Ameloblastomatous calcifying cystic odontogenic tumour involving the mandibular anterior region: An unusual case report.

Ameloblastomatous calcifying odontogenic cyst (COC) is a very rare histopathological variant of COC, which is an odontogenic cyst of the jaw. The term "calcifying odontogenic cyst" is not covered in the World Health Organisation (WHO) Classification of Tumors 2005 and was re-named as calcifying cystic odontogenic tumour (CCOT). There are only a few reports containing details on CCOT being associated with ameloblastoma. This variant has been classified as ameloblastomatous CCOT (type 3) as per the WHO 2005 classification. In this article, we reported an exceptional case of ameloblastomatous CCOT in a 15-year-old boy involving the mandibular anterior region, which is a rare combination for age and site of the lesion, along with an impacted tooth which is again an uncommon association.

Incidence of grinspan syndrome among tribal and suburban population of Maharashtra - A cross sectional study.

BACKGROUND: Grinspan syndrome is characterised by presence of the triad: hypertension, diabetes mellitus (DM) and oral lichen planus (OLP). OLP, seen in hypertension and diabetes mellitus, is caused by drugs used to treat these diseases according to literature, however the incidence of this syndrome in India has not yet been reported anywhere. Hence the present study was conducted with the following objectives: (i) To determine the incidence of Grinspan syndrome amongst tribal and suburban study population of Maharashtra in different gender and age groups (ii) To correlate occurrence of OLP with DM type 2 and hypertension (iii) To find out the number of patients with OLP, DM type 2 and hypertension either alone or in combination. METHODS AND MATERIAL: The present study was conducted on 4681 new patients attending the routine outpatient department (O.P.D.) of the dental hospital between January 2017 and December 2018. Patients with OLP or DM (type-2) or hypertension or any combination of these diseases were included in the present study. Brief case history of each patient was recorded. Data thus collected were analysed using SPSS version 20 for Chi-square test. RESULTS: Grinspan syndrome was found in 1.62% of the study population. Syndrome was seen in 1.02% of female and 0.59% of male. Maximum patient affected by syndrome were in 35-50 years of age group. CONCLUSIONS: Incidence of Grinspan syndrome was 1.62%, mainly seen in sub-urban females of 35-50 years and OLP seen in hypertension and diabetes mellitus has different etiology and is not caused by drugs used to treat these diseases.

An unusual case of polyostotic fibrous dysplasia-A case report.

Fibrous dysplasia (FD) is a fibro-osseous lesion where normal bone and marrow is replaced with fibrous tissue, resulting in formation of bone that is weak and prone to expansion. It is classified according to the number of affected bones, and its association to endocrine alterations, that is, monostotic (80-85%), polyostotic forms (20-30%), and Albright's disease. Involvement of two or more bones is termed as polyostotic FD, a relatively uncommon condition. Here we report a rare case of polyostotic FD involving facial bones, orbital bones, sphenoid bone, and spine in a 21-year-old male patient.

Haemangioendothelioma of Oral Cavity: A Rare Entity with Unusual Location.

Hemangioendothelioma is a rare, locally aggressive vascular tumor, originating from soft tissue, bone, skin, and organs such as liver or lung and exceptionally the oral cavity. It is usually benign but can show variable grades of malignancy. Most of the cases of oral epithelioid hemangioendotheliomas are asymptomatic, and diagnosis is hampered by the fact that the histological features somewhat overlap with hemangioma and angiosarcoma, with epithelioid cells, intracytoplasmic vacuoles, low mitotic activity, and rarely necrosis. Immunohistochemical analysis is required to rule out carcinoma or other epithelioid vascular neoplasms. Here, we report a very rare case of oral haemangioendothelioma in a 41-year female patient which presented as an exophytic, painless, mass on the labial gingiva, clinically diagnosed as pyogenic granuloma, which presented a diagnostically challenging histological picture, which required immunohistochemistry to achieve at the correct diagnosis.

Comparative Study using Papanicolaou Stain and Silver-stained Nucleolar Organizer Region Counts in Exfoliative Smear of Oral Mucosa in Bidi Smokers and Nonsmokers.

AIM: The aim of this study is to compare the proliferative activity of exfoliated cells in bidi smoker's and nonsmoker's oral mucosa. MATERIALS AND METHODS: The oral mucosal exfoliate smears were prepared from 40 individuals (20 nonsmokers and 20 smokers) with the age group ranging from 25 to 70 years, in and around Akola (Maharashtra). The Papanicolaou (PAP) stain and silver-stained nucleolar organizer region (AgNOR) were used to prepare cytogenic smear to evaluate the presence of cytological alterations, suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. The present study involves PAP Class I and Class II smears. The obtained data were tabulated and statistically analyzed using statistical software IBM SPSS IBM Corp., Statistics for Windows, Version 20.0. Armonk, NY, USA: IBM Corp., and using t-test. RESULTS: There was a significant difference in mean number of AgNORs/nucleus between nonsmokers (0.947 ± 0.2533) and smokers (3.021 ± 0.2256). There were 90% inflammatory changes observed in smokers whereas nonsmokers showed only 75% changes. PAP Class II changes, i.e., significant proliferative activity, were found between smokers and nonsmokers mucosa. CONCLUSION: A significant difference of AgNORs/nucleus was found between nonsmokers and smokers.

The cell biology and role of resorptive cells in diseases: A review.

Resorptive cells are responsible for the resorption of mineralized matrix of hard tissues. Bone-resorbing cells are called osteoclasts; however, they can resorb mineralized dental tissues or calcified cartilage and then they are called odontoclasts and chondroclasts, respectively. Resorptive cells form when mononuclear precursors derived from a monocyte-macrophage cell lineage are attracted to certain mineralized surfaces and subsequently fuse and adhere onto them for exerting their resorbing activity. These cells are responsible for degradation of calcified extracellular matrix composed of organic molecules and hydroxyapatite. The activity of these cells can be observed in both physiological and pathological processes throughout life and their activity is mainly required in bone turnover and growth, spontaneous and induced (orthodontic) tooth movement, tooth eruption, and bone fracture healing, as well as in pathological conditions such as osteoporosis, osteoarthritis, and bone metastasis. In addition, they are responsible for daily control of calcium homeostasis. Clastic cells also resorb the primary teeth for shedding before the permanent teeth erupt into the oral cavity.

Comparative evaluation of antimicrobial effect of herbal root canal irrigants (Morinda citrifolia, Azadirachta indica, Aloe vera) with sodium hypochlorite: An in vitro study.

AIM AND OBJECTIVES: Successful root canal treatment involves the complete elimination of microorganism from the root canal and the three-dimensional obturation of the canal space. Enterococcus faecalis is the most commonly found bacteria in failed root canal. Chemical irrigation of canals along with biomechanical preparation helps in the elimination of microorganisms. The present study was aimed to evaluate the antimicrobial effect of herbal root canal irrigants (Morinda citrifolia, Azadirachta indica extract, Aloe vera) with sodium hypochlorite (NaOCl). MATERIALS AND METHODS: The bacterial E. faecalis (ATCC) culture was grown overnight in brain heart infusion (BHI) broth and inoculated in Mueller-Hinton agar plates. Antibacterial inhibition was assessed using agar well diffusion method. All five study irrigants were added to respective wells in agar plates and incubated at 37°C for 24 h. Bacterial inhibition zone around each well was recorded. Results were tabulated and statistically analyzed using Statistical Package for the Social Sciences software for Windows, version 19.0. (IBM Corp., Armonk, NY. RESULTS: Highest inhibitory zone against E. faecalis was seen in NaOCl fallowed by M. citrifolia and A. indica extract, and the least by A. vera extract. CONCLUSION: Tested herbal medicine (A. indica extract, M. citrifolia, A. vera) showed inhibitory zone against E. faecalis. Hence, these irrigants can be used as root canal irrigating solutions.

Estimation of salivary nitric oxide in recurrent aphthous ulcer and oral lichen planus patients with its clinical significance.

AIM: The present study was undertaken to study the role of nitric oxide in human saliva and its diagnostic/prognostic role in recurrent aphthous ulcers (RAU) and oral lichen planus (OLP). MATERIALS AND METHODS: The study was carried out at outpatient department of Govt Dental College and Hospital, Aurangabad. Twenty cases with RAU, 15 with OLP and 30 healthy individuals were included in the study. The clinically diagnosed known cases of RAU and OLP were included after taking the detail case history and subjected to blood analysis for hemogram and biochemically salivary nitric oxide was estimated. RESULTS: The salivary nitric oxide levels were found to be increased significantly in RAU and OLP group, when compared with controls. Further, significantly increased levels have been observed in OLP group, when compared with RAU group (p < 0.001). The salivary nitric oxide levels were found to be increased significantly in minor RAU than major RAU and increased in erosive type of OLP than nonerosive type of OLP. CONCLUSION: Thus, salivary nitric oxide can be treated as a diagnostic tool for the differential diagnosis of RAU and OLP. CLINICAL SIGNIFICANCE: Nitric oxide plays an important role in modifying physiopathological processes of oral mucosal membrane so has diagnostic as well as prognostic value.

The study of role of stress in children with behavior disorders and orofacial lesions.

AIM: (1) To study the behavior disorders in children between 5 to 15 years. (2) To study the role of stress in causing behavior disorders. (3) To interpret the orofacial findings in children with behavior disorders. (4) Correlate the orofacial findings with behavior disorder. MATERIALS AND METHODS: Ninty children with behavior problems between age of 5 to 15 years along with their parents who visited the Department of Child-Guidance Clinic, BYL Nair Charitable Hospital, Mumbai. Intraoral examinations were conducted. Behavioral disorders and factors predisposing to those disorders were recorded. RESULTS: Behavior disorders with orofacial lesions was more common in age group of 8 to 10 years. The children were continuously under stress, which manifested in the form of various orofacial disorders or oral lesions. Most common orofacial condition was bruxism. CONCLUSION: Awareness of behavior disorders in dental treatment should guide the pediatric dentist to seek child psychiatric consultation for behavioral disorders to enable early evaluation of the underlying disorder. CLINICAL SIGNIFICANCE: The present study suggested that orofacial and behavior characteristics can serve as markers to diagnose children with behavioral disorders. It also serves as a guide to dental clinicians to refer such children to psychiatrists or pediatricians for early identification, prevention and treatment.