A study to estimate the serum IgA and salivary IgA levels in patients with oral leukoplakia and oral squamous cell carcinoma.

Context: The increasing death rate because of oral cancer is mainly due to its late diagnosis. Tumour markers are often detected in abnormal amounts in blood, urine or saliva of patients with certain types of cancer. Diagnosing cancer through human saliva has advantages such as low invasiveness, minimum cost and easy sample collection. We have used serum immunoglobulin A (IgA) and salivary IgA for our present study. Aims: The aim of present study was to estimate serum and salivary IgA levels in oral leukoplakia and oral squamous cell carcinoma (OSCC) patients. Settings and Design: The study included 40 patients; 10 in the control group, 15 cases with oral leukoplakia and 15 cases with OSCC. Methods and Material: The blood samples and saliva were taken from clinically diagnosed oral leukoplakia and OSCC patients and were tested for IgA levels. Statistical analysis used: The data were analysed using SPSS 16.0. The mean values were compared between the groups by using analysis of variance (ANOVA) followed by post-hoc test for group-wise comparison. P value ≤ 0.05 was considered significant. Results: It was observed that the comparison of levels of serum IgA in control and leukoplakia group; control and OSCC group; leukoplakia and OSCC group were found to be statistically significant. Also, comparison between the levels of salivary IgA in control and OSCC group was found to be statistically significant. Conclusion: It is suggested that the serum and salivary IgA levels could be a better adjuvant diagnostic marker along with routine markers in patients with premalignant and malignant lesions.

Evaluation of magnesium levels in serum and saliva by calmagite method in individuals with tobacco habits with or without potentially malignant disorders.

Aim: To evaluate and compare the magnesium levels in serum and saliva of individuals with tobacco habits with and without potentially malignant disorders (PMDs). Materials and Methods: A total number of 60 patients were taken in the study, which included group A: 20 healthy patients without any tobacco or alcohol habits, without any PMDs, and without any systemic diseases; group B: 20 patients with tobacco habits and without PMDs; and group C: 20 patients with tobacco habits and with PMDs. The serum and salivary samples were collected from the patients and were subjected to magnesium level estimation using the calmagite method. Statistical analysis was performed using the Shapiro-Wilk W test and Mann-Whitney test. Results: The mean salivary magnesium levels were increased in group B (1.442 mg/dl), followed by group C (0.551 mg/dl), and then group A (0.463 mg/dl). The mean serum magnesium levels were increased in group B (1.891 mg/dl), followed by group C (1.608 mg/dl), and then group A (1.589 mg/dl). The salivary and serum magnesium levels were significantly high in patients with tobacco habits and without PMDs compared to the control group. The salivary and serum magnesium levels were significantly decreased in patients with tobacco habits with PMDs compared to the patients with tobacco habits and without PMDs. Conclusion: The study established a significant correlation between the salivary and serum magnesium levels in patients with tobacco habits, with or without PMDs, and showed that as the disease progressed, the salivary and serum magnesium levels decreased.

Evaluation and comparison of vertical marginal fit of three different types of multiunit screw-retained framework fabricated for an implant-supported prosthesis - An in vitro study.

Aim: The present study aimed to evaluate on a comparative basis the vertical marginal fit between conventionally casted, direct metal laser sintered (DMLS), and milled computer-aided design/computer-aided manufacturing (CAD-CAM) one-piece metal framework supported by five implants using one-screw test and screw resistance test. Settings and Design: This is an in vitro study. Materials and Methods: Five implants were placed parallel to one other in a Styrofoam master model. A total of 30 implant-supported screw-retained superstructures were manufactured using three techniques, i.e., conventionally casted, milled, and sintered. To evaluate the vertical marginal discrepancy, screw resistance test, and one-screw test were used, and measurements were made using a stereomicroscope. Statistical Analysis Used: The data was analysed using two statistical tests, i.e., ANOVA and the post hoc Bonferroni test. Results: On evaluating the frameworks using one-screw test, the mean vertical misfit value at the terminal implant for the control group was 292.58 ± 15.46µm, for conventionally casted framework 398.41 ± 21.13 µm, for DMLS 343.44 ± 24.73 µm, and for CAD-CAM was 304.03 ± 14.23 µm, whereas the average misfit values at four implants on applying screw resistance test were 1268.65 ± 84.24 (control), 1774.88 ± 67.70 (casted), 1508.02 ± 62.19 (DMLS), and 1367.29 ± 81.87 (CAD-CAM). The average misfit values on two implants using screw resistance test were 635.02 ± 57.33 for the control group; for conventionally casted, it was 879.75 ± 35.93; for (DMLS) framework, it was 761.51 ± 32.85; and for milled CAD-CAM framework, it was 687.07 ± 42.17 µm. Conclusion: The mean vertical marginal discrepancy, when compared with control, was least in milled CAD-CAM frameworks, followed by sintered DMLS and conventionally casted frameworks. Hence, according to the present study, CAD/CAM technique is recommended to achieve maximum marginal fit in full mouth screw-retained implant-supported FDPs.

Acceptability of coronavirus disease 2019 vaccination among Indian health-care professionals: A cross-sectional survey.

Objective: The epidemic of novel coronavirus disease 2019 (COVID-19) has led to the development of several vaccine candidates which has been progressing at an unprecedented rate. Health-care professionals are somewhere standing between their professional commitments and personal well-being, amid concerns about the safety and efficacy of the vaccine. The present survey was conducted to analyze their approach toward vaccination. Materials and Methods: An online questionnaire-based cross-sectional survey was conducted among 250 health-care professionals comprised of Medical, Dental, Ayurveda, Physiotherapy doctors, and nursing staff working at a tertiary care hospital in Gurugram city. A self-administered 10-item questionnaire in the Google document format was developed to assess their perception and attitude toward vaccination. The present survey was carried out for 2 months from November to December 2020. The responses recorded were subjected to the statistical analysis using the Chi-square test and the level of statistical significance was set at P ≤ 0.05. Results: Among all participants, 72 (28.8%) were male and 178 (72.2%) were female. Of all, 60.4% of the health-care professionals somewhat or completely agreed to accept a vaccine as soon as it is available. Nursing staff reported more likely to accept COVID-19 vaccination than the other health-care professionals. Majority of the HPs (44%) were found to be concerned about the rapidity in the development of vaccine. Conclusion: The overall attitude toward vaccination was positive but specific concerns regarding COVID-19 vaccine are prevalent. Thus, to maintain the benefits of vaccination programs and for its successful implementation, understanding and addressing their vaccine hesitancy will be crucial.

COVID-19: A gender-biased pandemic.

The world today is in the midst of its second wave of the coronavirus disease 2019 (Covid-19), which started as an outbreak first reported in December 2019, Wuhan City, the capital of Hubei Province in China. Then soon enough, it was declared as a public health emergency of international concern on January 30, 2020 by WHO and a pandemic on March 11, 2020. While initially greater emphasis was laid on the elderly and people with co-morbidities such as diabetes mellitus, hypertension, obesity, and immune-compromised states as being at high risk of contracting the Covid-19 disease and/or dying of it, but by now, it is clear that being male is also a factor. Data and studies from different countries across the globe involving China, the United States of America, and European nations such as Italy have showed that although there is no difference based on sex in the number of cases testing positive for the virus, more men died from the virus, and the case-fatality ratio is greater among men than women. Women are infected by the virus as frequently as men but men are more likely to contract severe forms of disease and succumb to it. The reason behind this sex-biased mortality seen in Covid-19 cannot be explained by a single genetic or social factor. The present short communication aims at enumerating the possible reasons behind this gender-biased pandemic.

Perception and willingness toward oral pathology and histology as a subject and profession among Indian dental undergraduates.

BACKGROUND: Oral pathology, a branch of dentistry which is often termed as a nonclinical branch deserves a better description as fundamental knowledge of oral pathology is essential to become a successful dental clinician. This study was conducted to analyze the approach toward Oral Pathology and Histology as a subject and profession among dental undergraduates. MATERIALS AND METHODS: A questionnaire-based, cross-sectional study was conducted among 200 students which included the 3rd year, 4th year and interns studying in a Dental College in Gurugram, Haryana. The questionnaire comprised 14 close-ended questions, divided under three parameters which included demographic characteristics, students' perception about the Oral Pathology and Histology as a subject, and willingness to choose it as a career option. The data recorded was subjected to statistical analysis using the Chi-square test. The level of statistical significance was set at P ≤ 0.05. RESULTS: Among all the participants, 53 (26.5%) were males and 147 (73.5%) were females. It was found that 33.5% of the total students find the subject interesting, but 24.5% students reported their main focus on just passing this subject. Although they reported liking toward the subject, majority of them (64%) did not express their interest to pursue it as their postgraduation specialty. CONCLUSION: The present scenario of Oral Pathology and Histology as a subject is alarming and in that scenario it should be our prime concern to change the attitude of students toward the subject who perceive it as a nonclinical subject having a lesser scope for practice with a need to broaden the scope of the specialty and to make it more practical.

Role of Cytokeratin-7 in the pathogenesis of odontogenic cysts - an immunohistochemical study.

INTRODUCTION: Odontogenic cysts are distinct entities and quite a common occurrence in the jaw bones. These are individual lesions which arise from the same odontogenic apparatus but with varying pathogenesis. Cytokeratins are integral components in tooth development and are expressed across the odontogenic tissues in physiological and pathological states. AIM: To elucidate the role of cytokeratin-7 in the pathogenesis of odontogenic cysts by immunohistochemistry. METHOD: Cytokeratin-7 (CK-7) was assessed in 39 cases of odontogenic lesions retrieved from the archival files which included 15 cases of dentigerous cysts (DC), 12 cases of odontogenic keratocysts (OKC) and 12 cases of radicular cysts (RC) and also 8 cases of control specimens. STATISTICAL ANALYSIS: Results obtained were statistically analyzed using chi-square test to assess the association between different odontogenic cysts used in this study and Cytokeration-7 staining. The difference was considered to be of statistical significance if the p value was ≤ 0.05. RESULTS: CK7 expression was maximum in dentigerous cycts (66.66%) followed by radicular cysts (41.66%) and odontogenic keratocysts (16.6%). On evaluation of staining and expression pattern, highest positivity is shown in dentigerous cysts and the positivity is seen in suprabasal (60%) and superficial layers (40%) whereas radicular cysts and odontogenic keratocysts showed positivity in superficial and spinous layers. CONCLUSION: Cytokeratin-7 expression correlates with the degree of differentiation of the epithelium. So the cysts with a well-differentiated epithelium (RC and DC) express CK-7, while the cysts with a less well-differentiated epithelium (OKC) show slight positivity. Thus it can be useful to differentiate OKC from DC and RC.

Is focal melanotic lesion potentially malignant? A case report.

Malignant melanoma is a lesion of melanocytes that is commonly observed on cutaneous surfaces. In 35-50% of cases, it originates from a pigmented precursor. Although oral melanocytic pigmentation is very common, melanocytic malignancies such as melanoma, are rare. Oral melanoma may arise from pre-existing pigmentation, but definitive precursor lesions have not been identified. Common sites for oral melanoma are the maxillary gingiva and palate. We report a case of malignant melanoma that transformed from a long-standing, focal, pigmented lesion on the mandibular gingiva and vestibular mucosa, suggesting the potentially malignant nature of focal oral melanotic lesions.

Granular cells in ameloblastoma: An enigma in diagnosis.

Ameloblastoma is an epithelial odontogenic tumor exhibiting diverse microscopic pattern that occurs singly or in combination with other patterns. This article describes a case of granular cell ameloblastoma (GCA) involving mandible in a 55-year-old male. The possibility of granular component is there in other odontogenic and nonodontogenic lesions. Sometimes dilemma exists in the diagnosis of such lesions. The purpose of this article is to unveil the hidden characteristics in GCA, which might help in differential diagnosis of GCA.

Ameloblastic fibroma with ghost cell differentiation and calcification: A unique case report.

The ameloblastic fibroma (AF) is an uncommon odontogenic tumor that may present an aggressive behavior and may have potential for malignant transformation. Ghost cell differentiation within AF is extremely rare. There are only seven cases in English literature in which ghost cells are found in AF but all these previously reported cases were associated with typical calcifying odontogenic cyst. Here, we present a unique case in 3(1/2)-year-old child with solid lesion which comprised odontogenic epithelium strands, islands, and myxoid ectomesenchyme with focal areas of ghost cell differentiation and calcification associated with neoplastic epithelium.

Comparative Evaluation of the Effect of Menstruation, Pregnancy and Menopause on Salivary Flow Rate, pH and Gustatory Function.

OBJECTIVE: There are five situations in a women's life during which hormone fluctuations make them more susceptible to oral health problems - during puberty, at certain points in the monthly menstrual cycle, when using birth control pills, during pregnancy, and at menopause. The present study aimed at evaluating the effect of menstruation, pregnancy and menopause on salivary flow rate, pH and gustatory function. MATERIALS AND METHODS: The study was carried out on 120 patients including 30 controls (with normal menstrual cycle of 28 to 30 d) and 90 cases (30 patients within three days of menstruation, 30 pregnant and 30 postmenopausal). Paraffin-stimulated saliva samples were obtained by expectoration to calculate salivary flow rate, pH was measured electrometically and patients were prospectively evaluated for gustatory function. Then, whole mouth taste test was performed in which the quality identification and intensity ratings of taste solutions were measured. RESULTS: No statistically significant difference was found between the groups with respect to salivary flow rate but pH values were significantly lower in post menopausal women (p<0.05). Regarding correct quality identification the results were non-significant. Intensity for taste perception for sucrose was significantly lower in postmenopausal women than intensity of taste perception for other tastes (p<0.05). Also, postmenopausal women reported change in their dietary habits as all of them expressed liking for sweeter food. CONCLUSION: Reduced salivary flow rate and pH in postmen-opausal women may make them more prone to the occurrence of oral health problems. Also, pregnant and postmenopausal women appeared to have a reduced perception of sucrose, which can alter eating habits, such as intake of more sweet foods whereas no significant difference is observed in taste perception of NaCl, citric acid and quinine hydrochloride between the subjects.