Unique Oral Presentations of Deep Fungal Infections: A Report of Four Cases.

Deep fungal infections rarely involve the oral cavity and most commonly affect immunocompromised patients. Oral deep fungal infections typically manifest as chronic mucosal ulcerations or granular soft tissue overgrowths. Since these lesions are non-specific and can mimic malignancy, it is crucial to obtain a thorough clinical history and an adequate biopsy to render the appropriate diagnosis. We report four new cases of deep fungal infections, diagnosed as histoplasmosis, blastomycosis and chromoblastomycosis, exhibiting unique oral and perioral presentations. Awareness of these unusual entities can help dental and medical practitioners expedite proper multidisciplinary care and minimize morbidity and mortality.

Overexpression of S100A4 as a biomarker of metastasis and recurrence in oral squamous cell carcinoma.

UNLABELLED: S100A4, a biomarker of epithelial mesenchymal transition (EMT), plays an important role in invasion and metastasis by promoting cancer cell motility. In oral squamous cell carcinoma (OSCC), metastasis results in 90% of cancer associated mortality. OBJECTIVE: To investigate the role of S100A4 expression as an important component of the epithelial mesenchymal transition (EMT) program in oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: S100A4 protein expression was assessed semi-quantitatively by immunohistochemistry in 47 histologically confirmed cases of oral squamous cell carcinoma (OSCC) and 10 normal oral mucosal biopsies. The association between the S100A4 overexpression and the aggressive features of OSCC were analyzed by X2 test. RESULTS: Moderate to strong cytoplasmic expression of S100A4 was observed in 30 out of 47 specimens of OSCC (64%). Overexpression of S100A4 was significantly associated with the clinical stage, lymph node involvement, metastases, pattern of invasion and recurrence (p<0.05). CONCLUSION: S100A4 expression represents an important biomarker of prognostic significance that may be used to identify a subset of patients at high risk of invasion and metast.

Oral leukoplakia - is biopsy at the initial appointment a must?

BACKGROUND: Oral leukoplakia is a potentially malignant disorder of the oral cavity. Leukoplakias with chances of undergoing malignant transformation owing to the presence of dysplastic changes may not be clinically distinguishable from leukoplakias without dysplasia. The study was carried out to evaluate the usefulness of biopsy in assessing the clinico-pathologic correlations of oral leukoplakia at the patient's initial visit. MATERIALS AND METHODS: Hospital records with clinical diagnosis of oral leukoplakia were retrospectively analysed. All these patients had undergone biopsy in their initial visit. Histopathological slides were reviewed and reported by a single pathologist. Diagnosis agreement was considered to be present if the clinical diagnosis matched the histopathological diagnosis. Misdiagnosis was considered if the clinical diagnosis did not match the histopathological diagnosis and underdiagnosis when malignancy was detected on histopathological examination. RESULTS: A total of 115 patients were clinically diagnosed with oral leukoplakia. According to clinical appearance of the leukoplakia patch was categorized in to three types viz homogeneous leukoplakia (n= 24 i.e. 20.87%), speckled leukoplakia (n=76 i.e. 66.08%) and verrucous leukoplakia (n=15 i.e. 13.04%). Histopathological examination confirmed clinical diagnosis in 88 cases (a diagnosis agreement of 76.52%). Histopathological examination of 19 cases revealed a different diagnosis, thus categorized as misdiagnosis (16.52%) and 8 cases had unexpected malignancy which accounted for underdiagnosis in 6.96% cases. There was dysplasia in 45 (51.13%) of the histopathologically confirmed cases of leukoplakia. CONCLUSION: The clinical appearance of suspicious white lesions does not provide a true nature of its disease status and malignant changes may be missed.

Overexpression of S100A4 as a biomarker of metastasis and recurrence in oral squamous cell carcinoma

S100A4, a biomarker of epithelial mesenchymal transition (EMT), plays an important role in invasion and metastasis by promoting cancer cell motility. In oral squamous cell carcinoma (OSCC), metastasis results in 90% of cancer associated mortality. Objective: To investigate the role of S100A4 expression as an important component of the epithelial mesenchymal transition (EMT) program in oral squamous cell carcinoma (OSCC). Material and Methods: S100A4 protein expression was assessed semi-quantitatively by immunohistochemistry in 47 histologically confirmed cases of oral squamous cell carcinoma (OSCC) and 10 normal oral mucosal biopsies. The association between the S100A4 overexpression and the aggressive features of OSCC were analyzed by X2 test. Results: Moderate to strong cytoplasmic expression of S100A4 was observed in 30 out of 47 specimens of OSCC (64%). Overexpression of S100A4 was significantly associated with the clinical stage, lymph node involvement, metastases, pattern of invasion and recurrence (p<0.05). Conclusion: S100A4 expression represents an important biomarker of prognostic significance that may be used to identify a subset of patients at high risk of invasion and metast .

Utility of cheiloscopy, rugoscopy, and dactyloscopy for human identification in a defined cohort.

BACKGROUND: Identification is of paramount importance in any forensic investigation. Positive identification of living or deceased using distinctive traits is a cornerstone of forensic science. The uniqueness of these patterns and subtle distinction between traits has offered worthy supplemental tools in establishing the true nature of facts. AIM: The first aim of our study was to determine the most common pattern of lip prints, palatal rugae, and finger prints in the study subjects. Secondly, to determine if any specific pattern of lip print, palatal rugae, or the finger print concurs in individuals, and thereby establish a database of these prototypes for human identification from a defined cohort. MATERIALS AND METHODS: The sample size comprised 100 female students of a dental college staying together in the hostel. Lip prints were recorded on a white bond sheet using lipstick, palatal rugae on dental casts, and finger prints using printer's blue ink. RESULTS: Our observation suggested that the reticular pattern of lip print, the wavy pattern of palatal rugae, and the loop pattern of finger prints were the predominant patterns. Correlation of the three parameters did not reveal significant differences. CONCLUSIONS: This approach of human identification utilizing conventional techniques and relevant parameters is pertinent in defined groups. However, larger representative sample with robust analytical tools may provide a necessary blueprint of human identification.

Adenomatoid odontogenic tumor: A unique report with histological diversity.

Odontogenic tumors are a group of heterogeneous lesions, features of which have been catalogued for several decades. Adenomatoid odontogenic tumor (AOT) is a relatively rare and distinct odontogenic tumor that is exclusively odontogenic epithelium in origin. Although considerable number of reports is available with regard to the clinical and histological spectrum of AOT, very few have highlighted its varied histological presentations. Therefore, this article focuses on the assorted histoarchitectural patterns of AOT.

Evaluation of osteoporosis in diabetic individuals using digital intra oral periapical radiographs / Avaliação de osteoporose em indivíduos diabéticos utilizando radiografias periapicais digitais

Introduction: Osteoporosis is a major cause of fractures in middle aged individuals. There has been drastic increase in the number of osteoporotic patients over the past two decades. The relationship of osteoporosis and diabetes continues to be a topic of debate among research workers. Detection of osteoporosis is very important for oral diagnostics as it can bring changes in treatment plan and modifications in oral procedures. Current literature is directed at diagnosing this condition on dental radiographs. Objectives: The present study was aimed at detecting osteoporosis using digital dental radiographs of premolar and molar region using Adobe Photoshop CS2 software. Materials and methods: A total of 40 patients visiting the dental department who were already diagnosed with type II diabetes for minimum of 1 year Arch Oral Res. 2011 May/Aug.;7(2)169-75 Mutalik S, Goyal M, Sanghamesh B, Guttal SK, Naikmasur VG, Mutalik VS. 170 obesity, hyperglycemia and advanced glycation end products. Albright and Reifenstein were first to report low mineral density and risk of fracture in diabetic subjects in 1948 (3). The relationship between diabetes and osteoporosis continues to be debated among the research workers. A recent meta-analysis showed that diabetic patients had higher hip bone mineral density (BMD) than non-Diabetic controls suggesting that BMD values may not reflect bone fragility in diabetic patients (4). Bone density is determined by several modalities ranging from quantitative computed tomography (qCT) to dual energy x-ray absorptiometry (DEXA) or peripheral ultrasound measurement. Each modality has been shown to be independently predictive of fracture risk, yet each has its own limitations (5). Introduction Osteoporosis is a systemic skeletal disease characterized by reduced bone mineral density and micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. It is one of the most common...

Introdução: A osteoporose é uma das principais causas de fraturas em indivíduos de meia idade. Houve aumentodrástico no número de pacientes com osteoporose nas duas últimas décadas. A relação entre osteoporosee diabetes continua a ser um tema de debate entre os pesquisadores. A detecção da osteoporose é muitoimportante no diagnosticador bucal, uma vez que ela pode refletir em mudanças no plano de tratamento emodificações nos procedimentos bucais. O diagnóstico dessta condição por meio de radiografias dentais temsido discutido na literatura atual. Objetivos: O presente estudo teve como objetivo detectar a osteoporose utilizandoradiografias digitais dentais da região de pré-molar e molar utilizando o software Adobe PhotoshopCS2. Materiais e métodos: Um total de 40 pacientes que visitaram o departamento de odontologia e já previamentediagnosticados com diabetes tipo II no período mínimo de um ano foram selecionados aleatoriamentepara o estudo. Radiografias digitais intra-orais periapicais orais da região inferior de pré-molar e molar foramobtidos pela técnica de paralelismo. As imagens foram então convertidas em formato de arquivo bitmap eavaliadas usando o software Adobe Photoshop CS2. O número de trabéculas em uma área específica foi contadoe comparado com indivíduos saudáveis de mesma idade e sexo e controle glicêmico normal. Resultados:A média do número de trabéculas/mm2 em indivíduos normais foi 0,1987 ± 0,0244, e de 0,1737 ± 0,0279 parao grupo diabético, sendo a diferença estatisticamente significativa (p < 0,05). Conclusão: Este estudo confirmouque o número de trabéculas/mm2 em indivíduos diabéticos foi menor em comparação aos observados emindivíduos normais.