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Background: Early diagnosis is the single most effective means of reducing the mortality rate of oral cancer., Aim: This study was undertaken to assess the expression of minichromosome maintenance protein 5 (MCM5) in oral epithelial dysplasias and oral squamous cell carcinomas (OSCCs) and to evaluate their possible role as a biomarker for early diagnosis and prognosis of OSCC., Design: A retrospective cross-sectional study., Materials and Methods: The study was conducted to assess the expression of MCM5 immunohistochemically in the tissue samples of oral epithelial dysplasias ( n = 27) and OSCCs ( n = 30) diagnosed between 2014 and 2019., Statistical Analysis: The difference in the mean nuclear labelling index (LI) between the groups and the subgroups was analysed statistically using the Kruskal-Wallis test and the post hoc test, and the Dunn-Bonferroni multiple comparison analysis was conducted for pairwise comparison between the four main groups and the subgroups. The association between mean MCM5 LI and clinicopathological parameters was analysed using Spearman's rank correlation coefficient., Results: A progressive increase in the nuclear expression of MCM5 protein ( P -value <0.001) was noticed from normal oral mucosa through oral epithelial hyperplasia and oral epithelial dysplasia to OSCC. A significant correlation was also observed between the mean nuclear MCM5 LI of OSCC and TNM staging (R 2 = 0.268, P = 0.029)., Conclusion: Our findings suggest that MCM5 may be of great value in assessing the malignant potential of dysplastic lesions and may serve as biomarker of utility in the early diagnosis and prognosis of OSCC., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Oral and Maxillofacial Pathology.)

Premetastatic niche (PMN) concept, introduced by David Lyden and colleagues, is an area that can support cancer cells to nurture in it, but the area itself being bereft of cancerous cells. It provides a microenvironment that is congenial for tumor invasion, endurance, and or proliferation of malignant cells to develop into metastasis. These are noncancerous variations in a tumor-free organ and are the most primitive indications of metastasis. These may have a potential to serve as a diagnostic aid, prognostic biomarkers, and therapeutic target. Nevertheless, there is still no clear elucidation on diverse trails of tumor metastasis via lymphatic or hematogenous route, especially in relationship with the PMN. In this review, contemporary knowledge associated with nodal premetastatic niche formation with forthcoming directions on translational and clinical research is deliberated., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2023 Journal of Pharmacy and Bioallied Sciences.)

Melanotic neuroectodermal tumour of infancy (MNTI) is a locally aggressive neoplasm of neural crest origin. It is primarily a paediatric tumour, and 95% of the cases occur in children below 1 year. The tumour mainly affects the head and neck region. It shows a predilection for the craniofacial sites and the most common site affected is anterior maxilla. Microscopically, it is characterized by a biphasic population of neuroblastic cells and pigmented epithelial cells. Although generally considered as a benign tumour, it can invade the adjacent muscle and bone, causing destruction of the involved site. The rapidity in growth and the aggressive clinical behaviour of the tumour can be deceptive and hence lack of familiarity with the clinical characteristics of the tumour may often lead to an erroneous diagnosis of malignancy. The treatment of choice for MNTI is excision, and it is usually curative. Extensive surgery in a child may interfere with the normal growth and development of the facial structures and reconstruction can be very challenging in infants. Hence, early diagnosis is critical for the effective management. Clinical findings, histopathological features, and differential diagnosis of a classic case of melanotic neuroectodermal tumour of infancy are discussed., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Immunotherapy is a promising approach in the management of human cancers and has been proven to provide a durable response in many cancers. It is helpful as an adjuvant therapy for cancers and at present is considered as a fourth pillar supporting surgery, chemotherapy and radiotherapy. In the treatment of oral cancer, immunotherapy is approved in late-stage diseases where surgical resection cannot be carried out or fails, leading to recurrences and metastasis. Evidences suggest that when given as a first-line treatment, it can elicit an immune response that shrinks tumours, which could provide long-term benefit for patients. But unlike the traditional approach which follows the uniform protocol for all oral cancer patients, effective immunotherapy requires a more site-specific personalized approach. The aim of this paper is to review the various immune evasive mechanisms adopted by tumour cells and their relevance as potential targets for immunotherapy in oral tongue squamous cell carcinoma., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Oral and Maxillofacial Pathology.)

Background: Salivary gland tumors are histologically the most heterogeneous group of tumors. Traditional diagnostics and grading of these tumors often fail to provide any insight into patient's clinical course. Cathepsin-D is a lysosomal acid protease secreted in increased levels in several malignancies. However, its role in salivary gland tumors has not been studied extensively. The present study aims to assess the expression of cathepsin-D in malignant and benign salivary gland tumors and to compare its expression in these tumors., Materials and Methods: A total of 40 salivary gland tumors which included 10 cases each of adenoid cystic carcinoma, mucoepidermoid carcinoma, pleomorphic adenoma and Warthin's tumor were evaluated immunohistochemically for cathepsin-D expression. Intergroup comparison of cathepsin-D expression was done between the benign and malignant groups using the Mann-Whitney U -test. Intragroup comparison was also done using Kruskal-Wallis test., Results: A statistically significant difference in the expression of cathepsin-D was observed between the benign and malignant groups. The malignant group showed a considerably higher cathepsin-D expression (mean value 6.284 ± 4.377) when compared to the benign group (mean value 2.281 ± 2.459). The differences in the immunopositivity between the malignant and benign groups were found to be highly significant ( P = 0.004)., Conclusions: Increased expression of cathepsin-D is observed in the malignant salivary gland neoplasms. This may prove to be a useful marker for the aggressive biologic behavior as well as invasive potential of salivary gland neoplasms., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Oral and Maxillofacial Pathology.)

Congenital granular cell epulis is a congenital growth rarely found on the gingiva of neonates. These remarkably large tumours present in an infant's mouth may impede with feeding, respiration or adequate mouth closure. Recognition of this entity and prompt treatment are essential for preventing any difficulties for the neonate. This is a case report of a 35-day-old female neonate who presented with a single exophytic lesion in the maxillary alveolar ridge. The differential diagnosis, management regimens and complications of this condition are reviewed. The lesion was excised under intravenous sedation and subjected to histopathological analysis. Based on the microscopic findings, the diagnosis of congenital granular cell epulis was confirmed. Clinicians including paediatricians, sonographers, dentists and surgical pathologists should be able to timely recognise and intervene such tumours as they may be potentially harmful to the infant., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Carcinoma cuniculatum is a locally aggressive, low-grade variant of squamous cell carcinoma. Though primarily a tumour of the skin, it has also been found to be arising from various mucosal surfaces including oral mucosa. When it occurs in the mandible it starts as a mucosal lesion which progressively invades the jaw and destroys the underlying bone, often presenting as a cystic lesion. With only around 30 cases reported in the mandible, this entity remains an elusive one for the pathologist and all except a few cases reported so far, had been misdiagnosed initially. The delay in the diagnosis is a major concern as it results in further progression of the disease with extensive involvement of bone and associated soft tissue structures. The aim of this article is to discuss the histopathological challenges faced in arriving at the diagnosis of a case of carcinoma cuniculatum involving the mandible. Owing to its overlapping clinico-pathological characteristics with odontogenic keratocyst the lesion has been misdiagnosed initially resulting in inadequate management, leading to multiple recurrences and unexpected complications. As a few cases like the present one had been erroneously diagnosed as odontogenic keratocyst previously, it becomes important to identify the varied clinical presentation and unique histopathological characteristic of carcinoma cuniculatum of mandible to help us in recognizing this often-missed entity at an earlier stage, so that it can be managed effectively., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

Canalicular adenoma is a unique, rare, benign salivary gland neoplasm whose reported prevalence varies in different studies. According to literature, this neoplasm has a marked predilection to occur in the upper lip of elderly women. Histological features are usually distinctive and diagnostic. This neoplasm has good prognosis after conservative surgical management but the propensity of multifocal nature and recurrence of this lesion mandates regular follow-up. This case report illustrates the case of a canalicular adenoma in the palate in a 71-year-old male patient. Here, we discuss the differential diagnosis with a brief review of literature., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Lichen planus is a chronic mucocutaneous disease of unknown etiology with well-established clinical and microscopic features. Oral lichenoid reactions are a family of lesions triggered by contact with specific agents such as metallic restorative materials, resins and drugs. Oral lichenoid reactions share clinical and histological features of oral lichen planus (OLP) but has varied management options. Hence, the discrimination between these two lesions is a major challenge for clinicians as well as pathologists., Aim: Histopathologic categorization of OLP and oral lichenoid reaction by comparing the thickness of basement membrane and the distribution of mast cells using special stains., Materials and Methods: The test group consists of formalin-fixed paraffin-embedded blocks of OLP ( n = 15), and oral lichenoid reactions ( n = 15) obtained from the archives of the Department of Oral Pathology, Amrita School of Dentistry. Three serial sections of 4 μm thickness were cut from each block. The sections were stained with H & E, periodic acid-Schiff (PAS) and toluidine blue, respectively., Results: A significant increase in the maximum basement membrane thickness (BMT) was noticed in OLP when compared to oral lichenoid reaction. A definite increase was also noticed in the number of mast cells in OLP and oral lichenoid reaction when compared to normal oral mucosa. There was a statistically significant increase in the number of degranulated mast cells in the deeper connective tissue in oral lichenoid reaction when compared to OLP., Conclusion: OLP and oral lichenoid reactions are two different entities showing similar clinical and microscopic presentation. The histochemical analysis of basement membrane and mast cells in these lesions might provide a more authentic method for differentiating these two lesions and might be of utmost value in deciding the treatment options., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Oral and Maxillofacial Pathology.)

Malignant salivary gland carcinomas arising primarily within the jaw bones are extremely rare. The most common salivary malignancy in these locations is mucoepidermoid carcinoma followed by adenoid cystic carcinoma and adenocarcinoma. The clinical picture and imaging studies of these malignancies may be confused with odontogenic lesions which are more common in this location. Adenoid cystic carcinomas have a prolonged clinical course, tendency for perineural invasion and distant metastasis and multiple recurrences. The diagnosis of these tumors requires thorough histopathologic examination. Immunohistochemical studies may be required in cases showing solid growth pattern. High-grade transformation, earlier termed as dedifferentiation, has been observed in several salivary gland carcinomas including adenoid cystic carcinoma. These transformed tumors are reported to have an extremely poor prognosis. Here, we report a case of primary intraosseous adenoid cystic carcinoma with extensive skeletal metastases which showed a negative staining with p63 and positive staining with CD117. The tumor had a predominant solid growth pattern with areas indicative of high-grade transformation. A negative p63 staining may indicate an incomplete or focal loss of abluminal layer and this is one of the criteria for high-grade transformation in adenoid cystic carcinoma.

Myofibromas are benign neoplasms of myofibroblastic origin and rarely encountered in the oral cavity. Myofibroma may frequently grow rapidly leading to suspicion of malignancy. This may lead to a tendency for aggressive management. The histopathology of this tumour has similarity with other spindle cell tumours and often requires immunohistochemical staining for diagnosis. Here, we present a case of myofibroma in a 15-year-old female patient who reported with an aggressive gingival swelling and discuss the various histopathological differential diagnosis., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Salivary gland tumours can arise in any location in the oral cavity but are rather rare in the retromolar region. The majority of the salivary neoplasms arising here are malignant in nature. Mucoepidermoid carcinoma is more commonly seen in the palate. Tumours arising in the retromolar region tend to show symptoms late in onset and may be greater in extent than evident clinically. Imaging studies will help in understanding the full extent of these lesions. We report a case of mucoepidermoid carcinoma arising in a young female patient who reported for orthodontic correction. In the course of examination, a palpable swelling was identified in the right retromolar area, which was eventually diagnosed as intermediate-grade mucoepidermoid carcinoma. Wide resection with adjuvant radiotherapy was the treatment given for the patient., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Increased mortality in oral squamous cell carcinoma (OSCC) had been attributed to delay in diagnosis. Lack of a specific marker to assess the malignant potential of premalignant lesions is thought to be one of the reasons for late detection. Expression of Cytokeratin 19, which is widely used as an odontogenic epithelial marker had been reported in OSCC. Downregulation of CK 19 expression plays an important role in terminal differentiation of superficial squamous cell and increased expression in various epithelial malignancies has been suggested to be an indicator of malignant change., Aims and Objectives: To assess the role of CK19 as a potential marker in predicting malignant transformation in oral precancerous lesions and as a prognostic marker in OSCC., Materials and Methods: Study population consisted of ten samples each of normal oral mucosa, epithelial hyperplasia, varying grades of both oral epithelial dysplasias and OSCC. The tissue sections were subjected to immunohistochemical staining for the marker cytokeratin 19., Results: An increased expression of CK19 was noted in oral epithelial hyperplasia, severe dysplasia and in superficial epithelium at the invading front in OSCC. In mild and moderate dysplasias, CK19 expression was lower than the normal mucosa. In oral squamous cell carcinoma, the expression of CK19 was restricted to either a few islands or a few cells within the islands, resulting in a lesser expression than the normal epithelium. The malignant epithelial islands in the superficial connective tissue stroma were showing greater expression than the deeper islands. The epithelial cells associated with formation of keratin pearls were found to be showing more expression than those with infrequent keratin pearls., Conclusion: The study suggests that malignant transformation of epithelium can be predicted based on the increased expression of CK19. But it should be done with caution as a similar increased expression may also be noticed in presence of inflammation., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Oral and Maxillofacial Pathology.)

Background: Odontogenic cysts (OCs) constitute a major part of oral pathological lesions, but little is known about their distribution patterns in various populations., Aims: The aim was to determine the prevalence and factors associated with the cases of histopathologically diagnosed OCs that report to our institution and to analyze the factors associated with the presence of OCs and to study the biologic behavior of different types of cysts., Materials and Methods: A cross-sectional study was performed on 596 oral and maxillofacial specimens during 2013-2017. Out of these, the cases which were histopathologically proven as OCs were separated and data were collected and analyzed regarding the age, gender, primary symptom, site, radiographic feature, histopathologic diagnosis, treatment given, recurrences and associated conditions if any., Results: Of the 596 cases included in the study, 67 (11.2%) had a histopathological diagnosis of OCs. 41 cases were inflammatory cysts and 26 developmental cysts. 28 cases (41.8%) were reported as periapical cysts, 10 cases (14.9%) were odontogenic keratocysts (OKCs), 9 cases (13.4%) were dentigerous cysts, 8 cases (11.9%) were inflamed cyst wall, 5 cases (7.5%) each of residual cyst and developmental OCs and one case (1.5%) each of orthokeratinized OC and calcifying OC., Conclusion: This study showed that the prevalence of OCs was similar to other reported studies. Periapical cysts were the most common cysts reported, followed by OKCs showing that the latter were more frequent than dentigerous cysts., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Oral and Maxillofacial Pathology.)

A multitude of disease processes ranging from periodontitis to malignancies can lead to formation of solitary ulcer on the palate. Hence solitary ulcers of palate can often be a challenging one to diagnose. We report an interesting case of a diffuse large B cell lymphoma of the maxillary sinus which perforated the palatal bone and presented clinically as a palatal ulcer. Initially the lesion manifested as a small ill-defined swelling in the posterior palatal slope in relation to 24and25 which were mobile and hence was erroneously diagnosed as chronic periodontal abscess. This paper is intended to stress the relevance of including non-Hodgkin's lymphoma in the differential diagnosis of solitary palatal ulcers as it may be often misdiagnosed as more common reactive or inflammatory lesions., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Oral leukoplakia (OL) is a potentially malignant disorder with increased risk for the development of oral squamous cell carcinoma (OSCC). Many cases of OSCC arise from the malignant transformation of preexisting OL. However, the risk of progression into OSCC and the possible prediction of malignant potential of OL remain inconclusive. Recent studies have shown that podoplanin, a mucin-like transmembrane glycoprotein specifically expressed in lymphatic endothelial cells, is expressed in various neoplasms including OSCC, indicating its possible biologic role in tumor cells. In this study, an evaluation of podoplanin expression in OL and OSCC has been carried out to assess its potential role as a biomarker to predict the possibility of malignant transformation in OL cases., Aims and Objectives: To assess the usefulness of podoplanin as a potential biomarker for predicting the risk of malignant transformation in OL, by comparing its immunohistochemical expression in OL and OSCC., Materials and Methods: Archival paraffin-embedded blocks of 25 OL cases with varying grades of dysplasia and 30 OSCC cases showing its varying grades were selected. Sections were subjected to immunohistochemical staining for podoplanin and compared with the control group for evaluation of results in the three groups., Results: A statistically significant increase in podoplanin expression was observed from normal mucosa through OL to OSCC. In the OL cases, the podoplanin staining score progressively increased from mild dysplasia to carcinoma in situ , whereas in OSCC, well-differentiated group showed the maximum expression of podoplanin., Conclusion: The progressive increase in podoplanin expression through the increasing grades of dysplasia in OL is suggestive of an increased risk for malignant transformation with increased expression of podoplanin in OL cases. A high podoplanin expression in the well-differentiated OSCC may indicate a vital role for podoplanin in the early stages of tumorigenesis., Competing Interests: There are no conflicts of interest.

We present here a case of a 64-year-old female patient who reported with a complaint of pain in the chin region of 3-month duration. The radiographs revealed an irregular radiolucent lesion in the anterior part of the mandible. An incisional biopsy was carried out and the microscopy showed features of adenocarcinoma. Suspecting a metastatic lesion, the patient was then sent for whole body examination which showed a mass in the lungs. A whole body scan also showed metastasis to other organs such as kidney, gallbladder and vertebrae. This case is unusual in that the patient complained only of a vague jaw pain with no other systemic symptoms even in the presence of widespread disease., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Mucoepidermoid carcinoma (MEC) is the most common malignant tumour of the major and minor salivary glands. Minor salivary glands are scattered in different areas of the oral cavity such as palate, retromolar area, floor of the mouth, buccal mucosa, lips and tongue, but so far, only a few lingual MEC cases have been documented in the literature and most of the studies have shown a predilection for base and dorsum of the tongue. We report a rare case of MEC involving the posterior-lateral border of the tongue., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Background: Early detection of oral squamous cell carcinoma (OSCC) remains one of the most efficient ways to ensure patient survival and improved quality of life. Although specific biomarkers related to OSCC have been investigated, a useful biomarker that assesses the transition potential of potentially malignant lesion to OSCC remains to be found. Osteopontin (OPN) has been recognized as an important factor in tumorigenesis and their expression in OSCC have been investigated earlier. In the present study, evaluation of OPN expression in premalignant and malignant lesions has been carried out to assess their possible role as a biomarker in the early diagnosis and prognosis of OSCC., Objectives: The objective of this study is to evaluate the role of OPN as a biomarker in the diagnosis and prognosis of OSCC., Materials and Methods: The study group consisted of archival paraffin-embedded blocks of ten cases each of varying grades of OSCC, oral epithelial dysplasias and epithelial hyperplasias. Sections were subjected to immunohistochemical staining for the biomarker OPN., Results: A positive OPN expression was noticed in epithelial dysplasias and SCC arising from the oral epithelium. A progressive increase in the intensity of staining was seen with increasing grades of dysplasias and a decrease in OPN expression with an increase in grades was observed in OSCC., Conclusion: The expression of OPN in full thickness of epithelium in severe dysplasias, carcinoma in situ, and in the superficial epithelium of OSCC suggest the possibility of considering OPN expression in full epithelial thickness in dysplasias as an indicator for malignant transformation., Competing Interests: There are no conflicts of interest.

Context: Myofibroblasts are fibroblasts with smooth muscle-like features characterized by the presence of a contractile apparatus and found in the connective tissue stroma of normal tissues such as blood vessels and lymph nodes. They are now thought to play a role in the synthesis and reorganization of extracellular matrix, which could contribute to the aggressive biologic behavior of the lesions., Aims: To compare the mean number of stromal myofibroblasts in dentigerous cysts (DCs), keratocystic odontogenic tumor (KCOT) and ameloblastoma; and to derive a correlation between the stromal myofibroblasts and the known biologic behavior of the lesions., Settings and Design: A cross-sectional immunohistochemical analysis of cases of DC, KCOT and ameloblastoma., Materials and Methods: Twenty paraffin-embedded tissue blocks each of DC, KCOT and multicystic ameloblastoma were selected for the study and diagnosis confirmed through hematoxylin and eosin staining. Tissue sections were analyzed for the number of myofibroblasts using alpha smooth muscle actin (α-SMA) immunostaining., Statistical Analysis: Differences in the mean number of α-SMA positive cells in each group were analyzed using one-way ANOVA test. Intergroup comparisons of mean values of α-SMA positive cells were performed using Mann-Whitney U-test., Results: Ameloblastoma showed the highest number of myofibroblasts, whereas DC showed the lowest. Among the groups, there were significant differences between the myofibroblast counts among DC and KCOT and between DC and ameloblastoma, whereas the difference in counts was not statistically significant between KCOT and ameloblastoma. A positive correlation was observed between the myofibroblast count and the known biologic behavior of the lesions., Conclusion: Myofibroblasts may act in close association with the epithelial cells to bring about changes in stromal microenvironment, favorable to the growth and progression of the lesion. They may be of great value in predicting the biologic behavior and growth potential of such lesions.

Pemphigus is a group of potentially fatal dermatoses with both cutaneous and oral manifestations. Characterized by the appearance of vesicle or bullae, their manifestations in the oral cavity often precede those on the skin by many months or may remain as the only symptoms of the disease. It is therefore important that the oral manifestations of the disease are recognized on time, to make a proper diagnosis and initiate timely treatment. Here we present a case of Pemphigus Vulgaris (PV) that presented with oral lesions at multiple sites including tongue, to highlight the importance of timely recognition of the oral lesions during routine dental practice for the diagnosis and management of this disease.

Filariasis affecting animals can rarely cause infections in human beings through the accidental bite of potential vectors. The resulting infection in man, known as zoonotic filariasis occur worldwide. Human dirofilariasis, the most common zoonotic filariasis, is caused by the filarial worm belonging to the genus Dirofilaria. Dirofilarial worms, which are recognized as pathogenic in man can cause nodular lesions in the lung, subcutaneous tissue, peritoneal cavity or eyes. Oral dirofilariasis is extremely rare and only a few cases have been documented. We report an interesting case of dirofilariasis due to Dirofilaria repens involving buccal mucosa in a patient who presented with a facial swelling. The clinical features, diagnostic issues and treatment aspects are discussed. This paper stresses the importance of considering dirofilariasis as differential diagnosis for subcutaneous swelling of the face, especially in areas where it is endemic.

Dentigerous cysts are developmental odontogenic jaw cysts, commonly manifesting in the second and third decades of life. Very few of these cysts have been reported in children younger than 10 years of age. This article describes a rare case of dentigerous cyst in a 1-year-old boy, the youngest case to be documented. The clinical, radiographic and histopathologic features are discussed; the increased possibility of occurrence of these cysts at a very young age and the importance of timely diagnosis of such cysts to avoid future complications is emphasized.

Background: The presence of neonatal line indicates live birth and it is possible to estimate the exact period of survival of the infant in days by measuring the amount of postnatal hard tissue formation, and thus can be an evidence to the brutal act of infanticide., Materials and Methods: Primary tooth germs of both the arches were removed from the sockets of an infant who died few days after birth. Ground sections were made with hard tissue microtome. Decalcified sections were made from the crown of primary right mandibular canine and the sections were stained with hematoxylin and eosin. To visualize the neonatal line, the sections were subjected to light mocroscopy, polarized microscopy and scanning electron microscopy. A developing permanent molar from a one and a half year old boy and ten fully developed deciduous molars were used as controls., Results: The ground sections of all the developing tooth germs showed the presence of neonatal line and the analysis of enamel showed six distinct cross striations along the enamel rod length indicating the period of survival of the baby to be six days which was later confirmed with the hospital records., Conclusion: Neonatal line could be used as an evidence of infanticide. Accurate detection of neonatal line with advanced techniques could rewrite this supplementary evidence of infanticide into substantial evidence.