Expression of cluster differentiation-44 stem cell marker in grades of oral epithelial dysplasia: A preliminary study.

INTRODUCTION: Oral cancer is one among the alarming diseases related to oral cavity. Its prevalence and incidence have increased in many folds, in the past decade. This has led the investigators to find the preliminary stages and related early evaluating methods to restrain it. Few clinical lesions such as leukoplakia, erythroplakia, oral submucous fibrosis and lichen planus reflected malignant changes. These premalignant disorders provided scope to assess the underlying cellular and molecular events, which shall be helpful in early detection, aggressiveness and prognosis of the patient. MATERIALS AND METHODS: Forty formalin fixed, paraffin embedded blocks were utilized and evenly subdivided into Group I - control tissue, Group II - mild epithelial dysplasia, Group III - moderate epithelial dysplasia and Group IV - severe epithelial dysplasia. The study group was categorized based on the WHO classification of dysplasia 2005. Routine staining was performed to reconfirm the diagnosis of all the samples. Simultaneously, immunohistochemical staining was done with cluster differentiation-44 (CD44) antibody. Positive cells were counted on 10 representative fields with a minimum of 100 cells per field using ×20. STATISTICAL ANALYSIS: Comparison of four groups with respective to number of positive cells was done using Kruskal-Wallis ANOVA test. Pair-wise comparison of three grades of oral epithelial dysplasia and the controls was done using Mann-Whitney U test. RESULTS: The mean of Group I is 745.50, Group II is 665.20, Group III is 530.10 and Group IV is 322.90. A statistically significant P = 0.00001 was ascertained on comparison of the mean between the groups. CONCLUSION: CD44, a cell membrane marker could help in cell adhesion and cell-cell interactions. Loss of CD44 expression enhances the binding of the growth factors with their principle receptors that enhances the cellular proliferation. It can be used as a prognostic marker for identifying the rate of malignant transformation in these disorders.

Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique.

OBJECTIVES: Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation. MATERIALS AND METHODS: This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee. RESULTS: All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissue re-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae. CONCLUSION: Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshell-derived nHA and PRF membrane from the patient's own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.

Quantitative analysis of dental age estimation by incremental line of cementum.

AIM: This study aims to examine the correlation between age and number of incremental lines in human dental cementum among single-rooted teeth (incisors and canines) and to assess the best tooth to estimate age group by studying cementum under phase-contrast microscope and to assess the use of cementum in age estimation. MATERIALS AND METHODS: The present study was carried out in the Department of Oral Pathology and Microbiology. A sample of eighty single-rooted undecalcified longitudinal ground sections is prepared from freshly collected teeth with age noted separately and observed under phase-contrast microscope, photographed and counted. Counting the number of alternating dark and light lines of the cementum and adding them to the average age at which the analyzed tooth erupts provided an estimate of the chronological age of the individual. RESULTS: The results obtained in the present study were statistically significant and positive correlation was observed between the actual age and the estimated age. The number of incremental lines was found to be gradually increased with increase in age of the individual. On an average, ±2 years of age difference were observed in our study on comparing the actual age with estimated age. CONCLUSION: Hence, the incremental lines of the cementum were found to be gradually increased with increase in age and hence can be used as one of the adjuvant tools in dental age estimation.

Systematic Analysis of Palatal Rugae Pattern for Use in Human Identification between Two Different Populations.

BACKGROUND: Forensic odontology plays important role in identification of human remains in mass disasters such as air crash, tsunami, and accidents. Palatal rugae act as an ideal requisite for human identification as they are present in all victims and are resistant to changes such as aging and trauma. The study aimed to analyze differences in shape and number of palatal rugae in population from Andhra Pradesh and Telangana states. METHODS: This study was conducted in SIBAR institute of Dental Sciences, Guntur, India in 2012 on 200 subjects, gender matched and equally divided as 100 from Andhra Pradesh and 100 from Telangana states. Rugae were studied using Kapali.S classification. Association between rugae shape and gender variation between the two populations were tested by chi-square analysis and student t-test. RESULTS: Average number of rugae was more (11.84±3.03) in subjects of Andhra Pradesh, compared to Telangana (9.50 ±1.65) population. Males of Andhra Pradesh showed significantly higher mean number of total rugae than in Telangana males. Distribution of total number of different rugae shapes in males and females of both the populations showed significant variation in wavy and circular rugae patterns. Wavy, curved and straight rugae were significantly higher in males and females of Andhra Pradesh compared to Telangana population. Telangana population showed significant increase in circular rugae. CONCLUSION: Our study revealed statistically significant variation in shape and total number of rugae between observed populations of Andhra Pradesh and Telangana states.

Oral submucous fibrosis: A quantitative assessment of serum malondialdehyde, superoxide dismutase and correlation with clinical staging.

BACKGROUND: Oral submucous fibrosis (OSMF) is a progressive disorder affecting the oral mucosa. OSMF predominantly seen in South-east Asian countries. There are some biochemicals parameters which are modify in oral submucous fibrosis; this alteration can be used as a tool for diseases progress and avert malignant transformation. AIMS AND OBJECTIVES: The aim of this study is to evaluate the serum malondialdehyde (malondialdehyde [MDA]), and Superoxide dismutase (SOD) in oral sub mucous fibrosis cases and compare clinical stages. MATERIALS AND METHODS: Thirty cases of clinical and histopathological established oral submucous fibrosis and thirty cases of nonsymptomatic features of oral submucous fibrosis preferred as controls. Venous blood was collected and separation of serum for estimation of MDA and SOD levels was done using an ultraviolet spectrophotometer. STATISTICAL ANALYSIS: Data were analyzed using SPSS software using Student's t-test and Kruskal-Wallis ANOVA test. RESULTS: Serum MDA levels were elevated when clinical staging increases, where as SOD levels were decreased when clinical stage increases when compared with control cases and it showed stastically significant. CONCLUSION: Estimation of serum MDA and SOD in patients with OSMF, we can assess the degree of oxidative damage of the disease. This can be used as an early diagnostic tool for preventing malignant transformation of oral submucous fibrosis.

Impact of highly active antiretroviral therapy on oral manifestations of patients with human immunodeficiency virus/acquired immuno deficiency syndrome in South India.

BACKGROUND: Human immunodeficiency virus (HIV) infection remains a global health problem, although the development of highly active antiretroviral therapy (HAART) has significantly modified the course of HIV disease into a manageable disease with improved quality-of-life mainly in the developed countries. Very few studies are available regarding effect of HAART on oral lesions in developing countries like India. AIMS AND OBJECTIVES: The aim was to document and compare oral lesions in HIV-seropositive patients before and after HAART. MATERIALS AND METHODS: Oral manifestations were recorded in 320 HIV seropositive patients attending to the Voluntary Counseling and Confidential Testing Centre at the Government General Hospital, Guntur, before and after treating with HAART and the results were statistically analyzed using Student's t-test and Chi-square test. RESULTS: Oral Candidiasis was significantly reduced in patients under HAART after 3 months. Furthermore, there was decreased incidence of periodontal diseases, but increased hyperpigmentation in patients undergoing HAART. CONCLUSION: The oral manifestations of HIV infection have changed due to the advent of HAART. Many opportunistic infections have resolved as a result of an improved immune system. Though the risk of hyperpigmentation in those with HAART has increased the prevalence of oral candidiasis and periodontal diseases were less in patients who had access to HAART.

Evaluation of salivary glucose, amylase, and total protein in Type 2 diabetes mellitus patients.

BACKGROUND: Diabetes mellitus is a complex multisystem metabolic disorder characterized by a deficit in the production of insulin. The oral complications of uncontrolled diabetes mellitus are devastating. Saliva is an organic fluid that can be collected noninvasively and by individuals with limited training. These reasons create an interest in evaluating the possibility of using saliva as a diagnostic tool. AIMS AND OBJECTIVES: The aim of this study was to determine, if saliva can be used as a noninvasive tool to monitor glycemic control in Type 2 diabetes. Comparative assessment of salivary (glucose, amylase, total protein levels) in patients with Type 2 diabetes and controls. MATERIALS AND METHODS: A total of 40 individuals, 20 with Type 2 diabetes and 20 controls of age group 40-60 years were selected for the study. Diabetic status was assessed by estimating random blood glucose levels. Unstimulated saliva was collected from each participant and investigated for glucose, amylase, and total protein levels. Salivary glucose estimation was performed using glucose-oxidase method, amylase by the direct substrate kinetic enzymatic method, and total protein by pyrogallol red dye end point method. All the parameters were subjected to statistical analysis using SPSS version 20.0. RESULTS: Significantly higher salivary glucose, lower amylase, and total proteins were observed in patients with Type 2 diabetes than controls. There was no significant correlation between salivary and blood glucose levels. CONCLUSION: These results suggest that diabetes influences the composition of saliva. Since a significant correlation was not observed between salivary and blood glucose levels, further research is needed to determine salivary glucose estimation as a diagnostic tool for diabetes mellitus.

Age estimation by assessment of dentin translucency in single rooted permanent teeth.

BACKGROUND: To estimate the age by evaluating the area and length of dentin translucency in single-rooted ground sections of extracted teeth using digital Vernier caliper and stereomicroscope. MATERIALS AND METHODS: Ground sections of single rooted permanent anterior teeth were made and stained with 1% methylene blue. The area and length of dentin translucency were measured using digital Vernier caliper and with the help of stereomicroscope. RESULTS: Linear regressive analysis showed that estimation of age by assessing the area of dentin translucency with Vernier caliper was statistically significant and showed a high regression co-efficient (R = 0.7738) when compared to evaluation of age by assessment of length. Multilinear regressive analysis done to calculate age by both area and length also showed a high co-efficient of regression (R = 0.7797). CONCLUSION: The area of dentin translucency showed good correlation with age when compared to the length.