Stromal response in different histological grades of oral squamous cell carcinoma: A histochemical study.

Objectives: The aim of the study is to evaluate the connective tissue changes in different grades of Oral Squamous Cell Carcinoma (OSCC's) and the influence of these changes in predicting the biological behavior of these tumors. Materials and Methods: A total of 39 cases of OSCC's and 6 sections of controls were examined using seven connective tissue special histochemical stains. Results: Staining intensity of collagen, reticulin, acid mucins, fibrin, glycoproteins, sulfated mucins, elastic fibers around the tumor islands and within the connective tissue was observed. Conclusions: Tumor cells which grow progressively in the host stroma have the capacity to pre-empt and subvert the response of host, which is essential for their growth and spread. Clinical Relevance: The reactive changes in the tumor stroma may alter the biological aggressiveness of oral cancer, and by incorporating this concept into a prognostic system, we may help to reflect the biologic diversity of oral cancer and predict its clinical outcomes.

Bisphosphonate-associated osteonecrosis of the jaws.

Bisphosphonates constitute a group of drugs capable of modulating bone turnover and reduce its remodeling when an excessive resorption occurs. This is why they are indicated in a large group of bone diseases like postmenopausal osteoporosis or osteolysis associated with breast cancer or multiple myeloma. Over the last few years and due to their extensive use, many cases of complications associated with their use have been published. Among the most important possible adverse effects are the oral ones, with the appearance of ulcerations and, especially, osteonecrosis of the jaws associated with this therapy. In this paper, we have analyzed the general characteristics of these drugs and their mechanisms of action as well as the described adverse effects, especially oral and maxillofacial, have been made special reference, regarding the prevention of osteonecrosis of the jaws, heightened by cases described in the medical and odontological literature. The preventive protocol backs up the fundamental role of the odontologist in the effective prevention of this process before, during and after the treatment.

Histological And Histometric Analysis of Solitary And Non-Syndrome Associated Multiple Odontogenic Keratocysts.

Objectives: Odontogenic keratocysts are common, locally destructive lesions of the head and neck region. They can occur as solitary or multiple lesions, and if multiple, they are mostly associated with Gorlin-Goltz syndrome. This study aims to categorize the OKCs which behave more aggressively, using conventional histopathological techniques. Methodology: The present study exploits conventional histopathological techniques to gain an insight into the behavior of the OKC (both solitary and non-syndrome associated multiple OKCs). The histological features (keratinization pattern, presence of satellite cysts / odontogenic islands, epithelial infoldings and corrugations) and histometric parameters (total number of nuclei, epithelial height, total nuclear density, number of basal nuclei, basement membrane length, basal nuclear density and mitotic index) were compared between the two groups of cysts. Result: Multiple OKCs exhibited increase in number of infoldings, corrugations, mitotic index, reduced epithelial height, total number of nuclei, number of basal nuclei, and basal nuclear density. This information may be used to predict their biologic behavior and thus serve as a basis for diagnostic and therapeutic strategies. Conclusion: Conventional histopathological techniques can provide valuable information which may be useful to categorize those OKCs that have more aggressive biological behavior and helps in deciding the treatment protocol.

Mucormycosis causing extensive destruction of maxilla.

Mucormycosis is a rare, often fatal opportunistic infection caused by a saprophytic fungus belonging to a class of Phycomycetes. It is characterized by its unrelenting progression towards vital organs with marked propensity towards arterial wall by direct extension producing vascular thrombosis leading to ischaemic necrosis. In normal circumstances the saprophytes are not pathogenic but represent opportunist-requiring impairments in patient's resistance to disease. If not treated the disease may prove fatal. We report a case of Mucormycosis with extensive necrosis of the maxilla in a 57-year-old patient suffering from uncontrolled diabetes with ketoacidosis.