Age estimation using extracted teeth in coastal Karnataka population.

Introduction: Age estimation using regressive alterations such as root dentin translucency, PDL attachment, and attrition are easy and reliable way of predicting the age. However, extensive and population-specific formula has not been generated. This attempt was to assess the correlation of these alterations with age and to generate a Linear regressive formula, specific to this population. Methods and Material: Three alterations were assessed such as dental attrition, root dentin translucency, and periodontal attachment level from the extracted teeth. Dental attrition was measured using Johanson's and Li and Ji criteria. PDL attachment level and root dentin translucency was measured using the Johanson method and the Lamendin method. Statistical Analysis: SPSS software (Version 27), Pearson correlation test, and Linear regressive analysis were used. Results: Our results showed all three factors/parameters such as attrition, periodontal ligament, and translucency having a very good correlation with age and correlation coefficient r value ranging from 0.6 to 0.8. All the parameters were having statistically significant correlation with P value <0.005. Among them, root dentin translucency with Johanson G method showed excellent correlation with r = 0.83 followed by PDL attachment by Johanson G method with r = 0.702. Conclusions: Regressive changes such as Dentin translucency, PDL attachment and attrition on Coastal Karnataka showed a very good correlation with age. Among them, Dentin translucency by Johanson G method had the best correlation with the a standard error of estimate (SEE). Results of our study indicates that all these parameters [Translucency, PDL attachment, and attrition] can be utilized in age estimation.

The effects of recasting on the cytotoxicity of dental base metal casting alloys.

AIM AND OBJECTIVES: In dentistry, base metal casting alloys are extensively used for the fabrication of inlays, onlays, crowns, bridges, partial dentures, etc. During the casting of these alloys, excess amount of material used than needed will be collected as sprue buttons at the end, which is either added to the fresh alloy during casting and reused or disposed of. MATERIALS AND METHODS: The aim of the present in vitro experimental study was to investigate the effect of the complete recasting of four commercially available cobalt-chromium (Co-Cr) and nickel-chromium (Ni-Cr) base metal casting alloys on their cytotoxicity. During the study, four groups of alloys were subjected to complete recasting up to twenty times without the addition of new alloy. The cytotoxicity assessment of the selected alloys after recasting (Co-Cr and Ni-Cr alloys) was carried out using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. RESULTS: The results indicated that Co-Cr alloys exhibit superior cell viability compared to Ni-Cr alloys, and cytotoxic potential of the alloys increased with repeated casting and led to increased cell death. The recasting of alloys in the present study did not show high cytotoxicity even after the 20th recasting. CONCLUSION: From the results of the present study, it can be concluded that the alloys generated as a waste in the dental laboratory can be safely reused up to five times or at least once before they can be disposed, which reduces the cost of the treatment and also helps in conserving the natural resources.

Floret-like giant cells in intra-osseous schwannoma.

Floret-like giant cells are very commonly seen in neurofibroma and as an indication to be associated with neurofibromatosis type 1 gene. This particular case of intraosseous schwannoma of mandible showing such giant cells, which is rarely reported.

BCL-X expression in oral cancer: Comparison between oral squamous cell carcinoma and verrucous carcinoma.

BACKGROUND: Verrucous carcinoma (VC) should be considered a distinct clinicopathologic entity different from the more common oral squamous cell carcinoma (OSCC) because of its unique biological behavior. Best way to understand the behavior of these carcinomas is to study them by means of molecular methods, especially in tumor progression tests and Bcl-X is an important antiapoptotic member of the Bcl-2 family and is one of the newest and most useful markers to determine the aggressiveness of many carcinomas. The relationship between this Bcl-X protein and carcinomatous behavior toward it is not studied extensively, which we attempted to evaluate using immunohistochemical analysis in selected carcinomas of the head and neck region. METHOD: We studied Bcl-X protein expression in sections of thirty OSCC and ten VC samples and correlated this with tumor differentiation. RESULTS: There was a significant difference in cytoplasmic staining of Bcl-X expression with statistical analysis (P < 0.005) for VC and OSCC when compared as a group. No significance was seen among the different histological grades of OSCC and when compared with VC individually. CONCLUSION: The significant result between OSCC and VC suggests that their biologic course is comparable and can be helpful in differentiating them with each other for establishment of a better treatment protocol.

Comparative immunohistochemical study of Bcl-X in ameloblastoma, keratocystic odontogenic tumor and adenomatoid odontogenic tumor.

OBJECTIVES: Since its recognition as a physiologic process associated with tumor, among molecular mechanisms involved in tumor progression, defects in regulation of apoptosis have generated an accelerating volume of research that has sought to elucidate the role of programed cell death in pathogenesis and treatment of various tumors. Therefore, this study was performed to understand better the diverse biological profile of epithelial odontogenic tumors with the help of immunohistochemical expression of Bcl-X protein. MATERIALS AND METHODS: We studied Bcl-X protein expression in 45 cases of epithelial odontogenic tumors which included 15 cases each of ameloblastomas, keratocystic odontogenic tumor (KCOT) and adenomatoid odontogenic tumor (AOT) and correlated the expression with their growth pattern. RESULTS: Cytoplasmic staining of Bcl-X revealed overexpression in ameloblastoma when compared to KCOT and AOT. Percentage of positive cells showed a statistically significant difference, P = 0.007 between ameloblastoma and KCOT, whereas P < 0.001 between ameloblastoma and AOT. However, no significance was observed between KCOT and AOT (P = 0.132). CONCLUSION: The present study supports the fact that epithelial odontogenic tumors show diverse growth profiles. An increased Bcl-X expression was seen in ameloblastoma compared to KCOT and least expression in case of AOT which could be indicative of more aggressive biological behavior and increased cell survival activity of ameloblastoma than KCOT and AOT. This signifies the diagnostic relevance of this biomarker and also could be a possible regulator of the proliferative compartment by contributing in tumor progression and cytodifferentiation of epithelial odontogenic tumors.

Heat shock protein (HSP70) as a marker of epithelial dysplasia in oral dysplastic lesions: A clinicopathological study.

OBJECTIVE: In the present study, expression of heat shock protein (HSP70) was evaluated and compared in oral dysplastic lesions, in particular leukoplakia (study group) and in normal mucosal tissues (control group). Additionally, correlation of HSP70 expression with clinical disease status was investigated. SUBJECTS AND METHODS: A total of 60 fresh tissue specimens were obtained from the oral cavity, consisting of 30 dysplastic cases and 30 normal mucosal tissues. The presence of epithelial dysplasia and its histologic grading was evaluated. Immunohistochemistry was carried out with the monoclonal HSP70 antibodies and expression of cytoplasmic HSP70 within the epithelium was compared between dysplastic and normal mucosal samples using Student's t-test. RESULTS: Expression of HSP70 was detected in 93% of the oral dysplastic tissues and 20% of the normal mucosal tissues. Statistical significant difference in the HSP70 expression was seen between oral dysplastic tissues and normal oral mucosal tissues (P < 0.000). The interexaminer reliability was 93.3%. Statistical significant difference was seen in the HSP70 expression between controls and different grades of dysplasia (mild, moderate and severe). There was no relationship of HSP70 expression with clinical parameters like age, sex, site of the lesion, history of adverse habits and duration of adverse habits. CONCLUSION: In the present study, HSP70 activity was significantly higher in oral dysplastic (leukoplakia) group than in the control group. Further, as the grade of dysplasia increased, the staining intensity and/or distribution increased, indicating that enhanced HSP70 expression occurs during oral carcinogenesis. Hence, it is concluded that increased HSP70 immunoexpression could be an objective marker for the presence of epithelial dysplasia.

Comparing the efficacy of coconut oil and xylene as a clearing agent in the histopathology laboratory.

BACKGROUND: The commonly used clearing agent, xylene is supposed to be highly toxic and carcinogenic. As previous research studies have shown the effectiveness of different vegetable oils as clearants, this study was designed to evaluate the efficacy of coconut oil. MATERIALS AND METHODS: Two equal halves of 60 soft tissue specimens were processed simultaneously in xylene and coconut oil as clearing agents. The Xylene-treated specimens (XY-S) and Coconut oil-treated specimens (CO-S) were checked for gross and histological features and comparison was done between the two groups. RESULTS: Significant shrinkage was noted in XY-S compared to that in CO-S. No difference was found in either of the sections when checked for cellular details and staining quality. Morphometrically, there was significant reduction in the mean cell area in XY-S compared to that in CO-S. CONCLUSION: Coconut oil may be substituted for the highly hazardous xylene as a clearing agent without compromising the quality of histological details.

Immunohistochemical expression of calretinin in ameloblastoma, adenomatoid odontogenic tumor, and keratocystic odontogenic tumor: a comparative study.

Calretinin is expressed primarily in the central and peripheral nervous system and extensively studied in colon adenocarcinoma and mesotheliomas. Calretinin is known to be expressed in the odontogenic epithelium and odontogenic tumors. However, the role of calretinin in the pathogenesis of odontogenic tumors is yet to be confirmed. Hence, the aim of the present study was to evaluate the expression and role of calretinin in selected odontogenic tumors. The study included 30 ameloblastomas, 30 adenomatoid odontogenic tumors, and 30 keratocystic odontogenic tumors. Staining intensity, pattern, and localization of the immunopositive cells were determined. Statistical analysis was performed using Mann-Whitney U test and Kruskal-Wallis analysis of variance test. P-values <0.05 were considered to be statistically significant. Results showed that 90% ameloblastomas and 80% keratocystic odontogenic tumors were immunopositive to calretinin, whereas none of the adenomatoid odontogenic tumors showed reactivity. Intensity was higher in the ameloblastomas compared with the keratocystic odontogenic tumors. Statistically significant differences were observed when the expression of calretinin was compared, except between the ameloblastoma and keratocystic odontogenic tumor. However, the intensity of calretinin was significantly higher in the ameloblastoma when compared with the keratocystic odontogenic tumor. On the basis of these results, it is suggested that calretinin might be used as a specific immunohistochemical marker for the ameloblastomas and could play an important role in the differentiation of aggressiveness of different odontogenic tumors. Depending on the cell regulatory processes, we suggest a possible role of calretinin in the pathogenesis of ameloblastomas and have to be further studied along with other proliferative cell cycle and apoptotic markers with larger sample size.

Analyses of odontometric sexual dimorphism and sex assessment accuracy on a large sample.

Correct sex assessment of skeletonized human remains allows investigators to undertake a more focused search of missing persons' files to establish identity. Univariate and multivariate odontometric sex assessment has been explored in recent years on small sample sizes and have not used a test sample. Consequently, inconsistent results have been produced in terms of accuracy of sex allocation. This paper has derived data from a large sample of males and females, and applied logistic regression formulae on a test sample. Using a digital caliper, buccolingual and mesiodistal dimensions of all permanent teeth (except third molars) were measured on 600 dental casts (306 females, 294 males) of young adults (18-32 years), and the data subjected to univariate (independent samples' t-test) and multivariate statistics (stepwise logistic regression analysis, or LRA). The analyses revealed that canines were the most sexually dimorphic teeth followed by molars. All tooth variables were larger in males, with 51/56 (91.1%) being statistically larger (p < 0.05). When the stepwise LRA formulae were applied to a test sample of 69 subjects (40 females, 29 males) of the same age range, allocation accuracy of 68.1% for the maxillary teeth, 73.9% for the mandibular teeth, and 71% for teeth of both jaws combined, were obtained. The high univariate sexual dimorphism observed herein contrasts with some reports of low, and sometimes reverse, sexual dimorphism (the phenomenon of female tooth dimensions being larger than males'); the LRA results, too, are in contradiction to a previous report of virtually 100% sex allocation for a small heterogeneous sample. These reflect the importance of using a large sample to quantify sexual dimorphism in tooth dimensions and the application of the derived formulae on a test dataset to ascertain accuracy which, at best, is moderate in nature.

Fibro-osseous lesions of the oral and maxillo-facial region: Retrospective analysis for 20 years.

BACKGROUND: Fibro-osseous lesions (FOLs) are one of the commonest entities reported in the head and neck region. However, studies on these groups of lesions on Indian population were not carried out before. So this motivated us to analyze the clinico-pathologic correlation of fibro-osseous lesions reported at our hospital. MATERIALS AND METHODS: A retrospective review was made of all the lesions surgically treated in our hospital. A total of 6,175 biopsies were performed during the study period. All the cases which were histopathologically diagnosed as FOLs were included in the study. The demographic data, radiographic features, and histopathologic findings were analyzed and compared with similar studies on other races. RESULTS AND CONCLUSION: We could find 80 cases diagnosed as fibro-osseous lesions and information about them was documented. The most common FOL reported in the region was cemento-ossifying fibroma (COF) (75%) than fibrous dysplasia (FD) (25%). These were commonly occurring in 2(nd) decade without any sex or site predilection. However, COF was showing a slight female predominance and FD with a definite male predominance. COF was commonly seen in mandible (posterior region) whereas FD mainly confined to the maxilla (as a whole bone). Radiographically, most of COF showed well-defined mixed opaque and lucent areas whereas FD showed diffuse borders. Cortical plate expansion and resorption of associated teeth was a frequent finding in COF when compared with FD. Histopathologically, stroma was fibrocellular in many cases of COF, whereas most FDs showed fibrous stroma, interspersed with mainly woven bone.

Are teeth useful in estimating stature?

Estimating stature is an important step in reconstructive identification of skeletonized and dismembered human remains. While numerous body parts such as the skull and long bones have been used for the purpose, the dentition has seldom been applied. The present study has ventured to ascertain the usefulness of tooth crown measurements in stature prediction. Buccolingual and mesiodistal dimensions of all teeth (except third molars) and stature measurements were obtained from 95 living adults (47 females, 48 males). Correlation analysis revealed that 21 of the 56 tooth crown variables had a low albeit statistically significant correlation to stature (p < 0.05); correlation matrix computed for the crown variables showed significant inter-correlations between most teeth (problem of multi-collinearity). Therefore, instead of regular least square regression analysis, ridge regression was performed for the dentition, which revealed a moderate but statistically significant correlation to stature (R = 0.68; p < 0.0001). The ridge regression equation derived had a standard error of estimate (SEE) of 8.09 cm. The multiple correlation for tooth dimensions is lower to, and the SEE larger than, most other body parts. The moderate correlation is probably due to early completion of growth of tooth crowns vis-à-vis other parameters such as long bones that mature later and have a higher stature-correlation. This indicates that the dentition may be used only as a supplement to more robust indicators of stature.

Etiopathogenesis of orofacial clefting revisited.

The cleft anomaly may be more ancient than the man himself. It is one of the most common developmental malformations reported in the literature. There are number of intriguing theories regarding its etiopathogenesis, each of which has some evidence in its favor. This review highlights all the genetic and environmental etiologic factors and focuses on its pathogenesis.

Inflammatory pseudotumor of maxillary sinus: Mimicking as an aggressive malignancy.

Inflammatory pseudotumor is a rare entity in the head and neck region. Clinically it behaves as an aggressive lesion with extensive destruction but considered to be a benign reactive process. Because of its extensive involvement and infiltrative nature, it is confused as a malignancy. Most of them respond very well to corticosteroid and surgical excision.

Validity of the mandibular canine index (MCI) in sex prediction: Reassessment in an Indian sample.

The dentition's use in sex assessment has been explored and advocated owing to its strength and resistance to peri- and postmortem insults. Among the teeth, canines have shown the greatest sexual dimorphism; they are also known for greater resistance to pathological alterations and trauma. These factors have prompted some researchers to explore its use alone in sex prediction. Specifically the mandibular canine index (MCI), which is the ratio of the mesiodistal (MD) dimension of the lower right canine and the inter-canine arch width, was developed by Rao et al. [Forensic Sci. Int. 42 (1989) 249-254] who predicted sex correctly in ∼86% of cases in a South Indian sample. These results were verified subsequently by other Indian researchers, both on southern and on northern Indians, although such success rates were not apparent in another South-Asian population as well as a European group. The present study re-examined the method in 203 Indians (103 males, 100 females) of age 19-32 years who originated from diverse states of the country, constituting all major religious and caste affiliations, and found relatively low sex estimation accuracy using the MCI (∼51%). This is in spite of the MD dimension of canines as well as inter-canine arch width - the absolute measurements used for deriving the MCI - showing statistically significant sex differences (p<0.05); also, the application of multivariate statistics, viz. logistic regression analysis, revealed higher accuracy levels of sex estimation for the absolute measurements (∼62-66%) vis-à-vis the MCI (∼50%). The results herein reinforce recent observations that ratios obtained from teeth, such as the MCI, do not reflect sexual dimorphism that may be present in absolute measurements. Furthermore, we believe that the basis for using MCI as a sex assessment tool is questionable, since it depends on the levels of sexual dimorphism between the absolute dimensions-low sexual dimorphism in one (e.g. MD measurement of canines) and proportionately high sexual differences in the other (e.g. inter-canine arch width), or vice versa, would lead to higher sex estimation accuracy of the MCI; on the other hand, relatively equal levels of sexual dimorphism in both would negate the ability of the MCI to accurately estimate sex. These suggest that the MCI has little utility in sex estimation and that its application should be restricted, if not discontinued altogether, in forensic and anthropological sex prediction.

Odontometric sex assessment from logistic regression analysis.

Odontometric sex assessment is considered a useful adjunct to more robust predictors such as pelvic and cranial bones, and discriminant function analysis (DA) has been widely applied in dental sex assessment. Logistic regression analysis (LRA) is considered a better alternative, although still untested in odontometric sex prediction. This study examines the use of LRA in dental sex assessment and compares its success to DA. Mesiodistal and buccolingual dimensions of all teeth, except third molars, were obtained on dental stone casts of 105 young adults (52 females, 53 males) using digital caliper. Application of LRA to teeth of both jaws combined and to maxillary and mandibular teeth separately yielded correct sex allocation rates ranging from 76% to 100%, which proved superior to sex assessment using DA (∼52-71%). LRA enabled optimal sex prediction (100%) when all teeth in both the jaws were included. Results were not as accurate when only maxillary (76.2%) or mandibular (84.8%) teeth were used. To assess and compare the use of these multivariate techniques in practical forensic casework, >25% of tooth variables were randomly deleted. LRA still performed better (∼91% sex allocation accuracy vs. 62.9% for DA), indicating that LRA may be superior in its ability to predict sex irrespective of the presence of complete or incomplete sets of dentitions and should be preferred in dental sex assessment. The 100% success rate of LRA in correctly assigning sex is also noteworthy considering that, in general, tooth measurements have yielded sub-optimal sex prediction levels. However, unambiguous sex assessment is possible only when the entire dentition is available and correct sex allocation levels decreases when teeth are missing.

Glandular odontogenic cyst mimicking central mucoepidermoid carcinoma.

Glandular odontogenic cyst (GOC) is a rare developmental cyst of the jaws. The most common site of occurrence is the anterior mandible, and it is most commonly seen in middle-aged people. It is a destructive lesion with a high rate of recurrence. A predilection for men is observed. Clinical and radiographic findings are not specific, and it can mimic as any other destructive lesion of the jaw. The histopathological features of GOC and those of low-grade central mucoepidermoid carcinoma (MEC) are similar. Often, they are misdiagnosed as MEC. We present a case of GOC in the posterior maxilla, which is a rare site. The similarities and differences between GOC and central MEC are also discussed.