Correlation of Vascular and Inflammatory Index in Oral Pyogenic Granuloma and Periapical Granuloma - An Insight into Pathogenesis.

INTRODUCTION: Angiogenesis is vital in the aetiology and pathogenesis of a number of pathological processes that include solid reactive lesions like pyogenic granuloma and chronic inflammatory disorders like periapical granuloma. Vascular Endothelial Growth Factor (VEGF) is a potent proangiogenic cytokine secreted by many cell types which present several pivotal functions in physiologic and pathologic angiogenesis. AIM: The aim of the present study was to evaluate and compare the expression of VEGF in oral Pyogenic Granuloma (PG) and Periapical Granuloma (PAG) and also to correlate with the inflammatory cell infiltrate. MATERIALS AND METHODS: Paraffin embedded tissue blocks of histologically diagnosed cases of PG and PAG, 20 of each were retrieved from the archives. The cases were selected randomly to evaluate the expression of VEGF marker and to assess the Mean Vascular Count (MVC) index and inflammation by Morphological Index (MI). The results were analysed using Unpaired t-test, Mann-Whitney U test and spearman correlation coefficient-test. RESULTS: The PG showed higher expression of VEGF when compared to PAG with no significant difference in inflammation. PG showed positive correlation and PAG showed negative correlation between inflammation and VEGF expression. CONCLUSION: Histologically similar PG and PAG are different not only by their clinical presentation but also by their mechanisms of formation and molecular sketch. Thereby raised expression of VEGF marker was established in PG emphasizing the fact that all histologically similar lesions need not have similar clinical course and molecular depiction.

A Rare Case Report of Spindle Cell Ameloblastic Carcinoma Involving the Mandible.

Ameloblastic Carcinoma (AC) is uncommon malignant epithelial odontogenic tumour of jaw, with characteristic histologic features and behavior. Clinically, it has aggressive, infiltrative growth pattern with a distinct predilection for mandible. It exhibits histologic features of ameloblastoma and gets dedifferentiated overtime to culminate in carcinoma. Majority of the cases arise denovo (primary) and only few cases arise from a pre-existing ameloblastoma (secondary). Spindle-cell differentiation in ameloblastic carcinoma is rare; Salter described it as a separate entity "low-grade spindle cell ameloblastic carcinoma. Here we report a case of 32-year-old female patient who presented with a swelling present for past six months. It was diagnosed as Spindle cell Ameloblastic Carcinoma (SpAC), after the hemimandibulectomy the patient was under regular follow up for 14 months, no sign of recurrence was seen.

Diagnostic accuracy of salivary creatinine, urea, and potassium levels to assess dialysis need in renal failure patients.

BACKGROUND: The prevalence of chronic renal failure is increasing because of increase in chronic debilitating diseases and progressing age of population. These patients experience accumulation of metabolic byproducts and electrolyte imbalance, which has harmful effects on their health. Timely hemodialysis at regular intervals is a life-saving procedure for these patients. Salivary diagnostics is increasingly used as an alternative to the traditional methods. Thus, the aim of the present study was to determine the diagnostic efficacy of saliva in chronic renal failure patients. MATERIALS AND METHODS: This case-control study included 82 individuals, of which 41 were chronic renal failure patients and 41 were age- and sex-matched controls. Blood and saliva were collected and centrifuged. Serum and supernatant saliva were used for biochemical analysis. Serum and salivary urea, creatinine, sodium, potassium, calcium, and phosphorus were evaluated and correlated in chronic renal failure patients using unpaired t-test, Pearson's correlation coefficient, diagnostic validity tests, and receiver operative curve. RESULTS: When compared to serum; salivary urea, creatinine, sodium, and potassium showed diagnostic accuracy of 93%, 91%, 73%, and 89%, respectively, based on the findings of study. CONCLUSION: It can be concluded that salivary investigation is a dependable, noninvasive, noninfectious, simple, and quick method for screening the mineral and metabolite values of high-risk patients and monitoring the renal failure patients.

Evaluation of cytomorphometric changes in tobacco users and diagnosed oral squamous cell carcinoma individuals.

AIMS: To determine the cellular and nuclear area of keratinocytes in smears obtained from the oral mucosa of tobacco users, those with oral squamous cell carcinoma (OSCC), and from normal healthy persons and resolve if any significant difference exists in these three groups. MATERIALS AND METHODS: The study group comprised 100 subjects 20 controls, (40 OSCC patients-20 from lesional sites and 20 from nonlesional sites, 20 tobacco smokers and 20 tobacco chewers) in the age group of 25-75 years. Oral mucosal smears obtained by using a cytobrush were stained with Papanicolaou (PAP) stain and using 20X objective in trinocular Olympus model BX53 with Jenoptik scientific grade-dedicated microphotographic camera images were taken. With ProgRes version 8.0 image analysis software, 20 cells with defined borders were evaluated from each slide. Finally, one-way analysis of variance (ANOVA) was used to compare the above parameters in the studied groups. STATISTICAL ANALYSIS USED: Minitab and Excel software were used to analyze the data. One-way ANOVA was used to compare the above parameters in the studied groups. RESULTS: The mean value of the cell area for groups I, II, III, IV, and V were 2838 ± 275.2, 2762.1 ± 511.4, 2861.9 ± 512.9, 2643.8 ± 333.3, and 3064.3 ± 362.7, respectively, the nuclear area (NA) was 83.88 ± 9.86, 106.19 ± 13.45, 95.11 ± 14.24, 85.55 ± 21.11, and 80.83 ± 13.45, respectively, and nuclear-to-cellular (N:C) ratio was 0.0297, 0.03924, 0.0337, 0.03257, and 0.02678, respectively. CONCLUSIONS: Thus, our study elucidates that cytomorphology gauges the effect of tobacco on the oral mucosa and possibly establishes a link between premalignant and malignant transformations even before a lesion is visibly noted.

Certainty of S100 from Physiology to Pathology.

S100 exists in wide variety of tissues and cell types, originally isolated from brain tissue and they are of low molecular weight proteins. S100 is evenly distributed in cytoplasm and also in nucleoplasm and is involved in both intercellular and extracellular functions. S100 protein is generally expressed in normal and also in pathological conditions. In current review, we discuss: a) update nomenclature of the various S100 proteins, b) expression of S100 in oral diseases (different soft tissue tumors, odontogenic cyst and tumor) for diagnostic value and also to know their histogenesis, c) role of S100 and RAGE receptor in oral squamous cell carcinoma.

Alveolar rhabdomyosarcoma of maxilla.

Rhabdomyosarcoma (RMS), a malignant neoplasm of skeletal muscle origin, is the most common soft tissue sarcoma seen in childhood and adolescence. The most frequent site is the head and neck accounting for 40% of all cases and other involved sites are genitourinary tract, retroperitoneum, and to a lesser extent, the extremities. RMS is relatively uncommon in the oral cavity and the involvement of the jaws is extremely rare. Here, we report a case of 50-year-old female with oral RMS involving maxillary alveolar region with clinical, radiological, histopathological and immunohistochemical findings.