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.

Prediction of spontaneous eruption of palatally displaced canine based on variables measurements in panoramic radiograph: A systematic review.

OBJECTIVE: This systematic review was aimed to find out possible predictive variables measured on panoramic radiographs to predict spontaneous eruption of palatally displaced canine (PDC) after interceptive extraction in late mixed dentition. MATERIALS AND METHODS: Electronic database searches were performed in MEDLINE, Cochrane's CENTRAL, Scopus, and in other sources up to June 2020. Randomized and nonrandomized controlled trials, and pre-post prospective studies without control groups were considered for review. Study selection, data extraction, risk of bias assessment (by RoB 2.0, ROBINS-I, and NHLBI score), and the certainty of evidence evaluation (GRADE approach) were performed during reviewing process. Only qualitative analyses of included literature were done due to presence of between study heterogeneity. RESULTS: Out of 970 retrieved records, 3 controlled trials and 3 prospective before and after studies without control fulfilled the eligibility criteria and were included in the review. Studies were assessed at low risk to high risk of bias. Overall certainty was moderate to very low. Results shows that PDCs in distal sectors, lower alpha angle, younger subjects, PDCs with less advanced developed root were significantly benefited from interceptive extraction. However, Vertical distance had insignificant roll on eruption prediction. CONCLUSIONS: Interceptive extraction at younger age, mesial canine crown position (sectors), and mesial inclination of PDC (alpha angulation) are the most important variables predicting the spontaneous eruption of palatally displaced canine. Findings of this review can be utilized to make evidence-based decisions for managing PDCs with diverse sectors and mesial inclinations. However, well designed clinical trials are recommended to strengthen the evidence.

Management of Asymmetric Mandibular Retrognathia with Differential Loading Technique: A Case Report.

Class II malocclusion cases possess a constant challenge to orthodontists since time immemorial. Mandibular retrusion is the most common feature of class II malocclusion, rather than maxillary prognathism. Association of class II with asymmetry, a condition called asymmetric mandibular retrognathia (AMR), gives a tougher challenge to orthodontists for management. The following case presents effective management of AMR using differential loading technique. A young boy aged 12 years presented with mandibular retrognathia associated with facial asymmetry. He was treated with a differential force loading technique using a fixed functional appliance. RESULTS: Improved facial profile with increased mandibular length achieved. A significant reduction in facial asymmetry was also appreciable. CONCLUSION: Differential force loading technique using fixed functional appliance while being least troublesome for the patient may prove beneficial to harness excellent and satisfactory results with minimal efforts in such cases of mandibular retrusion with facial asymmetries and also decrease the need for surgical correction. HOW TO CITE THIS ARTICLE: Parihar AV, Angamuthu KP, Sahoo R, et al. Management of Asymmetric Mandibular Retrognathia with Differential Loading Technique: A Case Report. Int J Clin Pediatr Dent 2021;14(S-1):S107-S113.

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.

Formulation and development of plasma volume expander using natural and modified starch from Solanum tuberosum.

BACKGROUND: To formulation and development of plasma volume expander (PVE) by using natural and modified starch from Solanum tuberosum. The function of blood circulation is to provide the needs of the body tissues and to maintain an appropriate environment in all tissue fluids of the body for the optimal survival and functions of the cells. Rapid restoration of the blood volume is necessary to decrease reduction in the amount of the blood. The PVEs are isotonic colloidal solutions, act by increasing the osmotic pressure of the intravascular compartment, which leads to the influx of the interstitial fluids through the capillary pore which, in turn, leads to the increase in the volume of the blood. Therefore, there is a need to discover the PVE with less side effects. The main aim of the present study is to use amylopectin as PVEs, fractionated from natural and modified starch obtained from S. tuberosum. METHODS: The starch extracted from the normal grains and the tubers of potatoes was selected for the production of starch. Statistical analysis includes in vitro characterization that involves viscosity studies, plasma-product interaction, osmotic pressure detection, molecular weight-viscosity relationship, determination of weight average molecular weight, enzymatic interaction, and in vivo characterization such as toxicity studies and the effect of the products on the blood coagulation. The isolated starch and fractionated amylopectin were analyzed for the physicochemical characteristics. RESULT AND CONCLUSION: The amylopectin fractionated from isolated starch from grains and tubers of potatoes can be used as PVE, as per the outcome of the study.

Synthesis and Evaluation of New Generation Cross-Bridged Bifunctional Chelator for (64)Cu Radiotracers.

Bifunctional chelators have been successfully used to construct (64)Cu-labeled radiopharmaceuticals. Previously reported chelators with cross-bridged cyclam backbones have various essential features such as high stability of the copper(II) complex, high efficiency of radiolabeling at room temperature, and good biological inertness of the radiolabeled complex, along with rapid body clearance. Here, we report a new generation propylene-cross-bridged chelator with hybrid acetate/phosphonate pendant groups (PCB-TE1A1P) developed with the aim of combining these key properties in a single chelator. The PCB-TE1A1P was synthesized from cyclam with good overall yield. The Cu(II) complex of our chelator showed good robustness in kinetic stability evaluation experiments, such as acidic decomplexation and cyclic voltammetry studies. The Cu(II) complex of PCB-TE1A1P remained intact under highly acidic conditions (12 M HCl, 90 °C) for 8 d and showed quasi-reversible reduction/oxidation peaks at -0.77 V in electrochemical studies. PCB-TE1A1P was successfully radiolabeled with (64)Cu ions in an acetate buffer at 60 °C within 60 min. The electrophoresis study revealed that the (64)Cu-PCB-TE1A1P complex has net negative charge in aqueous solution. The biodistribution and in vivo stability study profiles of (64)Cu-PCB-TE1A1P indicated that the radioactive complex was stable under physiological conditions and cleared rapidly from the body. A whole body positron emission tomography (PET) imaging study further confirmed high in vivo stability and fast clearance of the complex in mouse models. In conclusion, PCB-TE1A1P has good potential as a bifunctional chelator for (64)Cu-based radiopharmaceuticals, especially those involving peptides.

ACR appropriateness criteria radiologic management of infected fluid collections.

The best management of infected fluid collections depends on a careful assessment of clinical and anatomic factors as well as an up-to-date review of the published literature, to be able to select from a host of multidisciplinary treatment options. This article reviews conservative, radiologic, endoscopic, and surgical options and their best application to infected fluid collections as determined by the ACR Appropriateness Criteria Expert Panel on Interventional Radiology. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals, and the application, by the panel, of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Homodyne detection of coherence and phase shift of a quantum dot in a cavity.

A homodyne measurement technique is demonstrated that enables direct observation of the coherence and phase of light that passed through a coupled quantum dot (QD)-microcavity system, which in turn enables clear identification of coherent and incoherent QD transitions. As an example, we study the effect of power-induced decoherence, where the QD transition saturates and incoherent emission from the excited state dominates at higher power. Further, we show that the same technique allows measurement of the quantum phase shift induced by a single QD in the cavity, which is strongly enhanced by cavity quantum electrodynamics effects.

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.

New bifunctional chelator for 64Cu-immuno-positron emission tomography.

A new tetraazamacrocyclic bifunctional chelator, TE2A-Bn-NCS, was synthesized in high overall yield from cyclam. An extra functional group (NCS) was introduced to the N-atom of TE2A for specific conjugation with antibody. The Cu complex of TE2A-Bn-NCS showed high kinetic stability in acidic decomplexation and cyclic voltammetry studies. X-ray structure determination of the Cu-TE2A-Bn-NH2 complex confirmed octahedral geometry, in which copper atom is strongly coordinated by four macrocyclic nitrogens in equatorial positions and two carboxylate oxygen atoms occupy the elongated axial positions. Trastuzumab was conjugated with TE2A-Bn-NCS and then radiolabeled with 64Cu quantitatively at room temperature within 10 min. Biodistribution studies showed that the 64Cu-labeled TE2A-Bn-NCS-trastuzumab conjugates maintain high stability in physiological conditions, and NIH3T6.7 tumors were clearly visualized up to 3 days by 64Cu-immuno-positron emission tomography imaging in animal models.

ACR Appropriateness Criteria radiologic management of benign and malignant biliary obstruction.

The optimal treatment for patients with biliary obstruction varies depending on the underlying cause of the obstruction, the clinical condition of the patient, and anticipated long-term effects of the procedure performed. Endoscopic and image-guided procedures are usually the initial procedures performed for biliary obstructions. Various options are available for both the radiologist and endoscopist, and each should be considered for any individual patient with biliary obstruction. This article provides an overview of the current status of radiologic procedures performed in the setting of biliary obstruction and describes multiple clinical scenarios that may be treated by radiologic or other methods. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.