Formaldehyde is the widely employed fixative that has been studied for decades. The chemistry of fixation has been studied widely since the early 20 ^th century. However, very few studies have been focused on the actual physics/chemistry aspect of process of this fixation. This article attempts to explain the chemistry of formaldehyde fixation and also to study the physical aspects involved in the fixation. The factors involved in the fixation process are discussed using well documented mathematical and physical formulae. The deeper understanding of these factors will enable pathologist to optimize the factors and use them in their favor.

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Calcifying ghost cell odontogenic cyst (CGCOC) is a relatively uncommon odontogenic lesion characterized by varied clinical, radiographical features and biological behavior. CGCOC can exhibit either as a cystic or a solid lesion. Since its first description by Gorlin et al, in 1962, it has been known by different names and classified and sub-classified into various types. In this article we present a case of CGCOC and discuss the related literature regarding the terminology, classification and biological behavior of CGCOC.

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Aim: Well documented cases of oral lichen planus, a cell mediated immune condition is infrequently reported in paediatric population. This study was undertaken to obtain epidemiological data retrospectively and also to explore the possibility of any association that might exist among the clinical and histopathological features in paediatric patients suffering from oral lichen planus. Subjects and Methods: A retrospective study was carried out on 22 patients, younger than 18 years with clinical and histopathological diagnosis of oral lichen planus over a period of 14 years. The clinical characteristics and histopathological features were observed. The statistical analysis of the data was performed using Statistical Analysis Software (SAS), Version 9.1. Results: Analysis of data of 22 patients revealed that the average age of patient is 15.18 years with equal male and female predilection. The most common site is buccal mucosa (50%) and most frequent clinical form is erosive (63.64%). Focusing on the histopathological findings, parakeratosis was found in 86.36% of the cases, acanthosis in 63.64% of cases, moderate basal cell degeneration was identified in 63.64% of cases and dense lymphocytic infiltration at juxtaepithelial connective tissue region was found in 59.09% of cases. Conclusions: Oral lichen planus in paediatric population is rare and appeared between 8 to 18 years of age. There is no significant gender predominance. The most common clinical form is erosive, manifesting mainly in buccal mucosa. Histopathological findings characteristic of oral lichen planus in paediatric patients include parakeratosis, acanthosis, liquefaction degeneration of basal cells and lymphocytic infiltration in the subepithelial layer.

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Calcifying epithelial odontogenic tumor (CEOT) is a rare benign odontogenic neoplasm of the jaws, accounting for less than 3% of all odontogenic tumors. It rarely extends into the maxillary sinus. Till date, six cases involving maxillary sinus have been reported. In this paper, we report the seventh case of a 52-year-old male with CEOT in maxilla extending from distal surface of the right maxillary canine to retromolar area and involving maxillary sinus with no association with impacted teeth. The diagnosis was confirmed by aspiration cytology and histologically, the tumor was composed of sheets of epithelial cells, with areas of clear cell changes. The presence of clear cells in the histological sections, accounts for the aggressive nature of the tumor simulating the clinical appearance. Prevention of recurrence can be achieved by radical resection.

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Aims: This study was undertaken to analyze the histopathological findings of oral discoid lupus erythematosus with conventional light microscopy for early diagnosis of the oral lesions that would aid in prompt treatment. Objectives: To find out the predominant age, sex, site and clinical features of oral discoid lupus erythematosus. To study the histopathological features of oral discoid lupus erythematosus. To study the alterations of basement membrane changes of oral discoid lupus erythematosus. Materials and Methods: Our study consisted 21 cases of diagnosed DLE with oral lesions. A detailed clinical proforma was used for thorough clinical examination and light microscopy was used for histopathological study of the incisional biopsy specimens. Statistical Analysis Used: The lesions were diagnosed on the histopathological criteria given by Gisslen et al. and was statistically analyzed using the Chi square test. Results: In the present study 9.52% patients had only oral lesions, while 90.47% patients had oral lesions along with skin lesions with the most common site of oral involvement being labial mucosa (76.19%), vermillion border (71.42%) and buccal mucosa (42.85%). On clinical examination, white spots were present in 28.6%, ulcers in 19% and central erythema in 52.4% lesions. Histopathologically, atrophy was observed in 66.66% cases, acanthosis in 66.66% and acanthosis alternating with atrophy in 33.33% cases along with the basement membrane appearing thin and homogenous in 66.7% and partially destroyed in 81% cases with Periodic Acid Schiff stain. Conclusions: Thus, from this study it was found that a diagnosis of oral discoid lupus erythematosus was based on the combination of clinical and histopathological findings. Thus the dentist may be in an important position to establish the diagnosis with the aid of clinical and histopathological findings before the cutaneous lesions become apparent.

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Tooth enamel is a unique entity among all mineralized tissues because of the presence of high mineral content. It is non collagenous and does not undergo resorption and remodelling. Its formation occurs through a transient collaborating network of enamel matrix proteins which controls hydroxyapatite crystal growth and orientation. Amelogenins constitute about 90% of the total enamel matrix proteins and play a major role in enamel bio mineralization. Amelogenin isoforms coalesce into nanospheres thus dictating the width and thickness of apatite crystals. The X and Y copies of amelogenins do not undergo homologous recombination, thus preferring it for sex determination in modern forensics. Recently, it was discovered that application of amelogenin to diseased periodontal tissue surfaces enhanced the regeneration of all the periodontal tissues. Additionally, low molecular mass amelogenin polypeptides have also been thought to possess osteogenic potential. Recent data regarding usage of immunohistochemical markers for mesenchymal stem cells suggested that amelogenin has the capacity to induce the recruitment of mesenchymal stem cells directly or indirectly during regeneration of the supporting periodontal tissues. Thus, our current concepts of dental enamel formation should be reviewed thoroughly so that this information could be applied to clinical circumstances where this understanding may be particularly relevant.

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Objective : Giant cell fibromas (GCF) of the oral cavity are found predominantly in Caucasians and rarely in other races. This retrospective study was done to evaluate the clinicopathological features of GCFs in a sample of Indian population. Materials and Methods : 21 oral GCF cases were investigated from the year 1995 to 2010. Clinical data and microscopic features were reviewed and analyzed. Results : The mean age of patients at the time of diagnosis was 39years. Oral GCF occurred in patients between 6 and 67 years of age. The lesions were 4-17 mm in greatest dimension. GCF frequently has the provisional diagnosis of fibroma or papilloma. All tumors were treated by total surgical excision and no recurrence was reported. The consistent and diagnostic feature was the presence of large stellate giant cells, usually with one or two nuclei. Multinucleated giant cells were seen occasionally. These giant cells were most numerous in the connective tissue beneath the epithelium. Conclusion : Though there are distinct histopathologic features for GCF, its clinical presentation and prognosis are similar to the conventional fibroma/fibroepithelial polyp.

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Aglossia congenita (AC), congenital total absence of the tongue, is a very rare midline developmental anomaly, hypothesized to be associated with vascular disruption between the fourth and eighth week of gestation. It was classified by Hall (1971) as part of oromandibular limb hypogenesis syndrome (OLHS) type I B. Most of the cases reported with OLHS are actually hypoglossia with limb abnormalities whereas isolated aglossia is an extremely rare entity. A case of isolated AC is presented in a 28-year-old Indian male. He had long narrow face, tapering chin, low set ears, and microstomia. Intraorally, he had narrow palatal vault, constricted oropharyngeal isthmus, oligodontia, and maxillo-mandibular hypoplasia. Interestingly, the patient showed a median palatal groove, which has not been reported before. He also had an unusual acquired adaptive mechanism to compensate for aglossia. This report presents the manifestations of this rare syndrome, its complications, differential diagnosis, and rehabilitation strategies.

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Context: Carcinoma in an early stage of development is hard to detect clinically because the lesion may not be palpable and color of the lesional tissue is not necessarily different from the color of the surrounding mucosa. In order to improve the efficacy of the diagnosis, techniques are being developed to complement clinical examination and to facilitate the identification of initial carcinomas. Aims: To find out the efficacy of chemiluminescent illumination (ViziLite ^TM ) for the diagnosis in precancer and cancer patients and compare this result to toluidine blue staining and oral exfoliative cytology. Materials and Methods: This study was done in 3 groups. Each group consists of 10 cases. Group I consists of normal appearing mucosa. Group II and III consist of clinically diagnosed pre-cancer and clinically suggestive of cancer respectively. Chemiluminescent illumination, toluidine blue supravital staining, oral exfoliative cytology and biopsy were performed in all cases. Statistical analysis used: SPSS version 10.05 was used to calculate positive and negative predictive values. Results: In Group I, all 10 patients showed negative result to ViziLite ^TM . 8 patients showed positivity and 2 patients showed negativity to ViziLite ^TM test in Group II. 9 patients were positive and one patient was negative for ViziLite ^TM . Conclusions: Chemiluminescent illumination test was sensitive for precancerous and cancerous lesions, which presented as keratotic lesions and red-white lesions. It showed negative result to erosive lesions. Toluidine blue staining test was reliable in precancerous and cancerous lesions, which present as erosive and red-white lesions. It showed negative result to keratotic lesions. Oral exfoliative cytology has diagnostic value in cancer patients than in precancer patients. These Results indicate that chemiluminescent illumination test is relatively reliable and accurate than toluidine blue staining test and useful chair side diagnostic test.

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Hemangioma is one of the most common benign tumors of vascular origin affecting 10-12% of infancy. Approximately 50% of hemangiomas resolve by the age of 5 years and 90% resolve by 9 years of age. Rarely hemangiomas may persist, warranting systemic or surgical treatment. Treatment depends on size, location, and evolution stage of the lesion. In this study, we present a case of huge hemangioma involving lower lip in a 20-year-old male for whom early treatment was ignored due to poor economic status, which was recognized and treated in our institution.

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Parry Romberg syndrome is a rare disorder of unknown etiology, seen most commonly as an asymmetry of the face, rarely affecting the limbs. Trophic malfunction of sympathetic system has been proposed as a cause. The syndrome presents with characteristic skeletal, dental, and soft tissue changes in the affected half of the face, with or without neurological signs and symptoms. Imaging studies sometimes reveal lesions in the brain corresponding with the neurological defects. The disfiguring nature of the disease Results in psychological disturbance and communication disorders like speech defects, as also dental anomalies. The present article reports such a case of an 8-year-old girl who presented with mainly hard tissue changes, without neurological or intraoral soft tissue changes. There has to be prompt multi-disciplinary management of such cases keeping in mind development, aesthetics, speech, and masticatory function, along with symptomatic treatment of neurological deficits.

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The clinical presentation of diffuse pigmentation can be alarming to the patient as well as the clinician. A histopathologic examination of a pigmented lesion is necessary in most of the cases in the oral cavity. Oral melanoacanthoma is a very rare diffuse pigmentation with no specific treatment required. It shows increased number of dendritic melanocytes in an acanthotic epithelium. We present a rare case of diffuse pigmentation in the oral cavity whose diagnosis was done on the basis of clinical presentation and histopathology. Also immunohistochemistry was done.

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It is rare that multiple myeloma (MM) occurs as a primary lesion in the jaws; we report such a case in an elderly patient involving the gingiva of the left posterior mandible. Multiple myeloma is a monoclonal malignant neoplasm of plasma cell origin which occurs in the bone marrow and may result in extensive destruction of skeletal structures. If the jaws are involved, it usually indicates an advanced stage of the disease.Thi s makes our case very unique due to the fact no other osteolytic lesions were identified at the time of the diagnosis of multiple myeloma. We report a rare case of multiple myeloma which was diagnosed from an intraoral gingival lesion on the lower left mandible.

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Background: The purpose of the study was to evaluate the oral and dental findings of uremic patients receiving hemodialysis and to compare the Results between diabetic and non-diabetic groups. Materials and Methods: A total of 100 patients undergoing hemodialysis were classified into diabetic and non-diabetic groups and examined for uremic oral manifestations, dental caries (DMFT), and periodontal status (CPITN). Mann-Whitney test of significance has been applied for analyzing DMFT score and chi-square test is used for analyzing CPITN score. Results: Of the study group, 46% were diabetic and only 11% of them did not have any oral manifestation. Oral manifestations observed were xerostomia and uremic odor, which contributed to 47 (23%) and 37 (17%), respectively. Hyperpigmentation was present in 26 (12%), macroglossia in 23 (11%), and uremic tongue coating in 24 (11%). Mucosal petechiae were seen in 17 patients contributing to 8% of total patients. Eleven patients had tongue pallor (5%), 9 patients had glossitis with depapillation (4%), and 7 patients had dysgeusia (3%). Angular cheilitis and gingival swelling were seen in 5 patients (2%). Conclusion: The oral and dental manifestations were higher in prevalence in the study group. However, there was no significant difference between the two groups.

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Ameloblastic fibroma is a rare odontogenic tumor comprising neoplastic epithelial and mesenchymal tissues. This lesion was previously considered to be a benign lesion with very limited recurrence rate and malignant transformation. However, recent reports have suggested that this lesion has the potential for recurrence and malignant transformation. In this brief report, we report a case of AF in the context of its high cellularity on histopathological examination.

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Epidermoid cysts are rare, slow-growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Epidermoid cysts may grow anywhere on the body and about 7% of them are located in the head and neck. These cyst arise from traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. Histopathologically, they are lined by stratified squamous epithelium and ,lumen without any skin appendages. Here we present a case of epidermod cyst occurring in sub- mandibular region.

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Patients with head and neck carcinomas have high incidence (2-3% per year) of second primary lesions. Although "field cancerization" was first described in oral squamous cell carcinomas (OSCCs), only few studies have been concentrated on multifocal primary squamous cell carcinomas in the oral cavity. Synchronous carcinomas are defined as second neoplasms at the same time or within 6 months period of primary lesions. After this period, they are considered as metachronous neoplasms. Tumors composed exclusively or in large part of clear cells are rare in salivary glands, jaws and oral mucosa. OSCCs composed of clear cells or clear cell variant are not documented in the English literature. We present an unusual case of synchronous OSCCs composed predominantly of clear cells.

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Aim and Objective: The present study is undertaken to study the ultra structural features of muscle tissue in moderate and advanced stages of oral submucous fibrosis along with retrospective analysis of 80 cases of oral submucous fibrosis ( osmf) 0 during the period of year 2002 to 2005. Materials and Methods: Five patients with moderate and advanced stages of osmf0 were screened from outpatients department of oral diagnosis, sri Ramachandra dental college and hospital. After a detailed case history, they were subjected to incisional biopsy from an area of buccal mucosa with maximum palpable fibrotic bands.the specimens were cut into two halves, one half was fixed in 10% formalin for routine processing. Second half was fixed in 2.5% glutaraldehyde for electron microscopic examination. Results: Prospective study of muscle fibres from moderate and advanced stages of osmf0 revealed varying changes in high proportion of muscle fibres which includes, irregularity of surface of fibre,sarcolemmal foldings, reduplicated basement membrane, loss and alterations in the myofilaments, hypercontraction of myofibrils, Z line abnormalities, internal nucleus, autophagic vacuoles. These features are suggestive of muscle atrophy and necrosis. Conclusion: Within the limitations of this study, it can be concluded that the ultra structural features In moderate and advanced stages of osmf0 were best studied. These muscle changes can be manifestation of disease, atrophy being secondary to the limited functional activity of the muscles which is brought about by fibrosis or it could be essential part of the disease process itself.

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Aspergillosis of the nasal and paranasal sinuses is recognized as being second to candidiasis, among opportunistic fungal infections in immunocompromised patients. However, invasive variant in normal and mildly immunocompromised hosts is a very rare occurrence. We report one such case of aspergillosis involving paranasal sinuses in mildly immunocompromised patient.

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Objective: Radiographic and histopathological evaluation of mechanical trauma on the development of maxillary molars in rat. Materials and Methods: Experimental study with 7-day-old five new born Wistar rats. Trauma induced on 7 ^th postnatal day with #55 K file. Right first molar region of the maxilla was the experimental side, and the left side as control. Each animal was sacrificed for histopathological observation on 8 ^th day (immediately next day of injury), 10 ^th day (after 3 days of injury), 13 ^th day (Enamel completion), 19 ^th day (Emergence into oral cavity) and 42 ^nd day when all the teeth came into functional occlusion. Results : On the 42 ^nd day experimental side of the study, the 1 ^st molar tooth had not erupted and the radiographs taken revealed conglomerate mass suggestive of complex odontome. Reduced tooth size, altered enamel and dentin formation, abscess formation and complex odontome like structure were observed histopathologically. Conclusion: The diversity of morphlogical and histopathological changes to intrusive force implies intricate mechanism involved in tooth development.

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Aim : Sister chromatid exchange (SCE) test is a sensitive, biomarker of genotoxic substances. The present study was conducted to observe the frequency of SCEs in peripheral blood lymphocytes of 30 males with and without the habit of cigarette smoking and alcohol consumption. Materials and Methods : Subjects for this study were males aged between 25-50 years and were selected from the students, employees and the patients attending the outpatient department of Ragas dental college and Hospital, Chennai. Results: Controls, smokers, and smokers with alcohol habit were divided into two age groups as ≤30 years and ≥30 years. In controls the mean frequency of SCEs/cell in ≤30 years and ≥30 year's age group was 5.80 and 6.05, respectively. In Smokers SCEs/cell in ≤30 years and ≥30 year's age group was 7.7 and 8.8, respectively. In Smokers with alcohol habit SCEs/cell in ≤30 years and ≥30 years age group was 10.1 and 12.8, respectively. Conclusions: In this study, the duration of the smoking habit has shown a positive correlation with the mean SCE frequency. Whereas, frequency of the habit did not show any influence on the SCE levels. In smokers with alcohol habit, both the duration and frequency of their smoking habit has shown a significant effect on the SCE levels suggesting a synergistic effect of alcohol and smoking leading to excessive DNA damage.

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Fibrous dysplasia can present clinically in varied forms which may appear as collision of different pathologic processes. We report a rare case of craniofacial fibrous dysplasia with coexisting epithelial lined cyst and superimposed osteomyelitis with sequestrum formation. Its clinical features and management with possible hypotheses are described along with the post operative course. Pertinent literature has been reviewed with emphasis on pathogenesis of this unique occurrence.

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Background: Hereditary ectodermal dysplasia is a genetic recessive trait characterized by hypohydrosis, hypotrichosis, and hypodontia. The affected individual show characteristic physiognomy like protruded forehead, depressed nasal bridge, periorbital wrinkling, protruded lips, etc. There is marked decrease in sweat and salivary secretion. Due to skin involvement palm and sole ridge patterns are disrupted. Aim: In this study an attempt has been made to classify the affected members according to the degree of penetrance by pedigree analysis and also study karyotyping for cytogenetics, dermatoglyphic analysis for the various ridge patterns and variations in the number of sweat glands by sweat pore analysis in affected individuals. Materials and Methods: A total of five families who were affected with ectodermal dysplasia were considered. Pedigree analysis was drawn up to three generation by obtaining history. Dermatoglyphics and sweat pore analysis was done by obtaining palm and finger print impression using stamp pad ink. Karyotyping was done by collecting 3-5 ml peripheral blood. Karyotyping was prepared using lymphocyte culture. Chromosomes were examined at 20 spreads selected randomly under Χ100 magnification. Results were analyzed by calculating mean values and percentage was obtained. Results: Karyotyping did not show any abnormalities, dermatoglyphic analysis and sweat pore counts showed marked variations when compared with normal. Moreover, pedigree analysis confirmed the status of the disease as that of the recessive trait. Conclusion: Large number of affected patients needs to be evaluated for dermatoglypic analysis. Genetic aspect of the disease needs to be looked into the molecular level in an attempt to locate the gene locus responsible for ectodermal dysplasia and its manifestation.

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The granular enlargement of the gingiva may be the first clinical manifestation of Orofacial granulomatosis, preceding other local or systemic manifestations. The term Idiopathic Orofacial granulomatosis (OFG) refers to conditions restricted to the oral region without any identifiable systemic granulomatous diseases. We report a case of nine year old female patient with gingival enlargement as the sole manifestation without any systemic involvement. Laboratory investigations were done to rule out tuberculosis, sarcoidosis, allergic hypersensitivity, Crohn's disease. The patient was treated by gingivectomy and there is complete remission of the lesion without any recurrence. Thus the early investigations and diagnosis of OFG can help in the prevention of future systemic complications.

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Background: Tumors require blood supply for their growth and dissemination. It is a well accepted paradigm that tumors recruit new blood vessels from the existing circulation (angiogenesis) and this participates in tumor invasion and metastasis. Studies in the literature provide evidence for expression of Vascular Endothelial Growth Factor (VEGF) by the tumor for neo-angiogenesis, which is not only required for the tumor growth but also its metastasis. Based on the literary evidences we carried out an Immuno-Histochemical (IHC) study for VEGF in Oral Squamous Cell Carcinoma (OSCC) tissues to provide a strong link between the factor and oral cancer. Aim: To analyze the expression of VEGF in OSCC tissues of different histological grades, clinical sizes and lymph node status and to use this as an indicator for disease progression by helping in delineating a risk population, that may benefit from an attractive adjuvant therapeutic strategy for OSCC. Settings and Design: Studies published from 1990 till 2010 have only seen the association of VEGF with tumor angiogenesis and its possible role in metastasis. This is the first study that takes into account the clinical status of the lymph nodes and VEGF expressivity in a sample size of 30 cases. Materials and Methods: 30 oral squamous cell carcinoma tissue slides were stained using Hematoxylin and Eosin stain (to confirm the diagnosis) and immunohistochemically using VEGF antibody. IHC stained slides were thereafter evaluated for the positivity and intensity. Statistical Analysis: The result was subjected to statistical analysis using Chi-square test . Results and Conclusion: VEGF positivity was seen in approximately. 90% of cases which was independent of histological grade of OSCC. However the intensity increased with the clinical size of cancer and from palpable lymph node to a tender and hard lymph node.

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Talon cusp and fusion of teeth are two separate developmental dental anomalies affecting both primary and permanent dentitions. While the former is more common in permanent maxillary incisors, the latter occurs more commonly in deciduous maxillary anterior teeth. This paper describes a rare case of talon cusp in fused teeth affecting the permanent mandibular incisors. A note on the etiopathogenesis of these two anomalies and a possible hypothesis on their concurrent occurrence are mentioned. The importance of awareness and understanding of these lesions and the prophylactic measures to prevent complications is also discussed.

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Background: The diagnosis of oral malignancy and epithelial dysplasia has traditionally been based upon histopathological evaluation of full thickness biopsy from lesional tissue. As many studies had shown that incisional biopsy could cause progression of the tumors, many alternative methods of collection of samples had been tested. Oral brush biopsy is a transepithelial biopsy where it collects cells from basal cell layer noninvasively. Aim: To assess the diagnostic accuracy of brush biopsy when compared to histopathology in a group of patients with features of potentially malignancy. Materials and Methods : In the present study, 60 cases of clinically diagnosed leukoplakia are selected and subjected to histopathology and brush biopsy. Results and Conclusion: Results showed that of 16 dysplasia cases confirmed by histopathology, only 12 were positively reported in oral brush biopsy. In 44 cases, the reports are same for histopathology and brush biopsy. The sensitivity of oral brush biopsy is 43.5% and specificity is 81.25% with a positive predictive value of 58.3%. Oral brush biopsy with molecular markers like tenascin and keratins can be an accurate diagnostic test.

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Background: Oral leukoplakia is the best-known precursor lesion. Although a morphologic feature of oral epithelial dysplasia is well described, less is known about the pathobiologic changes within the cells and over the cell surfaces for malignant transformation. Aims: The present study is aimed at comparing and correlating the mast cell density (MCD) and micro vascular density (MVD) in Normal Mucosa (NM) and different grades of dysplasia and to analyze their role in disease progression. Materials and Methods: MCD was assessed using anti mast cell tryptase and MVD was assessed immunohistochemically using anti-Factor VIII related von Willibrand factor. Results: The Results of the present study showed an exponential increase in microvessel density as mast cell density increased. Conclusion: The role of mast cells in angiogenesis as it progresses from normal mucosa to dysplasia is in concordance with the study. The number of mast cells and microvessel can be used as indictors of disease progression.

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Localized gingival enlargement is often associated with systemic medications, abscess formation, trauma, or reactive lesions. Very few reports are available reporting enlargement of gingiva due to metastasis of adenocarcinoma of the esophagus. A case of localized gingival growth affecting right maxillary and mandibular gingiva was reported in a 60-year-old male patient in which excisional biopsy of the lesion was done. Histopathological examination showed metastatic signet ring cell adenocarcinoma, which on further examination showed lower one-third of esophagus as the primary site of metastasis.

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Aims: To compare the area and number of AgNORs (silver stained nucleolar organizer regions) by morphometry between follicular and plexiform variants of ameloblastoma in order to analyze their cell proliferation rates. Materials and Methods: This retrospective study was carried out on 30 cases each of follicular and plexiform ameloblastoma. The sections were obtained and stained with silver staining technique to identify the nucleolar organizer regions. AgNORs were quantified using two parameters; manual tag for the number of AgNORs and area measurement using the image analyzer software, Image-Pro-Express. Results: Morphometric area measurements of AgNOR were significantly higher for Plexiform ameloblastoma (0.831μm ² ) than follicular ameloblastoma (0.528μm ² ). Enumeration of the number of AgNORs showed a significantly higher number of AgNOR for follicular ameloblastoma (1.71) than plexiform ameloblastoma (1.43). Among the groups studied, follicular ameloblastoma was more aggressive than plexiform ameloblastoma, as it showed smaller AgNOR area and higher AgNOR number. Conclusion: The combination of counting the number and measuring the area of AgNOR dots showed a significant overall difference between AgNOR profiles of follicular and plexiform variants of ameloblastoma.

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Granular cell ameloblastoma is a variant of ameloblastoma where cells located in the central portion of the follicles have granular eosinophilic cytoplasm and the peripheral cells resemble ameloblasts. A case of granular cell ameloblastoma of the mandible having very similar histopathological features of oncocytoma (oxyphilic adenoma) is reported where tumor cells were arranged in cords, sheets and follicles and their cytoplasm was full of eosinophilic granules.

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Introduction: In India, it is estimated that 2.5 million people are currently living with Human Immunodeficiency virus infection (HIV) of which one million are women. Given the occurrence of oral lesions in our population, we studied the patter of these lesions with respect to the role played by gender. Materials and Methods: 3729 consecutive patients seen over a period of 10 years (from 1998 to 2008) attending the YRG CARE (Center for AIDS Research and Education), at Chennai, India constituted the study group. The oral lesions were diagnosed and the findings were entered into a database and analysed using the SPSS package SPSS11. Results: 3724 adult patients (71% males 29% females) were recruited in this study. 95% and 92% of males and females respectively acquired the infection through the heterosexual route. 69% of them presented with at least one oral lesion. There was a significant difference in the occurrence of oral candidiasis (OC) (18.8% males 10.3% females, P = 0.00) and oral hairy leukoplakia (OHL) (1.2% males 0.4% females, P = 0.023) between gender. The mean CD4 counts in males (n = 1908) was 284.48 ± 222.45 and in females (n = 1087) it was 394.51 ± 274.56. Males had 2.2 times higher risk of getting OC, 3.1 times higher risk of OHL and over all males had 1.58 times of having any oral lesion compared to females. Multivariate logistic regression that the odds of having OC (OR = 1.7, 95%CI 1.2-2.2, P = 0.001) and OHL (OR = 3.1, 95%CI 1.1-8.9; P = 0.03) were significantly higher for males than for females after controlling for duration of being HIV positive, CD4 count and HAART. 1412 patients had their spouses HIV status also as HIV positive and 769 patients had their spouse HIV status as negative. 858 patients were on HARRT (627 males and 231 females) The partial correlation analysis, done between gender and CD4 counts, when controlling for HAART was r = 0.2028 (P = 0.00). Conclusion: Our study confirms that males had a higher risk of oral lesions, especially OC and OHL, than females. The females in this study had a significantly higher mean CD4 counts than males. This different immunological status of the females compared to males should be taken in to consideration in the evaluation and management of HIV positive patients in our country.

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