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In children, lesions of the oral mucosa are common, and they can have various clinical signs such as ulceration, changes in the colour of mucosa or the presence of nodular lesions. Some lesions are asymptomatic, whereas others are symptomatic and sometimes even can disturb the routine activities of a child. It is important that, while evaluating the soft tissue lesions, dentists should be able to distinguish between normal, pathological conditions and normal anatomical variations. Sometimes children can present with oral mucosal lesions like those present in adults with a predisposition for some lesions. It was also observed that most of the common oral diseases were dental caries and mucosal diseases associated with cancer treatment. In literature, ere is a scarcity of information about oral lesions in children. This chapter explains various oral mucosal lesions in children along with their clinical presentation and management.

Childhood developmental disorders have serious adverse impacts on the psychological and social well-being of children and their families. Despite the burden that developmental disorders impose on children and adolescents, most countries do not provide satisfactory care to those in need. These developmental disorders can either be present as a single finding or as a part of syndrome. This chapter focuses on the developmental disorders affecting the teeth, tongue, and lip. The spectrum of these developmental disorders varies widely. In each case, the anomaly is first described, followed by diagnostic information, including the availability of various treatment options. Early diagnosis is often crucial for the effective treatment of functional and developmental aspects. This will improve the prognosis for better functional and aesthetic outcome for these patients and lead to a better quality of life, not only for the patients themselves but also for their families.

Tobacco abuse is a major risk factor associated with the development of oral squamous cell carcinoma. Differences in molecular aberrations induced by tobacco exposure by chewing or smoking form are not well studied in case of oral cancer. We used tandem mass tag-based quantitative proteomic approach to delineate proteomic alterations in oral cancer patients based on their history of tobacco using habits (patients who chewed tobacco, patients who smoked tobacco, and those with no history of tobacco consumption). Our data identified distinct dysregulation of biological processes and pathways in each patient cohort. Bioinformatics analysis of dysregulated proteins identified in our proteomic study revealed dysregulation of collagen formation and antigen processing/presentation pathway in oral cancer patients who smoked tobacco, whereas proteins associated with the process of keratinization showed enrichment in patients who chewed tobacco. In addition, we identified overexpression of proteins involved in immune pathways and downregulation of muscle contraction-mediated signaling events in all three cohorts, irrespective of tobacco using habits. This study lays the groundwork for identification of protein markers that may aid in identification of high-risk patients for cancer development based on the history of tobacco exposure habits.

Loss of cell differentiation is a hallmark for the progression of oral squamous cell carcinoma (OSCC). Archival Formalin-Fixed Paraffin-Embedded (FFPE) tissues constitute a valuable resource for studying the differentiation of OSCC and can offer valuable insights into the process of tumor progression. In the current study, we performed LC–MS/MS-based quantitative proteomics of FFPE specimens from pathologically-confirmed well-differentiated, moderately-differentiated, and poorly-differentiated OSCC cases. The data were analyzed in four technical replicates, resulting in the identification of 2376 proteins. Of these, 141 and 109 were differentially expressed in moderately-differentiated and poorly differentiated OSCC cases, respectively, compared to well-differentiated OSCC. The data revealed significant metabolic reprogramming with respect to lipid metabolism and glycolysis with proteins belonging to both these processes downregulated in moderately-differentiated OSCC when compared to well-differentiated OSCC. Signaling pathway analysis indicated the alteration of extracellular matrix organization, muscle contraction, and glucose metabolism pathways across tumor grades. The extracellular matrix organization pathway was upregulated in moderately-differentiated OSCC and downregulated in poorly differentiated OSCC, compared to well-differentiated OSCC. PADI4, an epigenetic enzyme transcriptional regulator, and its transcriptional target HIST1H1B were both found to be upregulated in moderately differentiated and poorly differentiated OSCC, indicating epigenetic events underlying tumor differentiation. In conclusion, the findings support the advantage of using high-resolution mass spectrometry-based FFPE archival blocks for clinical and translational research. The candidate signaling pathways identified in the study could be used to develop potential therapeutic targets for OSCC. SUPPLEMENTARY INFORMATION: The online version of this article contains supplementary material available at 10.1007/s12079-021-00609-3

Background: Oral submucous fibrosis (OSF) is a debilitating collagen-metabolic disorder leading to submucosal fibrosis and trismus. Lysyl oxidase (LOX), a critical collagen biosynthetic enzyme, is up-regulated in OSF. Polymorphisms in the Lysyl oxidase gene have been associated with increased risk of OSF and might affect normal collagen synthesis, accumulation, or degradation, crucial in determining fibrosis severity. Methods: One hundred OSF cases and 100 controls were genotyped for LOX G473A(Arg158Gln) polymorphism by polymerase chain reaction-restriction fragment length polymorphism. The expression of LOX was estimated both by quantitative mRNA analysis and western blot. Total soluble collagen was evaluated from mucosal tissue obtained from OSF cases. Immunohistochemical (IHC) localization of type 1 collagen was performed in mucosal tissue obtained from patients carrying various genotypes. Results: Heterozygous G473A genotype was significantly higher in OSF cases [2.063(95% CI =1.059-4.016)], among 26-40 years age-group [4.375(95% CI=1.323-14.267),p=0.029] and in male patients [2.38 (95% CI= 1.107-5.121), p= 0.042]. LOX expression was significantly higher in cases of the heterozygous or homozygous carrier (p

Oral submucous fibrosis is a potentially malignant disorder of the oral cavity, with a high rate of malignant transformation. It is very common among habitual areca nut chewers. The pathogenesis of oral submucous fibrosis is not well established, but it is believed to be a disease of multifactorial origin, including areca nut chewing, ingestion of chilies, genetic factors, immunologic processes and nutritional deficiencies. Genetically susceptible individuals when exposed to areca nut chewing develop this disease over a variable period of time. Oral submucous fibrosis is considered to be a disease of collagen metabolism. Several genetic factors are reported but there is no consensus about the exact mechanism of disease initiation. Variations in histopathological presentation are noted among oral submucous fibrosis patients with habitual areca nut chewing in different forms and other additive agents, eg betel quid, pan masala and gutkha, together with a variety of tobacco habits. The role of epigenetic modifications, such as miRNA regulation, and DNA methylation is also being reported as part of the pathogenesis of oral submucous fibrosis. A combined approach, including analysis of genetic and epigenetic regulations with different habits, might be helpful to better understand the contributory factors and pathogenesis of this serious disorder.

Oral cancer is one of the leading cancers in South-Asian countries. Despite the easy access of the oral cavity, the detection and five year survival rates of OSCC patients are dismal. Identification of non-invasive biomarkers to determine the progression and recurrence of OSCC could be of immense help to patients. Recent studies on oral cancer suggest the importance of non-invasive biomarker development. Micro-RNAs (miRNAs) are one of the important components of the cell-free nucleic acids available in different body fluids. Here, we have reviewed the current understanding of circulating miRNAs as non-invasive biomarkers in different body fluids of oral cancer patients. A number of circulating miRNAs are found to be common in the body fluids of OSCC patients, while many of these are study specific, the possible sources of this variability could be due to differences in sample processing, assay procedure, clinical stage of the disease, oral habit and environmental factors. The prognostic and therapeutic significance of these circulating miRNAs are suggested by several studies. Mir-371, mir-150, mir-21 and mir-7d were found to be potential prognostic markers, while mir-134, mir-146a, mir-338 and mir-371 were associated with metastases. The prognostic markers, mir-21 and mir-7d were also found to be significantly correlated with resistance to chemotherapy, while mir-375, mir-196 and mir-125b were significantly correlated with sensitivity to radiotherapy. Despite the promising roles of circulating miRNAs, challenges still remain in unravelling the exact regulation of these miRNAs before using them for targeted therapy.

BACKGROUND: Tobacco exposure (through smoking or chewing) is one of the predominant risk factors associated with the development of oral squamous cell carcinoma (OSCC). Despite the growing number of patients diagnosed with OSCC, there are few circulating biomarkers for identifying individuals at a higher risk of developing the disease. Successful identification of candidate molecular markers for risk assessment could aid in the early detection of oral lesions and potentially be used for community screening of high-risk populations. OBJECTIVE: Identification of differentially expressed proteins in the serum of oral cancer patients which can serve as biomarkers for the diagnosis of the onset of oral cancer among tobacco users. METHODS: We employed a tandem mass tag (TMT)-based quantitative proteomics approach to study alterations in the serum proteomes of OSCC patients based on their tobacco exposure habits (chewing and smoking) compared to healthy individuals with no history of using any form of tobacco or any symptoms of the disease. RESULTS: Mass spectrometry-based analysis resulted in the identification of distinct signatures in the serum of OSCC patients who either chewed or smoked tobacco. Pathway analysis revealed opposing effects of dysregulated proteins enriched in the complement-coagulation signaling cascades with a high expression of the Serpin family of proteins observed in OSCC patients who chewed tobacco compared to healthy individuals whereas these proteins showed decreased levels in OSCC patients who smoked. ELISA-based validation further confirmed our findings revealing higher expression of SERPINA6 and SERPINF1 across serum of OSCC patients who chewed tobacco compared to healthy individuals. CONCLUSIONS : This study serves as a benchmark for the identification of serum-based protein markers that may aid in the identification of high-risk patients who either chew tobacco or smoke tobacco.

Oral submucous fibrosis (OSMF) is regarded as a collagen and collagenase metabolic disorder. Aberrant expression of matrix metalloproteinases (especially MMP-9) plays important role in remodeling of extracellular matrix (ECM) during development of OSMF. Single nucleotide polymorphisms (SNPs) in MMP-9 promoter and coding region have been demonstrated to be associated with several diseases. In this case-control study, 196 controls and 189 OSMF patients were genotyped at four MMP-9 polymorphic sites on −1562C>T, R279Q, P574R and R688Q loci by Polymerase Chain Reaction - Restriction Fragment Length Polymorphism (PCR-RFLP) method to determine the susceptibility to OSMF. The functional effect of SNPs to the development of OSMF was analyzed by studying the expression of MMP-9, collagen type-I and IV in oral biopsy tissues. R279Q SNP was found to be associated with OSMF [OR 1.5, CI (1.04–2.43), p = 0.03]. The 574R and 668Q alleles were significantly associated with early age group at 2.08 (p = 0.007) and 2.12 (p = 0.011) fold risk to OSMF respectively. MDR analysis showed that -1562C>T and R688Q SNPs were in strong synergy (IG = 0.95%, p = 0.0032) with increased risk of OSMF. Genotypic and functional study revealed definitive role of MMP-9 coding SNPs R279Q, P574R and R668Q in the pathogenesis of OSMF with strong predictive and prognostic value to determine OSMF at early stages in the areca chewers. Pathologically, over-expression of MMP-9 leads to decrease in collagen type-IV and epithelial thinning which contribute to basement membrane degradation along with continuous accumulation of collagen type-I enhanced by MMP-9 −1562C>T, R279Q, P574R and R688Q SNPs, resulting into early onset of OSMF.

Early detection and identification of oral pre-malignancy or malignancy help in management of the disease and improve survival rates. Oral submucous fibrosis (OSMF) is a major threat to public health worldwide and especially in Southeast Asian countries. Identification of biomarkers is a necessary step toward early diagnosis and treatment. In this study, differentially expressed proteins between oral submucous fibrotic tissue and normal control tissues were recorded by proteomic analysis using two dimensional electrophoresis (2DE) and MALDI TOF mass spectrometry. By proteomic analysis, 15 proteins were found to be upregulated and 10 proteins downregulated in the OSMF tissues than the control tissues; among these identified proteins, Hsp-70 1B, Calreticulin, and Lumican variant exhibited higher expression in OSMF tissues compared to the control tissues. Immunohistochemical analysis also showed elevated expression of these in OSMF tissues. Further validation was done by real time quantitative RT-PCR analysis; gene expression of Hsp-70 1B, Calreticulin, and Lumican variant were significantly increased (6.2-, 3.3-, 2.8- fold, respectively), whereas Enolase 1 was decreased by 0.5 fold in the OSMF tissues, consistent with proteomic results. The expression of proteins indicates that various cellular signaling pathways must be involved in the processes of fibrosis and suggests that expressed protein molecules play an important role in the pathogenesis of OSMF. These identified proteins may be potentially used in future studies of OSMF enabling to determine diagnostic marker or therapeutic targets of this precancerous condition of oral cavity.

Chronic hyperplastic candidiasis (CHC), earlier known as candidal leukoplakia, is a variant of oral candidiasis that classically presents as a white patch on the commissures of the oral mucosa and it is mostly caused by Candida albicans. Clinically, the lesions are usually asymptomatic and regress after appropriate antifungal therapy and correction of the underlying cause. If the lesions are untreated, a small portion may develop dysplasia and later progress into carcinoma. The purpose of this article is to report a case of CHC in a 57-year-old male patient with a significant smoking habit, who presented with a thick, nonscrapable, brownish-white coating on the dorsum of the tongue for 9 years. This case is of particular importance and concern because of the high risk for malignant transformation in CHC. The role of biopsy and histopathology is also stressed through this case report in arriving at a definitive diagnosis and treatment planning. Further, this case is interesting because it was refractory to local and systemic antifungal treatment and so, surgery was chosen as an alternative treatment modality considering the side effects of the prolonged use of antifungal drugs.

Rhabdomyosarcoma is the malignant neoplasm of striated muscle and a relatively uncommon tumor of the oral cavity. Embryonal variety is the most common subtype, observed in children below 10 years of age but occasionally seen in adolescents and young adults. The present report describes a case of embryonal rhabdomyosarcoma in the left posterior buccal mucosa, with extension in the adjacent alveolus, soft palate, oropharynx and nasopharynx of a 17-year-old female.

Background: Head and neck cancers constitute about 5%–8% of total body cancers in Europe, America, but in India, this figure is somewhat higher. The aim of this study is to evaluate the current burden of oral cancers in India, particularly North-East India. Materials and Methods: A full-length study starting from patient counseling to clinical and histopathological examination and grading was planned. The study was conducted under the guidance of clinician, oral surgeon, oral pathologists, and statistician. Results: In the 3 years study, all the patients with oral lesions are examined clinically, out of them suspected oral cancer patients were histopathologically confirmed as oral squamous cell carcinoma patient. The socioeconomic profile of oral cancer patients in relation to all examined patients was summarized, and results are drawn. Conclusion: The studied population is heavily indulgent tobacco consumption. Education for cancer prevention, early detection, and treatment is needed.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in India. Despite improvements in treatment strategy, the survival rates of HNSCC patients remain poor. Thus, it is necessary to identify biomarkers that can be used for early detection of disease. In this study, we employed iTRAQ-based quantitative mass spectrometry analysis to identify dysregulated proteins from a panel of head and neck squamous cell carcinoma (HNSCC) cell lines. We identified 2468 proteins, of which 496 proteins were found to be dysregulated in at least two out of three HNSCC cell lines compared to immortalized normal oral keratinocytes. We detected increased expression of replication protein A1 (RPA1) and heat shock protein family H (Hsp110) member 1 (HSPH1), in HNSCC cell lines compared to control. The differentially expressed proteins were further validated using parallel reaction monitoring (PRM) and western blot analysis in HNSCC cell lines. Immunohistochemistry-based validation using HNSCC tissue microarrays revealed overexpression of RPA1 and HSPH1 in 15.7% and 32.2% of the tested cases, respectively. Our study illustrates quantitative proteomics as a robust approach for identification of potential HNSCC biomarkers. The proteomic data has been submitted to ProteomeXchange Consortium (http://www.proteomecentral.proteomexchange.org) via the PRIDE public data repository accessible using the data identifier - PXD009241. Keywords: HNSCC, iTRAQ, Parallel reaction monitoring, Mass spectrometry, OKF6/TERT1

Introduction Deleted in oral cancer-1 (DOC-1), a highly conserved tumor suppressor gene, encodes a specific cyclin-dependent kinase 2-associated protein 1 (p12 DOC-1 ). The protein DOC-1 arrests the cells in the G 1 phase of the cell cycle and regulates DNA replication in the S phase of the cell cycle. It is known that DOC-1 is downregulated in head and neck cancer. Hence, the aim of the study was to analyze the messenger RNA (mRNA) expressions of DOC-1 in patients with oral lichen planus (OLP), leukoplakia (LPK), oral submucous fibrosis (OSF), and oral squamous cell carcinoma (OSCC) in comparison to normal control subjects, and these were correlated with differential oral habits and duration of exposure. Materials and methods Semiquantitative one-step reverse transcriptase polymerase chain reaction (RT-PCR) was used to assess the potential role of DOC-1 in differential oral conditions. Results The expression of DOC-1 at the transcriptional level was found to be consistently reduced (39.13%) or non-detectable (60.87%) in OSCC cases; LPK cases also showed reduced (26.19%) or non-detectable (59.52%) DOC-1 expression, and overexpression of DOC-1 was observed in patients with OSF (42.3%) and OLP (35.29%) as compared to the normal control groups. A marked reduction in DOC-1 expression was observed in patients who smoke bidi and chew tobacco compared to patients who smoke cigarettes and chew pan . An overall reduced expression of DOC-1 with an increase in the duration of exposure was observed. Conclusions The overexpression of DOC-1 in oral premalignant disease groups with reduced or loss of expression in OSCC groups suggests its association in the progression of oral carcinogenesis, suggesting DOC-1 to be an important prognostic indicator for oral cancer.

Epithelial myoepithelial carcinoma (EMC) is a rare low-grade biphasic tumour of salivary gland. Most common site of origin is the parotid gland with female predominance. We present a case of a 51-year-old male patient with symptomless slow-growing 2-year-old lump on the floor of the mouth. Histopathological diagnosis is corroborative with tubular variant of epithelial myoepithelial carcinoma. The floor of the mouth is the rare site for this tumour. In this literature, we intend to discuss the clinical and pathological aspect of EMC located on the floor of the mouth.

Oral cancer is one of the most prevalent form of cancer and its severity is aggrandized specially among the socio-economically backward population in developing countries. A major fraction of patient population is unable to avail diagnosis for oral cancer due to scarcity of state-of-the-art infrastructure and experienced oral and maxillofacial pathologist. Contemporary gold standard of oral cancer confirmation relies on biopsy report. But biopsy is invasive and thus patients are usually reluctant to undergo this test. Moreover, biopsy yields considerable false negatives if investigated tissue is not collected precisely from the carcinogenic location. Till date, there is dearth of computer aided pre-screening tool for detection of oral cancer. The paper presents Digital Infrared Thermal Imaging as a viable modality for early screening of oral cancer. This is the pioneering attempt to discriminate normal subjects from patients by leveraging discriminating texture features on oral thermograms. Statistically significant texture features were selected from a) both halves of frontal face and b) right and left profile faces. Due to disparity of distribution of facial temperature between normal subjects and patients, the corresponding texture features form discriminative class specific local clusters. Such local conglomeration was exploited using k-means and fuzzy k-means clustering. We adopt the concept of cluster prototype classifier which assigns label to each cluster according to majority class labels within that cluster. Highest classification accuracy of 86.12% is attained on fusion of features from left and right half of frontal face of precancerous subject followed by fuzzy k-means guided cluster prototype classification. The proposed work outperforms our previously developed pre-screening framework by upto 6.5%. Such promising results boosts the viability of our approach.

This manuscript presents an analytical treatment on the feasibility of multi-scale Gabor filter bank response for non-invasive oral cancer pre-screening and detection in the long infrared spectrum. Incapability of present healthcare technology to detect oral cancer in budding stage manifests in high mortality rate. The paper contributes a step towards automation in non-invasive computer-aided oral cancer detection using an amalgamation of image processing and machine intelligence paradigms. Previous works have shown the discriminative difference of facial temperature distribution between a normal subject and a patient. The proposed work, for the first time, exploits this difference further by representing the facial Region of Interest(ROI) using multiscale rotation invariant Gabor filter bank responses followed by classification using Radial Basis Function(RBF) kernelized Support Vector Machine(SVM). The proposed study reveals an initial increase in classification accuracy with incrementing image scales followed by degradation of performance; an indication that addition of more and more finer scales tend to embed noisy information instead of discriminative texture patterns. Moreover, the performance is consistently better for filter responses from profile faces compared to frontal faces.This is primarily attributed to the ineptness of Gabor kernels to analyze low spatial frequency components over a small facial surface area. On our dataset comprising of 81 malignant, 59 pre-cancerous, and 63 normal subjects, we achieve state-of-the-art accuracy of 85.16% for normal v/s precancerous and 84.72% for normal v/s malignant classification. This sets a benchmark for further investigation of multiscale feature extraction paradigms in IR spectrum for oral cancer detection.

Automated face detection is the pivotal step in computer vision aided facial medical diagnosis and biometrics. This paper presents an automatic, subject adaptive framework for accurate face detection in the long infrared spectrum on our database for oral cancer detection consisting of malignant, precancerous and normal subjects of varied age group. Previous works on oral cancer detection using Digital Infrared Thermal Imaging(DITI) reveals that patients and normal subjects differ significantly in their facial thermal distribution. Therefore, it is a challenging task to formulate a completely adaptive framework to veraciously localize face from such a subject specific modality. Our model consists of first extracting the most probable facial regions by minimum error thresholding followed by ingenious adaptive methods to leverage the horizontal and vertical projections of the segmented thermal image. Additionally, the model incorporates our domain knowledge of exploiting temperature difference between strategic locations of the face. To our best knowledge, this is the pioneering work on detecting faces in thermal facial images comprising both patients and normal subjects. Previous works on face detection have not specifically targeted automated medical diagnosis; face bounding box returned by those algorithms are thus loose and not apt for further medical automation. Our algorithm significantly outperforms contemporary face detection algorithms in terms of commonly used metrics for evaluating face detection accuracy. Since our method has been tested on challenging dataset consisting of both patients and normal subjects of diverse age groups, it can be seamlessly adapted in any DITI guided facial healthcare or biometric applications.

Context: With an increase in the abuse of various oral habitual products in India over the past few decades; the incidence of oral potentially malignant conditions as leukoplakia, oral submucous fibrosis and squamous cell carcinoma (SCC) rates have also increased. No recent study has been conducted reporting the scenario of oral cancer and potentially malignant conditions in Eastern India (specifically Kolkata). Aims: The present study was conducted at Dr. R. Ahmed Dental College, Kolkata during 2010-2011 to find a possible correlation between the effects of the different oral habits, age, sex and the different types of oral mucosal lesions among patients reported to the hospital. This study also enabled us to see the predilection of the various histopathological stages of the lesions for different sites of the oral cavity. Subjects and Methods: The study group consisted of 698 patients having either oral potentially malignant or malignant lesion. The control group consisted of 948 patients who had reported to the hospital for different oral/dental problems and had the habit of tobacco, areca nut and/or alcohol usage for at least 1 year. Statistical Analysis : The unadjusted odds ratio, the 95% confidence interval, and the P value were calculated to correlate patients with/without different kinds of habit and having/not having various kinds of oral lesions. Results: Our study shows that for males having the habit of taking smokeless tobacco or mixed habit poses the highest risk for developing SCC. For females, significant risk of developing SCC was found in patients habituated to processed areca nut chewing. Conclusion: This study presents probably for the first time in recent years the occurrence of oral potentially malignant and malignant conditions amongst patients having deleterious habits in a hospital based population of Kolkata.

Oral submucous fibrosis (OSF) is prevalent mostly in Southeast Asia, particularly in the Indian subcontinent. Chewing betel nuts and betel leaves, with or without tobacco, has been associated with OSF. Betel quid contents including guvacine, arecoline, guvacoline, arecaidine, and chavibetol are considered to play an important part in the occurrence of OSF. Transformation of OSF to squamous cell carcinoma (SCC) is variable, but up to 13% conversion of OSF to SCC has been reported. Various genetic and molecular mechanisms impact the malignant transformation of OSF, causing changes in the cell cycle, DNA, keratinocytes, and keratin; tumor-cell proliferation and survival; angiogenesis; fibrosis through epithelial-mesenchymal transitions (EMTs), and tissue hypoxia. All are reviewed here, including potential biomarkers for malignant transformation of OSF. These interactions are not fully understood, but a critical mass of knowledge is building up to ultimately allow the understanding of all mechanisms involved.

Context: Ameloblastoma is the second most common odontogenic tumor after odontoma which occurs exclusively in the jaws and very rarely in the sinonasal cavities. Aims: The aim of the study was to determine the demographic and histopathological variations of ameloblastoma in Eastern Indian population by retrospectively comparing and evaluating diagnosed cases of ameloblastoma using different parameters. Materials and Methods: Histopathologically diagnosed cases of ameloblastoma retrieved from past records of the Department of Oral Pathology were selected for the study. Totally, 148 cases were isolated from record of previous 7 years. The patients were divided according to (a) gender, (b) age group, (c) site of the lesion and (d) histopathological types. The findings of this study were compared with those available in literature. Statistical Analysis Used: This is a retrospective study, mean and standard deviation was calculated. Results: Among 148 patients, 88 (59.45%) were male and 60 (40.55%) were female. A maximum number of cases (101 of 148) of ameloblastoma were found in the second to fourth decades of life. Mandiblular posterior region was commonly involved (48.6%). Solid/multicystic variety was found in 63.1% followed by unicystic with 21.5%. We found one case each of extraosseous and desmoplastic ameloblastoma. It was difficult for panel of experienced oral pathologists to pinpoint the exact type in 15 (10%) cases, this was due to mixture of follicular and plexiform variety with equal presence of both types of architecture, without predominance of any variety in particular. Conclusions: These data may serve as baseline information on occurrence of various histopathological types of ameloblastoma in Eastern Indian population and helps comparing it with other similar studies conducted in different geographic population.

Oral cancer consists of squamous cell carcinoma within the oral cavity or on the lip. The clinical prognosis of this cancer is mostly poor owing to delayed diagnosis and a lack of appropriate early detection biomarkers to identify the disease. In the current study, we investigated the role of the S100A7 calcium-binding protein in oral squamous cell carcinoma as an activator of the p38/MAPK and RAB2A signaling pathway. The aim of the present study was to determine whether S100A7 and RAB2A have a role in tumor progression and to assess their potential as early detection biomarkers for oral cancer. This study elucidated the functional and molecular mechanisms of S100A7 and RAB2A activity in oral cancer, leading us to conclude that S100A7 is the major contributing factor in the occurrence of oral cancer and promotes local tumor progression by activating the MAPK signaling pathway via the RAB2A pathway. We hypothesize that S100A7 affects cell motility and invasion by regulating the RAB2A-associated MAPK signaling cascades. Also, the downregulation of S100A7 expression by RNA interference-mediated silencing inhibits oral cancer cell growth, migration and invasion.

Objective: Oral submucous fibrosis (OSF) is a debilitating disease mainly attributed to chewing areca nut with a 7.4-13% malignant transformation rate. The present study explores the role of NADPH quinone oxidoreductase 1 (NQO1) C609T (Pro187Ser) polymorphism in susceptibility to OSF among habitual areca nut chewers in an eastern Indian population. Material and Methods: In this hospital-based study, 152 controls and 179 OSF cases were genotyped at NQO1 C609T polymorphic site by PCR-RFLP and its effect on NQO1 expression in OSF tissue was studied to determine the risk of the disease. Results: Overall, about 18% of the total OSF cases were detected carrying minor TT alleles (Ser/Ser) p=0.026. When categorized by age, both CT (Pro/Ser) and TT (Ser/Ser) alleles were significantly higher (p= 0.003 & 0.004 respectively) in cases above 40years of age. NQO1 protein was 42% reduced in buccal tissues of heterozygous (Pro/Ser) carriers, whereas a 70% reduction was observed in TT (Ser/Ser) OSF cases. Conclusion: Our study suggests that the NQO1 C609T polymorphism confers increased risk for OSF in habitual chewers.

Ewing's sarcoma (ES) is a rare malignancy primarily affecting skeletal system and it is commonly diagnosed in children and young adults. It seldom occurs in the head and neck region. ES has poor prognosis because of uncontrolled metastatic potential making early diagnosis and intervention critical for survival of the patient. This paper reports a rare case of ES involving mandible in an 8-year-old girl with clinical, radiological, histopathological and immunohistochemical features.

J Oral Pathol Med (2012) 41: 292–302 Background: Arecanut and smokeless tobacco usage is a major cause for oral submucous fibrosis (OSF) and its subsequent development to oral squamous cell carcinoma in South-east Asian population. Polymorphisms at N-acetyltransferase 2 locus, coding for an enzyme catalyzing acetylation of aromatic amines, might cause DNA adduct formation because of improper acetylation of these polyaromatic hydrocarbons. DNA repair enzymes remove these adduct to prevent malignancy. Methods: In this hospital-based study, 100 controls and 88 OSF patients were genotyped at four polymorphic sites on NAT2 481 (C > T; silent), 590 (G > A; Arg197 > Gln), 803 (A > G; Lys268 > Arg), 857 (G > A; Gly286 > Glu) and two on XRCC1 18067 (C > T Arg 194 > Trp), 28152 (G > A Arg 399 > Gln), and one of XRCC3 26304 (C > T Thr 241 > Met) loci by PCR-RFLP to determine the risk of the disease. Results: Heterozygous XRCC3 codon 241 [OR 2.07 (1.05–4.06)], homozygous variant of NAT C481T [OR 2.81 (1.09–7.21)], and both heterozygous and homozygous variants of NAT codon 268 and 286 [OR 2.31 (1.20–4.45) and 4.98 (1.87–13.14), and 6.12 (2.75–13.62) and 2.65 (1.04–6.72)] individually influenced susceptibility to OSF in the population. Conclusion: Gene–gene interaction analysis by multifactor dimensionality reduction (MDR) revealed that XRCC3 Thr 241 Met had the largest univariate effect followed by XRCC3 Thr 241 Met – NAT2 A857G in men that presents a highly synergistic interaction as one of the potential combinations of single nucleotide polymorphisms (SNPs) to increase the risk of OSF in men if exposed to arecanut or smokeless tobacco usage. These observations can speculate the impact of the studied SNPs on the etiology of OSF.

In order to ascertain possible correlation between alterations in trace elemental profile and the progression or regression of two most common potentially malignant disorders affecting oral cavity, namely oral submucous fibrosis and leukoplakia, blood from 60 patients from each group of patients as well from 30 healthy individuals was analyzed for elemental profiling employing EDXRF technique. Out of the 16 detected elements (K, Si, Ca, V, Cr, Ni, Mn, Fe, Cu, Zn, Se, Br, Rb, Sr, Co, and Pb), Mn, Fe, Zn, Br, and Co showed remarkable alteration in their profile in both leukoplakia and oral submucous fibrosis patients with respect to the normal healthy individuals. While Zn, Br, and Fe reflected similar changes--showing gross depletion in both the diseased groups, Mn and Co depicted inverse pattern of alterations in their concentrations in the two types of precancerous disorders when compared to the control subjects.

Trace elements have been at the focus of attention for decades with considerable emphasis on their role in biology and biomedical sciences, environmental sciences, geology, archaeology and material sciences. They comprise a large number of elements, some having essential physiological functions, whereas others are toxic, mutagenic or carcinogenic. A few even have antiproliferative and anticarciniogenic properties. The advent of various instrumental techniques and sophisticated instrumentations has made their detection to very low limits possible, making this a very important multidisciplinary study. Among these techniques the energy-dispersive X-ray fluorescence (EDXRF) technique is being widely used for trace element detection in various fields of science. Keeping the importance of trace elements in mind, the Kolkata centre of UGC-DAE Consortium for Scientific Research initiated several research schemes in different fields of trace element research using various techniques, EDXRF being one of the main techniques. A Xenemetrix (erstwhile Jordan Valley) EX 3600 EDXRF spectrometer is being used to carry out the research. This presentation aims to highlight some of the very recent applications of EDXRF in the study of the role of trace elements in pre-cancerous tissues, medicinal plants and also in some environmental studies.

Objectives: To identify potential candidate proteins which are secretory in nature and present at a higher abundance in oral cancer patients with tobacco habits. Methods: Conditioned media of tobacco-treated and -untreated non-neoplastic oral keratinocytes were analyzed using iTRAQ-based mass spectrometry. Hypersecreted proteins; SPARC (osteonectin), cwcv and kazal like domains proteoglycan 1 (SPOCK1); prosaposin (PSAP); and protein tyrosine phosphatase, receptor type S (PTPRS) were validated by enzyme-linked immunosorbent assay (ELISA) using saliva samples from oral cancer patients who are tobacco users. Results: Proteomic analysis of tobacco-treated and -untreated cells led to the identification of 2873 proteins. Among these, 378 proteins showed high abundance and 253 proteins showed low abundance (2-fold cutoff) in conditioned-media of tobacco-treated cells. ELISA-based validation showed significantly higher levels of SPOCK1, PSAP, and PTPRS in oral cancer patients with tobacco chewing habits compared to healthy controls. However, PSAP showed low specificity compared to SPOCK1 and PTPRS. Conclusions: This study indicates significantly increased levels of SPOCK1, PSAP, and PTPRS in saliva of oral cancer patients with tobacco habits. These protein biomarkers might be useful to identify tobacco users with high risk of developing oral cancers.

Background: Distinguishing mild and moderate epithelial dysplasia is difficult and controversial. We demonstrated earlier that silver-stainable nucleolar organizer region (AgNOR) is a simple, inexpensive and quantifiable method which can standardize this distinction reliably. Objective: To establish a cut-point mean AgNOR count for epithelial dysplasia validated by bootstrapping. Methods: One hundred oral leukoplakia biopsies at Dr R. Ahmed Dental College, Kolkata, India, examined for epithelial dysplasia using standard method (gold standard) were assessed for their mean AgNOR counts. A cut-point was selected employing receiver operating characteristic (ROC) curve. This estimate was stabilized by 10 000 resamples (with replacement) using parametric and non-parametric bootstrap, a Monte Carlo statistical method, corrected for bias to estimate standard errors (SE) of cut-point. Results: Area under the curve (AUC) was 74%; non-parametric method suggested mean AgNOR cut-point = 2.42 AgNORs/nucleus; parametric method suggested cut-point = 2.57. The cut-point 95% confidence intervals (CIs) (bias corrected and accelerated) from parametric method (2.31; 2.66) was lower than non-parametric (2.43; 2.82). Conclusion: Applying a conservative paradigm, taking the lowest of all bootstrap 95% CIs, we suggest that mean AgNOR count of 2.3 be used as a cut-point for distinguishing between mild and moderate dysplasia. This strategy will provide an inexpensive, meaningful, definitive, reproducible and consistent diagnostic test for epithelial dysplasia.