Prevalence of oral neurofibroma in Central Indian population: A retrospective study of 20 years.

CONTEXT: Neurofibroma is a benign peripheral nerve sheath tumor. Commonly found in the peripheral soft tissues, it can manifest as a solitary mass or as a component of neurofibromatosis. AIMS: The purpose of the retrospective cross-sectional study was contributing to the literature by providing data about the prevalence of oral neurofibroma in Central Indian population. SETTINGS AND DESIGN: Retrospective, cross-sectional study. SUBJECTS AND METHODS: All histopathologically diagnosed cases of oral neurofibroma were retrieved from the archives of our department and were reviewed. All the cases that met the inclusion criteria were reviewed in terms of the year when the patient reported, patient's age, gender, location of the lesion, i.e., soft tissue or intraosseous, clinical appearance, i.e., growth or swelling, histopathologic diagnosis and immunohistochemistry results if available. The results were aggregated and described qualitatively using Microsoft Excel 2013. RESULTS: In our retrospective analysis of 20 years (2000-2019), we came across 14 reported cases of oral neurofibroma, in five males and nine females. Two of these cases showed a recurrent nature and one case showed transformation into atypical neurofibroma. Two cases were encountered in the mandible as an intraosseous oral neurofibroma. CONCLUSIONS: In our study, we found that oral neurofibroma was more common in the third decade with a female predilection. Gingiva was the most common site. Of the 14 cases that were encountered, two cases showed recurrence and one case showed malignant transformation. Hence, in spite of being a benign neoplasm, oral neurofibroma is locally aggressive and should be diagnosed accurately.

Matrix metalloproteinases-3 gene-promoter polymorphism as a risk factor in oral submucous fibrosis in an Indian population: a pilot study.

AIM: Host-related factors could be important to the fundamental understanding of oral diseases. One such factor is matrix metalloproteinases (MMP). MMP3 (stromelysin 1) is crucial in connective tissue remodeling. Promoter regions are specific segments of DNA that control the rate of mRNA synthesis. Thus, polymorphism in the (5A/6A) promoter region of the MMP3 gene results in different transcriptional activities and is related to susceptibility in diseases. The aim of the present study was to detect polymorphism in the MMP3 gene-promoter region in oral submucous fibrosis patients (OSF), oral squamous cell carcinoma patients (OSCC), and normal individuals with tobacco and areca nut habit and without lesions, and to correlate the genotype as a risk factor in these diseases. METHOD: Genomic DNA from blood of OSF (n = 5), OSCC (n = 5), and normal individuals with tobacco and areca nut habit (n = 5) and without (n = 5) were subjected to polymerase chain reaction of the MMP3 gene-promoter region and DNA sequencing. RESULTS: The 5A allele in the MMP3 gene-promoter region was observed more frequently in the OSF group than the control groups. No significant difference was noted between OSCC and the control groups on the 5A allele. CONCLUSION: The results indicated that the 5A allele of the MMP3 gene-promoter region could be associated with OSF risk factor, but not OSCC, in an Indian population.

Effects of elevated temperatures on different restorative materials: An aid to forensic identification processes.

BACKGROUND: Heat-induced alterations to dental and restorative materials can be of great interest to forensic dentistry. Knowing the specific optical behavior of dental materials can be of high importance as recognition of changes induced by high temperatures can lead to the determination of material which was used in a dental restoration, facilitating identification of burned human remains. AIM: To observe the effects of predetermined temperatures (200°C-400°C-600°C-800°C-1000°C) on unrestored teeth and different restorative materials macroscopically and then examine them under a stereomicroscope for the purpose of identification. MATERIALS AND METHODS: The study was conducted on 375 extracted teeth which were divided into five groups of 75 teeth each as follows: group 1- unrestored teeth, group 2- teeth restored with all-ceramic crowns, Group 3- with class I silver amalgam filling, group 4- with class I composite restoration, and group 5- with class I glass ionomer cement restoration. RESULTS: Unrestored and restored teeth display a series of specific macroscopic & stereomicroscopic structural changes for each range of temperature. CONCLUSION: Dental tissues and restorative materials undergo a series of changes which correlate well with the various temperatures to which they were exposed. These changes are a consequence of the nature of the materials and their physicochemical characteristics.

Role of human papilloma virus-16 in the pathogenesis of oral lichen planus--an immunohistochemical study.

BACKGROUND: Oral lichen planus (OLP) is a common chronic inflammatory immune-mediated disease with an aetiopathogenesis associated with cell-mediated immunological dysfunction. It is possible that oral mucosal viral infections, including human papilloma virus-16 (HPV-16) infection, may have a causative role in OLP pathogenesis. AIM: To assess the prevalence of HPV-16 in histopathologically diagnosed specimens of OLP and to evaluate whether any clinical features (such as the localisation of specimens) or the age or gender of patients, are correlated with the presence of this virus. MATERIALS AND METHODS: This study was conducted on 30 specimens with a histopathological diagnosis of OLP, using the immunohistochemical marker HPV-16. Thirty normal oral mucosa specimens were also included as controls. Brown nuclear staining was accepted as positive for the HPV-16 antibody. The results were analysed using Fisher's exact test. P values<0.05 were considered to be significant. RESULTS: Significant correlation (P=0.0001) was observed between HPV-16 infection and samples with OLP. No statistical conclusions could be drawn regarding age, gender, localisation and HPV-16 positivity. CONCLUSION: Our study showed that HPV-16 may play a role in the pathogenesis of OLP. Taking into account the oncogenic potential of HPV-16, patients with OLP should be screened for the presence of this virus.

Estimation of vascular endothelial growth factor gene -460 C/T polymorphism as a biomarker in oral squamous cell carcinoma patients from the Indian subcontinent.

AIM: Oral squamous cell carcinoma (OSCC) is one of the most common malignancies in India. Vascular endothelial growth factor (VEGF), a major mediator of angiogenesis, is known to play a key role in the pathophysiology of tumorigenesis. Polymorphisms of the VEGF gene have been shown to influence the risk of OSCC, but it remains to be elucidated in the Indian population. Thus, the present study was designed to detect the VEGF gene -460 C/T polymorphism in OSCC patients from the Indian population, which is genetically distinct from previously-studied populations. METHODS: Peripheral blood samples of 80 OSCC patients and 80 healthy individuals were collected for a case-control study design. The VEGF gene -460 C/T polymorphism was detected by polymerase chain reaction-based restriction analysis. RESULTS: The analysis revealed significant differences between normal individuals and patients with OSCC (P < 0.05). The distribution of the TT homozygote and the T allele in the patient group was significantly greater than in the control group. CONCLUSION: The present study provides novel evidence of the role of the VEGF gene -460 C/T polymorphism as a suitable genetic marker of OSCC in the Indian population.

Scanning electron microscopic analysis of incinerated teeth: An aid to forensic identification.

BACKGROUND: Forensic dental identification of victims involved in fire accidents is often a complex and challenging endeavor. Knowledge of the charred human dentition and residues of restorative material can help in the recognition of bodies burned beyond recognition. AIM: To observe the effects of predetermined temperatures on healthy unrestored teeth and different restorative materials in restored teeth, by scanning electron microscope, for the purpose of identification. MATERIALS AND METHODS: The study was conducted on 135 extracted teeth, which were divided into four groups. Group 1-healthy unrestored teeth, group 2-teeth restored with all ceramic crowns, group 3-teeth restored with class I composite resin and group 4-teeth restored with class I glass ionomer cement (GIC). RESULTS: The scanning electron microscope is useful in the analysis of burned teeth, as it gives fine structural details, requires only a small sample and does not destroy the already fragile specimen. CONCLUSION: Scanning electron microscope can be a useful tool for the characterization and study of severely burnt teeth for victim identification.

Gorham's disease: A diagnostic challenge.

Gorham's disease is a rare disorder of uncertain etiology characterized by spontaneous and progressive osteolysis of one or more skeletal bones. Till date, less than 200 cases have been reported in the international literature with about 51 cases involving the maxillofacial site. The radiographic findings associated with Gorham's disease are particularly dramatic, as in some cases a complete resorption of the involved bone can occur, leading to the definition of phantom bone or disappearing bone disease. The purpose of this review is to make our community aware of this rare entity and to discuss the etiopathology, clinical presentation, radiographic findings, histopathology, differential diagnoses and treatment modalities for patients with vanishing bone disease.

Gorlin-Goltz syndrome: A rare case report.

Gorlin-Goltz syndrome is an uncommon autosomal dominant inherited disorder characterized by numerous basal cell carcinomas, odontogenic keratocysts (OKCs) and musculoskeletal malformations. A rare case of this syndrome observed in a 13-year-old male patient is presented in which multiple OKCs were causing disfigurement of the lower jaw as well as displacement and malocclusion of the teeth. Early diagnosis and treatment of this syndrome is important to reduce the severity of complications including cutaneous and cerebral malignancy and oromaxillofacial deformation and destruction due to jaw cysts.

Hereditary gingival fibromatosis.

Hereditary gingival fibromatosis is a rare benign oral condition characterised by slow and progressive enlargement of both maxillary and mandibular attached gingiva. It may develop as an isolated disorder but can feature along with a syndrome. A case of 12 year old female child who presented with generalised severe gingival overgrowth, involving both the arches and covering almost the entire dentition, and had all the teeth remaining invisible within the confinement of gingival tissues. The excess gingival tissue, in this non-syndromic case was removed by conventional gingivectomy using local as well as general anaesthesia. The post-operative result was uneventful and the patient appearance improved considerably. Good aesthetic result was achieved to allow patient to practice oral hygiene measures. After treatment regular recall visits are necessary in order to evaluate oral hygiene and stability of periodontal treatment.

Detection of Candida by calcofluor white.

OBJECTIVE: To assess the efficacy of calcofluor white (CFW) is compared to Gram stain and periodic acid-Schiff in detection of Candida in oral precancer and cancer. STUDY DESIGN: The study group consisted of patients with precancer (n = 45), cancer (n = 45) and control group (n = 45). Presence of Candida was confirmed by culture inoculation along with a germ tube and carbohydrate fermentation test. The cytopathologic smears were analyzed by Papanicolaou-CFW and Gram staining, whereas, tissue sections were stained by periodic acid-Schiff and CFW staining. RESULTS: Candida albicans was the predominant species identified. A highly significant association of Candida was seen more often in cancer than in precancer. Both in cytology and histopathology Candida detection by CFW was higher. In precancer it was 48.88% in smears and 40% in tissue sections, whereas, in cancer 60% in smears and 55.55% in histopathology. CONCLUSION: Among the various diagnostic tools used in the present study, the use of CFW is seen to be a simple, effective, rapid and reliable method, both in cytopathology and histopathology.