Morphometric Analysis of Collagen in Different Grades of Oral Squamous Cell Carcinoma Using Picrosirius Red Stain and Spectrophotometry.

Introduction: Oral squamous cell carcinoma (OSCC) is one of the most formidable health problems for mankind. These carcinomas are characterized by invasion of epithelial tumor cells into the stroma, which get embedded in extracellular matrix and collagen producing reactive changes. Such changes in the stroma may alter the biological aggressiveness of the tumor. An attempt was made to evaluate the collagen changes in different grades of OSCC which can contribute to understanding the biologic behavior of oral cancer and predict clinical outcomes. Aims and Objectives: To assess the quantitative changes in collagen in different grades of OSCC using hematoxylin and eosin (H and E) and Picrosirius red (PSR) stain through spectrophotometry and to compare the efficacy of these stains for estimation of collagen. Materials and Methods: The study comprised a total sample size of 60, which were distributed under 4 different groups, each containing 15 samples. Group I to IV consisted of normal buccal mucosa, with well-, moderately-, and poorly-differentiated OSCC, respectively. The tissues of 10 µm thickness were stained with H and E and PSR for spectrophotometric analysis. Results: The quantity of collagen decreased with increasing grades of OSCC. Comparison between two stains showed that PSR can provide a more reliable and accurate result than H and E. Conclusion: Collagen estimation is one of the methods to assess the progression of tumor. The method used in the present study for collagen estimation in different grades of OSCC is reliable and accurate.

EXPRESSION OF ALPHA-SMOOTH MUSCLE ACTIN IN ODONTOGENIC CYSTS AND TUMORS.

BACKGROUND: Odontogenic cysts and tumors exhibit different degrees of aggressiveness in their biological behavior. There has been evidence that the presence of myofibroblasts (MFs) at the invasion front promotes tumor invasion. Our study is based on the fact that MFs are important in the biological behavior of odontogenic cysts and tumors. AIM: To assess immunohistochemically expression of alpha-smooth muscle actin (α-SMA) of MFs in odontogenic cysts and tumors and correlate this expression to their biological behavior. MATERIALS AND METHODS: The archival tissues collected for 1.5 years were obtained from the Department of Oral Pathology & Microbiology, People's Dental Academy, Bhopal (India). A total of 40 cases consisting of 10 cases each of odontogenic keratocysts, radicular cysts, dentigerous cysts and ameloblastomas formed the study group. An immunohistochemical analysis of α-SMA expression and localization was carried out. RESULTS: Mean MF counts were the highest in odontogenic keratocysts which was followed by ameloblastomas, entigerous cysts and radicular cysts. Weak α-SMA-expression was found in 50% of cases, moderate in 22.5% of cases, and intense - in 10% cases. MFs were arranged in the spindle, focal, or network patterns in 35; 27.5 and 20% of cases, respectively. CONCLUSION: The analysis revealed that the MFs were distinctly heterogeneous in distribution and pattern of arrangement. This provided persuasive evidence that stroma of these lesions harbor MFs as reflected by α-SMA immunopositive cells.

Oral malignant melanoma.

Malignant melanoma in the head and neck area is rare. The incidence of oral malignant melanomas of the head and neck is approximately four per 10 million populations per year. They are derived from epidermal melanocytes and are most frequently seen on the palate and maxillary gingiva. They are asymptomatic initially but become painful with progress and enlargement. Later, they are associated with ulceration, bleeding, mobility of tooth, paresthesia and ill-fitting prosthesis. The diagnosis is often delayed due to silent growth and development of the lesion. Oral malignant melanomas are associated with poor prognosis due to their invasive and metastasizing tendencies. This case report is presented to emphasize the role of a dentist in identifying the pigmented lesions of the oral cavity.

Assessment of Tumor Cell Cannibalism as a Predictor of Oral Squamous Cell Carcinoma - A Histopathologic Correlation.

AIM: Cellular cannibalism is defined as the ability of a cell to engulf another cell of its own type or any other. It has been recognized in various malignancies and is linked well with the aggressiveness, degree of anaplasia, invasiveness and metastatic potential. Literature search fetched up very few studies related to the presence and significance of cannibalism with respect to Oral squamous cell carcinoma [OSCC]. The present study was aimed to detect tumor cell cannibalism in OSCC and to validate its role as a prognosticator of OSCC in relation to metastasis and degree of differentiation. METHOD: 30 histopathologically proven cases, 15 cases each of metastatic OSCC (7 well differentiated OSCC and 8 moderately differentiated OSCC) and non-metastatic OSCC (8 well differentiated OSCC and 7 moderately differentiated OSCC) were included in the study. Quantitative assessment of tumor cell cannibalism was done. The data was analyzed using Mann Whitney test. RESULT: Metastatic OSCC showed higher frequency of cannibalistic cells compared to non-metastatic OSCC. More number of cannibalistic cells were found in moderately differentiated OSCC than well differentiated OSCC in both groups. Moreover, Grade III cannibalism and complex cannibalism was also found to be associated with metastatic, moderately differentiated OSCC exclusively. CONCLUSION: It has been found that higher number of cannibalistic cells were associated with OSCC showing metastasis indicating their aggressive behavior. So, we recommend that quantitative assessment of tumor cell cannibalism should become a part of the routine histopathological examination of OSCC to screen its hostile behavior.

Peripheral ossifying fibroma: A rare case affecting maxillary region.

Focal gingival enlargements are a diverse group of lesions with almost similar clinical presentation but varied etiology and histopathology. The actual cause of peripheral ossifying fibroma (POF) has been debated over many years. POFs are usually seen in childhood and younger ages. There is a slight female predilection. It is usually localized, rarely generalized. Usually, the treatment option is only surgical excision with minimal chances of recurrence. Here, we report a case of POF of the right maxillary posterior region with a review of literature.

Assessing Difficulties Encountered by Dental Students Studying Oral Pathology and Addressing Their Concerns.

INTRODUCTION: The present scenario of Oral Pathology and Oral Histology as a subject is alarming. In spite of so many advancements in terms of books, internet and conferences there are still lacunae between the understanding and interest for the subjects in the students. It can be partly due to the fact that the students perceive it as a non-clinical subject having a lesser scope for practice. AIM: The present study was aimed at evaluating the students approach towards oral pathology department and the subject. The purpose of the study was to analyze practical hurdles encountered by students and to find out solutions to overcome them. MATERIALS AND METHODS: The cross-sectional questionnaire based study was done with BDS students of People's Dental Academy, Bhopal, India, to gauge the understanding of their knowledge in the subject of Oral Pathology and Oral Histology. Questionnaire comprised of 28 multiple choice questions under five parameters. The data recorded was subjected to statistical analysis using chi-square test. RESULTS: We found that study samples were efficient enough in terms of following instructions related to their day to day training. Although they were content with light microscope, they thought that some more interactive sessions could be beneficial for them in Oral Pathology. CONCLUSION: Through our study we found out that the students are well oriented on the whole about Oral Pathology. They certainly encounter difficulties which are easy to handle if proper measures are taken. We through our study would like the readers to be aware of the changing trends in teaching and to incorporate them routinely.