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Background: Dental caries, although of infectious origin along with its multiple predisposing factors, may have a genetic predisposition. This study was executed to evaluate the association of dermatoglyphics as a genetic predictor of the susceptibility of participants to acquire dental caries considering environmental factors such as salivary pH, Decayed, Missing and Filled Permanent (DMFT) Score and Plaque Index Score. Methods: 531 student volunteers of a dental college were included in the study. Thumbprint patterns of the thumbs of their respective dominant hands were analyzed. DMFT Index, Plaque Index Score and Salivary pH for each subject was recorded. Statistical analysis was executed using nonparametric chi-square tests, correlation coefficients and measures of central tendencies. Results: The predominant thumbprint pattern seen was loop type followed by whorl and arch type with 52%, 31% and 17% of occurrence and a salivary pH of 7, 5 and 6 respectively. The Chi-Square tests concluded that whorl type of thumbprints show association with increased DMFT score. Mean and median plaque index score was considerably higher in the individuals with a whorl type of thumbprint. Conclusion: There was distinct association between pattern of thumbprints and prevalence of dental caries. Whorl type thumbprint could prove itself as a genetic predictor towards increased caries incidence.

Oral soft-tissue myxomas of the oral cavity have been sparsely cited in the medical literature worldwide. This could be due to other clinically and/or histologically similar lesions requiring accurate differential diagnosis by experienced physicians and pathologists. Although myxomas are benign and do not metastasise, they have higher rates of recurrence and deserve proper attention and to be reported as well. Soft-tissue myxomas of the oral cavity are extremely rare and very few cases have been reported in the literature. The article describes a soft-tissue myxoma in a male patient in his 40s and review of published cases.

Background: The process of aging in the immediate toxic environment occurring in this Industrialized world is detrimental for human body. This is accelerating aging process and at the cellular level, the toxins present in environment are inducing chromosomal(micronuclei) and nuclear degenerative changes (karyorrhexis, karyolysis, pyknosis, condensed chromatin). The given study evaluates the effects of aging and environment on the chromosomal/nuclear degenerative changes, thus affecting the exfoliated cells collected from buccal mucosa. Methods: The sample included 86 healthy subjects divided into two groups according to age: 46 women aged above 60 years and 40 women of 20- 25 years of age. A questionnaire was prepared to retrieve all the data related to health and drug related history. Buccal smears were prepared and stained with both Papanicolaou and H&E stain. Hundred cells were counted from each slide to determine the number of micronuclei and other nuclear degenerative changes. Results: The number of micronuclei and other nuclear degenerative changes were signicantly higher among the elderly women (p

Oral pathologists or dentists in general opting for alternate career paths are very common nowadays. Financial security, lesser availability of jobs and work satisfaction are the most commonly observed reasons for this openness to switch career. While there is a multitude of alternate career options available such as medical writing and pharmacovigilance in this review, we aim to give an insight specifically on opportunities available in the medical journals aspect of the publishing industry. Oral pathologists can opt to take this field as a full-time engagement and attain a constant growth in terms of finances, knowledge and personal development. One of the authors has opted for this career path and has provided personal opinions about the scope, opportunities and perks of working in this industry.

Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. Histologically, squamous metaplasia has been reported in PA, but has rarely been documented as being extensive enough to cause significant misdiagnosis. Here, we present an unusual case of PA in a 50-year-old female patient presenting with swelling on the postero-lateral aspect of the palate for a week. Histopathologically, the tumor exhibited the features of conventional PA with extensive squamous metaplasia and giant keratotic lamellae in cyst-like areas. Such exuberant squamous metaplasia and keratin can be a diagnostic and prognostic pitfall and lead to overtreatment of the patient.

Background: DNA analysis has a key role in forensic dentistry. However, techniques of DNA extraction and analysis are far from the reach of majority of medical professionals owing to its expensive set up. Aim: The present study was aimed at formulating a crude method of extracting DNA from human buccal mucosa cells using materials commonly available in the laboratory so that the medical professionals could get more exposure to molecular biology techniques. The objectives were to identify the DNA and to assess its purity. Methods: Buccal mucosa cells from 10 healthy volunteers were taken for DNA extraction following the protocol of cell lysis, purification, and precipitation. DNA was identified using standardized techniques like Diphenylamine test and its purity was assessed using a spectrophotometer. A gel electrophoresis apparatus was also constructed using readily available materials. Results: DNA was extracted from human buccal mucosa cells using a crude method. The standardized tests confirmed the presence of DNA contaminated with proteins. The locally made Gel electrophoresis model exhibited a faint halo around the wells instead of DNA bands. Conclusion: DNA extraction from human buccal mucosa cells was made possible using locally available materials and a crude method, but it was not of high purity.

Osseous choristoma is a rare, benign lesion of the oral cavity. This report presents a case of osseous choristoma in the submental region of a 30-year-old female subject. Her chief complaint was a painless swelling in the submental region. Panoramic radiography showed a well-defined, round, radiopaque lesion near the inferior border of the left mental region. The lesion was diagnosed as an osseous choristoma based on the histopathological examination of the surgical specimen. This paper is an attempt to bring forward a unique occurrence of osseous choristoma, which would further help the medical fraternity in improvising their knowledge, diagnosis, and treatment of this entity.

In general, the conviction is that psychological factors are important in the development of all disease. Epidemiological surveys have revealed that there are different ways in which emotional stressful stimuli can act on oral mucosal target sites. Whether their role is in initiation, progression, aggravation or exacerbation of disease or in predisposition or reaction to a disease is still not clear. Based on available evidences, a need for the understanding of oral psychosomatic disturbances is felt. This review summarizes the underlying pathophysiology of bodily changes brought about by stress related psychosomatic mechanism and their role in further development of structural changes seen in association with oral cavity. An effort has also been made to realize the significant

Accurate histopathological diagnosis of any tumour is imperative because of variable prognostic and clinical implications. Basaloid squamous cell carcinoma (BSCC) is a rare distinctive histological variant of oral squamous cell carcinoma (OSCC) exhibiting an aggressive clinical course and poor prognosis. The advanced stage of presentation is speculatively responsible for this biological behaviour which is manifested by development of metastasis and subsequently poor survival. However, the non-specific clinical appearance and histopathological resemblance of BSCC with OSCC and other oral basaloid malignancies (OBM) especially in limited sample size poses diagnostic difficulties. The article emphasizes on the diagnostic criteria and pitfalls encountered in making the differential diagnosis of BSCC from OBMs along with report of a case presented at a dental college in January 2012.Kathmandu University Medical Journal Vol.12(2) 2014: 141-145

Leukoplakia is one of the most frequently encountered white lesions by the clinicians. The definitions and terminologies associated with leukoplakia have been proposed by various authors. Also, various attempts have been made to clinically and histopathologically grade leukoplakia by evaluating different criteria. Although there are numerous reviews that have discussed the definitions and classifications of leukoplakia, none has attempted to provide a clear visualization of the shortcomings associated with each definition and classification. Hence, this review article is an attempt to highlight the main points as well as shortcomings in terminology, definitions, clinical classifications and histopathologic gradings which have been associated with leukoplakia till date.

Background: To revisit the nomenclature, prevalence, histogenesis and the diagnostic dilemmas in cases of cholecystitis with lymphoid hyperplasia received in a private laboratory in one-year duration.Methods: A total of 51 cases of cholecystectomy were examined histopathologically to identify and review all the cases with emphasis on cholecystitis with marked lymphoid infiltration.Results: Out of 51 cholecystectomy specimens, some rare entities were observed such as 4 cases (8%) of xanthomatous change, 2 cases (4%) of cholecystitis with follicular lymphoid hyperplasia and a case of hyalinizing cholecystitis.Conclusions: The literature on cholecystitis with marked lymphoid infiltrate (with or without follicle formation) was overlapping and thus confusing. The same has been simplified with review of literature.

To fully understand cellular processes, scientists often examine events at the level of nucleic acids and protein molecules. These studies are complicated by the fact that cells have miniscule amounts of molecules of interest which are too small to be seen. So we require molecular tools to visualize these molecules. Polymerase chain reaction is one such technique widely used in molecular biology and produce quantities that are sufficient to study and visualize. With the advancement in this technique, it has revolutionized the field of research and diagnosis. In this article, we present a review on the principle, basic technique, applications, limitations and recent advances of Polymerase Chain Reaction.

Introduction Micronuclei (MNi) are acentric chromatid or chromosome fragments produced via genetic damage through genotoxic agents contained in tobacco and betel nut. Evidently, the various Oral Potentially Malignant Disorders (OPMDs) like oral lichen Planus, oral leukoplakia and Oral Submucous Fibrosis (OSMF) demonstrate MNi, as a substantiation of genetic damage. As these changes can be easily appreciated in oral exfoliated cells, an exfoliated cell based MNi assay might be utilized as handy and non invasive biomonitoring tool for gauging the genetic damage and hence the propensity for malignant transformation in OPMDs. To this end, MNi are definitely easier to evaluate when compared to chromosome aberrations. Aim To compare the MNi frequency in normal mucosa, in individuals using various tobacco forms without oral leukoplakia, individuals using various tobacco forms with oral leukoplakia, and areca nut chewers with OSMF, using three different stains. Materials and methods Oral exfoliated cells from 50 cases of normal mucosa (Group I), 50 cases of tobacco chewing people without Oral Leukoplakia (Group II), 50 cases of people with Oral Leukoplakia (Group III) and 50 cases of areca nut chewers with OSMF (Group IV) were taken. MNi frequencies were compared in these groups using three different stains i.e., Papanicolaou (PAP) stain, May Grunwald Giemsa (MGG) stain and Feulgen stain. The data between cases (Group II, III and IV) and control groups (Group I) was analyzed by Kruskal-Wallis Test. The comparison between two independent groups was done by Mann-Whitney U test and interstain comparison between cases and control was done by Wilcoxon Signed Rank Test and the individual p-value was obtained. Results A significant increase in the count was observed during transition of normal mucosa to OPMDs. The best stain for detecting MNi was PAP stain followed by MGG stain and Feulgen stain. Conclusion The higher mean MNi count for PAP stain and MGG stain could be attributed to nonspecific staining. Further study using a larger sample size on quantitative assessment of MNi count in various OPMDs is warranted.

Ameloblastomas of jaws are benign odontogenic tumours with four clinical variants being solid multicystic type, unicystic type, extra osseous type and desmoplastic type. Unicystic ameloblastoma accounts for only 13% of all the known cases in the scientific literature. Follicular and plexiform patterns are the commonly seen histopathological patterns in unicystic ameloblastoma. Though rare in itself, presence of granular cells along with acanthomatous changes occurring in unicystic ameloblastoma is a rare phenomenon. We present a rare case report of unicystic ameloblastoma of right mandible with an unusual histopathology. It exhibited both luminal and mural types as well as both acanthomatous and granular cell changes found together. As occurrence of unicystic ameloblastoma of jaws with such varied histopathology is rare, their course, clinical outcome, prognosis and recurrence rate are not clear. Documentation of more such cases in literature may make pathogenesis and nature of these lesions more insightful.

Background: Cytological artifacts are important to learn because an error in routine laboratory practice can bring out an erroneous result. Aims: The aim of this study was to analyze the effects of delayed fixation and morphological discrepancies created by deliberate addition of extraneous factors on the interpretation and/or diagnosis of an oral cytosmear. Materials and Methods: A prospective study was carried out using papanicolaou and hematoxylin and eosin-stained oral smears, 6 each from 66 volunteer dental students with deliberate variation in fixation delay timings, with and without changes in temperature, undue pressure while smear making and intentional addition of contaminants. The fixation delay at room temperature was carried out at an interval of every 30 minutes, 1 day and 1 week and was continued till the end of 1 day, 1 week, and 1 month, respectively. The temperature variations included 60 to 70°C and 3 to 4°C. Results: Light microscopically, the effect of delayed fixation at room temperature appeared first on cytoplasm followed by nucleus within the first 2 hours and on the 4 th day, respectively, till complete cytoplasmic degeneration on the 23 rd day. However, delayed fixation at variable temperature brought faster degenerative changes at higher temperature than lower temperature. Effect of extraneous factors revealed some interesting facts. Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy.

Introduction: Age estimation is a preliminary step in the identification of an individual. It is a crucial and often most critical step for forensic experts. The assessment has been standardized utilizing common dental diagnostic x-rays, but most such age-estimating systems are European population-based and their applicability has not been determined in the context of the Indian population. Aims and Objectives: To assess the applicability and to compare the methods of dental age estimation by Demirjian's method and the same method as modified by Willems (i.e. the Willems method) in Indian children of the National Capital Region (NCR). Also, to find a correlation among skeletal maturity using the Cervical vertebrae maturation index (CVMI), dental maturity, and chronological age in the same population. Materials and Methods: This cross-sectional study was conducted using dental radiographs of 70 orthodontic patients (37 males, 33 females) in the age range 9-16 years selected by simple random sampling. pantomogram were used to estimate dental age by Demirjian's method and the Willems method using their scoring tables. Lateral cephalograms were used to estimate skeletal maturity using CVMI. The latter was compared with Demirjian's stage for mandibular left second molar. Results: Overestimation of age among males by 0.856 years and 0.496 years was found by Demirjian's and the Willems methods, respectively. Among females, both the methods underestimated the age by 0.31 years and 0.45 years, respectively. Demirjian's stage G corresponded to CVMI stage 3 in males and stage 2 in females. Conclusion: In our study, the Willems method has proved to be more accurate for age estimation among Indian males, and Demirjian's method for Indian females. A statistically significant association appeared between Demirjian's stages and CVMI among both males and females. Our study recommends the derivation of a regression formula by studying a larger section of the Indian population instead of applying the European system of age estimation directly to the Indian scenario.

Introduction Chronic inflammatory periodontal diseases i.e. gingivitis and periodontitis are one of the most common afflictions faced by human beings. Dental plaque, which is a pool of pathogenic microorganisms, remains to be current mainstay in etiopathogenesis. Dental calculus, which is a mineralized product of this plaque remains ignored and is considered merely as an ash heap of minor significance. However, the intriguing array in disease etiopathogenesis bulldozed researchers to suspect the role of calculus in disease chrysalis but still the viability of bacteria inside calculus and thus its pathogenicity remains an intricacy; the answer to which lies in the Pandora's Box. Aim The present study was undertaken to investigate the viability of bacteria within dental calculus along with their identification. Also, to classify dental calculus on the basis of mineralization and to observe the variation of viable microflora found in dental calculus with the extent of mineralization and disease severity. Materials and methods A total of 60 samples were obtained, by harvesting two samples of supragingival calculus from each patient having chronic inflammatory periodontal disease. These samples were divided into two groups (Group A and Group B). Samples of Group A were kept non-irradiated and samples of Group B were exposed to UV radiation. The samples were categorized into less, moderately and highly mineralized according to the force required for crushing them. All the crushed calculus samples were then divided into three parts. These were used for dark-field microscopy, gram staining and bacterial cultures. Bacterial identification of the cultures obtained was also carried out by performing various biochemical assays. Results The present study revealed the presence of motile spirochaetes within the samples under dark-field microscope. Gram staining revealed presence of numerous gram positive cocci and gram negative bacilli. Bacterial cultures showed growth of variety of aerobic and capnophilic microorganisms. Conclusion The present study concludes the presence of viable aerobic and capnophilic bacteria inside dental calculus which may reside within the lacunae and channels in the calculus.

Introduction Collagen degradation is important both for carcinogenesis and in its progression. Research regarding the co-relation of collagen with Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (OSCC) is less explored. Aim To elucidate the nature of collagen in Oral Epithelial Dysplasia (OED) and Oral Squamous Cell Carcinoma (OSCC) using Picrosirius Red Stain (PSR) under polarizing microscopy. Materials and methods The study consisted of a total 40 samples which were divided into three groups. Group I included buccal mucosa as negative and irritation fibroma as positive control, group II consisted of OED and group III consisted of Oral Squamous Cell Carcinoma (OSCC). A histochemical analysis was conducted using PSR-polarization method by two independent observers. Results The control group shows predominantly reddish-orange birefringence. In OED with the advancement of grades, the colour changed from yellowish-orange colour to yellow-greenish with progressive increase in greenish hue. As OSCC regresses from well to poorly differentiated, the colour changed from reddish-orange to yellowish orange to greenish-yellow suggesting a transition from mature to immature collagen. Conclusion An observable gradual change in collagen of both OED and OSCC was noted as they were proceeding from benign to critical step. Thus, PSR is a useful tool for studying stromal changes as supporting collagen shows the transition in the form besides the alterations in epithelial cells.

Aim: Putrefaction of the human body with its rate and stages of the various changes occurring in this entire process have been explored widely by the forensic medicine experts to estimate the time elapsed since death. However, experimental data reported in literature pertaining to rates of putrefaction of the dental pulp retrieved from jaws of the dead is scarce. This study makes an attempt to find out the series of various changes which occur during the process of putrefaction of the dental pulp in a coastal environment like that of Southern India. An attempt has also been made to estimate the time elapsed since the death by assessing the duration for which dental pulp remains microscopically intact. Materials and Methods: Three different study setups at different times, followed one by other were created. In each setup, 10 specimens of porcine jaws with teeth were buried in surface soil and 10 specimens in subsurface soil. Dental pulp was retrieved at an interval of every 24 h to see for the various changes. All the environmental parameters including average daily rainfall precipitation, temperature, soil humidity, soil temperature, and soil pH were recorded. Results: A specific series of morphological changes in terms of changes in size, color, consistency, and odor; and a sequence of histological changes were observed from both surface and subsurface samples. Conclusion: Dental pulp buried in a coastal environment goes through a specific series of morphological and histological changes which can be interpreted up to 144 h from burial, after which pulp ceases to exist.

Oral lesions show a wide range of biologic behaviours. There are various lesions which may mimic others and present in such an unusual manner thus making them very difficult to diagnose clinico-pathologically. An accurate diagnosis is not only important for correct treatment planning but also for determination of prognosis. Thus, it is very important for a surgical pathologist to be aware of the various atypical presentations of the lesions. The present unusual case report of basal cell adenoma occurring on upper lip with frank areas of calcifications and abundant inspissated mucoid secretions is an example of one such case. BCA is an uncommon benign epithelial salivary gland neoplasm. It is one of the nine subcategories of salivary gland epithelial tumours according to WHO 2005 classification of salivary gland tumors. It is composed of basaloid cells organized with a prominent basal cell layer and distinct basement membrane-like structure and no myxochondroid stromal component as seen in pleomorphic adenomas. To our best knowledge, no case in English literature has been reported BCA with exuberant inspissated mucoid secretions and frank areas of calcifications to such a large extent and this is the first case to report the same. Key words: Basal cell adenoma, calcifications, diagnosis, inspissated mucoid secretions, surgical pathologist.

To assess the overall prevalence of betel quid, areca nut, tobacco and alcohol use in the rural population of Muradnagar tehsil of Ghaziabad district and their awareness level towards adverse effects of these habits on general as well as oral health.A total of 422 persons from 63 households of four (4) villages were enrolled for the participation in the study. A preformed, pretested questionnaire was used to collect the information on prevalence of risk behaviours of chewing tobacco, areca nut, betel quid, smoking and alcohol consumption.72.5% of respondents reported indulgence in one or more habits of chewing areca nut, betel quid, tobacco, smoking and alcohol consumption. Smoking tobacco was the most common type of adverse habit in males while chewing tobacco in females. 26% of respondents believed that the community residents would quit the habit only if they personally experience any health problem due to the habit.In spite of being aware of risk of having multiple health problems, a major proportion of respondents were using betel quid, areca nut, tobacco and alcohol.

Ghost cells have been a topic of controversy since a long time. The appearance of these cells in different lesions has given it varying terms. In lesions like that of Calcifying cystic odontogenic tumor (CCOT), these cells have been termed as ′Ghost cells′ whereas similar descriptive cells have been called shadow/translucent cells in non-odontogenic lesions like Craniopharyngiomas of the pituitary gland and Pilomatricomas of skin. Controversy arises because of the fact that there are varying opinions and incomplete knowledge about their origin, nature, significance and relation in different neoplasms. Irrespective of the origin, these cells are seen in odontogenic and non-odontogenic neoplasms, which probably direct us towards a missing link between these differing neoplasms. This article attempts to present a review on the concepts around these peculiar cells and shed some light on these ghosts that are still in dark.

Background: Many studies have been carried out to study the role of extracellular matrix proteins, growth factors and matrix metalloproteinases on tumor invasion. However, literature related to the analysis of connective tissue fibers in varying grades of oral squamous cell carcinoma (OSCC) is very limited. Aim: To analyze the changes in collagen and elastic fibers in varying grades of (OSCC). Settings and Design: This retrospective study was carried out using a light and polarizing microscope. Materials and Methods: Three sections each were cut from fifty samples of varying grades of OSCC and ten samples of control followed by staining with H and E, Picrosirius-Red and Verhoeff-Van Gieson. Qualitative and quantitative analysis of collagen and elastic fibers were accomplished using set criteria. Statistical Analysis: Data were entered into the Statistical Package for Social Sciences (SPSS) version 13.5 for analysis. Results: A change in colors of collagen fibers was seen on progressing from well to poorly differentiated OSCC. Thin collagen fibers predominantly exhibited greenish yellow, but the thick fibers exhibited a variety of colors. As the grade of OSCC progressed, collagen fibers were loosely packed haphazardly arranged. Statistically insignificant results were obtained for quantitative analysis of collagen and qualitative analysis of elastic fibers. Conclusion: The collagen fibers undergo a change in color, orientation and packing in the stroma of varying grades of OSCC. The uniqueness of this study lies in the exploration of elastic fibers in OSCC which has not been done so far.

Background: Recent studies have indicated that although malignant cells at the invasive tumor front, bare morphological resemblance to the cells at central portion of the tumor, their molecular character differs significantly. E-cadherin is a cell-cell adhesion molecule that connects epithelial cells. This study attempts to correlate the E-cadherin expression at the invasive tumor front with tumor differentiation along with its clinico-pathological parameters. Materials and Methods: Immunohistochemical staining with E-cadherin was carried out on archival cases of primary oral squamous cell carcinomas (n = 30). The E-cadherin expression at the invasive tumor front was analyzed and was linked to clinico-pathological parameters including patient prognosis. Results: The downregulation of E-cadherin expression at the invasive tumor edge when compared with patient's prognosis yielded a significant correlation (P = 0.041) but its correlation with the degree of differentiation determined was not significant (P = 0.27). Also, its association with tumor size and lymph node status was negative. Conclusions: Loss of E-cadherin expression at the invasive tumor front is an important event in the progression of oral squamous cell carcinomas. Tumors with a loss of expression of E-cadherin are those which had a poor prognosis

Being a rare benign condition of the gingiva, PCG is characterized with erythematous and edematous gingivitis. The biologic phenomenon of the hypersensitive reaction appears to be chief etiology behind this occasionally presenting clinical entity. Plasma cell gingivitis has a close resemblance to discoid lupus, lichen planus, cicatricial pemphigoid or leukemia , and HIV gingivitis.It is known to present as a hypersensitive response to allergen, but sometimes it could present as a clinical entity with unknown etiology. The histological picture comprises of a dense infiltration of plasma cells separated with strands of collagen. Plasma cell gingivitis is a rare benign condition of the gingiva, which is marked with dense infiltration of the plasma cells separated with the strands of the collagen. The biologic phenomenon of the hypersensitive reaction appears to be chief etiology behind this occasionally presenting clinical entity. Plasma cell gingivitis has a close resemblance to discoid lupus, lichen planus, cicatricial pemphigoid or leukemia, and HIV gingivitis. We document herea case report of this clinical situation with an unusual gingival enlargement.