[ 30-year evaluation of the agreement between clinical and histopathological diagnoses of peripheral epithelial and mesenchymal lesions in Mashhad Dental School: 1976-2006]

Statement of Problems: Sufficient knowledge, experience and careful examination usually lead to appropriate clinical diagnosis. However, lesions with similar clinical features present a diagnostic challenge. Therefore, a confirmatory histopathological examination can be helpful to reach the final diagnosis

Purpose: The present study was conducted to evaluate the agreement between clinical and histopathological diagnoses of oral epithelial and mesenchymal lesions in a period of 30-years [1976-2006] at Mashhad Dental School

Materials and Methods: The percentage of concurrence and discrepancy between clinical and histopathological diagnoses of 625 epithelial and 2480 mesenchymal lesions was compared. Clinical data including the patient's gender and age and the lesion's location were also evaluated in cases with discrepancy. Data were analyzed using Mann-Whitney, T-Test, Chi-Square, Likehood Ratio, Fisher's Exact and Kappa tests

Results: An overall agreement between clinical and histopathological diagnoses was seen in 71/4% of epithelial lesion cases, with maximum parity in squamous cell carcinoma and papilloma. In 57/1% of the mesenchymal cases, the diagnosis was in total agreement. Denture hyperplasia, epulis fissuratum, and pregnancy tumor showed the highest concurrence, respectively

Conclusion: Although histopathological examination leads to final diagnosis, in some cases proper strategies and more attention to clinical features of the lesion are necessary to minimize the discrepancy, especially for those with non-specific clinical presentation

[Evaluation of Adenoid cystic carcinoma and polymorphous low-grade adenocarcinoma by immunohistochemistry]

Salivary gland tumors classification continuously undergoes alternations, especially in the recent years. This study used immunohistochemical markers for distinguishing between polymorphous low-grade adenocarcinoma [PLGA] and adenocarcinoma carcinoma [AdCC] which have several overlapping histological and clinical features. Ten AdCC and eight PLGA with five normal minor salivary glands were selected after review by two oral pathologists. LSAB method was used for seven markers: carcinoembryonic antigen, epithelial membrane antigen, muscle specific actin, vimentin, S 100, P53 and Ki-67. Finally, the data were analyzed by Mann-Whiteny test. Analysis of data showed a high expression of CEA, EMA and Ki-67 in AdCC compared to PLGA. Although, CEA [P<0.001] expression was limited to luminal cells .In contrast, MSA [P=0.034] expression in nonluminal cells, and Ki-67 [P<0.001] occurred in both luminal and nonluminal cells. Also there was highly expression of vimentin and S-100 in PLGA with no significancy for EMA and Tp53. The result of this study suggests that ICH can be a helpful tool. The immunostaining of AdCC and PLGA with CEA, Vimentin and Ki-67 were of greater significant, S-100 and MSA were less significant and the others [EMA and P53] could not offer an adjunctive aid in differential diagnosis between the two tumors

[ histological study of the effect of hyaluronic acid and curcuma longa-ghee compound on the gingival healing following gingivectomy in dogs]

Currently, hyaluronic acid is used to reduce the side effects of periodontal surgery including hemorrhage, inflammation and pain and accelerate the healing process of the wound. Oral or local application of Ghee can be relatively effective in enhancement of the wound healing process. The present study was performed with the aim of comparing the effects of hyaluronic acid with curcuma longa- ghee on the healing process of gingival tissue following ginivectomy. In a double blind controlled randomized experimental study, 5 male beagle dogs, 18 to 24 months old [approximately 15 kg], with intact teeth and clinical signs of gingivitis with similar Gingival Index [GI] and no periodontitis, were used. In each Jaw, two regions were randomly selected as control and six regions as test groups. Following gingivectomy periodontal packs were used in the control groups and three materials including curcuma longa-ghee with two different ratios [material A and material B] and hyaluronic acid [material C] were used in the test groups Histological changes were evaluated 4 and 7 days after gingivectomy in order to assess the healing process. Data were analyzed using Kruskal Wallis test. Significant statistical differences were found in all parameters for the three materials used in experimental groups compared with control groups. On the fourth day, the inflammatory parameters decreased and repairing parameters increased remarkably in the regions with materials A and B compared to those with material C, while the difference in the degree of epithelialization was statistically meaningful [p = 0.002]. On the seventh day, the inflammatory parameters decreased and repairing parameters increased remarkably in the material B regions compared to the regions on which materials A and C were placed. According to the above results, curcuma longa-ghee is more effective than hyaluronic acid in repairing process and reduction of the inflammation. Therefore, it can be considered as a suitable substitute for accelerating of healing process after periodontal surgery

[Ten-year-evaluation of odontogenic cysts and tumors related to the impacted teeth]

Odontogenic cysts and tumors are associated with some lesions that impacted teeth are one of them. Impacted teeth are those cease to erupt before emergence. Varying incidences have been reported in different literature about this condition. The aim of this retrospective study was to achieve the sexual, location and age related distribution of odontogenic cysts and tumors and frequency of each one in relationship with an impacted tooth in order to prompt of clinician knowledge and easy selection of treatment plan. In this retrospective study, we used registration books and paraffinized blocks and slides of pathology archives of Mashhad dental school which had belonged to the patients involving with impacted teeth pathology, were evaluated from 1996-2006.Over all of these lesions were 304 cases in this period and relation between impaction of tooth and type of lesion was done by exact test. This study included 160 lesions consisting of 140 cysts [87.5%] and 20 tumors [12.5%]. Dentigerous cyst was the most common cyst [58.7%], and Odontoma was demonstrated to be the most common tumor [5%]. These lesions affected males [59.8%] more than females [41.2%] and they occurred with a pick in the second decade. The left-sided posterior mandible was more commonly involved by far. The findings of this study for Dentigerous cyst and Odontogenic keratocyst were similar to the findings of the other studies; nevertheless, Mandible and males predilection of Calcifying odontogenic cyst, one decade later involvement of Odontoma [3[rd] decade], one decade sooner involvement of Ameloblastoma [3[rd] decade], male predilection of Adenomatoid odontogenic tumor were not identical to the other studies, findings. However, more studies are recommended to achieve this purpose