Evaluation of mast cells in oral premalignant and malignant lesions: A histochemical study.

INTRODUCTION: Oral leukoplakia, oral submucous fibrosis, and oral lichen planus are the precancerous or potentially malignant lesions and conditions whereas oral squamous cell carcinoma (OSCC) is a cancerous or malignant lesion of the oral cavity. They have characteristic clinical and histopathological features. These diseases not only originate from epithelium but also associated with chronic inflammation juxta-epithellialy. Mast cells present in the connective tissue stroma and release pro-inflammatory and mitogenic cytokines. These functions of mast cells contribute and enhance the pathogenesis translation of diseases. AIM: The study was done to histologically evaluate the number of mast cells in oral epithelial dysplasia and OSCC and compare it with normal oral mucosa (NOM). MATERIALS AND METHODS: Forty-five cases each of oral dysplasia, OSCC and ten cases of NOM were studied for mast cell number using toluidine blue. RESULTS: There was a highly significant increase of mast cells in oral epithelial dysplasia on comparison with OSCC whereas there was only a significant increase in mast cells in OSCC on comparison with NOM. CONCLUSION: The literature has proven that mast cells can be an indicator of increased angiogenesis and hence can help in the prediction of carcinogenesis, its progression, and also the prognosis of the malignant lesions.

Forensic Facial Reconstruction: The Final Frontier.

Forensic facial reconstruction can be used to identify unknown human remains when other techniques fail. Through this article, we attempt to review the different methods of facial reconstruction reported in literature. There are several techniques of doing facial reconstruction, which vary from two dimensional drawings to three dimensional clay models. With the advancement in 3D technology, a rapid, efficient and cost effective computerized 3D forensic facial reconstruction method has been developed which has brought down the degree of error previously encountered. There are several methods of manual facial reconstruction but the combination Manchester method has been reported to be the best and most accurate method for the positive recognition of an individual. Recognition allows the involved government agencies to make a list of suspected victims'. This list can then be narrowed down and a positive identification may be given by the more conventional method of forensic medicine. Facial reconstruction allows visual identification by the individual's family and associates to become easy and more definite.

Artefacts produced by normal saline when used as a holding solution for biopsy tissues in transit.

Oral surgeons, surgeons and dentists carrying out small biopsy procedures on an out-patient basis have been frequently sending poorly stored biopsy tissues to the Departments of Oral Pathology of various dental colleges, wherein the tissues were being stored in normal saline and then transferred to formalin. Such tissues often show abnormal cellular and architectural changes, which pose a challenge to diagnosis, especially when the histopathologist is not aware that the tissue was stored in normal saline for some time. We wanted to know the extent of artefactually induced cellular and architectural changes in tissues that were transported in normal saline and received by us, based on the duration for which they were held in normal saline. Normal oral soft tissue was subjected to storage in normal saline for periods varying from 1 to 36 h, before being fixed in 10 % formalin. Soft tissue specimens were collected during routine surgical extractions and each was cut into six parts. One was transferred immediately to formalin as control and other bits kept in normal saline for intervals of 1, 3, 12, 24, and 36 h before fixing in formalin. A comparative photographic analysis was carried out to analyze the histopathological changes. The tissues kept in normal saline before fixation underwent various changes. In no way should normal saline be used, even for a short time, to store and transport excised tissue; it is imperative that such tissues be placed immediately in a proper fixative like 10 % formalin.

Binder's syndrome: Report of two cases.

Binder's syndrome is an uncommon entity characterized by midfacial hypoplasia along with Class III incisal relationship. The individuals with this syndrome are easily recognizable and the syndrome is mostly associated with other malocclusions. The current article presents two cases of this rare syndrome and describes its general features.

Forensic odontology as a victim identification tool in mass disasters: A feasibility study in the Indian scenario.

AIM: The aim of this study was to evaluate the awareness of practicing dentists about the subject of forensic odontology and to assess their willingness to maintain and share patient records. MATERIALS AND METHODS: A blind questionnaire survey was carried out among 100 randomly selected practicing dentists in district Ghaziabad, Uttar Pradesh. RESULTS: Most of the dentists interviewed were familiar with the subject of forensic odontology and its relation to dentistry, despite forensic dentistry having been newly introduced since 2007 into the undergraduate dental curriculum in India. However, dental records are maintained by only a few dentists, and only a very small percentage of them reported to have shared records, which may have helped in the identification of victims in a mass disaster. CONCLUSION: The result of our survey concluded that more awareness needs to be developed among practicing dentists regarding maintaining and sharing patient records for forensic odontology to succeed as a victim identification tool.

An erupted compound odontoma.

Odontomas are familiar entities but their eruption into the oral cavity is an extraordinary occurrence, which may be associated with pain, infection, malocclusion, etc. Not many cases of erupted odontomas have been reported in the literature. This paper puts forth a case of erupting odontoma in an attempt to add to the list of reported cases of this unique pathology.

Ameloblastic fibroma: an uncommon entity.

Ameloblastic fibroma is an uncommon mixed odontogenic tumour, which is often confused with ameloblastoma. It exhibits both epithelial and mesenchymal components with absence of any calcified dental structure. This paper presents two cases of this rare entity with detailed review of literature.

Cleidocranial dysplasia: complete clinical, radiological and histological profiles.

Cleidocranial dysplasia is an autosomal-dominant condition characterised by widely patent calvarial sutures, clavicular hypoplasia, supernumerary teeth and short stature. Though it is not a very uncommon occurrence, its histopathological features are not frequently reported. This paper presents a similar case with complete clinical, radiological, histological and treatment profiles.

Rhabdomyosarcoma of mandible: A diagnostic predicament.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children under 15 years of age and rare among persons older than 45 years of age. It is considered to result from malignant transformation of primitive mesenchymal cells. Although it has a relative predominance for head and neck region, it is found less often in oral cavity. Here we report a case of RMS of mandible in an adult patient, which was initially diagnosed as carcinosarcoma. Clinical and pathologic findings are described, which were confirmed by histochemical and immunohistochemical stains.

Evaluation of collagen in connective tissue walls of odontogenic cysts--a histochemical study.

BACKGROUND: The purpose of this study was to evaluate the nature of collagen in the connective tissue walls of odontogenic cysts, like the odontogenic keratocyst (OKC), dentigerous cyst and radicular cyst using picrosirius red stained sections. Furthermore, it was intended to assess if the capsular connective tissue can affect the nature of overlying epithelium, thus emphasizing the role of epithelial-mesenchymal interactions in biological behaviour of the cysts. MATERIALS AND METHOD: The material for the study included 51 formalin-fixed paraffin-embedded tissue blocks (15 odontogenic keratocyst, 15 dentigerous cysts, 15 radicular cysts and four normal mucosa and two dental follicular tissue as controls), retrieved from the Department of Oral Pathology and Microbiology, MCODS, Manipal. Tissue blocks were sectioned at 5-µm thickness, stained with picrosirius red stain and observed with polarization and light microscopy. RESULTS: Few sections of OKC and dentigerous cyst exhibited greenish-yellow birefringence in sub-epithelial region, whereas others showed a yellowish-orange birefringence under polarization microscopy. Most radicular cysts had yellowish-orange to orange birefringence. Shift in colour in case OKC and dentigerous cyst was attributed to the presence of inflammation in those sections. These regions also exhibited either a change in phenotype or thickness of overlying epithelium. CONCLUSION: This technique can be used to study the nature of collagen fibres in odontogenic cyst walls. Further studies with an increased sample size and using various epithelial and mesenchymal markers and ssDNA antibodies should be carried out to confirm the effect of epithelial-mesenchymal interactions on the nature of epithelium of odontogenic cysts.

Dentinogenic ghost cell tumor of the peripheral variant mimicking epulis.

Dentinogenic ghost cell tumor (DGCT) is an uncommon locally invasive odontogenic tumor regarded by many as a variant of calcifying odontogenic cyst. The peripheral variant of this clinical rarity appears as a well-circumscribed mass mimicking a nonspecific gingival enlargement. Microscopic appearance of odontogenic epithelium admixed with focal areas of dentinoid formation and sheets of ghost cells giving the definitive diagnosis of dentinogenic ghost cell tumor imply that microscopic examination is compulsory for any gingival mass. Van Gieson histochemical stain further confirmed the nature of dentinoid-like material. A complete workup of a case of peripheral dentinogenic ghost cell tumor is presented in this paper and the current concept as well as the appraisal of literature is presented.

Primary intraosseous carcinoma of the mandible: A report of two cases.

Primary intraosseous carcinoma arising as a de novo lesion is a unique and rare carcinoma affecting the jaws, especially at younger ages. Two case reports, a 26-year-old Indian female with primary intraosseous squamous cell carcinoma and a 16-year-old Indian male with intraosseous carcinoma arising in an odontogenic cyst, both within the body of the mandible, are presented here.