Micronuclei in Exfoliated Cells: A Biomarker of Genotoxicity in Tobacco Users.

AIMS: The aim of this study was to analyze the tobacco-related genotoxic effects in individual with habit of smoking and chewing tobacco. MATERIALS AND METHODS: The present study sample consisted of 120 individuals attending the outpatient department of D. J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh (UP). The sample was divided into four groups as follows: Group I (individuals with habit of smoking tobacco), Group II (individuals with habit of chewing tobacco), Group III (individuals with habit of smoking and chewing tobacco), and Group IV control group (nontobacco-exposed individuals). Patients were asked to rinse their mouth gently with water. The exfoliated cells were obtained by scraping the buccal mucosa of individuals with a wooden spatula. The scraped cells were placed on the precleaned slides. The smears were then stained with RAPID-PAP™ and analyzed under the microscope. Data were analyzed using SPSS statistical software. RESULTS: In the present study, an arbitrary unit was obtained using frequency/day multiplied by the duration of years (risk multiplication factor [RMF], a positive and significant correlation were observed between the RMF and the mean percentage of micronucleated cell count in smokers, chewers, and in individuals with both smoking and chewing habit, respectively. A weak positive and nonsignificant correlation were observed between age and mean percentage of micronucleated cells in smokers and smokers + chewers, respectively, while it was weak negative and nonsignificant in chewers. In control group, correlation between age and percentage of micronucleated cells was weak positive and nonsignificant at 5% level of significance. CONCLUSION: The micronuclei in exfoliated mucosal cells from buccal mucosa can be used as a biomarker of genotoxicity in predicting the effects of carcinogens.

Micronuclei in exfoliated cells : a biomarker of genotoxicity in tobacco users

Aims: The aim of this study was to analyze the tobacco-related genotoxic effects in individual with habit of smoking and chewing tobacco. Materials and Methods: The present study sample consisted of 120 individuals attending the outpatient department of D. J. College of Dental Sciences and Research, Modinagar, Uttar Pradesh (UP). The sample was divided into four groups as follows: Group I (individuals with habit of smoking tobacco), Group II (individuals with habit of chewing tobacco), Group III (individuals with habit of smoking and chewing tobacco), and Group IV control group (nontobacco-exposed individuals). Patients were asked to rinse their mouth gently with water. The exfoliated cells were obtained by scraping the buccal mucosa of individuals with a wooden spatula. The scraped cells were placed on the precleaned slides. The smears were then stained with RAPID-PAP™ and analyzed under the microscope. Data were analyzed using SPSS statistical software. Results: In the present study, an arbitrary unit was obtained using frequency/day multiplied by the duration of years (risk multiplication factor [RMF], a positive and significant correlation were observed between the RMF and the mean percentage of micronucleated cell count in smokers, chewers, and in individuals with both smoking and chewing habit, respectively. A weak positive and nonsignificant correlation were observed between age and mean percentage of micronucleated cells in smokers and smokers + chewers, respectively, while it was weak negative and nonsignificant in chewers. In control group, correlation between age and percentage of micronucleated cells was weak positive and nonsignificant at 5% level of significance. Conclusion: The micronuclei in exfoliated mucosal cells from buccal mucosa can be used as a biomarker of genotoxicity in predicting the effects of carcinogens

Quantitative analysis of AgNOR counts and pap stain in exfoliative cytology specimens of oral mucosa in bidi smokers and nonsmokers.

Background: Bidi smoking is a serious health hazard which is common throughout South Asia and parts of the Middle East. It has been strongly implicated to various benign and malignant lesions of oral cavity and oropharynx. These tobacco-filled leaves deliver more than three times the amount of nicotine, carbon monoxide, and tar as cigarettes which exert injurious effects on cells reflected in terms of accelerated proliferative activity in normal oral mucosal cells. Aim: This study aimed to compare the exfoliated cells from the oral mucosa of bidi smokers and nonsmokers, with emphasis on proliferative activity. Materials and Methods: Exfoliative smears were obtained from the oral mucosa of forty participants (twenty nonsmokers and twenty smokers) with age group ranging from 30-80 years, in and around Barwala (Haryana). The cytologic smears were evaluated using Papanicolaou (PAP) stain and AgNOR in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. Only PAP Class I and Class II smears were observed. Results: Comparison of the mean number of AgNORs showed a significant difference between nonsmokers and smokers. Inflammatory alterations were found in 70% of smokers and 55% of nonsmokers. A significant difference in proliferative activity was observed between smokers and nonsmokers classified as PAP Class II. Conclusion: A significant difference of AgNORs/nucleus was observed between bidi smokers and nonsmokers.

RésuméContexte: Bidi fumeurs est un grave danger pour la santé qui est commune dans toute l'Asie du Sud et certaines parties du Moyen-Orient. Il a été fortement impliqué dans diverses lésions bénignes et malignes de la cavité buccale et l'oropharynx. Ces feuilles de tabac offrent plus de trois fois la quantité de nicotine, monoxyde de carbone et de goudron que les cigarettes qui exercent des effets préjudiciables sur les cellules reflétés sous la forme d' une accélération de l'activité proliférative des cellules de la muqueuse buccale normale. Objectif: Cette étude visait à comparer les cellules exfoliées de la muqueuse orale des bidis fumeurs et non fumeurs, avec l'accent sur l'activité proliférative. Matériels et méthodes: frottis Exfoliative ont été obtenus à partir de la muqueuse orale de 40 participants (20 non-fumeurs et fumeurs) avec 20 Groupe d'âge allant de 30-80 ans, dans et autour de Barwala (Haryana). Le frottis cytologique ont été évalués à l'aide de la coloration de Papanicolaou (PAP) et d'AgNOR afin d'évaluer la présence d' altérations cytologiques évocateurs d'infl ammation, dysplasie, la kératinisation, et l'activité proliférative des cellules épithéliales. PAP uniquement les catégories I et II de Papanicolaou n'a été observé. Résultats: comparaison du nombre moyen d'AgNORs ont montré une différence entre les non-fumeurs et les fumeurs. Des modifications ont été trouvés infl ammatory dans 70% des fumeurs et 55% des non-fumeurs. Une différence dans l'activité proliférative a été observée entre les fumeurs et les non-fumeurs PAP, le niveau d'emploi de la classe II. Conclusion: une différence de AgNORs/noyau a été observée entre fumeurs et non-fumeurs bidi. Mots-clés: AgNOR, frottis exfoliative, les fumeurs.

Immunoexpression of Ki-67 and Endoglin Corroborating Hamartomatous Nature of Sialoangiolipoma.

Mesenchymal neoplasms of salivary gland including adipocytes are relatively uncommon entity classified as monophasic and biphasic. Sialolipoma, a biphasic mesenchymal salivary gland neoplasm, with a prominent vascularity designated as sialoangiolipoma (SAL) is a recently discussed entity with debates on the hamartomatous nature of the lesion. We have endorsed the hamartomatous nature through evaluating the immunoexpression of Ki-67 and endoglin in SAL in hard palate of a 60-year-old patient. To the best of our knowledge, this would be the second case of SAL in hard palate in a global platform.

Two Concurrent Large Epidermoid Cysts in Sublingual and Submental Region Resembling Plunging Ranula: Report of a Rare Case.

An elderly female patient presented to surgical outpatient clinic with complaint of gradual onset of painless submental and sublingual midline swellings for 6 months of duration. The swellings were noncompressible, nontranslucent, nonpulsatile, and nontender on palpation. Clinical diagnosis was plunging ranula or dermoid cysts. Ultrasound examination of sublingual swelling showed cystic lesion with particulate content. Submental swelling showed cystic swelling with few echogenic floating lobules inside suggesting possibility of epidermoid/dermoid cyst. Magnetic resonance imaging of the face showed homogeneous fluid content within the sublingual cystic lesion and heterogeneous fluid content with few floating nodules within submental swelling. Both cystic lesions were noncommunicative and were showing diffusion restriction and no fat signal. Radiological diagnosis was sublingual and submental epidermoid cysts. She was operated under general anesthesia, and two separate cystic masses were excised with intact capsule. Histopathological diagnosis of masses confirms epidermoid cyst. Several literature have reported isolated sublingual or submandibular epidermoid cyst. However, concurrent sublingual and submental epidermoid cysts with different imaging appearance are rarely reported.

Stepwise case selection using Guy's stone score reduces complications during percutaneous nephrolithotomy training.

INTRODUCTION: Traditional percutaneous nephrolithotomy (PCNL) training involved subjective award of cases to the trainee. We restructured this according to the Guy's stone score (GSS) such that each trainee stepwise completed 25 cases of each grade before progressing. This study compares the outcomes of training with traditional versus stepwise approach. METHODS: Four hundred consecutive cases equally distributed for two trainees in each group were compared in terms of complications (Clavien-Dindo), stone free rate (SFR), operative and fluoroscopy time. External comparison was also done against a benchmark surgeon. Multivariable regression model was created to compare SFR and complications while adjusting for comorbidity, Amplatz size, access tract location, number of punctures, body mass index, stone complexity, and training approach. RESULTS: The distribution of cases in terms of calculus complexity was similar. Overall, in comparison to traditional training, stepwise training had significantly shorter median operative time (100 vs. 120 min, P < 0.05), fluoroscopy time (136 vs. 150 min, P < 0.05) and fewer overall (29.5% vs. 43.5%, P < 0.005) as well as major complications (3% vs. 8.5%, P - 0.029), though initial SFR was higher but not statistically significant (77% vs. 71.5%). On multivariable analyses, stepwise training was independently associated with lower complications (odds ratio 0.46 [0.20-0.74], P - 0.0013) along with GSS grade, number of punctures, and Amplatz size. Stepwise training had similar fluoroscopy time, major complications and final clearance rate compared to expert surgeon. CONCLUSIONS: PCNL has a learning curve specific for each grade of calculus complexity and stepwise training protocol improves outcomes.

Comparative Evaluation of Pediatric Patients with Mental Retardation undergoing Dental Treatment under General Anesthesia: A Retrospective Analysis.

INTRODUCTION: Behavioral management of patients forms one of the foremost components of pediatric dental treatment. Some children readily cooperate with dental treatment, while others require general anesthesia as a part of treatment protocol for carrying out various dental procedures. Hence, we evaluated the pediatric patients with and without mental retardation, who underwent dental treatment under general anesthesia. MATERIALS AND METHODS: The present study analyzed the record of 480 pediatric patients reporting in the department of pedodontics from 2008 to 2014. Analysis of the records of the patients who underwent dental treatment under general anesthesia was done and all the patients were divided into two study groups depending upon their mental level. For the purpose of evaluation, the patients were also grouped according to their age; 4 to 7 years, 8 to 12 years, and 13 to 18 years. Measurement of decayed, missing, and filled teeth and scores for both deciduous and permanent dentition was done before and after the commencement of the dental treatment. Chi-square test and independent t-test were used for evaluating the level of significance. RESULTS: While comparing the patients in the two groups, maximum number of patients is present in the age group of 13 to 18 years. While comparing the indices' score between the two study groups in various age intervals, no statistically significant results were obtained. Restorative treatment and dental extractions were the most common dental treatments that were seen at a higher frequency in the intellectual disability study group. CONCLUSION: In patients with mental retardation, a higher frequency of restorative treatment and extractions occurs as compared to healthy subjects of similar age group. Therefore, they require special attention regarding maintenance of their oral health. CLINICAL SIGNIFICANCE: Special attention should be given for maintaining the oral health of patients with special health care needs as compared to their physically and mentally normal counterparts.

Retrospective Analysis of Different Bracket Systems used in the Treatment of Patients with Anterior Crowding: A Longitudinal Comparative Study.

INTRODUCTION: New design of brackets have been introduced in the field of orthodontics in the recent past, and one of such advancement is the self-ligating brackets. These brackets are said to have less friction, with a shorter period of treatment. Better patient acceptance and good treatment results are some of the other advantages offered by self-ligating brackets. Hence, we comparatively evaluated root resorption of anterior teeth by self-ligating and conventional preadjusted brackets in cases of severe anterior crowding in class I patients. MATERIALS AND METHODS: The present study was carried out at the department of orthodontics in a dental institution and included 140 patients that presented with the chief complaint of Angle class I malocclusion with crowding of more than 6 mm in the anterior tooth region. Two groups were formed with 70 patients in each group. In one group self-ligating brackets were used, while in other group conventional brackets were used. Malmgren's method was sued for evaluating the root resorption score ranging from 0 to 4. All the results were analyzed by the Statistical Package for the Social Sciences software. Chi-square test, nonpaired t-test, and paired t-test were used to evaluate the level of significance. RESULTS: The mean age of the patients in groups I and II was 13.92 and 13.81 years respectively. While comparing age of the patients and time duration of the treatment, no significant results were obtained. While comparing the root resorptions at various time intervals in groups I and II patients, significant results were obtained. While comparing the root resorptions in between groups I and II patients, no statistically significant results were obtained (p-value > 0.05). CONCLUSION: Statistically similar amount of resorption is seen in patients in both the groups either on self-ligating brackets or on conventional preadjusted brackets during treatment of Angle class I patients with severe anterior crowding. CLINICAL SIGNIFICANCE: In treating anterior crowding patients with Angle class I patients, choice of brackets has no effect on the amount of root resorption.

Evaluation of Outcome of Orthodontic Treatment in Context to Posttreatment Stability: A Retrospective Analysis.

INTRODUCTION: One of the main aims of orthodontic treatment is the improvement of esthetics along with enhancement of functions of the orofacial regions. Complications are observed even after final completion of the orthodontic treatment due to relapse and loss of stability. Hence, we retrospectively analyzed angle class I malocclusion cases to study the correlation of outcome of orthodontic treatment and posttreatment stability. MATERIALS AND METHODS: A total of 100 patients were included in this retrospective analysis, which accounted for the patients reporting to the department of orthodontics from 2013 to 2015 with angle class I malocclusion. Pretreatment, posttreatment, and postretention casts of the patients were made and analyzed. The Richmond et al criteria was used to evaluate peer assessment rating (PAR) index and Little irregularity index, followed by scoring with American weight. Measurement of Pearson's coefficient was done to calculate the p-value. p-value of less than 0.05 was considered as significant. RESULTS: No significant amount of alteration was seen in the systematic errors of Little index and PAR index, while casual errors were also within the normal range. While comparing the PAR index at pretreatment and posttreatment phases, statistically significant results were obtained, whereas in case of Little index at same time intervals, scores showed nonsignificant results. CONCLUSION: Even after delivering ideal orthodontic treatment, stability of the treatment is still not ensured until unless posttreatment follow-up is properly maintained.

Supracostal percutaneous nephrolithotomy: A prospective comparative study.

INTRODUCTION: A widely prevalent fear of thoracic complications with the supracostal approach has led to its underutilization in percutaneous nephrolithotomy (PCNL). We frequently use the supracostal approach and compared the efficacy and thoracic complications of infracostal, supra 12(th), and supra 11(th) punctures. MATERIALS AND METHODS: This was a prospective study of patients who underwent PCNL between January 2005 and December 2012. The patients were divided into three groups based on the access: infracostal, supra 12(th) (between the 11(th) and 12(th) ribs) and supra 11(th) (between the 10(th) and 11(th) ribs). Clearance rates, fall in hemoglobin levels, transfusion rates, perioperative analgesic requirements, hospital stay and thoracic complications were compared. RESULTS: Seven hundred patients were included for analysis. There were 179 (25.5%) patients in the supra 11(th) group, 187 (26.7%) patients in the supra 12(th) group and 334 (47.8%) patients in the infracostal group. The overall clearance rate was 78% with no difference in the three groups. The postoperative analgesic requirements were significantly higher in the supracostal groups and showed a graded increase from infracostal to supra 12(th) to supra 11(th). During the study period, only 2 patients required angioembolization (0.3%) and none required open exploration. The number of patients requiring intercostal chest drain insertion was extremely low, at 1.6% and 2.2% in the supra 12(th) and supra 11(th) groups, respectively. CONCLUSIONS: Our results confirm the feasibility of the supracostal approach including punctures above the 11(th) rib, albeit at the cost of an increase in thoracic complications. Staying in the line of the calyx has helped us to minimize the most dreaded complication of bleeding requiring angioembolization.

A novel approach for retreatment of multirooted tooth by partial radisection.

Modern advances in all phases of dentistry have provided the opportunity for patients to maintain a functional dentition for lifetime. Therapeutic measures performed to ensure retention of teeth vary in complexity. The treatment may involve combining restorative dentistry, endodontics, and periodontics so that the teeth are retained in whole or in part. Thus, tooth resection procedures are used to preserve as much tooth structure as possible rather than sacrificing the whole tooth. This treatment can produce predictable results as long as proper diagnostic, endodontic, surgical, prosthetic, and maintenance procedures are performed. The keys to long-term success appear to be thorough diagnosis, selection of patients with good oral hygiene and careful surgical and restorative management.

Emergence of micronuclei as a genomic biomarker.

The presence of micronuclei (MN) in mammalian cells is related to several mutagenetic stresses. MN are formed as a result of chromosome damage and can be readily identified in exfoliated epithelial cells. MN is chromatin particles derived from acentric chromosomal fragments, which are not incorporated into the daughter nucleus after mitosis. It can be visualized by chromatin stains. A variety of factors influences the formation of MN in cells such as age, sex, genetic constitution, physical and chemical agents, adverse habits such as tobacco, areca nut chewing, smoking, and alcohol consumption. Micronucleation has important implications in the genomic plasticity of tumor cells. The present paper reviews the origin, fate and scoring criteria of MN that serves as a biomarker of exposure to genetic toxins, and for the risk of cancer.

Association between use of tobacco and age on graying of hair.

AIMS AND OBJECTIVES: To determine the association between smoking, chewing tobacco (gutka), and age of individual on graying of hair. MATERIALS AND METHODS: The present study was conducted on 120 patients attending the Outpatient Department of the DJ College of Dental Sciences and Research, Modinagar, UP. The individuals were classified into four groups (group I, II, III, IV) on the basis of the form of tobacco use (smoking or chewing). The Pearson correlation coefficient was utilized to find the correlation between the mean percentage of individuals with gray hair, risk multiplication factor (RMF), and age of the individual. RESULTS: Mean percentage of individual with gray hair and RMF (r = 0.6487) are found to be positively associated. A significant and positive correlation was observed between the age of the individual and the frequency of individuals with gray hair. CONCLUSION: This study suggests that there is a significant association between tobacco use and aging on graying of hair.

An Insight in to Paget's Disease of Bone.

Paget's disease of bone (PDB) is a common disorder which may affect one or many bones. Although many patients are asymptomatic, a variety of symptoms and complications may occur. PDB is a focal disorder of bone turnover characterized by excessive bone resorption coupled with bone formation. PDB begins with a period of increased osteoclastic activity and bone resorption, followed by increased osteoblast production of woven bone that is poorly mineralized. In the final phase of the disease process, dense cortical and trabecular bone deposition predominates, but the bone is sclerotic and poorly organized and lacks the structural integrity and strength of normal bone. This article briefly reviews the etiopathogenesis, clinical radiographic and histological features of Paget's disease.

E.coli Associated Extensive Bilateral Maxillary Osteomyelitis: A Rare Case Report.

With the advent of broad spectrum antibiotics, chronic osteomyelitis of jaw, especially of maxilla, has become a rare lesion. Osteomyelitis of jaw is associated with a complex microbiota, the most common oral microorganism being, Staphylococcus sp. Reported cases of jaw osteomyelitis caused by enteric bacteria are very few in literature. Hereby, we are reporting a case of E.coli associated osteomyelitis in a diabetic individual who had presented with very aggressive bilateral maxillary necrosis. After extensive literature search, to the best of our knowledge, this is the first case of maxillary osteomyelitis associated with E.coli which we have come across.