Comparative Evaluation of Azadirachta indica (Neem) Chip and Soft Tissue Diode Lasers as a Supplement to Phase I Periodontal Therapy in Localized Chronic Moderate Periodontitis: A Randomized Controlled Clinical Trial.

Introduction: The current trial aimed to assess and compare the efficacy of neem chip and diode laser as a local drug delivery (LDD) agent as a supplement to phase I periodontal therapy in treatment of localized chronic moderate periodontitis. Materials and Methodology. Fourteen systemically healthy participants with 4-6 mm deep periodontal pockets at least in three quadrants (with no alveolar bony defect amenable to respective or regenerative osseous surgery, as seen in orthopantomograph) were selected for the trial. One week after phase I therapy, 10% absorbable chip of neem (commercially prepared by staff of a pharmacy college, Sheriguda, India) was placed in the periodontal pocket on one site, and soft tissue diode laser pocket sterilization was performed on the other site of the arch. Remaining one site was considered as a control. Parameters recorded clinically were plaque index (PI), papillary bleeding index (PBI), probing pocket depth (PPD), and relative attachment level (RAL) measured at baseline, 21st day, and one month postoperatively. Results: Statistically significant improvements were observed in all clinical parameters at one month as compared to baseline for both treatment groups. Conclusion: Neem chip supplemented with phase I therapy showed best improvement in clinical parameters followed by laser supplemented with phase I therapy in comparison to phase I therapy alone at one month follow-up. Clinical Significance. Neem chips are nature's products, affordable without side effects, with a potential to be used as a local drug delivery agent in treating moderate chronic periodontitis.

Quantification of mast cells in nonreactive and reactive lesions of gingiva: A comparative study using toluidine blue and immunohistochemical marker mast cell tryptase.

Background: Mast cells (MCs) are immune cells derived from a multipotent CD34 precursor. The most significant identifying feature of MCs is the presence of metachromatic granules. MCs are increased in oral reactive lesions and are possibly involved in pathogenesis of these lesions. Objectives: 1. To compare the number of MCs between reactive and nonreactive lesions of gingiva using toluidine blue (TB) and mast cell tryptase (MCT) as a specific marker for MCs 2. To compare the staining specificity/efficacy of TB and MCT. Methodology: The study sample comprised 90 tissues which were divided into three groups: Group A comprised 30 cases of pyogenic granuloma (PG), Group B consisted of 30 cases of gingival hyperplasia (GH) and Group C comprised 30 cases of pericoronitis. Staining was done between 1% TB and immunohistochemistry (IHC) marker MCT. Results: A significant increase in number of MCs was observed in PG as compared to GH and pericoronitis. IHC marker MCT proved to be a more specific marker for MCs compared to TB. Conclusion: IHC marker MCT is a specific marker compared to TB. The position of MCs changed from juxtaepithelial in GH to deeper connective tissue in PG which was in correlation with the proliferating tissue that is epithelium in GH and blood vessel in PG.

Current status and future trends in telepathology and digital pathology.

OBJECTIVE: The purpose of this study was to assess the current status and future trends in telepathology (TP) and digital pathology (DP) in central India. MATERIALS AND METHODS: A self-constructed questionnaire including 12 questions was designed with five specialists, to improve the design ambiguity. The study was conducted through postal and online survey consisting of 12 questions and sent to 300 histopathologists. RESULTS: A total of 247 histopathologists answered the survey. The overall response rate was 81%. 98% pathologists felt the need for TP and DP. 34% pathologists used digital photomicrographic images in routine practice. Utilization of DP in most efficient way was observed by 48% pathologists mainly for the purpose of teaching in academic institutions. 82% believed that TP is helpful to take an expert opinion whereas only26% believed that a second opinion has to be taken. With respect to limitations, 67% pathologists believed that its cost-effective whereas 51% revealed high use of TP in next 5 years. CONCLUSIONS: Our survey shows that as the field evolves, pathologists are more towards welcoming TP and DP, provided frequent workshops and training programs are conducted. The results of this survey indicates that pathology staff across central India currently utilize gross digital images for educational or academic purposes. They also revealed that technology will be required in near future applications in academics, consultation and for medico-legal purposes.

Evaluation of efficacy of 1% Crystal Violet & Nuclear Fast Red stain compared to Haematoxyline & Eosin stain for assessing mitotic figures in oral premalignant and malignant lesions.

Various chromosomal arrangements in cells undergoing division are referred to as Mitotic figure (MF). The abnormal excess of mitotic figures is commonly seen in oral epithelial dysplasia (ED) and oral squamous cell carcinoma (OSCC). In present study, we compared the number of mitotic figures in normal oral mucosa, epithelial dysplasia & OSCC sections with haematoxyline & eosine (H&E) and 1%Crystal Violet & Nuclear Fast Red (CV&NFR) stain, also the efficacy of the CV&NFR stain as compared to H & E stain. We investigated the correlation between the number of mitotic figures & grades of OSCC. Study sample comprised of two serial sections of archival blocks of normal oral mucosa & diagnosed cases of epithelial dysplasia & OSCC. One slide stained with H& E & the other one with 1% CV & NFR. Mitotic figures were counted with the grid eyepiece. There was significant increase in number of MFs in oral ED and OSCC in comparison with normal oral mucosa. There was a highly significant increase in number of MFs in CV&NFR stained tissue sections when compared with H & E stain. Metaphase is the most commonly observed phase of mitosis. In summary, our study proposes the use of Crystal violet & Nuclear fast red stain as a selective stain for better contrast & easy identification MFs.

Malignant melanoma of gingiva: Report of a rare case.

According to the World Health Organization, oral malignant melanoma (OMM) is a rare disease, accounting for only 0.8% of all melanomas, 8% of head and neck melanomas, and up to 0.5% of all oral malignancies. OMM presents as a pigmented lesion with asymmetrical borders, irregular surface characteristics, and a distinct color. Melanoma-associated pigmented lesion of the oral cavity does not possess clinical specificity and frequently divert the clinical diagnosis; hence, differential diagnosis becomes mandatory. Furthermore, the unpredictable pathophysiological behavior and delayed detection, contributes for poor prognosis of the disease. As a result, the 5 years survival rate is only 10-25%. Commonly OMM is seen in maxillary gingiva of males. However, we report a rare case of a middle-aged female having pigmentations and growth over mandibular gingiva.