Oral Amelanotic Melanoma

Malignant melanomas of the mucosal regions of the head and neck are extremely rare neoplasms accounting for less than 1of all melanomas. Approximately half of all head and neck melanomas occur in the oral cavity. Less than 2of all melanomas lack pigmentation; in the oral mucosa however; up to 75of cases are amelanotic. No etiologic factors or risk factors have been recognized for oral melanomas. Some authors have suggested that oral habits and selfmedication may be of etiological significance. Oral melanoma is rare but it is relatively frequent in countries like Japan; Uganda; and India. It is rarely identified under the age of 20 years. In Australia where cutaneous melanomas are relatively common primary melanoma of the oral mucosa is rare. The surface architecture of oral melanomas ranges from macular to ulcerated and nodular. The lesion is said to be asymptomatic in the early stages but may become ulcerated and painful in advanced lesions. The diagnosis of amelanotic melanoma is more difficult than that of pigmented lesions. The neoplasm consists of spindle-shaped cells with many mitotic figures and no cytoplasmic melanin pigmentation. Immunohistochemistry using S-100; HMB-45; Melan-A and MART-1 will help in establishing the correct diagnosis. Radical surgery with ample margins and adjuvant chemotherapy are appropriate management protocol for malignant melanoma. Oral melanoma is associated with poor prognosis but its amelanotic variant has even worse prognosis because it exhibits a more aggressive biology and because of difficulty in diagnosis which leads to delayed treatment

The Role of Forensic Dentist Following Mass Disaster

This review article focuses on mass disaster situations that may arise from natural or manmade circumstances and the significant role of forensic dental personnel in human identification following such occurrences. The various forensic dental modalities of identification that include matching techniques; postmortem profiling; genetic fingerprinting; dental fossil assessment and dental biometrics with digital subtraction were considered. The varying extent of use of forensic dental techniques and the resulting positive impact on human identification were considered. The importance of preparation by way of special training for forensic dental personnel; mock disaster rehearsal; and use of modern day technology was stressed. The need for international standardization of identification through the use of Interpol Disaster Victim Identification (DVI) for ms was further emphasized. Recommendations for improved human identification in Nigerian situation include reform of the National Emergency Management Association (NEMA); incorporation of dental care in primary health care to facilitate proper ante mortem database of the populace and commencement of identification at site of disaster