Mucoepidermoid Carcinoma of Sublingual Salivary Gland: A Rare Case Report.

RATIONALE: Sublingual salivary gland tumours are very rare but are mostly malignant. As very limited literature is available, we present a rare case of mucoepidermoid carcinoma (MEC) of sublingual salivary gland. PATIENT CONCERNS: A56-year-old female presented with an asymptomatic swelling of 15-year duration in the floor of the mouth and chin region. DIAGNOSIS: Mandibular occlusal view, computed tomography scan, and ultrasonogram revealed calcification and the tumour to be of salivary origin. Incisional biopsy showed clear cell changes. TREATMENT: The sublingual and submandibular salivary gland along with the associated nodes was excised through transoral approach with midline osteotomy. OUTCOMES: The histopathologic diagnosis of excised specimen was "Intermediate grade MEC" with clear cell changes, stromal hyalinization, and local invasion. The patient was followed up for 12 months, and there was no evidence of any recurrence. TAKEAWAY LESSONS: Sublingual salivary gland malignancies show early invasion and a higher rate of metastases, thus requiring a vigilant intervention.

Effect of 2 h of room temperature storage on salivary glucose concentration.

Background of the Study: Although many studies are available validating the role of saliva as an alternative diagnostic tool, no reliable data are available on the duration of time, a salivary sample can be reliably stored at room temperature for estimation. It varies from one analyte to another and has to be researched. Aim: The aim of the study was to determine the effect of 2 h of room temperature storage on salivary glucose concentration. Materials and Methods: Saliva samples obtained by spitting method from thirty healthy volunteers were centrifuged and glucose concentration determined in the supernatant obtained. The test was repeated 2 h later following room temperature storage of the supernatant. Results: The data obtained were analyzed using wilcoxson signed rank test. No significant difference between was observed between the two values. Conclusion: Salivary glucose can reliably estimate on centrifuged samples following 2 h of room temperature storage.

Evaluation of Change in Surface Enamel Microhardness in Patients Undergoing Fixed Orthodontic Appliance Therapy - A Randomized Control Trial.

AIM: This study aims at determining the amount of enamel decalcification in terms of microhardness. MATERIALS AND METHODS: Twenty patients requiring treatment by extraction method for Class I malocclusion with bimaxillary protrusion were selected for the study. Twenty patients were randomly divided into control group and experimental group. In the control group (n = 40), extraction of permanent first premolars was done on day 1 of bonding to assess the Vickers hardness number (VHN) of enamel surface, and in the experimental group (n = 40), extraction of the contralateral premolars was done on the 28th day after bonding to assess the VHN of enamel surface. The values are tabulated and analyzed by SPSS software. RESULTS: There is significant surface enamel dissolution of enamel crystals in the experimental group compared to the control group, and a statistically significant difference in VHN is evident between the control and experimental groups. The surface enamel dissolution (VHN) is not significant difference noted between mandibular and maxillary premolars of the control and experimental groups. CONCLUSION: The present study has demonstrated a higher level of surface enamel dissolution in the experimental group. There is a marked difference in the VHN between the control and experimental groups, which is statistically significant. The scanning electron microscopy study also confirms the presence of surface enamel demineralization following orthodontic bonding.

Focal cemento-osseous dysplasia.

Focal cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion of bone characterized by the replacement of normal bone by fibrous tissue and subsequently followed by its calcification with osseous and cementum-like material. It is mostly asymptomatic in nature and requires no treatment. When secondarily infected, it becomes symptomatic and intervention is required. Here, we report a case of symptomatic FCOD of mandible in a 52-year-old female patient. Histopathological evaluation of the biopsy specimen by ground sections and decalcified sections aided in the final diagnosis of the case.

Cytological intracellular glycogen evaluation using PAS and PAS-D stains to correlate plasma glucose in diabetics.

BACKGROUND: Oral cytology studies have claimed that cytoplasmic Periodic Acid Schiff (PAS) positivity in type-2 diabetics is due to glycogen content. But, it can also be due to mucin and glycoconjugates. AIM: 1. To confirm that cytoplasmic PAS positivity in type-2 diabetics is due to glycogen using diastase. 2. To know the effect of diabetes by determining the number of glycogen-containing cells in the smear. 3. To assess the impact of duration of diabetes based on PAS staining of cells. 4. To correlate between random blood glucose level and the number of PAS-positive cells. MATERIALS AND METHODS: Study population comprised 45 individuals with 30 type-2 diabetics as case group (Group I < 5 years duration; Group II > 5 years duration) and 15 healthy volunteers (age and gender-matched) as control. For all subjects, random blood glucose was estimated and two cytosmears were obtained. The smears were stained with PAS and PAS-diastase stains (PAS-D). Staining intensity was documented as score 1 (mild-to-moderate) and score 2 (moderate-to-intense) and data obtained were statistically analyzed in SPSS version 16.0. RESULTS: Mann-Whitney U test revealed that in diabetics cytoplasmic PAS positivity is because of glycogen (P < 0.05). There is an increase in the number of glycogen-containing cells (P < 0.05) in diabetics. The duration of diabetes had less impact on intracellular glycogen accumulation (P > 0.05). Spearman's correlation test revealed no significant correlation (P > 0.05) between random blood glucose and a number of PAS-positive cells. CONCLUSION: PAS positivity is because of intracellular glycogen accumulation in type-2 diabetics. It can convey the glycaemic status of an individual in the recent past, thus a beneficial role in screening and therapeutic monitoring.

Evaluation of salivary alkaline phosphatase levels in tobacco users to determine its role as a biomarker in oral potentially malignant disorders.

BACKGROUND: Elevated salivary alkaline phosphatase (S-ALP) levels have been observed in oral squamous cell carcinoma, but its status in tobacco users and in individuals with oral potentially malignant disorders (OPMDs) is less explored. AIMS AND OBJECTIVES: The aims and objectives were to estimate and compare the levels of S-ALP among tobacco users, nonusers and in individuals with OPMD. MATERIALS AND METHODS: The study population comprised 42 individuals, categorized into four groups with/without tobacco usage habit and with/without lesion. 5 ml of unstimulated saliva sample was collected, centrifuged at 3000 rpm for 15 min and supernatant separated. S-ALP was estimated in the supernatant by using kinetic photometric method in an automatic analyzer. RESULTS: Data obtained were subjected to statistical analysis. The mean S-ALP was 18.00 IU/L for normal individuals without tobacco usage, 4.60 IU/L for smokers without lesion, 7.50 IU/L for tobacco chewers without any lesion and 64.90 IU/L for individuals with OPMD. The mean difference between the groups was statistically significant (P < 0.001) using Kruskal-Wallis' ANOVA. No statistically significant difference (P > 0.05) was obtained in the S-ALP levels between tobacco users and nonusers and between smokers and tobacco chewers, using Mann-Whitney U-test. S-ALP levels in individuals with OPMD were statistically significantly higher (P < 0.001) than those without lesions, with or without tobacco usage habit, using Mann-Whitney U-test. CONCLUSION: We conclude that S-ALP could be used as a reliable noninvasive biomarker in monitoring OPMD.

Recurrent keratocystic odontogenic tumor of right maxillary sinus involving the right infraorbital rim.

Keratocystic odontogenic tumor (KCOT) is a benign odontogenic tumor with an aggressive behavior and high recurrence rate. The most common site of predilection is the posterior mandible. In contrast, KCOTs occurring in the maxillary region are relatively rare. However, the maxillary involvement poses a greater and increased threat, due to proximity to vital structures such as maxillary sinus, orbital floor, and infratemporal fossa. This report presents such a case of KCOT involving the maxillary sinus eroding the floor of the orbit and provides an account of the factors that need to be considered during management.