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Objective: Recent advances in techniques for detecting oral premalignant lesions and oral squamous cell carcinoma have improved the chances of early diagnosis. Adjuncts for detection of lesions include toluidine blue staining and cytologic examination. The primary objective of this study was to assess the efficacy of 1% toluidine blue (modified Mashberg technique) and cytology in detection of oral premalignant lesions and oral squamous cell carcinoma. Method and Materials: The study included 86 participants suspected of having oral premalignant lesions or oral squamous cell carcinoma. One percent toluidine blue was applied to the lesions, followed by cytology. A biopsy was then performed on the tissue. Histopathologically proven oral premalignant lesions/oral squamous cell carcinoma lesions were analyzed for sensitivity, specificity, positive predictive value, and negative predictive value of both screening techniques. The association of screening techniques and histopathologic diagnosis among the oral premalignant lesions, oral squamous cell carcinoma and benign groups were analyzed using the Fisher exact test. P<.05 was considered significant. Results: The specificity and sensitivity for oral squamous cell carcinoma and oral premalignant lesions detection of 1% toluidine blue was 81.35% and 66.67%, respectively, while cytology attained 77.97% and 70.37%, respectively. Negative predictive value and positive predictive value were 84.21% and 62.06% for 1% toluidine blue and 85.18% and 59.37% for cytologic examination, respectively. Comparison of 1% toluidine blue and cytology with histopathologic diagnosis shows a significant difference between carcinoma/epithelial dysplasia and no dysplasia and carcinoma/epithelial dysplasia and benign lesions (all, P< .05). Conclusion: The results of this study suggest that 1% toluidine blue and cytology have high sensitivity, specificity, and accuracy in detecting oral premalignant lesions and oral squamous cell carcinoma and can be used as an adjunct for early detection of such lesions. [ABSTRACT FROM AUTHOR]

Background: Sarcomatoid carcinoma is a rare biphasic tumor composed of both carcinomatous and spindle cell components and has not previously been reported in malignant transformation of odontogenic cysts. Clinical note: A case of primary intraosseous sarcomatoid carcinoma, arising from the recurrent orthokeratinized odontogenic cyst in the mandible of a 42-year-old male is described. The lesion presented as expansile radiolucency with a pathological fracture. Histopathology showed dysplastic orthokeratinized epithelium and sheets; cords and islands of pleomorphic hyperchromatic epithelial cells in the underlying capsule. The most striking feature was the admixture of dysplastic epithelial cells with numerous atypical spindle shaped cells in the connective tissue capsule. Immunohistochemically the lesion stained positive with Pancytokeratins and HMW Cytokeratins, Vimentin & Ki-67 and stained negative for CD-45; CD-34; S-100; Desmin etc. As the lesion was positive for both cytokeratins and vimentin it was diagnosed as Primary intraosseous sarcomatoid carcinoma. This rare entity expands the morphologic spectrum encountered in primary intraosseous carcinoma. [ABSTRACT FROM AUTHOR]

This case report presents an unusual swelling of the palate in a 61-year-old-male patient. Histopathologically, it revealed features of two separate adjacent lesions, a spindle cells lesion showing diffuse immune-positivity for S-100 protein and focal positivity to glial fibrillary acid protein and an osseous lesion with numerous trabaculae of bone, adipocytes and myxoid tissue confirming the diagnosis of collision tumor of benign peripheral nerve sheath tumor and osteoma. Extensive search of English literature shows no reported cases of peripheral nerve sheath tumor with osteoma. The probable histogenesis of this collision tumor is discussed in detail. The purpose of this case report is to document this rare case in the literature so as to increase the awareness of this entity. [ABSTRACT FROM AUTHOR]

Localized growths are commonly seen on the gingiva. Many of these enlargements are considered to be reactive rather than neoplastic in nature. Clinically differentiating one from the other as a specific entity is often not possible. Histopathologic examination is needed in order to positively identify the lesion. The peripheral ossifying fibroma is one such lesion. The pediatric patient with a peripheral ossifying fibroma has special management considerations compared to the adult, as it requires early recognition and treatment by the dentist. It requires proper treatment protocol with close post-operative follow-up. The present report describes a case of a 1 3-year-old female child with peripheral ossifying fibroma in anterior mandible region. Clinical, radiographic and histopathological features along with etiopathogenesis and differential diagnosis are also discussed. [ABSTRACT FROM AUTHOR]

Background: Pericoronal tissue is the soft tissue located between the bony crypt and the impacted tooth, which is histologically composed of fibrous connective tissue and is usually lined by the reduced enamel epithelium. Increased epithelial cell proliferation in the pericoronal tissue is associated with pathological changes such as development of an odontogenic cyst or an epithelial odontogenic tumor. This study is an attempt to evaluate and compare the proliferative index in the epithelium surrounding the impacted third molar teeth, dentigerous cysts, and gingiva. Materials and Methods: A case control study on pericoronal tissues and dentigerous cysts was carried out using immunomarkers. Forty pericoronal tissues were obtained from asymptomatic impacted third molars with pericoronal radiolucency less than 2.5 mm. Samples of 20 dentigerous cysts and normal gingiva were also included. Routine hematoxylin and eosin and immunostaining for Ki-67, a cell proliferation marker and Bcl-2, an anti apoptotic protein were performed on sections of pericoronal tissues, dentigerous cysts, and gingival tissues. The percentage of Ki-67-positive cells and Bcl-2 positive areas was found using the DigiPro™ version 4.0 Image analysis software. Bcl-2 immunopositivity and Ki-67-Li were analyzed using the Chi-square test and paired t-test. P- values of less than .05 were considered to indicate statistical significance. Results: The immunohistochemical analysis revealed overexpression of Bcl-2 in the pericoronal tissues with squamous metaplasia, which was comparable to the dentigerous cyst. Ki-67 Li of the pericoronal tissue with squamous metaplasia was equal to the proliferative index of the dentigerous cyst. The expression of Ki-67 Li and inflammatory cells were highly significant (P < 0.0001). Conclusions: The results of this study indicate that the pericoronal tissues of asymptomatic impacted third molars may be actively proliferating and normal pericoronal radiolucency cannot serve as an indicator for the differentiation potential. [ABSTRACT FROM AUTHOR]

Introduction: Odontomas are the most common odontogenic tumors of the jaws which are benign, slow growing and nonaggressive. They are usually asymptomatic and are diagnosed on routine radiological examination. The eruptions of odontomas are uncommon and very few cases are reported in the literature. Objective: To report two rare cases of erupted compound odontomas. Case report: Two cases of erupted compound odontomas are reported in middle aged patients. Erupted miniature teeth-like structure were seen on clinical examination. The condition was diagnosed on the basis of conventional intraoral radiographs and histopathological examination. Both cases were treated by surgical excision under local anaesthesia without any complications. Conclusion: Odontomas are benign tumors with uncertain etiology. Odontomas erupting in the oral cavity is an infrequent situation. Surgical excision is the treatment of choice in all such cases followed by histopathological examination to confirm the clinical diagnosis. [ABSTRACT FROM AUTHOR]

Odontomas are the most common of the odontogenic tumors of the jaws, which are benign, slow growing and nonaggressive. Odontomas are usually asymptomatic but sometimes may interfere with the eruption of the associated tooth leading to impaction or delayed eruption. These lesions are usually diagnosed on routine radiological examination in the second decade of the life. The aim of this paper is to present a thorough review on the etiology, clinical presentation, histopathological features and treatment aspects of odontomas. A case of compound odontoma has been reported along with. [ABSTRACT FROM AUTHOR]

Ackerman's tumor or verrucous carcinoma (VC) is a unique clinico-pathological variant of squamous cell carcinoma, occurring mainly in the oral cavity and larynx; buccal mucosa being the most commonly involved site. Since VC was first reported by Ackerman, there has been ongoing discussion regarding the preferred treatment. There is a considerable controversy in the literature regarding anaplastic transformation of verrucous carcinoma following chemotherapy, cryosurgery, laser surgery, and even after multiple conventional operations, resulting in a more aggressive behaviour. A detailed review about the different management modalities are being discussed in this paper along with a case report. [ABSTRACT FROM AUTHOR]

Odontomas are considered to be hamartomatous rather than true neoplasms. They are generally asymptomatic and are usually discovered on routine radiographic examination. In this article we are reporting a case of a 14-year-old girl with compound composite odontome which resulted in imparted right permanent lateral incisor in the mandible. The treatment of choice is the surgical removal of the lesion followed by histological evaluation. The histological evaluation resulted in compound composite odontome which is of denticulate-particulate type. [ABSTRACT FROM AUTHOR]

Background: Teeth form an excellent material for anthropological, genetic, odontologic and forensic investigations. The morphometric criteria for canines are found to exhibit sexual dimorphism. Objective: To investigate the sexual dimorphism of the permanent mandibular and maxillary canine width and intercanine distance for establishing sex identity. Meth od: Hie greatest mesiodistal width of the canine and the intercanine distance of both arches were measured intraorally and on casts using Vernier's calipers from 40 subjects. The procedure of multivariate discriminant analysis was used for establishing the sex identify. Results: This study indicated that the mesiodistal width of the mandibular and maxillary canine teeth was larger in males than in females, but the differences were not statistically significant. In this study the magnitude of sexual dimorphism of the mandibular and maxillary canine teeth was observed to be low. The intercanine distance was more in males than the females and itwas statisticallysignificant. Conclusion: Mesiodistal width of canine and inter caninedistance could be he Ip fill in sex determination. [ABSTRACT FROM AUTHOR]

Nerve sheath myxoma (NSM) or neurothekeoma (NTK) is an uncommon benign tumor of nerve sheath origin. On the basis of the amount of myxoid content it is classified into classical, mixed and cellular variants. Among the 41 reported intraoral cases only six cases have been previously reported in the pediatric age group patients. Out of these six none of the case has been reported in the gingiva. We report a first case of gingival neurothekeoma in an 11-year-old child which was provisionally diagnosed as pyogenic granuloma. We also review the oral neurothekeoma in pediatric age group patients and discuss the histopathological provisional diagnosis. [ABSTRACT FROM AUTHOR]

Aim: Pulp stones are discrete calcified bodies found in the dental pulp. Sialolithasis is the most common salivary gland disease. The aim of the present study was to determine the relationship between the pulp stones and salivary gland stones., Material and Methods: 196 patients were randomly selected from the out patient department for the study. The periapical radiographs for all patients were evaluated for the presence or absence of the narrowing of dental pulp chambers and pulp canals. The intra oral occlusal radiographs were also evaluated to determine the presence or absence of salivary stones. The results were compared and analyzed using the Chi-square test (p<0.001)., Results: Salivary gland calcifications were detected in 5 patients. 191 patients had pulp narrowing and 118 patients had pulp stones. There was no statistical correlation between pulp narrowing and salivary stones (p>0.001) and also between pulp stones and salivary gland stones (p>0.001)., Conclusions: However, the incidental findings of salivary gland stones on intra oral occlusal radiographs can provide useful information in the early diagnosis of the condition, but in the present study no significant relationship was found between the presence of pulp stones and salivary gland stones. Key words:Pulp stone, salivary gland stone, periapical radiograph, occlusal radiograph.

Objectives: Developmental anomalies of the dentition are not infrequently observed by the dental practitioner. The aim of the present study was to determine the prevalence of dental anomalies in the Indian population., Study Design: A retrospective study of 4133 panoramic radiographs of patients, who attended the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 to December 2012 was done. The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The orthopantomographs (OPGs) and dental records were examined for any unusual finding such as congenitally missing teeth, impactions, ectopic eruption, supernumerary teeth, odontoma, dilacerations, taurodontism, dens in dente, germination and fusion, among others., Results: 1519 (36.7%) patients had at least one dental anomaly. The congenitally missing teeth 673 (16.3%) had the highest prevalence, followed by impacted teeth 641 (15.5%), supernumerary teeth 51 (1.2%) and microdontia 41 (1.0%). Other anomalies were found at lower prevalence ranging from transposition 7 (0.1%) to ectopic eruption 30 (0.7%)., Conclusion: The most prevalent anomaly in the Indian population was congenitally missing teeth (16.3%), and the second frequent anomaly was impacted teeth (15.5%), whereas, macrodontia, odontoma and transposition were the least frequent anomalies, with a prevalence of 0.2%, 0.2% and 0.1% respectively. While the overall prevalence of these anomalies may be low, the early diagnosis is imperative for the patient management and treatment planning. Key words:Dental anomaly, prevalence, panoramic radiography.

Objectives: Taurodontism affects primarily molars and premolars in both the deciduous and permanent dentition. The aim of the study was to assess the prevalence of taurodontism in the North Indian population., Study Design: 4143 patients were studied by analyzing the panoramic radiographs for the presence of taurodontism which is defined as the presence of an apically displaced pulp chamber and the tooth lacks the usual constriction at the cementoenamel junction. The age of the patients ranged from 13 to 38 years with a mean age of 21.8 years., Results: Taurodontism was found in 17 patients with a prevalence of 0.4% of which 0.21% were males and 0.19% females. Taurodonts were significantly more common in the maxilla (65.6%) than in the mandible (34.4%) (p<0.05) and the maxillary second molar (34.4%) was the most commonly involved tooth. According to the morphology hypotaurodonts were most common (75%) but there was no significant difference in males and females (p>0.05)., Conclusion: Taurodontism is relatively uncommon in the North Indian population. Further large scale studies need to be carried out to assess its prevalence in the general population. A family history of other anomalies should also be considered for affected patients. Key words:Taurodontism, prevalence, maxillary second molar.

Objective: Tongue lesions are a health concern for the dental practitioners and the patients as they constitute a significant proportion of oral mucosal lesions. The aim of the present study was to determine the prevalence of various tongue lesions in the Indian population., Material and Methods: 4926 patients attending the Department of Oral Medicine and Radiology were examined for the presence of various tongue lesions during the period from October, 2010 to September, 2012. The age of the patients ranged from 12-80 years with a mean age of 36.51 years., Results: The prevalence of tongue lesions was 12.07%. The most common lesion diagnosed was coated tongue affecting 28.0% of the subjects, followed by geographic tongue (16.4%), fissured tongue (14.9%) and depapillated tongue (11.5%). Males were more frequently affected than females. The most common systemic condition observed in the patients with tongue lesions was anaemia (189), followed by hypertension (47) and diabetes mellitus (38)., Conclusion: The high prevalence necessitates adequate awareness of the various tongue lesions in the general population. The dental clinicians should also be knowledgeable about the etiopathogenesis, clinical presentation, diagnosis, and treatment of these lesions. Key words:Tongue lesions, prevalence, Indian population, coated tongue.

Background: Pericoronal tissue is the soft tissue located between the bony crypt and the impacted tooth, which is histologically composed of fibrous connective tissue and is usually lined by the reduced enamel epithelium. Increased epithelial cell proliferation in the pericoronal tissue is associated with pathological changes such as development of an odontogenic cyst or an epithelial odontogenic tumor. This study is an attempt to evaluate and compare the proliferative index in the epithelium surrounding the impacted third molar teeth, dentigerous cysts, and gingiva., Materials and Methods: A case control study on pericoronal tissues and dentigerous cysts was carried out using immunomarkers. Forty pericoronal tissues were obtained from asymptomatic impacted third molars with pericoronal radiolucency less than 2.5 mm. Samples of 20 dentigerous cysts and normal gingiva were also included. Routine hematoxylin and eosin and immunostaining for Ki-67, a cell proliferation marker and Bcl-2, an anti apoptotic protein were performed on sections of pericoronal tissues, dentigerous cysts, and gingival tissues. The percentage of Ki-67-positive cells and Bcl-2 positive areas was found using the DigiPro™ version 4.0 Image analysis software. Bcl-2 immunopositivity and Ki-67-Li were analyzed using the Chi-square test and paired t-test. P- values of less than .05 were considered to indicate statistical significance., Results: The immunohistochemical analysis revealed overexpression of Bcl-2 in the pericoronal tissues with squamous metaplasia, which was comparable to the dentigerous cyst. Ki-67 Li of the pericoronal tissue with squamous metaplasia was equal to the proliferative index of the dentigerous cyst. The expression of Ki-67 Li and inflammatory cells were highly significant (P < 0.0001)., Conclusions: The results of this study indicate that the pericoronal tissues of asymptomatic impacted third molars may be actively proliferating and normal pericoronal radiolucency cannot serve as an indicator for the differentiation potential.

Aim: The relationship between the hepatitis C virus (HCV) and oral lichen planus (OLP) remains a controversial subject for clinicians. Many studies aimed at studying the association between HCV and OLP have been conducted over the years. Geographical variations have been shown to be a major factor influencing this association. This study aimed at determining whether such an epidemiological relationship exists in an Indian population., Methods: One hundred and thirty clinically and histopathologically confirmed OLP patients (46 males and 84 females, mean age 43.47±10.48 years) and 130 age- and gender matched controls were examined for serological evidence of chronic hepatic disease, hepatitis B surface antigen (HBsAg), and anti-HCV seropositivity. The blood samples were collected from both the groups and subjected to biochemical analysis for total bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase enzymes using a semi-automated biochemistry analyser. HBsAg and antibody to HCV were tested by ELISA. Statistical analysis was calculated using Levene's test and the independent t-test., Results: No significant difference between serum levels of total bilirubin, alanine aminotransferase, alkaline phosphatase and aspartate aminotransferase was observed between both groups. All patients with OLP had normal liver function. None of the patients with OLP or the control subjects had antigens for HBsAg and HCV., Conclusion: Patients with OLP did not have any evidence of chronic liver disease or HBV or HCV infection. The exact mechanism that exists between the association of HCV and OLP still remains unclear and this study rejects the hypothesis that established a co-relation between OLP and HCV infection.

The recent advances in molecular biology have revolutionized all aspects of dentistry. DNA, the language of life yields information beyond our imagination, both in health or disease. DNA fingerprinting is a tool used to unravel all the mysteries associated with the oral cavity and its manifestations during diseased conditions. It is being increasingly used in analyzing various scenarios related to forensic science. The technical advances in molecular biology have propelled the analysis of the DNA into routine usage in crime laboratories for rapid and early diagnosis. DNA is an excellent means for identification of unidentified human remains. As dental pulp is surrounded by dentin and enamel, which forms dental armor, it offers the best source of DNA for reliable genetic type in forensic science. This paper summarizes the recent literature on use of this technique in identification of unidentified human remains.