Oral squamous cell carcinoma (OSCC) is among the most common malignancies and a leading cause of death in developing countries. Late diagnosis and regional and/or distant metastasis worsen the prognosis of this condition. Despite the advances in diagnostic modalities and management strategies, there is little improvement in the 5-year survival rate. A deeper insight into the molecular events of various tumours has enabled the use of minimally invasive methods for monitoring disease progression, prognostication and treatment monitoring. Although studies in OSCC are preliminary, the use of liquid biopsies has opened new frontiers for the development of biomarkers that can serve as alternatives to conventional biopsies and imaging methods. Circulating biomarkers in blood allow for the real-time monitoring of tumour and therapeutic responses. This review aims to outline the promises and challenges of circulating biomarkers in OSCC with special emphasis on circulating tumour cells, circulating tumor DNA, and exosomes.

Introduction: Akt, also known as protein kinase B, is a serine/threonine-specific protein-kinase which plays a key role in multiple cellular processes such as glucose metabolism, apoptosis, transcription and cell migration. The activation of Akt is one of the most frequent alterations observed in human cancer and tumour cells. Akt regulates cellular survival and metabolism by binding and regulating many downstream effectors, e.g., Nuclear Factor-kB, murine double minute 2(MDM2). Aims: To evaluate and compare immunohistochemical expression of Akt in normal epithelium and different histological grades of epithelial dysplasias. Materials and Methodology: Forty paraffin-embedded tissue sections were used for the immunohistochemical study of which 10 cases of normal epithelium, 10 cases of each mild, moderate and severe epithelial dysplasia which were diagnosed by haematoxylin and eosin procedures. The tissue sections were immunohistochemically analysed for expression of Akt in different grades of epithelial dysplasia by using anti-Akt-1 monoclonal antibody. Statistical analysis was carried out using statistical package for social science (SPSS, V 10.5). The data were analysed using Chi-square test and P < 0.05 was considered statistically significant. Results and Conclusion: An overall significant difference was observed when normal tissues were compared with epithelial dysplasia with a Chi-square value of 21.04, but there was no statistical significance between the three grades of epithelial dysplasias. In conclusion, this study suggests that Akt-1 overexpression can be one of the useful diagnostic markers for predicting the potential behaviour of oral dysplasias transforming into oral squamous cell carcinoma (OSCC).

Context: The bcl-2 proto-oncogene was discovered at the chromosomal breakpoint of t (14;18) found in follicular lymphoma. Histological changes in dysplasia are considered the earliest signs preceding the progression into squamous cell carcinoma. Serving as critical regulators of apoptotic pathways, bcl-2 prohibits programmed cell death and subsequently assists in uncontrolled neoplastic growth. Settings and Design: This study included 48 cases, eight each of epithelial dysplasia and squamous cell carcinoma. Immunohistochemical staining using bcl-2 antibody was performed and different histological parameters were correlated with bcl-2 positive cells in all the cases. Materials and Methods: All 3 μm thick sections were stained with bcl-2 antibody. After identifying four representative fields at 40x, their images were obtained for assessment of bcl-2 labelled cells and their intensity along with different histological parameters in all the cases. Statistical Analysis: The differences between different histological parameters were analysed using the Anova test, post hoc test and Bonferroni test. Pearson's Chi-square test was carried out to determine the level of correlation between the bcl-2 positive cells in both epithelial dysplasia and oral squamous cell carcinoma cases. Conclusion: Sequential increase in the bcl-2 expression was observed in increasing grades of epithelial dysplasia, whereas bcl-2 expression was significantly decreased in ascending stages of squamous cell carcinoma thus, suggesting a possible role of bcl-2 in disease progression from premalignancy to malignancy.

Background: Cell adhesion molecules are essential to maintain the integrity of stratified squamous epithelium but their expression has to be dynamic to aid the mobility and turnover of cells. Paxillin is one such multi-domain protein which integrates numerous signals from cell surface receptors, integrins and growth factors. It thus functions as a regulator of various physiological and pathological processes including tissue remodeling, cell motility, gene expression, matrix organization, cell proliferation, metastasis and survival. Hence, the assessment of paxillin expression in normal control, potentially malignant disorders and oral squamous cell carcinoma patients was carried out. Material and Methods: The present retrospective study comprised of 20 each clinically and histologically confirmed case of normal control, potentially malignant disorders, and oral squamous cell carcinomas. All the slides were stained immunohistochemically using Paxillin antibody. Results: The localization, staining intensity and percentage of positivity for paxillin expression was statistically significant among normal control and potentially malignant disorders, whereas oral squamous cell carcinoma showed a non-significant difference. Upon comparison of histopathological grading of potentially malignant disorders, mild versus severe and moderate versus severe epithelial dysplasia showed a statistical significant difference among all the parameters of paxillin expression. However, WDSCC & MDSCC a statistically significant difference among localization and staining intensity of paxillin. Conclusion: Paxillin may play an important role in pathogenesis of oral squamous cell carcinoma by altering the adhesive properties of the tumor cells interacting with the extracellular matrix which in turn affects their invasive behavior and histologic differentiation.

Introduction: Over the past century, several antibiotics have been discovered and used to treat various microbial diseases. However, over the past few decades, with the emergence of anti-microbial resistant strains of microbiomes, it has become increasingly necessary to discover and develop alternative anti-microbial agents. Herbal formulations have shown promising results in the past decade. However, many herbal formulations remain unexplored. The present study aims to explore the anti-microbial properties of a newly prepared Vanilla planifolia extract. Methodology: Vanilla planifolia leaves were collected, shade-dried, and then powdered. The powdered leaves of Vanilla planifolia (100 gm) were extracted by the cold percolation method with 300 ml ethanol at room temperature for 72 hours. The extracts were then tested for its constituent anti-microbial activity by the agar well method and disk diffusion method against different commonly found oral micro-biomes. The zones of inhibition were noted and measured, and the results were derived. Statistical analysis was performed using the Student t-test (P <_ 0.001). Based on the statistical analysis, conclusions were drawn. Results: The ethanolic extracts of Vanilla planifolia on the agar plates showed considerable anti-microbial activity in both the test methods against Staphylococcus aureus, Streptococcus mutans, and Enterococcus. However, no effect was found against Candida albicans. There was no significant difference in the results obtained by the two test methods (P >_ 0.001). Conclusions: This experimental study presents a medicinal plant, an orchid Vanilla planifolia, which demonstrates the presence of essential anti-microbial agents in it, making it a potent, potential dental biomaterial with a positive and benefitting effect on the oral micro-environment.

Background: In India, Oral cancer is one of the most common cancers. Despite advances in treatments, prognosis for oral cancer has remained poor with a five-year survival rate of 40–50%. Therefore, it is necessary to develop effective diagnostic methods for early diagnosis and better prognosis. Homocysteine (Hcy) has been reported as a 'tumour marker' in various cancers such as breast cancer, colorectal cancer, lung cancer, cervical cancer. Aim: To study the levels of serum Hcy in oral squamous cell carcinoma (OSCC) patients. Objectives: To assess the clinical utility of serum Hcy as a potential tumour marker for OSCC cases. Methodology: Serum Hcy levels were studied and compared between patients with OSCC and healthy individuals. Results: Serum Hcy levels were higher in patients having OSCC. Conclusion: Serum Hcy levels could be utilized as a biological marker in the diagnosis and the prognosis of OSCC patients.

Context: There has been extensive focus on forensic odontology with an increase in the research for age estimation procedures. Teeth are biological markers for human age estimation. In adults, age estimation with a tooth has to be done by the analysis of cementum annulations, root transparency and determination of aspartic acid racemization. Various age estimation methods are known in literature; however, the reliability and relevance of these methods for the Indian population have seldom been studied. Aim: To assess and compare age estimation by Drusini's method and Jeon's method and correlate chronological age and age estimation by both the methods in Indian Adults. Objective: Comparative assessment of Drusini's method and Jeon's method for age estimation within Indian adults. Subjects and Methods: Two hundred intraoral periapical radiovisuographs of the patients aged 20–69 years with optimum diagnostic quality radiographic images of permanent mandibular first molars were selected from the digital archive of the Department of Oral Medicine Diagnosis and Radiology from the dental college. Measurements were done using Drusini's and Jeon's methods and compared with the chronological age. A P < 0.05 was considered statistically significant. Statistical Analysis Used: Analysis of variance followed by Tukey's Post hoc test, t-test. Results: Mean chronological age, estimated using Jeon's method and estimated by Drusini's method, was 30.77 ± 9.32, 29.790 ± 7.729 and 27.885 ± 8.190, respectively. This difference was statistically highly significant, whereas Jeon's method showed a strong positive correlation between chronological age and age. Conclusions: The study concludes that Jeon's method is more accurate than Drusini's in the Indian population.

Context: Mucoepidermoid Carcinoma (MEC) accounts for 10–15% of all salivary gland neoplasms and its management is related to tumour grading. The expression of mucin in the tumour cells presumably affects and predicts tumour behaviour. Aims: To analyse the expression of MUC1 (membrane bound mucin), MUC2 and MUC5AC (secreted mucins) in mucoepidermoid carcinoma and correlate with tumour grade and patient outcome. Settings and Design: In this retrospective correlation study the expression of MUC1, MUC2 and MUC5AC were investigated using immunohistochemistry in confirmed cases of MEC. Methods and Material: The staining patterns of MUC1, MUC2 and MUC5AC were analysed in 10 confirmed cases from the year 2013 to 2020. Statistical Analysis Used: SPSS 23 was used for bivariate correlations. Results: All of the tumours expressed MUC1, showing strong membranous to focal cytoplasmic localization in all cells. The goblet cell component expressed a strong apical membranous pattern. MUC2 expression was moderate, showed cytoplasmic localisation in 40% of mucinous cells and was minimal in intermediate cells and epidermoid cells. MUC 5AC expression was strong apical membranous in goblet cells and mainly negative in intermediate cells and epidermoid cells. Conclusions: Although MUC1 is a reliable marker for all cell types of MEC but has no significant correlation with the tumour grade. MUC 2 has not been found to be a reliable diagnostic marker and has no significant correlation with the tumour grade. MUC 5AC has been found to have a significant expression in tumours with lymphoid infiltrate. There was no statistically significant correlation of MUC expression with the site, tumour grade and patient outcome.

Background: Pathologists come across various structures in the microscopic sections that are unrelated to the tissues. Artifacts can occur in the tissue from the time the area is prepared for biopsy, during fixation, grossing, processing, sectioning and staining of the specimen. Food substances may get entrapped into the oral tissues and can lead to misdiagnosis. The aim of this study was to observe the microscopic appearances of commonly implanted food particles. Methods: Fourteen food samples were procured from a local market in Chennai, India. This included guava, chilli, chickpeas, channa dal (split chickpeas), cucumber, brinjal, carrot, capsicum, cabbage and urad dal and brown chickpea. The food samples were fixed in 10% formalin for 24 h and were subsequently processed. Hematoxylin and eosin staining was performed, and the sections were observed under the microscope. Results: Each specimen revealed unique, distinct histology of each food type. Channa dal microscopically in hematoxylin- and eosin-stained sections revealed round-to-oval structures with central pale eosinophilic lobulation. Capsicum showed round-to-polygonal structures of different shapes and sizes with clear central areas. Urad dal microscopically showed cluster of 5–6 eosinophilic structures separated by regular partitions. Conclusion: It is important to study the microscopic appearances of commonly implanted food particles to prevent any diagnostic dilemmas. Further studies are required involving various other food particles and their microscopic appearances.

Introduction: Musculoskeletal disorders are very commonly seen in dentists. These disorders can hinder their clinical practice and at times results in severe complications leading to an early retirement. Aim: The aim of this study is to find a correlation between physical and psychological factors with the prevalence of musculoskeletal disorders in practicing dentists. This study is a culmination of two fields of medicine, physiotherapy and dentistry, thus proving to be of significant value in terms of interdisciplinary approach to healthcare. Materials and Methods: The sample size consisted of 50 dentists. It was an observational cross-sectional study with a questionnaire divided into three sections. Inclusion and exclusion criteria includes Section 1 - Demographic data and basic questions related to the aim of the study. Section 2 - Cornell Musculoskeletal Disorder Questionnaire. Section 3 - General Health Questionnaire-12 for assessment of psychological stress. Results: Wrong posture, existing physical illness, lack of exercise and increases levels of psychological stress increase the prevalence of musculoskeletal disorders. This study could be used to implement better treatment options to dentists suffering from musculoskeletal disorders considering both physical and mental factors. Conclusion: It is very important to increase the awareness of ergonomics and the influence of psychological stress in practicing dentists so that they can avoid these disorders and provide a high-quality treatment to their patients without any hindrance in their professional careers due to these disorders.

Background: Oral squamous cell carcinoma is an invasive epithelial neoplasm with varying degrees of squamous differentiation that arises from the following anatomic sites: the oral cavity, particularly oral soft tissues including the gingival and alveolar mucosa, floor of the mouth, tongue, soft and hard palate, tonsils and oropharynx. In normal epithelium EGFR is localized to basal cell layer, while its expression beyond basal localization in cancerous tissue suggest that correlation of EGFR and tumor progression might exist. The present study aimed to assess epidermal growth factor receptor in histological, clinical and pathological staging of oral squamous cell carcinoma. Materials and Methods: The current study was performed on subject with confirmed histological diagnosis of oral squamous cell carcinoma of age group between 35 and 70 years reported to Kempe-Gowda Institute of Medical Science and Hospital, Department of Oral and Maxillofacial Surgery, Vokkaligara Sangha Dental College and Hospital Bangalore and KIDWAI Memorial Institute of Oncology, Bangalore between December 2019 and March 2021. Total of 30 subjects included in the study of age group between 35 and 70 years. In the selected subject for the study, tumor was resected and preserved in 10% formalin, which was sent to department of pathology for analysis and PTNM was recorded. Immunohistochemical evaluation of EGFR was done. Total score of EGFR of each subject was co-related with pathological prognostic factor. Results: Correlation of EGFR with adjuvant therapy and histological grading, P values were 0.001 and 0.005, respectively. The obtained results were tabulated statistically using Chi square test and significance was set at P < 0.05. Conclusion: A preventive approach and assessment of EGFR in early stage of SCC provide better results. Subjects with higher EGFR value have poor prognosis and have to undergo postsurgical adjuvant therapy for long term-survival.

Background: Although oral cancer is multifactorial in origin only few had evaluated the diagnostic parameters for candidal infection in oral squamous cell carcinoma (OSCC). Aims: To compare and assess the accuracy of Calcofluor White (CFW) to that of conventional staining methods to identify the presence of candidal infection in OSCC. Methods: Archival collections of 43 OSCC were retrieved for this investigation. Standard staining protocol was followed for the index test (CFW) and reference standard (Periodic Acid Schiff). Two examiners were blinded for either one of the staining techniques. Diagnostic test evaluation and Kappa statistic was calculated using MedCalc software. Results: The study comprised 37 males, six females, and their mean age at the time of presentation was 51 (range 23 to 75 years). The sensitivity and specificity of CFW was 75.8% (CI 57.7 to 88.9%) and 10.0% (CI 0.2 to 44.5%). While the positive predictive and negative predictive values were 63.1% (CI - 50.6-74.0%) and 67.0% (CI - 49.2-81.0%). Conclusion: Our results show minimal agreement with PAS with a Kappa score of 0.148 (95% CI = 0.39 to 0.09). Overall detection rate was similar for both the index test and reference standard although there was considerable number of intermediate test results. Sensitivity of CFW was comparable to that of earlier studies but specificity was low and the degree of concordance was 60.4%. Although CFW staining can come with high false positive they are a useful test for ruling out candida infection when the test result is negative.

Background: Salivary gland tumours are relatively uncommon, and there exists considerable diagnostic difficulty. This is due to individual lesions having diverse histopathological features, presence of number of types and variants, and overlapping histological features in different tumour entities. Aim: The current study aimed at assessing the expression of centromere protein F (CENPF) in benign and malignant salivary gland tumours and to evaluate the efficacy of CENPF as a proliferative marker to aid in the diagnosis of malignancy so that it will help in surgical pathology practice. Materials and Methods: The study group involved 20 cases of benign salivary gland tumours, 20 cases of malignant salivary gland tumours, and 10 normal salivary gland tissues. All the cases were subjected to immunohistochemical analysis for CENPF expression and were assessed by two independent observers and further taken up for evaluation. Statistical Analysis: The results were analysed statistically among different groups using analysis of variance (ANOVA) or Kruskal–Wallis test with Chi-squared test using IBM's Statistical Package for the Social Sciences (SPSS) version 17.0. Results: CENPF expression in normal salivary gland was negative with gradual increase in expression from benign salivary gland tumours to malignant salivary gland tumours. CENPF expression was high in malignant salivary gland tumours. Conclusion: Findings of the study suggest that CENPF can be regarded as a new cell proliferation marker for malignant salivary gland tumours.

Introduction: Oral and oropharyngeal cancers together are the 6^th most common cancers in the world and more than 90% are squamous cell carcinomas (OSCC, OPSCC). HPV is an important risk factor. p16 expression apart from indirectly assessing HPV infection, is an independent favorable prognostic marker. Lewis/Modified Lewis criteria of p16 grading identifies a subset of patients with improved overall survival. Aims: (1) To evaluate p16 expression in these cancers. (2) To correlate p16 expression with age, gender, sub-site, histological type and grade. (3) To utilize the Lewis/modified Lewis criteria. Methodology: The study included 70 cases of OSSC's and OPSCC's. Histological features were analyzed. p16 expression was determined and graded. Results were analyzed and evaluated using Chi-square test (value of P < 0.05 was taken significant). Results: p16 positivity was seen in 46/70 (66%) cases (44 OSCC & 26 OPSCC). It was more frequent in younger patients and significantly higher in males. There was no correlation between degree of differentiation and p16 expression. In OSCC, 72.7% were p16 positive, mostly from tongue, buccal mucosa, and hard palate. p16 positivity was seen in 53.8% of OPSCCs, mostly from base of tongue and tonsil. Also, 30.4% of all cases could be included in Lewis criteria and 39.1% in modified Lewis criteria. Conclusion: p16 is an inexpensive, easily available marker, it may be incorporated routinely in all histologically diagnosed cases of OSCC and OPSCC.

Context: Nidogen-2 (NID-2) hypermethylation has been implicated in many types of cancers, such as lung, bladder, and gastric carcinomas. However, its role has not yet been studied adequately in head and neck squamous cell carcinomas (HNSCC). HNSCCs constituting a major portion of the global cancer load, it is of importance to diagnose and treat them at earliest. This systematic review was performed to assess the role of NID-2 in HNSCCs and assess its utility as a diagnostic and prognostic marker. Materials and Methods: A systematic search was performed across multiple databases to identify studies pertaining to analysis of expression or methylation of NID-2 in HNSCCs. The sample size, type of cancer/premalignant condition studied, type of tissue/fluid analysed, and the various methodologies used and their results were extracted. PROSPERO registration number: CRD42021245326. Results: Four studies were identified after a systematic search of literature. The studies analysed NID-2 expression or methylation in conditions such as nasopharyngeal carcinoma, esophageal carcinoma, and oral squamous cell carcinoma (OSCC). NID-2 was found to be a highly specific marker for HNSCCs, and serum NID-2 levels also correlated with poor survival. Conclusion: Data from the reviewed studies indicate that hypermethylation of NID-2 is highly specific for HNSCC. The high specificity is maintained in salivary and serum samples, facilitating accurate and non-invasive prognostication of HNSCC. The relatively lower sensitivity of NID-2 methylation may be overcome by analysing it along with a panel of multiple biomarkers such as HOX-A2 and YKL20.

An association of periodontal disease with the severity of COVID 19 disease has been observed during COVID 19 pandemic. This article explores the various hypotheses that link the two conditions, to understand their interrelationship. Targeted research may help elucidate evidence for screening of high-risk groups and identification of therapeutic targets.

Transepidermal elimination (TE) is a well-known phenomenon by which dermal materials are expelled through an active epithelial-dermal connective tissue interaction. It has been associated with many cutaneous disorders and described as a regular or sporadic occurrence in a variety of dermatologic conditions. TE as a means of expulsion by skin, either externally introduced or endogenously generated foreign material, is well recognized but rarely appreciated phenomenon. Hence, here we are presenting a case of TE of suture material from the labial surface of the lower lip in a patient who was previously operated for mucocele a year back and reported with the impression of the recurrent lesion.

Choristoma (aberrant rest or heterotopic tissue) is defined as a histologically normal tissue proliferation, which is not normally found in the anatomic site of proliferation. Choristoma with a proliferation of chondroid tissue is known as cartilaginous choristoma. Clinically, they present as a painless firm nodule and may produce local dysfunction. They occur most frequently in the tongue and less commonly in other sites, such as buccal mucosa, soft palate and gingiva. We report a 35 years female patient with pedunculated globular growth over the left lateral border of the tongue, resembling papilloma but histopathological analysis of the excised specimen revealed to be cartilaginous choristoma.

Tuberculosis (TB) is an infectious disease caused mostly by Mycobacterium tuberculosis. Oral lesions caused by this disease are not common, and most of them represent secondary involvement of the initial pulmonary focus. Therefore, the discovery of lung tuberculosis because of the investigation of oral lesions is rare. This paper reports a case of a 61-year-old male patient who presented with a painfully ulcerated lesion in labial commissure and buccal mucosa, without any comorbidities or symptoms associated. An incisional biopsy was performed, and histopathology showed a chronic granulomatous lesion extending to involve the underlying muscle. Based on these findings, investigation for tuberculosis was suggested. Chest radiography displayed excavated macronodular lesions suggestive of an inflammatory-infectious/granulomatous process of bronchogenic dissemination. The search for acid-alcohol–resistant bacillus in sputum was positive. After using drug therapy for tuberculosis for 3 months, there was a total regression of the oral lesions, in addition to weight recovery in the period. Thus, in patients with isolated oral mucosa lesions, we must consider the possibility of oral manifestation of systemic diseases, even without typical clinical signs and symptoms.

Infiltrating lipomatosis is a rare benign condition causing diffuse fatty infiltration into the surrounding soft tissue and in rare cases causes hyperplasia of the adjacent bone. We report a case with clinical and radiological evidence of a 34-year-old female patient who reported a swelling in the left middle third of the face with exophytic temporomandibular joint (TMJ) ankylosis of the left side resulting in restricted mouth opening and facial asymmetry since 21 years. The number of cases reported in the literature is rare. Surgery is the treatment of choice.

Odontogenic myxofibroma is a benign tumour that is rarely encountered in any bone other than jaws. It accounts for only 3–11% of all odontogenic tumours. The pathogenesis of these tumours is still controversial and may arise from myxomatous degeneration or fibrous stroma or from the mesenchymal portion of the tooth germ. Clinically, they are slow-growing and can cause gradual expansion of the cortical plates, loosening, displacement of teeth, and rarely root resorption. Biologically, the tumour is locally aggressive with a high recurrence rate, which warrants extensive surgical treatment. Here, we present a case of central odontogenic myxofibroma in a 45-year-old female resulting in the extensive involvement of the mandible within a month.

Background: The determination of gender is of utmost importance for forensic science and medico-legal purposes. The mandibular bone may play a vital role in gender determination as it is the most dimorphic bone of the skull that is often recovered intact. In this respect, orthopantomograms are of great value in accurate age and sex estimation. The mandibular angles, especially the gonial angle is an important parameter of the craniofacial complex giving an indication about the vertical parameters and symmetry of the facial skeleton. The purpose of the current study was to evaluate the usefulness of mandibular gonial and coronoid-condyle angle measurements on digital panoramic images as an indicator for gender determination in the Bagalkot population. Materials and Methods: A total of 200 panoramic images (100 males and 100 females) of Bagalkot district patients aged (18–58) yrs old were selected. Two mandibular parameters 1) gonial angle and 2) condyle-coronoid angle were analyzed using trophy DICOM 6.1.2.0, masterview 4.2.0. Two-way analysis of variance (ANOVA) test and Tukey's multiple post hoc procedures were used to compare the gender and two sides (left and right) with respect to gonial angle and condyle-coronoid angle. Results: The analysis of the present study confirmed a statistically significant difference between the right and left sides of the gonial angle and condyle-coronoid angle in both genders. The mean comparison also shows a variation between males and females, based on gonial angle and condyle-coronoid values; females have statistically significant higher mean values than males. Based on the analysis, the present study concludes that this difference between males and females from both sides suggests that the gonial angle and condyle-coronoid angle help in gender determination. Conclusion: The results of the study show that greater mandibular angle aids in gender dimorphism and proves to be beneficial in gender estimation. Gonial angle and condyle-coronoid angle can be used to differentiate gender with high accuracy.

Context: Oral potentially malignant disorders (OPMDs) are a group of heterogeneous lesions with an increased risk of malignancy. S100A7 expression serves as a biomarker to identify the dysplastic lesion. Aims: To study the status of S100A7 antigen in healthy oral mucosa and OPMDs. Settings: Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune. Design: S100A7 antigen in healthy oral mucosa and OPMDs. Methods: Biopsies were collected of clinically diagnosed OPMDs as well as of healthy oral mucosa and analysed for the malignancy potential. Material: Polyclonal rabbit S100A7 25 μl, BioGenex detection system, hydrogen peroxide, non-streptavidin biotin-HRP, wash buffer, DAB chromogen, TRIS buffer, Harris haematoxylin and eosin. Statistical Analysis Used: Data analysis was performed using Statistical Package for Social Sciences Version 27.0. Qualitative data variables expressed were analysed using frequency and percentage. Quantitative data variables were expressed using mean and standard deviation. The Chi-square test was used to compare the grade of intensity, where P value <0.05 was considered significant. Results: Healthy oral mucosa did not reveal any immunopositivity. Oral leukoplakia showed some focal expression till middle middle third of epithelium. Oral erythroplakia was found with maximum expression while submucous fibrosis showed increased intense staining in six cases. Conclusions: S100A7 antigen showed significant immune expression in OPMDs and may be used as a marker for early diagnosis and precision therapy.

Background: Diabetes mellitus, a chronic hyperglycemic disorder has been associated with several manifestations in the body including the oral cavity. The oral manifestations are of importance and may significantly contribute to the detection of undiagnosed diabetes. Objective: To find out the prevalence of oral diseases in type 1 and type 2 diabetics, to evaluate and compare the periodontal status of diabetics and non-diabetics. Materials and Methods: This was a cross sectional study conducted on 110 diabetic subjects of >5 years duration at the M.V. Hospital for Diabetes, Diabetes Research Centre, Chennai. One hundred apparently healthy non-diabetic subjects in the age group of 40-60 years were studied as control. The oral cavity was examined by using a mouth mirror and periodontal status was assessed by utilizing oral hygiene index - simplified (Greene and Vermillion), Miller's mobility index and Ramjford's periodontal disease index. Results: Subjects with diabetes were found to have significant association with xerostomia (P < 0.003) and chronic periodontitis (P < 0.026). However, no significant association was found forleukoplakia, traumatic ulcer, frictional keratosis, smoker's melanosis, mucocele, aphthous ulcer, fissured tongue, lichen planus, parotid enlargement, parulis, chronic gingivitis, fibroma, and periodontal abscess. Conclusion: The study reaffirmed higher prevalence of xerostomia and periodontal disease among diabetic subjects. However, contrary to previous studies, no significant differences were found in the prevalence of traumatic ulcer, fissured tongue, lichen planus, and parotid enlargement.

Background: Dermatoglyphics play an important role in the identification of a person as well as identifying a person with a genetic abnormality. Hence, the present study was conducted with an aim to explore the association between the fingerprint patterns and oral potentially malignant disorders, oral squamous cell carcinoma (OSCC), individuals with habit and without lesion and the control group. Materials and Methods: A cross-sectional study comprising of 100 individuals divided into 5 groups with 20 individuals in each group based on their habit and the presence of oral lesions. Group 1 included individuals with oral leukoplakia (OL), Group 2 included individuals with oral submucous fibrosis (OSMF), Group 3 included individuals who had OSCC, Group 4 individuals had tobacco habits but without lesion and Group 5 comprised of control individuals. The fingerprints of all the study subjects were recorded using a standard ink method. They were analyzed qualitatively and quantitively. Results: The present study showed a predominance of that loop patterns in all the groups. The frequency of the whorled pattern was higher in subjects with OSMF as compared to OL and OSCC. The arch pattern was comparatively lesser in subjects with OL than OSMF subjects. The right-left comparison of the fingerprint patterns in all the five groups, except Group 4, showed a significant association and correlation. The Group 4 individuals were showing the least correlation between sides. Conclusion: The study concluded that dermatoglyphics can be used as a potential marker to identify the subjects with risk for potentially malignant oral disorders and oral cancers.

Background: High levels of cholesterol in the body can be alarming and point toward a possible cardiac or diabetic problem. Current evidence reveals that the harmful low-density lipoproteins (LDL) cholesterol tend to increase in poorly controlled diabetes, whereas the useful high-density lipoprotein (HDL) cholesterol, known for its protective anti-inflammatory and antioxidant activities, is decreased. With a positive evidence of periodontal disease being implicated in diabetes, it was decided to investigate whether there was any association between serum HDL, LDL, glycated hemoglobin (HbA1c) and periodontal status with Type II diabetes mellitus patients. Materials and Methods: A total of 500 nonsmoking patients (males and females) aged between 35 and 55 years with Type 2 diabetes mellitus and no other systemic disease were selected from the diabetic center, Diacon hospital, Bengaluru, Karnataka, India. Periodontal examination consisted of the clinical parameters, namely, attachment loss, gingival index (GI) and plaque index based on which the patients were divided into periodontally healthy and diseased groups. Blood samples were collected from each patient to evaluate the serum levels of HDL, LDL and HbA1c. Results: No significant differences were observed between the HDL, LDL and HbA1c levels in both the periodontal groups (P > 0.05). Linear regression analysis showed significant positive correlations of clinical attachment level with LDL and negative correlation with HbA1c, whereas GI has a positive correlation with LDL and negatively with HDL and Hba1c levels (P < 0.05). Conclusion: Varied associations were found between dyslipidemia, glycemic control and periodontal inflammation. Further longitudinal as well as interventional studies may be beneficial to ascertain the causal relationship between cholesterol levels, periodontal status and diabetes mellitus.

Background: Melanin is the predominant pigment responsible for the color of skin, hair, iris of eyes, and oral mucosa. Tyrosinase (TYR) is the key enzyme involved in melanin synthesis. Studies in dermatology have shown a positive correlation between TYR enzyme levels and melanin pigmentation of the skin. However, no study has been conducted to assess TYR levels in the gingiva. Hence the present study was conducted to assess TYR levels in gingival melanin hyperpigmentation. Aim: To assess the TYR gene expression in gingiva in individuals with moderate to severe gingival melanin hyperpigmentation. Methodology: Subjects with a chief complaint of blackish appearance of gums with an unesthetic smile were included in the study. Informed consent was obtained. Scaling and root planning were done and subjects were recalled after 2 weeks. The gingival depigmentation procedure was performed using the conventional scalpel technique under adequate local anesthesia. The selected sites underwent conventional gingival depigmentation technique using Bard-Parker handle no: 3 and blade no: 11. The excised layer of epithelium along with a thin layer of underlying connective was sent to the laboratory to assess the TYR gene expression by real-time polymerase chain reaction technique. Results: The levels of the TYR enzyme activity in the gingival tissues from the selected sites were assessed. [Table 1] and [Graph 1] show the levels of TYR enzyme gene expression in the gingival tissue. Conclusion: TYR gene expression and the degree of gingival melanin hyperpigmentation are positively correlated. Hence the assessment of TYR enzyme activity in gingiva could be of great value in today's cosmetologically conscious individuals.

Objective: In pathology practice, one frequently encounters benign lesions which superficially resemble malignancy clinically and histopathologically. The diagnostic pitfalls can be avoided if the approach exemplified in the present study is followed. We expect that familiarity of these cases will be helpful for pathologists at the beginning of their career. Methods: Clinical case records of all the pathological specimens reported in our laboratory from January 2018 to September 2019 were queried. Cases displaying pseudotumor features were reviewed along with the special stains were performed and immunohistochemistry (IHC) studies. A working classification of pseudotumors presenting in the oral cavity was proposed. Results: Immunoglobulin G4-related disease, nodular fasciitis, fibrolipoma, odontogenic keratocyst with giant cell granuloma, juvenile ossifying fibroma with central giant cell granuloma and tumor-induced osteomalacia were the most common diagnoses where the tissue specimens resembled malignancies on routine clinicoradiological evaluation and light microscopy of tissue specimens. Their differential diagnosis and the pathological diagnostic dilemmas are explained. We have also highlighted the importance of correlating clinical, radiological and microscopic details with the findings deduced from advanced pathological aids to establish the final diagnosis. Conclusions: Pathologists should be aware of the conditions where the diagnosis of malignancy needs stricter evaluation to rule out malignant mimics. In such scenarios, correlation of light microscopy findings with clinical and radiological details cannot be overemphasized. Advanced pathological aids such as IHC, where necessary are often indispensable for reaching the accurate diagnosis in these cases.

Background: Double facial talon's cusp is a rare developmental anomaly affecting the deciduous or/and permanent dentition. The major complications associated with facial talons of maxillary incisors include poor esthetic appearance with increased susceptibility to caries and, sometimes, even soft tissue irritation, thereby needing early detection and precise management. Case Report: We report a case of a 10 year-old female patient with a large double talon's cusp on the permanent left maxillary central incisor who presented with issues of soft tissue irritation and esthetic concern. One of the highlighting feature of this documented case was the difference in the extent of both talon's cusps on the facial surface of 21 teeth. As per Mayes' classification system, the talon towards the midline belonged to stage 2 and the talon away from the midline belonged to stage 3. Highlights: Based on the previous literature search on classification systems, we intended to propose a new classification system for double facial talons depending on their size (equal/unequal) and presence of developmental grooves (separate or fused). The aim of this new classification system is to enlighten a new area of research that can be conducted on the treatment aspect by studying the difference in the structure of enamel rods, dentin, especially in case of double talons of unequal size (as the direction of enamel rods/dentinal tubules of the talons with that of the direction of enamel rods/dentinal tubules of the underlying tooth will vary) and their compatibility with choice of dental materials, to be used for proper adaptation and develop new treatment protocols of tooth preparation and restoration for such cases.

Spindle cell haemangioma is a rare benign vascular neoplasm. Its occurrence in the oral cavity is uncommon and may be mistaken for other common oral lesions such as mucoceles or fibromas. Microscopically, it has features which are similar to those of other vascular neoplasms and may be a cause for potential mis-diagnosis. In this article, we report a case in the lower lip of a young male patient.

A calcifying epithelial odontogenic tumour (CEOT) is a rare benign odontogenic tumour, which was first described by J. J. Pindborg in 1955, hence it is also called the Pindborg tumour. It constitutes less than 1% of the entire odontogenic tumours and 0.4–3.0% of all intraosseous tumours. The origin of CEOT is still unclear. It may be derived from the oral epithelium, reduced enamel epithelium, stratum intermedium or remnants of the primitive dental lamina. Surgical management is usually enucleation and the recurrence rate is 15%. In this case report, we have described a case of CEOT that occurred in the left posterior region of the maxilla in a young adult male which clinically appeared as a peripheral lesion but radiological findings showed a central variant.

Granulomatosis with polyangiitis (GPA) is a rare multisystem disease characterized by a triad of necrotizing granulomas affecting the upper and lower respiratory tract, vasculitis and glomerulonephritis. Oral lesions are seen in 6–13% of cases, although not life threatening but might be the first symptoms reported by the patient. Here we present a case of gingival growth, later diagnosed as GPA owing to the timely recognition by the dentist. A 33-year-old female reported for evaluation of soft tissue growth in her lower left back tooth region present for past 3 months. She had no relevant medical or family history. Clinically it looked like a benign hypertrophic gingival enlargement. The histopathological picture was suggestive of vasculitis and nonspecific granuloma formation. On further examination altered Renal Function Test and cavitating granulomas were noted in her lungs along with a positive cytoplasmic ANCA (c-ANCA) test which led to the diagnosis of GPA.