A case report of angiosarcoma of the tongue: A diagnostic dilemma at presentation.

Rationale: Angiosarcoma is a malignant mesenchymal tumor arising from vascular endothelial cells. This is an aggressive malignancy associated with poor prognosis. Angiosarcoma in the head and neck is exceedingly rare, accounting for less than 4 % of tumors.[1]. Patient Concern: We report a unique case of angiosarcoma involving the tongue underlying the diagnostic conundrum and pointers towards an accurate diagnosis. Take-away lesson: Due to rarity of the disease, consensus on optimal treatment approach is lacking and multicenter prospective studies would be helpful to set clinical guidelines.

In vitro assessment of the effect of probiotic lactobacillus reuteri on peri-implantitis microflora.

BACKGROUND: Probiotics affect both the development and stability of microbiota by altering the colonization of pathogens and thus helps in stimulating the immune system of the individual. The aim of the present study is to assess the effect of probiotics on peri-implantitis microflora, by determining the minimum inhibitory concentration (MIC) of Lactobacillus reuteri, that can be effectively administered as an antimicrobial agent on specific peri-implantitis pathogens. Hence, this study will be helpful in finding the MIC of L. Reuteri that can be effectively administered as an antimicrobial agent on specific peri-implantitis pathogens. METHODS: This experimental research was conducted on patients visiting the periodontology department in M. A. Rangoonwala college of dental sciences and research centre. Sub-gingival plaque samples were collected from peri-implantitis patients to identify various peri-implantitis microorganisms. The identified microorganisms were compared to each other and Chi-Square test was used to calculate statistical significance. The isolated microorganisms were subjected to the effect of probiotic Lactobacillus reuteri in-vitro. Minimum inhibitory concentration (MIC) was assessed using serial dilution method. RESULTS: The research results showed the presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Streptococcus salivaris and Staphylococcus aureus in the subgingival samples from peri-implantitis patients. Statistically, significantly higher proportion of samples had Porphyromonas gingivalis. When subjected to the effect of L. reuteri, all the microorganisms were affected by L.reuteri except Aggregatibacter actinomycetemcomitans. CONCLUSION: This study provides the various MIC value for each isolated pathogen against L.reuteri. The authors recommend to avoid using standard guidelines for probiotic dose in the treatment of peri-implant infections as the antimicrobial profile is different for each periodontal pathogen.

Dentinogenic ghost cell tumor - A case report and review of literature.

Dentinogenic ghost cell tumor (DGCT) was first described by Praetorius et al. in 1981 and now believed to be the tumor counterpart of the calcifying odontogenic cyst (COC). DGCT is an extremely rare odontogenic tumor and accounts for only 2% to 14% of all COCs. A case of DGCT in a 40-year-old female patient is being reported.

Dentition status and treatment needs and its correlation with oral health-related quality of life among men having sex with men and transgenders in Pune city: A cross-sectional study.

INTRODUCTION: Dental diseases are universal in nature. Their presence and severity may vary from one individual to another and is also affected by multiple factors such as gender, knowledge, attitude and the affordability of dental/oral care. Gay, bisexual and transgender community is one among the socially disadvantaged community in our country. The present study was carried out in the city of Pune, India, to evaluate the prevalence of dentition status and the treatment needs among the men who have sex with men (MSMs) and transgenders (TGs) and its correlation with the oral health-related quality of life. MATERIALS AND METHODS: The sample size was 270. Convenience sampling was followed. The WHO oral health assessment for 1997 was used to record dentition status and treatment needs. Oral Health Impact Profile-14 was used to record the oral health-related quality of life. SPSS 22.0 (Chicago, IL, USA) was used for statistical analysis. All P < 0.05 were considered to be statistically significant. RESULTS: There was no statistically significant difference seen across the various domains in the overall impact of the oral quality of life. There was a significant correlation between the decayed teeth, missing teeth and overall decayed, missing and filled teeth scores with respect to the seven domains. Problems arising due to past dental experience (dental caries), lost natural tooth structures replaced with restorative material and a cumulative impact significantly affected the outcome of the oral health-related quality of life of the participants. CONCLUSION: There was an alteration in quality of life of the MSMs and TGS with respect to dental caries. This calls for an intervention that is tailor-made to meet the needs of this group.

Kerosene: Contributing agent to xylene as a clearing agent in tissue processing.

BACKGROUND: Research methodology in oral and maxillofacial pathology has illimitable potential. The tissue processing involves many steps of which one of the most important step is "Clearing," which is a process of replacing dehydrant with a substance which is miscible with embedding medium or paraffin wax. Xylene is one of the common clearing agents used in laboratory, but it is also hazardous. The main aim of this study is to substitute conventionally used xylene by a mixture of kerosene and xylene in clearing steps without altering the morphology and staining characteristics of tissue sections. This will also minimize the toxic effects and tend to be more economical. MATERIALS AND METHODS: One hundred and twenty bits of tissue samples were collected, each randomly separated into 4 groups (A, B, C and D) and kept for routine tissue processing till the step of clearing; during the step of clearing instead of conventional xylene, we used mixture of xylene and kerosene in 4 ratios ([A-K:X - 50:50]; [B-K:X - 70:30]; [C - Ab. Kerosene]; [D - Ab. Xylene - as control]) and observed for the light microscopic study adopting H and E staining, IHC (D2-40), Special stains (periodic acid-Schiff and congo red) procedure. The result was subjected to statistical analysis by using Fisher's exact test. RESULTS: The results obtained from the present study were compared with control group, i.e., D and it was observed that Groups A and B were absolutely cleared without altering the morphology of tissue and cellular details; optimum embedding characteristics and better staining characteristics were also noted, whereas Group C presents poor staining characteristics with reduced cellular details. Embedded tissues in Group C presented with rough, irregular surface and also appeared shrunken. CONCLUSION: Combined mixture of xylene and kerosene as a clearing agent in different ratio, i.e., Group A (K:X - 50:50) and B (K:X - 70:30) can be used without posing any health risk or compromising the cellular integrity.

Glandular odontogenic cyst: A diagnostic dilemma.

Glandular odontogenic cyst (GOC) is a rare and uncommon jaw bone cyst of odontogenic origin described in 1987 by Gardener et al. as a distinct entity. It is a cyst having an unpredictable, potentially aggressive behavior, and has the propensity to grow in large size with relatively high recurrence rate. It poses a diagnostic challenge as it can be clinically and histopathologically confused with lateral periodontal cyst, botryoid odontogenic cyst, radicular and residual cysts with mucous metaplasia, and low-grade mucoepidermoid carcinoma. The present case report describes GOC in both male and female patients with intra-oral swelling following extraction of 36 and 46, respectively. Careful histopathological examination is needed to diagnose GOC, and a careful long-term follow-up is advocated.

Levels of salivary thiocyanate and its relation with occurrence of micronuclei using exfoliative cytology in smokers and nonsmokers.

AIMS: To evaluate the levels of salivary thiocyanate and its relation with the occurrence of micronuclei (MN) using exfoliative cytology in smokers and nonsmokers. MATERIALS AND METHODS: One hundred and twenty patients were divided into 3 groups: nonsmoker group 1 (control), smokers group 2, and smokers group 3. Their saliva was collected and analyzed for thiocyanate levels, and exfoliative cytology was evaluated for the presence of MN. STATISTICAL ANALYSIS USED: Fisher's exact test and ANOVA test were used. RESULTS: It was seen that as the grade of smoking increased, the levels of salivary thiocyanate and occurrence of MN increased. CONCLUSIONS: Detection and quantification of "biomarkers" such as salivary thiocyanate and MN in noninvasive and painless procedures such as oral exfoliative cytology can be an upcoming research domain in the field of cancer prevention and therapeutics.

Immunohistochemical analysis of syndecan-1 in leukoplakia and oral submucous fibrosis.

BACKGROUND: Syndecan-1 is abundant in normal tissues and reduced in squamous cell carcinomas. Leukoplakia and oral submucous fibrosis (OSF) are oral pre-cancerous disorders that have potential for malignant transformation. The aim of this study was to evaluate the expression of syndecan-1 in leukoplakia and OSF and to identify its role as a reliable marker for predicting malignant changes. MATERIALS AND METHODS: Expression of syndecan-1 was examined immunohistochemically in 42 cases of oral leukoplakia with or without epithelial dysplasia, 28 cases of OSF and 10 cases of normal oral epithelia as control. Mann-Whiteny 'U' test was used for statistical analysis and the level of significance was fixed at P < 0.05. RESULTS: Intense syndecan-1 expression was observed in nine cases with normal epithelium. Immunopositivity was lost gradually as the extent of epithelial dysplasia increased. The significant reduction in syndecan-1 expression was observed in leukoplakia as epithelial dysplasia progressed from moderate or severe. Similarly, significant reduction was observed in staining intensities in OSF with dysplasia. CONCLUSION: The results reveal that down-regulation of syndecan-1 expression is associated with dysplastic changes in leukoplakia and OSF. Thus syndecan-1 can be considered as marker for predicting malignant changes.

Expression of extracellular matrix-laminin in oral squamous cell carcinoma: an immunohistochemical study.

AIM: To evaluate the expression of laminin in various grades of oral squamous cell carcinoma (OSCC) in order to determine whether this protein can be used as a marker for early detection and elucidation of oral cancer. MATERIALS AND METHODS: Immunohistochemical staining for laminin was done on 60 selected archival blocks of histopathologically diagnosed cases of primary OSCC and the laminin expression was compared between the different histopathological grades of primary OSCC. The statistical analysis was performed by using Chi-square (X square) test and Gaussiantest with a probability of p > 0.05 was considered as significant. RESULTS: It was observed that laminin expression decreased with tumor progression which may be correlated to the tumor aggressiveness. CONCLUSION: There was a gradual decrease of laminin staining with decreasing cellular differentiation, with differentiated lesions showing a more conspicuous staining of basement membrane glycoprotein than less differentiated lesions. CLINICAL SIGNIFICANCE: An understanding of how the extracellular matrix influences tumor development and invasion is fundamental in the development of new prognostic indicators and treatment strategies for oral squamous cell carcinoma..

Juvenile scleredema of Buschke.

AIM: To recognize a line of treatment for scleredema of Buschke in an adolescent. BACKGROUND: Scleredema of Buschke is an uncommon disorder characterized by induration of the skin, which includes a non pitting hardening of the skin around the neck, shoulders, and trunk sometimes the face. Three variants are recognized. The histopathologic features of scleredema are characterized by thickened collagen bundles within the reticular dermis that are separated by mucin containing fenestrations. No consistent treatment modality is currently followed. CASE REPORT: The present case report describes scleredema of Buschke in a 10-year-old female child reported with stiffness of facial skin and difficulty in opening the mouth. The patient was treated with antibiotics and vitamin supplements and there was drastic improvement with decrease in skin stiffness and increase in mouth opening. The stiffness of facial muscles decreased and mouth opening increased. CONCLUSION: Multiple treatment modalities for scleredema have been used. In the present case, high-dose antibiotic therapy was used with good prognosis. CLINICAL SIGNIFICANCE: High-dose antibiotic therapy can be used for treatment of dermatologic disorders with reasonably good prognosis.