Paradental cyst with hyaline ring granuloma masquerading as pericoronitis.

Paradental cyst is an odontogenic cyst associated with pericoronitis in partly erupted mandibular third molars. It is an inflammatory cyst common among the mandibular molars. The cyst is most commonly seen on the distal or distobuccal aspect of the third molars. The angle of tooth and food impaction has been postulated to be responsible for the development of the cyst in third molars. The source of the epithelium has been reported as reduced enamel epithelium. The paradental cyst is frequently misdiagnosed as a radicular cyst or dentigerous cyst. We report a case of paradental cyst in a patient with partially erupted mandibular third molar with food impaction and resulting hyaline ring granuloma.

Clinicopathological characteristics of oral squamous cell carcinoma arising from oral submucous fibrosis: A systematic review.

Introduction: Oral submucous fibrosis (OSMF) is considered to be a potentially malignant oral disorder with high risk of malignant transformation. Oral squamous cell carcinoma (OSCC) arising from OSMF has peculiar clinical and histopathological features. Aim: To assess the clinicopathological features of OSCC arising in the background of OSMF in an attempt to identify the patients with OSMF who are at increased risk of developing OSCC. Methodology: A systematic review was performed based on PRISMA guidelines to include articles published until May 2021 in English, relating the clinicohistopathological characteristics of OSCC arising from OSMF (OSMF-OSCC) or OSMF associated with OSCC (OSCC-OSMF). All the eligible articles were analyzed and relevant data were extracted. Results: Seventeen articles were included for systematic review after following strict inclusion and exclusion criteria. The malignant transformation rate of OSMF-OSCC ranged from 1.9 to 9.13 and the prevalence of OSCC-OSMF ranged from 2.8 to 66. The mean age of the patients ranged from 36.6 years to 47.2 years and buccal mucosa was the common site to be affected. Majority of the OSCC-OSMF was well-to-moderately differentiated and majority of them did not metastasize to the lymph nodes. Conclusion: OSCC associated with OSMF presents at a younger age with early tumor stage, better differentiation, and better prognosis when compared to OSCC not associated with OSMF. However, more multicentric prospective studies with large sample size are required to determine the true biologic behavior of OSCC arising in the background of OSMF to establish less aggressive treatment strategies considering them as a separate entity.

Anti-cariogenic property of Carica papaya, Trachyspermum ammi, Caesalpinia crista linn extracts and their effect on human oral keratinocytes.

Objectives: Dental caries is a dynamic and composite process. The multifactorial etio-pathogenesis thus influences the initiation and the progression of the disease. The prime pathogenic bacterium includes Streptococcus mutans, Lactobacillus sp and Actinomyces viscosus. The purpose of this in vitro study was to analyze the antimicrobial property of the test herbal extracts and also their effects on the human oral keratinocytes. Materials and Methods: The bacterial strains S. mutans (American Type Culture Collection [ATCC]-25175); Lactobacillus species (ATCC 4356) and A. viscosus (ATCC 15987) were cultured in the specific culture media-Mitis Salivarius Bacitracin, Man Rogosa Sharpe and Enrichment media, respectively. The test extracts were exposed to the cultured plates and the mean zone of inhibition was measured. The test herbal extracts were also tested for deleterious effects on oral keratinocytes via the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Independent Student's t-test and analysis of variances were performed.-25175); Lactobacillus species (ATCC 4356) and A. viscosus (ATCC 15987) were cultured in the specific culture media-Mitis Salivarius Bacitracin, Man Rogosa Sharpe and Enrichment media, respectively. The test extracts were exposed to the cultured plates and the mean zone of inhibition was measured. The test herbal extracts were also tested for deleterious effects on oral keratinocytes via the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Independent Student's t-test and analysis of variances were performed. Results: The extracts of Carica papaya, Trachyspermum ammi and Caesalpinia crista linn inhibited the growth of bacteria and the antimicrobial effect was found to be statistically significant at the neat/standard concentration (100 µg/ml). The three extracts showed a cell viability range 96%-99% indicating that the test extracts did not produce or display any deleterious effects on the oral keratinocytes. Conclusions: The three test herbal extracts possess effective anti-cariogenic properties with near par with the efficacy of chlorhexidine and T. ammi proved to be the most potent. The extracts at different concentrations also proved to be safe, noncytotoxic producing a range of 96%-99% of cell viability of the oral keratinocytes.

Rapid economical acetic acid Papanicolaou staining procedure versus conventional staining procedure in normal oral mucosa.

Background: Papanicolaou (Pap) staining technique is a conventional technique used in cytology but it is time consuming. Aim: The aim of the study was to determine the efficacy of Rapid Economical Acetic acid Papanicolaou stain (REAP) over conventional staining technique in studying normal oral mucosa. Materials and Methods: Eighty patients were selected and were grouped based on their habits. Two smears were obtained from each patient and were subjected to both the staining techniques. A total of 160 slides were studied for features such as cellular outline, nuclear outline, nuclear details, cellular differentiation, micronuclei and cellular transparency. Results: The conventional staining procedure showed 79 cases of optimal cellular staining, 78 cases of optimal nuclear staining, 35 cases of optimal nuclear details, 57 cases of optimal differentiation and 27 cases of optimal transparency and 33 cases of optimal micronuclei. REAP staining showed 75 cases of optimal cellular staining, 64 cases of optimal nuclear staining, 20 cases of optimal nuclear details, 36 cases of optimal differentiation and 28 cases of optimal transparency and 25 cases of optimal micronuclei. Conclusion: REAP staining effectively reduces the time and the cost factor, but the cytological details are well observed under conventional staining technique in normal patients.

Phyto-intruders in oral tissues: A polarized light microscopic study.

OBJECTIVES: Foreign body reactions are common in the oral cavity due to its proximity to the external environment. Rarely, foreign body of plant origin may be encountered in the histopathological sections making the diagnosis problematic. The aim of the present study was to analyze the histological features of various products of plant origin emphasizing on the pathogenesis of tissue reaction occurring in response to their implantation. METHODS: This observational study included various plant products or phytoproducts commonly consumed in South Indian diet such as rice, curry leaves, coriander leaves, spinach leaves, coconut, green chilli, onion, French beans, urad dal, lentil beans, mustard seed, ginger, and garlic. Formalin-fixed specimens were routinely processed and stained with hematoxylin and eosin. The slides were viewed under light microscope and polarized microscope and evaluated by two oral pathologists. RESULTS: Each of the phytoproducts had distinctive histological appearance and exhibited positive birefringence. Phytoproducts such as rice, curry leaves, French bean, onion, and green chilli resembled pathological structures such as calcifications, ghost cells, clear cells, atypical adipocytes, and fungal hyphae, respectively. CONCLUSIONS: Plant products appear as puzzling structures in histological section posing difficulties to the pathologist. Recognition of these structures as foreign body based on their histological appearance is inevitable and their identification may avoid unnecessary delay in treatment planning. The current study serves as an atlas for the histology of extraneous material study and also as a reference for the pathologists whenever mystifying structures are encountered.

Alpha-L-fucosidase levels in patients with oral submucous fibrosis and controls: A comparative study.

Background: Oral submucous fibrosis (OSMF) in recent times has been recognized as a potentially malignant disorder (PMD) with an increased risk of developing oral squamous cell carcinoma with malignant transformation rates that vary from 0.6% to 36%. Alpha-L-fucosidase (AFU) is a lysosomal enzyme that is involved in maintaining the homeostasis of fucose metabolism. In benign and malignant tumors, the cells modulate their surface by increasing fucosylation leading to uncontrolled growth. Aims and objectives: This study was designed to estimate the levels of salivary and serum AFU in patients with OSMF and healthy controls and also to evaluate the clinical utility of salivary AFU levels over serum. Materials and Methods: Saliva and blood samples were collected from twenty participants in both the groups (OSMF and healthy controls). Serum and salivary alpha-L-fucosidase levels were measured by enzyme-linked immunosorbent assay. The data were subjected to appropriate statistical analysis. Results: We found a significant increase in alpha-L-fucosidase level in OSMF compared with healthy subjects. Pearson's correlation showed salivary alpha-L-fucosidase level to have superior sensitivity in detecting OSMF compared with serum alpha-L-fucosidase. Conclusion: The outcome of this study suggests that salivary alpha-L-fucosidase can be utilized as a biomarker in early detection of oral precancer and cancer.

Solitary neurofibroma of the palate mimicking mucocele: A rare case report.

Neurofibroma is a benign, slow-growing, peripheral nerve neoplasm. It presents as a solitary tumor or component of neurofibromatosis (NF) and von Recklinghausen's disease. The occurrence of solitary neurofibromas in the oral cavity is less frequent, and those in the palate are reported in less numbers. This report describes an unusual case of solitary neurofibroma in the hard palate which clinically mimicked a mucocele.

Antemortem dental records versus individual identification.

BACKGROUND: Forensic odontology plays a pivotal role in the identification of victims in mass disasters utilizing "preserved dental records" or "ante-mortem records" available with the general dental practitioners. Identification of a deceased individual by comparing antemortem and postmortem records is more reliable and easier as compared to other methods. However, in India, the practice of maintaining dental case record requires additional emphasis. AIM: The aim of the present study is to assess the knowledge, attitude, and practices of dental practitioners in South India regarding awareness and importance of maintaining patient's dental records. SETTINGS AND DESIGN: A descriptive questionnaire study was conducted among the alumni of the dental institution over a period of 3 months. The alumni who passed out from 2000 to 2015 were included in the study. MATERIALS AND METHODS: A structured questionnaire containing 24 questions regarding the knowledge, attitude, and practice of maintaining clinical case records was prepared and validated. Data were collected from 543 dental practitioners from various parts of South India who were the alumni of the dental institution. STATISTICAL ANALYSIS: The data were summarized and analyzed using the statistical software Statistical Package for the Social Sciences. The descriptive analysis was done in percentages, and the results were tabulated. RESULTS: Overall, 58.39% of dentists were found to be maintaining records promptly, and 84.6% dentists have knowledge about forensic odontology, but only 8.4% of dentists have helped the government agencies during mass disasters. CONCLUSION: This study reveals that the need of the hour is to change the attitude and to cultivate interest among practicing dentists regarding dental record maintenance which can tremendously help in the deceased individual identification process.

Association of acute toxic encephalopathy with litchi consumption in an outbreak in Muzaffarpur, India, 2014: a case-control study.

BACKGROUND: Outbreaks of unexplained illness frequently remain under-investigated. In India, outbreaks of an acute neurological illness with high mortality among children occur annually in Muzaffarpur, the country's largest litchi cultivation region. In 2014, we aimed to investigate the cause and risk factors for this illness. METHODS: In this hospital-based surveillance and nested age-matched case-control study, we did laboratory investigations to assess potential infectious and non-infectious causes of this acute neurological illness. Cases were children aged 15 years or younger who were admitted to two hospitals in Muzaffarpur with new-onset seizures or altered sensorium. Age-matched controls were residents of Muzaffarpur who were admitted to the same two hospitals for a non-neurologic illness within seven days of the date of admission of the case. Clinical specimens (blood, cerebrospinal fluid, and urine) and environmental specimens (litchis) were tested for evidence of infectious pathogens, pesticides, toxic metals, and other non-infectious causes, including presence of hypoglycin A or methylenecyclopropylglycine (MCPG), naturally-occurring fruit-based toxins that cause hypoglycaemia and metabolic derangement. Matched and unmatched (controlling for age) bivariate analyses were done and risk factors for illness were expressed as matched odds ratios and odds ratios (unmatched analyses). FINDINGS: Between May 26, and July 17, 2014, 390 patients meeting the case definition were admitted to the two referral hospitals in Muzaffarpur, of whom 122 (31%) died. On admission, 204 (62%) of 327 had blood glucose concentration of 70 mg/dL or less. 104 cases were compared with 104 age-matched hospital controls. Litchi consumption (matched odds ratio [mOR] 9·6 [95% CI 3·6 - 24]) and absence of an evening meal (2·2 [1·2-4·3]) in the 24 h preceding illness onset were associated with illness. The absence of an evening meal significantly modified the effect of eating litchis on illness (odds ratio [OR] 7·8 [95% CI 3·3-18·8], without evening meal; OR 3·6 [1·1-11·1] with an evening meal). Tests for infectious agents and pesticides were negative. Metabolites of hypoglycin A, MCPG, or both were detected in 48 [66%] of 73 urine specimens from case-patients and none from 15 controls; 72 (90%) of 80 case-patient specimens had abnormal plasma acylcarnitine profiles, consistent with severe disruption of fatty acid metabolism. In 36 litchi arils tested from Muzaffarpur, hypoglycin A concentrations ranged from 12·4 µg/g to 152·0 µg/g and MCPG ranged from 44·9 µg/g to 220·0 µg/g. INTERPRETATION: Our investigation suggests an outbreak of acute encephalopathy in Muzaffarpur associated with both hypoglycin A and MCPG toxicity. To prevent illness and reduce mortality in the region, we recommended minimising litchi consumption, ensuring receipt of an evening meal and implementing rapid glucose correction for suspected illness. A comprehensive investigative approach in Muzaffarpur led to timely public health recommendations, underscoring the importance of using systematic methods in other unexplained illness outbreaks. FUNDING: US Centers for Disease Control and Prevention.

Squamous cell carcinoma of the gingiva: A diagnostic enigma.

Oral squamous cell carcinoma (OSCC) is the most common epithelial malignant neoplasm affecting the oral cavity; early detection is an important criterion for achieving high cure rate. Occasionally, it may be misdiagnosed because of its variable and innocuous clinical appearance. Carcinomas of the gingiva are a unique subset of OSCC, constituting approximately 10% of OSCCs and can mimic a multitude of oral lesions especially those of inflammatory origin with benign features, often leading to delay in the diagnosis and hence delayed treatment. This article reports a rare case of gingival OSCC in a 62-year-old female patient mimicking an inflammatory gingival mass.

Oral Kaposi's sarcoma: Sole presentation in HIV seropositive patient.

Acquired immunodeficiency syndrome (AIDS)-associated Kaposi's sarcoma (KS) occurs with increased frequency in all HIV transmission groups and at a particularly high rate among homosexual men. It usually presents initially as violaceous cutaneous lesions, but oral mucosa, lymph nodes and visceral organs may be affected, sometimes without skin involvement. KS in a 20-year-old HIV-seropositive patient with oral involvement as the sole presentation of the disease is presented herewith; thus contributing a new AIDS-related KS case reported in Indian Literature.

Outbreaks of unexplained neurologic illness - Muzaffarpur, India, 2013-2014.

Outbreaks of an unexplained acute neurologic illness affecting young children and associated with high case-fatality rates have been reported in the Muzaffarpur district of Bihar state in India since 1995. The outbreaks generally peak in June and decline weeks later with the onset of monsoon rains. There have been multiple epidemiologic and laboratory investigations of this syndrome, leading to a wide spectrum of proposed causes for the illness, including infectious encephalitis and exposure to pesticides. An association between illness and litchi fruit has been postulated because Muzaffarpur is a litchi fruit-producing region. To better characterize clinical and epidemiologic features of the illness that might suggest its cause and how it can be prevented, the Indian National Centre for Disease Control (NCDC) and CDC investigated outbreaks in 2013 and 2014. Clinical and laboratory findings in 2013 suggested a noninflammatory encephalopathy, possibly caused by a toxin. A common laboratory finding was low blood glucose (<70 mg/dL) on admission, a finding associated with a poorer outcome; 44% of all cases were fatal. An ongoing 2014 investigation has found no evidence of any infectious etiology and supports the possibility that exposure to a toxin might be the cause. The outbreak period coincides with the month-long litchi harvesting season in Muzaffarpur. Although a specific etiology has not yet been determined, the 2014 investigation has identified the illness as a hypoglycemic encephalopathy and confirmed the importance of ongoing laboratory evaluation of environmental toxins to identify a potential causative agent, including markers for methylenecyclopropylglycine (MCPG), a compound found in litchi seeds known to cause hypoglycemia in animal studies. Current public health recommendations are focused on reducing mortality by urging affected families to seek prompt medical care, and ensuring rapid assessment and correction of hypoglycemia in ill children.

Validation of the diagnostic utility of salivary interleukin 8 in the differentiation of potentially malignant oral lesions and oral squamous cell carcinoma in a region with high endemicity.

OBJECTIVE: To evaluate the clinical utility of salivary interleukin 8 (IL-8) in the differential diagnosis of potentially malignant lesions (PMLs) and oral squamous cell carcinoma (OSCC) in a region with high oral cancer prevalence. STUDY DESIGN: Saliva and blood samples were collected from 100 participants in each group (OSCC, PMLs, and healthy controls). Serum and salivary IL-8 levels were measured by enzyme-linked immunosorbent assay. The data were subjected to appropriate statistical analysis. RESULTS: A significant increase in levels of serum and salivary IL-8 was found in OSCC compared with PMLs and healthy controls. Receiver operating characteristic curve analysis found salivary IL-8 to have superior sensitivity in detecting OSCC. A significant increase in IL-8 levels based on the histologic grading of OSCC was also observed. CONCLUSIONS: This study confirms that salivary IL-8 can be a potent marker that can be used as a tool in the differential diagnosis of PMLs and OSCC.

Speciation of selenium in groundwater: seasonal variations and redox transformations.

Speciation of selenium in groundwater is essential from the viewpoint of toxicity to organisms and biogeochemical cycling. Selenium speciation in groundwater is controlled by aquifer redox conditions, microbial transformations, dissolved oxygen (DO) and other redox couples. A suburban area of Chennai city in India, where improper waste disposal measures have been practiced is selected for this study. Se(IV), Se(VI) and other hydrochemical parameters were monitored in shallow ground water during pre- and post-monsoon seasons for a period of three years. The objective of the study was to investigate the effect of groundwater recharge on selenium speciation. The concentration of Se(IV), and Se(VI) ranged between 0.15-0.43 µg L(-1) and 0.16-4.73 µg L(-1), respectively. During post-monsoon period the concentration of Se(IV), and Se(VI) ranged between 0.15-1.25 µg L(-1) and 0.58-10.37 µg L(-1), respectively. Se(VI) was the dominant species of selenium during the pre- and post-monsoon periods. During the post-monsoon periods, leaching of selenium from soil was more effective due to the increased oxidizing nature of the groundwater as indicated by the DO and redox potential (Eh) measurements. This finding has important implications on the behavior of selenium in groundwater, and also on the health of people consuming groundwater from seleniferous areas.

Chromium speciation in groundwater of a tannery polluted area of Chennai City, India.

Chromium speciation in groundwater of a tannery polluted area was investigated for the distribution of chromium species and the influence of redox couples such as Fe(III)/Fe(II) and Mn(IV)/Mn(II). Speciation analysis was carried out by ammonium pyrolidinedithiocarbamate (APDC)-methylisobutylketone (MIBK) procedure. The groundwater samples were analyzed for Cr(III), Cr(VI), and Cr(III)-organic complexes. The APDC could not extract the Cr(III)-organic complexes, but HNO3 digestion of the groundwater samples released the Cr(III)-organic complexes. The groundwater of the area is relatively oxidizing with redox potential (Eh) and dissolved oxygen (DO) ranged between 65 and 299 mV and 0.25 and 4.65 mg L(-1), respectively. The Fe(II) reduction of Cr(VI) was observed in some wells, but several wells that had Fe(II)/Cr(VI) concentrations more than the stoichiometric ratio (3:1) of the reduction reaction also had appreciable concentration of Cr(VI). This could partly be due to the oxidation of Fe(II) to Fe(III) by DO. It appears that the occurrence of Mn more than the Fe(II) concentration was also responsible for the presence of Cr(VI). Other reasons could be the Fe(II) complexation by organic ligands and the loss of reducing capacity of Fe(II) due to aquifer materials, but could not be established in this study.

Mechanism of volatile hydride formation and their atomization in hydride generation atomic absorption spectrometry.

The mechanism of volatile hydride generation (HG) and the formation of analyte atoms in the quartz cell atomizer used in the determination of hydride-forming elements (As, Bi, Ge, Pb, Sb, Sn, Te etc.) by atomic absorption spectrometry (AAS), have been critically reviewed. The nascent hydrogen mechanism failed to explain hydride generation under different experimental conditions when tetrahydroborate (THB), amineboreanes (AB) and cyanotrihydroborate (CBH) were used as reductants. Various experimental evidence suggested a non-nascent hydrogen mechanism, in which the transfer of hydrogen directly bonded to boron to an analyte takes place. In electrochemical hydride generation (EcHG), the reduction of the analyte species and subsequent hydrogenation was proposed. The mechanism of analyte atom formation in a quartz tube atomizer has been explained by the following hypotheses: thermal decomposition, oxidation by 02 and collisions by hydrogen free radicals. The free-radical mechanism satisfactorily explains most of the analytical implications. The significant variation in the experimental conditions required to generate different analyte hydrides makes it difficult to arrive at a generalized mechanism of hydride formation.