covering by stratified squamous epithelium.

Conclusion:

Gingival papules are common findings in patients referring to Urmia Dental School; the lesions were almost white in color, well defined and appeared in the keratinized gingiva. The lesions were a variation of normal oral structures with no treatment requirements.
Evaluation of total glutathione-s-transferase levels in serum of patients with oral malignancy
Authors: Shaikh Firdous , Sodhi Sonia Kaur , Farooqui Aamena , Kale Lata , Shaikh Nida
Published: April 2023

Introduction:

Squamous cell carcinoma-related antigen is not always sensitive enough for the early detection of oral cancer which is why a new marker has been desired as a substitute to be applied for serum diagnosis of oral cancer. Reactive oxygen species (ROS) has been known to play an important role in carcinogenesis. Glutathione-s-transferases (GSTs) are a family of eukaryotic and prokaryotic phase-II metabolic isoenzymes involved in xenobiotic detoxification. This correlation of the ROS species function and their role in initiation and progression of cancer could be exploited as of diagnostic value. The biologic function of the GSTs in human head-and-neck squamous cell carcinomas has been studied by researchers at gross as well as molecular levels. Taking into consideration this scientific background, future scope and perspectives, we initiated this study.

Materials and Methods:

This study was performed as a prospective case–control in vitro analytical study with subjects (n = 40) fulfilling the prerequisite conditions and were compliant. The case group (n = 20) was subjects with histopathologically proven cases of oral malignancy and age- and sex-matched control group (n = 20). The enzyme GST was evaluated in sera of all participants and then comparison was done between two groups as well as correlation with histopathologic grading for oral malignancy.

Results:

The mean serum GST activity in oral cancer patients was significantly higher than that of the control group. The present study has compared the alterations of enzyme in relation to histopathological grading of oral malignancy and found increased serum GST activity of well-differentiated and moderately differentiated carcinomas than the poorly differentiated carcinoma in terms of mean.

Conclusion:

Increased expression of the enzyme, as reported in the present study, can be due to tumor burden which attributes to overproduction of GST by cancer cells. The major clinical significance of the present study is that it gives important information regarding a new tumor progression and prognosis marker.
Rapid economical acetic acid Papanicolaou staining procedure versus conventional staining procedure in normal oral mucosa
Authors: Panneerselvam Karthika , Karthik. K Raghavendhar , Ramadoss Ramya , Kumar A. Ramesh , Rajkumar K.
Published: April 2023

Background:

Papanicolaou (Pap) staining technique is a conventional technique used in cytology but it is time consuming.

Aim:

The aim of the study was to determine the efficacy of Rapid Economical Acetic acid Papanicolaou stain (REAP) over conventional staining technique in studying normal oral mucosa.

Materials and Methods:

Eighty patients were selected and were grouped based on their habits. Two smears were obtained from each patient and were subjected to both the staining techniques. A total of 160 slides were studied for features such as cellular outline, nuclear outline, nuclear details, cellular differentiation, micronuclei and cellular transparency.

Results:

The conventional staining procedure showed 79 cases of optimal cellular staining, 78 cases of optimal nuclear staining, 35 cases of optimal nuclear details, 57 cases of optimal differentiation and 27 cases of optimal transparency and 33 cases of optimal micronuclei. REAP staining showed 75 cases of optimal cellular staining, 64 cases of optimal nuclear staining, 20 cases of optimal nuclear details, 36 cases of optimal differentiation and 28 cases of optimal transparency and 25 cases of optimal micronuclei.

Conclusion:

REAP staining effectively reduces the time and the cost factor, but the cytological details are well observed under conventional staining technique in normal patients.
Infiltrating lipomatosis, an etiology for TMJ ankylosis?
Authors: Melethil Alakananda , Menon Suresh , Sham M. E. , Kumar Veerendra
Published: April 2023

Infiltrating lipomatosis is a rare benign condition causing diffuse fatty infiltration into the surrounding soft tissue and in rare cases causes hyperplasia of the adjacent bone. We report a case with clinical and radiological evidence of a 34-year-old female patient who reported a swelling in the left middle third of the face with exophytic temporomandibular joint (TMJ) ankylosis of the left side resulting in restricted mouth opening and facial asymmetry since 21 years. The number of cases reported in the literature is rare. Surgery is the treatment of choice.
Assessment of epidermal growth factor receptor in histological, clinical and pathological staging of oral squamous cell carcinoma
Authors: Umarani Priyanka Jagadish , Rudresh K B , Smitha T , Rajaram Prashanth
Published: April 2023

Background:

Oral squamous cell carcinoma is an invasive epithelial neoplasm with varying degrees of squamous differentiation that arises from the following anatomic sites: the oral cavity, particularly oral soft tissues including the gingival and alveolar mucosa, floor of the mouth, tongue, soft and hard palate, tonsils and oropharynx. In normal epithelium EGFR is localized to basal cell layer, while its expression beyond basal localization in cancerous tissue suggest that correlation of EGFR and tumor progression might exist. The present study aimed to assess epidermal growth factor receptor in histological, clinical and pathological staging of oral squamous cell carcinoma.

Materials and Methods:

The current study was performed on subject with confirmed histological diagnosis of oral squamous cell carcinoma of age group between 35 and 70 years reported to Kempe-Gowda Institute of Medical Science and Hospital, Department of Oral and Maxillofacial Surgery, Vokkaligara Sangha Dental College and Hospital Bangalore and KIDWAI Memorial Institute of Oncology, Bangalore between December 2019 and March 2021. Total of 30 subjects included in the study of age group between 35 and 70 years. In the selected subject for the study, tumor was resected and preserved in 10% formalin, which was sent to department of pathology for analysis and PTNM was recorded. Immunohistochemical evaluation of EGFR was done. Total score of EGFR of each subject was co-related with pathological prognostic factor.

Results:

Correlation of EGFR with adjuvant therapy and histological grading, P values were 0.001 and 0.005, respectively. The obtained results were tabulated statistically using Chi square test and significance was set at P < 0.05.

Conclusion:

A preventive approach and assessment of EGFR in early stage of SCC provide better results. Subjects with higher EGFR value have poor prognosis and have to undergo postsurgical adjuvant therapy for long term-survival.
Expression of S100A7 in oral potentially malignant disorders
Authors: Das Pushpanjali , Deshmukh Revati
Published: April 2023

Context:

Oral potentially malignant disorders (OPMDs) are a group of heterogeneous lesions with an increased risk of malignancy. S100A7 expression serves as a biomarker to identify the dysplastic lesion.

Aims:

To study the status of S100A7 antigen in healthy oral mucosa and OPMDs.

Settings:

Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune.

Design:

S100A7 antigen in healthy oral mucosa and OPMDs.

Methods:

Biopsies were collected of clinically diagnosed OPMDs as well as of healthy oral mucosa and analysed for the malignancy potential.

Material:

Polyclonal rabbit S100A7 25 μl, BioGenex detection system, hydrogen peroxide, non-streptavidin biotin-HRP, wash buffer, DAB chromogen, TRIS buffer, Harris haematoxylin and eosin.

Statistical Analysis Used:

Data analysis was performed using Statistical Package for Social Sciences Version 27.0. Qualitative data variables expressed were analysed using frequency and percentage. Quantitative data variables were expressed using mean and standard deviation. The Chi-square test was used to compare the grade of intensity, where P value <0.05 was considered significant.

Results:

Healthy oral mucosa did not reveal any immunopositivity. Oral leukoplakia showed some focal expression till middle middle third of epithelium. Oral erythroplakia was found with maximum expression while submucous fibrosis showed increased intense staining in six cases.

Conclusions:

S100A7 antigen showed significant immune expression in OPMDs and may be used as a marker for early diagnosis and precision therapy.
Expression of tyrosinase gene in gingiva
Authors: Sanadi Rizwan M. , Deshmukh Revati S.
Published: April 2023

Background:

Melanin is the predominant pigment responsible for the color of skin, hair, iris of eyes, and oral mucosa. Tyrosinase (TYR) is the key enzyme involved in melanin synthesis. Studies in dermatology have shown a positive correlation between TYR enzyme levels and melanin pigmentation of the skin. However, no study has been conducted to assess TYR levels in the gingiva. Hence the present study was conducted to assess TYR levels in gingival melanin hyperpigmentation.

Aim:

To assess the TYR gene expression in gingiva in individuals with moderate to severe gingival melanin hyperpigmentation.

Methodology:

Subjects with a chief complaint of blackish appearance of gums with an unesthetic smile were included in the study. Informed consent was obtained. Scaling and root planning were done and subjects were recalled after 2 weeks. The gingival depigmentation procedure was performed using the conventional scalpel technique under adequate local anesthesia. The selected sites underwent conventional gingival depigmentation technique using Bard-Parker handle no: 3 and blade no: 11. The excised layer of epithelium along with a thin layer of underlying connective was sent to the laboratory to assess the TYR gene expression by real-time polymerase chain reaction technique.

Results:

The levels of the TYR enzyme activity in the gingival tissues from the selected sites were assessed. Table 1 and Graph 1 show the levels of TYR enzyme gene expression in the gingival tissue.

Conclusion:

TYR gene expression and the degree of gingival melanin hyperpigmentation are positively correlated. Hence the assessment of TYR enzyme activity in gingiva could be of great value in today's cosmetologically conscious individuals.
Evaluation of e-cadherin and vimentin expression for different grades of oral epithelial dysplasia and oral squamous cell carcinoma – An immunohistochemical study
Authors: Puneeta Nagiredla , Santosh Tummidi , Mishra Isha , Gaikwad Pravin , Sahu Anshuta
Published: April 2023

Background:

Oral cancer is the 11thcommon cancer in the world and ranks 6thglobally in deaths. The incidence of oral cancer in India accounts for approximately 30%–40% of all cancers.

Aims and Objective:

The present study was undertaken to evaluate the expression of Vimentin and E-cadherin in different grades of oral epithelial dysplasias (OEDs) and oral squamous cell carcinoma (OSCC).

Materials and Methods:

Biopsies/blocks of oral cavity lesions were retrieved from the archives of the department. Normal oral mucosa (5 cases), oral epithelial dysplastic (60 cases) and different grades of OSCC (60 cases) evaluated by hematoxylin and eosin sections. Immunohistochemical analysis was done on the blocks and expression of E-cadherin and Vimentin was recorded.

Results:

Our study included various grades of OED, OSCC and normal mucosa as control cases. The mean age of OED and OSCC was 49 and 56 years, respectively, with male predominance. Tobacco habit was present in approximately 90% cases, and buccal mucosa was the most commonly involved site in oral cavity with whitish patch and ulceroproliferative lesions being the common clinical presentations respectively. In OED, downregulation and altered localization of e-cadherin (81.6%) and increased expression of vimentin (52.3%) along with their concurrent increase in the stroma represent epithelial mesenchymal transition. In OSCC, reduction in expression (<50%) for e-cadherin (56.6%) with altered localization for e-cadherin was seen in 88.3% of OSCC along with neoexpression of vimentin in the epithelial cells was seen in 68.3% suggestive of mesenchymal phenotypic modification (P= 0.05).

Conclusion:

It is very crucial to evaluate the invasiveness of dysplasia and tumor with specific molecular biomarker that may help in early prediction of malignancy and also guide in deciding best treatment strategy for established cases of malignancy.