Dermatoglyphic findings in dental caries and their correlation with salivary levels of Streptococcus mutans and Lactobacillus in school-going children in and around Moradabad.

INTRODUCTION: Dental caries is the disease of the calcified tissues of the teeth resulting from the action of microorganisms on carbohydrates characterized by a decalcification of inorganic portion of the tooth and accomplished or followed by disintegration of organic portion. Genetic susceptibility to dental caries is dependent on certain factors, which, if evaluated, can help in estimating disease situation prematurely. Dermatoglyphics are the genetically determined dermal ridge configurations on the digits, palms and soles, influenced by environmental forces that are operating before birth. Hence, the study was undertaken to establish a possible link between dental caries and dermatoglyphics and to determine whether specific dermatoglyphic patterns exist which help in predicting the occurrence of dental caries. SUBJECTS AND METHODS: The dermatoglyphics of 50 caries free (CF) and 50 individuals with dental caries (WDC) were taken and compared with the microbial levels of Streptococcus mutans and lactobacilli, and results were evaluated qualitatively and quantitatively. STATISTICAL ANALYSIS: Analysis was done using P value, Chi-square test and Student's t-test. RESULTS AND CONCLUSION: (1) Whorl pattern was more common in individuals WDC (P < 0.0001) as compared to the CF individuals who exhibited more loop pattern (P = 0.002). (2) Whorl pattern had significant association with the microbial counts of S. mutans (P = 0.383) and Lactobacillus (P = 0.015) with no such statistically significant correlation with loop pattern in the disease group. (3) ≤6 loops was a good predictor of caries. ≥4 whorls was a moderate predictor of caries.

Evaluation of histomorphometric changes in tissue architecture due to fixation delay.

INTRODUCTION: All good tissue specimen preparations require complete fixation. The process of tissue handling and processing from patient to paraffin block is too frequently invisible to the pathologists. Many times due to certain emergencies or unavailability of a proper fixative, tissues are kept in different carrying media such as normal saline (NS) or local anesthetic till the availability of a proper fixative solution. This fixation delay can lead to various tissue architectural changes which can affect its diagnostic value. AIMS: The aim of this study was to assess sectioning ability, staining intensity and microscopic details of tissues kept in different carrying media at different time intervals followed by standard fixation. MATERIALS AND METHODS: Fresh tissue specimen, i.e., goat tongue was collected and its middle portion was retained and was used for study purpose. The tissue was grossed and kept in various carrying media for five different time intervals. Standard formaldehyde fixation was then carried out followed by sectioning and staining. The sections were evaluated histologically under light microscope. STATISTICAL ANALYSIS: For sectioning parameter, Fisher's exact test and for staining and microscopic details, Mann-Whitney U-test was used. RESULTS: According to the study, NS is considered as a best carrying media followed by 10% honey and local anesthetic. Two percent hydrogen peroxide cannot be used as a carrying media. CONCLUSION: It was concluded that NS should be given first preference as a carrying media till the availability of a suitable fixative. Clinicians and Pathologists should have to familiarize themselves with the advantages and disadvantages of using various carrying media and the histomorphometric changes associated with delayed fixation which may lead to incorrect diagnosis.

Anthropometric study using craniofacial features to determine gender in Lucknow population.

BACKGROUND: Gender is one of the main characteristics analyzed for positive human identification in forensic medicine. The methods involving physical anthropology present high rate of accuracy for human identification and gender estimation. AIM: This study aimed to determine gender through different craniofacial variables using physical anthropometric methods. MATERIALS AND METHODS: A cross-sectional study was conducted among 100 individuals (50 males and 50 females) in Lucknow. Variables studied through physical anthropometry in both the genders were facial height, nasion-to-menton distance, interzygomatic arch width, and intercanthal width using a digital sliding caliper. All the measurements were taken twice. The final value was the average of the two obtained values. RESULTS: Comparing the mean craniofacial features between two genders, t-test revealed significantly higher facial height, pronasale-to-menton distance, and interzygomatic width in males as compared to females, but the mean intercanthal width was found to be the same. Pearson's correlation analysis revealed a positive correlation between facial height and pronasale-to-menton distance, facial height and interzygomatic width, pronasale-to-menton distance and interzygomatic width, and interzygomatic width and intercanthal width. CONCLUSION: The craniofacial features may serve as diagnostic markers for gender identification and can be used interchangeably.

Image analysis assisted study of mitotic figures in oral epithelial dysplasia and squamous cell carcinoma using differential stains.

BACKGROUND: Mitosis is a process of cell division resulting in two genetically equivalent daughter cells. Excessive proliferation of cells due to mitosis is the hallmark in pre cancer and cancer. AIMS: This study was conducted to count the number of mitotic figures in normal oral mucosa, oral epithelial dysplasia and squamous cell carcinoma in both Hematoxylin and Eosin (H&E) and Crystal Violet stained sections. Also the overall number of mitotic figures with both stains were compared along with the evaluation of staining efficacy of both the stains. METHODS AND MATERIAL: The present study was conducted on 20 specimens each of the three categories. These were further divided into two groups for staining with H&E and with 1% Crystal Violet respectively. Images were captured and analyzed using image analysis software Dewinter Biowizard 4.1. RESULTS: Comparison of mitotic figure count in three categories in sections stained with both stains showed statistically significant difference (p < 0.001). The mean number of mitotic figures seen in Crystal Violet reagent were significantly higher as seen in H&E stain (p < 0.001). The overall diagnostic efficacy of Crystal Violet was 87.6%. Crystal Violet scored over H&E stain and also helped to better appreciate metaphases in Squamous cell carcinoma and telophases in dysplasia. CONCLUSION: Number of mitotic figures progressively increase with the advancement of the pathology. Use of 1% Crystal Violet provides better appreciation of mitotic figures and can be employed as a selective stain in routine histopathology.

Evaluation of Histomorphometric Changes in Tissue Architecture in Relation to Alteration in Fixation Protocol - An Invitro Study.

INTRODUCTION: Preparation of good tissue specimens for microscopy requires complete fixation. No ideal fixative has been found till date, with every fixative showing advantages and disadvantages. Appropriate fixation is required to maintain clear and consistent morphologic features for histologic examination. Pathologists mostly examine formalin fixed tissue sections and are less used to the morphologic changes induced by other fixatives. Underfixed and overfixed tissue in various fixatives can lead to tissue architectural changes which can affect its diagnostic value. AIM: To assess sectioning ability, staining intensity and microscopic details of tissues kept in different fixatives at different time intervals. MATERIALS AND METHODS: Fresh tissue specimen i.e., goat tongue was collected and its middle-third portion was used for the study purpose. The tissue was grossed into 10 equal pieces and kept in various fixatives (10% Buffered formalin, Carnoy's solution, Absolute ethyl alcohol, Bouin's fluid) for five different time intervals (6, 12, 18, 24 and 30 hours) and normal tissue processing steps were carried out followed by sectioning and staining. During sectioning, sectioning parameter was assessed. Following sectioning, sections were observed under light microscope and were histologically evaluated for staining and microscopic details. To calculate the sectioning parameter Fisher's exact test was used and to assess parameters for staining and microscopic details Mann-Whitney U test was used. RESULTS: According to the study, 10% buffered formaldehyde is considered as a superior fixative under all parameters followed by Bouin's fluid, Carnoy's solution and Absolute alcohol. CONCLUSION: In our study, it was concluded that 10% buffered formaldehyde should be continued as a routine fixative however, other fixatives can be used depending upon the non-availability of required fixative or in case of emergencies. Pathologist should be accustomed to histologic and morphologic changes of underfixed and overfixed tissue which can affect its diagnostic value.

Incidence of Mast Cells in Gingival and Periapical Inflammation- A Kaleidoscopic Study.

INTRODUCTION: Mast cells are large granular cells that have classically been related to neutrophil stimulation during early step of inflammation. AIM: The objective of this work was to identify the incidence of mast cells in inflammatory lesions like periapical granuloma, pyogenic granuloma, gingival hyperplasia. 1. To assess the staining intensity of mast cells by using different metachromatic stains. 2. To correlate the above findings histopathologically. MATERIALS AND METHODS: In this study, we used 5 micron thick sections from paraffin-embedded tissue blocks of previously diagnosed periapical and gingival inflammatory lesions. The sections were stained with routine H & E and metachromatic stains like Toluidine blue, Alcian blue, Aldehyde fuchsin and Giemsa. The number of mast cells was quantified. Statistical analysis was done and mast cell numbers were compared. RESULTS: In both gingival and periapical inflammatory lesions, toludine blue showed more number of mast cells followed by giemsa. Giemsa stain showed statistical significance in differentiating both periapical and gingival lesions (p<0.05) in terms of mast cell count. Moderate inflammation (46.4%) was seen in a higher propotion of gingival inflammations whereas periapical inflammatory lesions revealed severe inflammation (53.3%). In both types of inflammatory lesions, higher staining intensity was shown by toludine blue followed by giemsa which was statistically significant. CONCLUSION: Mast cell number is inversely proportional to inflammatory response in gingival inflammatory lesions and directly proportional to inflammatory response in periapical inflammatory lesions. Although, toludine blue is found to be a better stain, giemsa has equivalent properties as that of toludine blue.

Analysis of the Genotoxic Effects of Mobile Phone Radiation using Buccal Micronucleus Assay: A Comparative Evaluation.

INTRODUCTION: Micronucleus (MN) is considered to be a reliable marker for genotoxic damage and it determines the presence and the extent of the chromosomal damage. The MN is formed due to DNA damage or chromosomal disarrangements. The MN has a close association with cancer incidences. In the new era, mobile phones are constantly gaining popularity specifically in the young generation, but this device uses radiofrequency radiation that may have a possible carcinogenic effect. The available reports related to the carcinogenic effect of mobile radiation on oral mucosa are contradictory. AIM: To explore the effects of mobile phone radiation on the MN frequency in oral mucosal cells. MATERIALS AND METHODS: The subjects were divided into two major groups: low mobile phone users and high mobile phone users. Subjects who used their mobile phone since less than five years and less than three hours a week comprised of the first group and those who used their mobile since more than five years and more than 10 hours a week comprised of the second group. Net surfing and text messaging was not considered in this study. Exfoliated buccal mucosal cells were collected from both the groups and the cells were stained with DNA-specific stain acridine orange. Thousand exfoliated buccal mucosal cells were screened and the cells which were positive for micronuclei were counted. The micronucleus frequency was represented as mean±SD, and unpaired Student t-test was used for intergroup comparisons. RESULTS: The number of micronucleated cells/ 1000 exfoliated buccal mucosal cells was found to be significantly increased in high mobile phone users group than the low mobile phone users group. The use of mobile phone with the associated complaint of warmth around the ear showed a maximum increase in the number of micronucleated cells /1000 exfoliated buccal mucosal cells. CONCLUSION: Mobile phone radiation even in the permissible range when used for longer duration causes significant genotoxicity. The genotoxicity can be avoided to some extent by the regular use of headphones.

Dimorphic Mandibular canines in gender determination in Moradabad population of Western Uttar Pradesh.

BACKGROUND AND OBJECTIVES: Among morphological characteristics that differentiate a male from a female, tooth size has also been evaluated in various populations for its applicability in anthropologic and forensic investigations to identify the gender from dental remains. The present study was undertaken to investigate the accuracy of mesio-distal width of the mandibular canines, inter-canine arch width, and Mandibular Canine Index (MCI) with which gender can be differentiated in Moradabad population and to correlate the results with other available data. MATERIALS AND METHODS: A cross-sectional study was conducted on the casts of 30 males and 30 females between the age group of 19-30 years. RESULTS: The mean right and left canine dimension (RCW and LCW) for females was between 6.28 mm and 6.54 mm while that of males was 7.06 mm and 7.45 mm. The mean inter-canine arch width (ICW) in males was 27.64 mm, whereas in females was 23.42 mm. Area under curve (AUC) of ICW, RCW, and LCW had 100%, 98%, and 99.7%. The predicted sensitivity and specificity observed of three criteria was 100% for ICW, 93.3% and 93.3% for RCW, and 96.7% and 100% for LCW, which were found to be highly statistically significant. The mean values of right and left CMI were significantly higher in females as compared to males (P < 0.001). CONCLUSION: The MCI parameter in the present study was a quick and reliable method for sexual identification and showed sexual dimorphism by both the RMCI and LMCI with greater significance in identifying females by using RMCI.

An overview of the risk factors associated with multiple oral premalignant lesions with a case report of extensive field cancerization in a female patient.

BACKGROUND: Field cancerization is a well-known and well-documented process of malignant transformation first coined by Slaughter et al. in 1953. Tobacco chewing was associated with the greatest increase in the risk of multiple oral premalignant lesions and may be the major source of field cancerization of the oral cavity in the Indian population. The field cancerization will probably help clinicians in complementing evaluation of pathologic biopsy specimens. MATERIAL AND METHODS: We present a case report of field cancerization in a 63-year-old Indian female. She presented with an intra-oral generalized hyperkeratotic verruciform type white lesions involving right and left buccal mucosa, lower labial mucosa, upper and lower vestibule, dorsal, ventral and right lateral border of the tongue, hard and soft palate. Microscopic examination revealed features of verrucous carcinoma in one area, squamous cell carcinoma in another and carcinoma in situ in other areas. Based on the overall features in various areas of the oral cavity, the lesion was diagnosed as field cancerization. CONCLUSION: Reviewing the literature revealed the presence of a field with genetically altered cells appear to be induced by tobacco (smoking/smokeless form). The large number of premalignant cells in the fields may increase cancer risk considerably. Thus screening and monitoring of the field may have serious implications for oral cancer prevention.

Training module for cheiloscopy and palatoscopy in forensic odontology.

INTRODUCTION: Studies of lip prints and palatal rugae, dates back to late 19(th) and early 20(th) centuries and since then, various methods of classification and analysis were introduced, however systematic recording and analysis of data is still need to improve further, to arrive at flawless and meaningful conclusions. Moreover, the awareness among dental personnel regarding the practical knowledge of cheiloscopy and palatoscopy is ambiguous. So, efforts have been made to introduce training module to improve the education of cheiloscopy and palatoscopy for dental students. AIMS AND OBJECTIVE: 1. To prepare training module for cheiloscopy and palatoscopy. 2. To assess the efficacy of designed training module. MATERIALS AND METHODS: Training module was used to train the dental students. Random matching of lip and palatal rugae patterns was carried out by dental students before and after training. Pre- and post-training matched results were then compared. Intraobserver variability assessed by comparing first and second assessment of lip print and palatal rugae patterns. RESULTS: It was inferred statistically that training module had improved the ability to identify individuals based on lip prints and palatal rugae, with insignificant intraobserver variation.

Immunohistochemical analysis of factors related to apoptosis and cellular proliferation in relation to inflammation in dentigerous and odontogenic keratocyst.

BACKGROUND: The effect of inflammation on pathogenesis and biological behavior of odontogenic keratocyst (OKC) and dentigerous cyst (DC) is not completely understood. Hence, we aimed to analyze the effect of inflammation on biological behavior of OKC and DC using a proliferative and anti-apoptotic marker, i.e., proliferative cellular nuclear antigen (PCNA) and Bcl-2, respectively. MATERIALS AND METHODS: Immunohistochemical staining was performed using anti-PCNA and Bcl-2 antibody in 10 cases each of classical OKC, inflamed OKC and classical DC and inflamed DC. RESULTS: Inflamed OKC and DC showed a significant increase in PCNA expression and decrease in Bcl-2 expression when compared with non-inflamed cyst. Correlation between inflammation and proliferative and anti-apoptotic activity was found to be statistically non-significant. CONCLUSION: Inflammation is responsible for change in behavior of neoplastic epithelium of OKC and hence should be treated meticulously, whereas in DC it is responsible for changes in the epithelial lining.

Minor salivary glands and dental caries: Approach towards a new horizon.

INTRODUCTION: Reduction of functioning minor salivary glands may contribute to emergence of mucosal infections, mucosal ulceration, and possibly dental caries. A study was, therefore, designed to understand the exact role of minor salivary gland secretions over dental caries. METHODOLOGY: We studied the average labial distribution of functional minor salivary glands using various pre-defined locations, counted the minor salivary gland secretion imprints, and correlated the decayed missing filledlevels in subjects. The functional level and amount of secretion of minor salivary gland were evaluated. The radial immunodiffusion was performed by Diffu-Plate kit and the dimensions of the ring were correlated with the amount of immunoglobulin A in saliva. RESULTS: The mean number of functional labial minor salivary glands, amount of secretion, level of glycoprotein secretion, and immunoglobulin A secretion levels could very well dictate the functional status and role of minor salivary glands over caries assessment. CONCLUSION: The above-mentioned tests could be of major significance in routine diagnosis of the most common oral disease, i.e., dental caries.

Revealing anti-cariogenic efficacy of smokeless tobacco: A pilot study.

BACKGROUND: The tobacco plant, Nicotiana tabacum, has been responsible for more deaths than any other herb. However, the literature has also been endowed with its use as "holy herb" since the pre-Columbian era. Used for treating pain, poisonous bites, ulcers, nasal polyps, and basal cell carcinoma; it also acts as an important ingredient of commercially available toothpastes; and even used as tobacco vaccines against Streptococcus species as highlighted in the literature. AIMS AND OBJECTIVES: (1) To elicit the anti-microbial property of tobacco against Streptococcus mutans, if any, in raw smokeless tobacco. (2) To study the relationship of duration and growth inhibition efficacy of smokeless tobacco. MATERIALS AND METHODS: Extracts were prepared by centrifugation of mixed raw smokeless tobacco with Ringer's lactate solution and with saliva. The extracts were placed in wells prepared on Mitis salivarius culture plate and incubated at 37°C for 24 h after 0 h, 1 h, and 2 h of extract preparation. The inhibition zones were measured on the underside of plate using the vernier calipers. RESULTS: Smokeless tobacco has a statistically significant zone of inhibition, which proves its anti-microbial activity against S. mutans. However, the mean zones of inhibition were greater for Ringer's lactate and tobacco group as compared to test samples (saliva and tobacco) with subsequent reduction of inhibition zones with an increase in duration. CONCLUSION: The anti-microbial property of extensive tobacco resources can be utilized from their extracts in order to balance the deterioration it had caused to mankind.