Introduction: Oral submucous fibrosis (OSF) is a chronic, insidious disease that is associated with significant functional morbidity and an increased risk for malignancy. Turmeric and its active ingredient "curcumin'' are being studied upon as chemopreventive agents in various diseases. The present study aims to determine the efficacy of curcumin in the treatment of OSF. Materials and Methods: Thirty clinically diagnosed OSF patients were divided into two groups, 15 patients in each group from the Outpatient Department. Test group patients were treated with Longvida (curcumin) lozenges and control group with Tenovate ointment (clobetasol propionate (0.05%). The treatment was given for 3 months duration and follow-up was done for 6 months. Both the groups were advised for physiotherapy exercises by mouth exercise device. The baseline and follow-up results were compared for IIO (interincisal distance on maximum mouth opening), Visual Analogue Scale (VAS) for normal food and VAS for spicy food. Results: The test group showed 5.93 (±2.37) mm increase in mouth opening compared to 2.66 (±1.76) mm of the control group. In relation to VAS scale with spicy and normal food the average reduction was 64 (42-73) and 77 (70.5-82) as compared to 34 (14.5-64.5) and 64 (46-75.5) respectively in control group. The test group results achieved in the treatment span was sustained in the follow-up (P < 0.05) compared to control group which showed statistically significant (P < 0.05) relapse. Conclusion: It can be concluded that combination strategies for the management of OSF which include the stoppage of causative ill habits, appropriate medicinal and physiotherapy management is more efficient than single therapeutic modality. It is evident from the study that curcumin holds good promise in the treatment of OSF in future.

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Background: Over the years many grading systems have been put forward in an attempt to obtain objectivity in grading oral epithelial dysplasia (OED). However, despite these efforts variability remains unresolved. Our study aimed to evaluate the intra- and inter-observer variability in grading OED, using World Health Organization (WHO), Smith and Pindborg and Ljubljana grading systems and discuss the possible reasons for this variability if any. Materials and Methods: Three oral pathologists graded 50 slides of OED independently twice at a time interval of 3 months. Variability was evaluated by multivariate kappa analysis. Results: Intra-observer reproducibility ranged from moderate to good in WHO system, fair to moderate in Smith and Pindborg system and moderate to poor in Ljubljana grading system. Inter-observer agreement was found to be fair in WHO, poor in Smith and Pindborg system and poor to fair in Ljubljana grading systems. Intra-observer reproducibility of the dysplastic features in WHO system was good for all except the loss of polarity and basilar hyperplasia for first observer and enlarged nucleoli for the third observer. Inter-observer agreement was good for increased number of mitosis and nuclear hyperchromatism. Intra-observer reproducibility and inter-observer agreement were found to be best in the WHO grading system though variability within this system still existed. Conclusion: There is a need for an International body of pathologists to come to a consensus on a more definable grading system to resolve the issue of variability in grading dysplasia.

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In recent years, saliva has attracted much interest among researchers especially in the field of forensic sciences.This complex body fluid is gaining popularity due to its ease of collection, safety in handling and its close relationship with plasma. Analysis of saliva for serological testing and cellular content has proved to be of wide use in crime detection, drug and alcohol abuse, hormone identification, cases of poisoning and animal bites.There is a need for forensic laboratories to automate the settings specific for saliva as routinely done for blood or urine in order to consider saliva as the primary investigating tool in the absence of other body fluids.This update is aimed at highlighting the many uses of saliva in the practice of forensic odontology.

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β catenin belongs to the armadillo family of proteins. It plays a crucial role in developmental and homeostatic processes. Wnts are a family of 19 secreted glycoproteins that transduce multiple signaling cascades, including the canonical Wnt/β catenin pathway, Wnt/Ca ²⁺ pathway and the Wnt/polarity pathway. This is a review on β catenin, Wnt proteins and their secretion, the signaling pathway, the associated factors and the crucial role of β catenin in odontogenesis.

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Context: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease with female predominance with the potential for malignant transformation. Human papillomavirus (HPV) is associated with both malignant and benign disease in the head and neck region. Aims: The present study assesses the prevalence of high-risk HPV-16 and HPV-18 in tissue and saliva samples from an Iranian population diagnosed with OLP. Subjects and Methods: Deoxyribonucleic acid was extracted and investigated using polymerase chain reaction from tissue and saliva samples of the same individuals from 40 OLP cases and saliva samples of 40 healthy controls. Statistical Analysis: The prevalence of data was compared using the Chi-square test and inter-group differences were analyzed using Fisher's exact test. Results: OLP specimens were HPV-positive in 11 of 40 (27.5%) cases compared with three of 40 (7.5%) saliva specimens, representing a statistically significant difference (P = 0.0367). HPV-16 and HPV-18 were positive in eight of 40 (20%) OLP tissues and three of 40 (7.5%) saliva samples. Five of the 40 healthy saliva samples were positive for HPV-16. In the OLP patients with dysplasia, four of seven tissue samples were HPV-positive; threeof these four were HPV-16- positive in comparision with seven of 33 HPV-positive samples from OLP patients without dysplasia. Conclusions: Biopsies were more accurate than saliva analysis for evaluating HPV prevalence in OLP patients. HPV prevalence was higher in dysplastic than nondysplastic OLP lesions in this Iranian cohort.

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The neural crest cells (NCCs), a transient group of cells that emerges from the dorsal aspect of the neural tube during early vertebrate development has been a fascinating group of cells because of its multipotency, long range migration through embryo and its capacity to generate a prodigious number of differentiated cell types. For these reasons, although derived from the ectoderm, the neural crest (NC) has been called the fourth germ layer. The non neural ectoderm, the neural plate and the underlying mesoderm are needed for the induction and formation of NC cells. Once formed, NC cells start migrating as a wave of cells, moving away from the neuroepithelium and quickly splitting into distinct streams. These migrating NCCs home in to different regions and give rise to plethora of tissues. Umpteen number of signaling molecules are essential for formation, epithelial mesenchymal transition, delamination, migration and localization of NCC. Authors believe that a clear understanding of steps and signals involved in NC formation, migration, etc., may help in understanding the pathogenesis behind cancer metastasis and many other diseases. Hence, we have taken this review to discuss the various aspects of the NC cells.

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Aim: To investigate and record the palatal changes in individuals habituated to reverse chutta smoking in rural coastal Andhra population. Materials and Methods: Sixty individuals out of whom 47 females and 13 males habituated to reverse smoking with no other tobacco and alcohol habits and no other systemic disturbances were selected. The palatal changes were recorded by six examiners. Database were searched for the following terms "reverse smokers," "nicotina palatini" and "palatal lesions." Results: The mean and percentage prevalence of the each lesion recorded and agreed by six examiners among 60 subjects showed presence of 87.77% hyperpigmented areas, 64.44% depigmented areas, 51.66% excrescences, 32.22% potentially malignant lesions and 9.72% frank ulcerations. Conclusion: Reverse smoking is an endemic tobacco habit still practiced in the coastal rural Andhra Pradesh. It is a well-established and socially acceptable habit among adult females. The changes recorded clinically shows characteristic features that are unique among this population group.

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Introduction: Oral submucous fibrosis (OSMF) is a precancerous condition predominantly seen in people of Asian descent. About 7-12% OSMF patients develop oral squamous cell carcinoma (OSCC). Morphological features of OSMF especially fibrosis suggests a possibility of the hypoxic environment in diseased tissues. Oral cancer usually develops from hyperplasia through dysplasia to carcinoma. Neovascularization and increased glycolysis, represent adaptations to a hypoxic microenvironment that are correlated with tumor invasion and metastasis. The adaptation of cells to hypoxia appears to be mediated via hypoxia inducible factor-1α (HIF-1α). HIF-1α is said to be associated with malignant transformation of epithelium in other sites. It appears that HIF-1α plays a significant role in both prostate and cervical carcinogenesis at early stages. We hypothesize that progression of OSMF and malignant transformation in the background of fibrosis mediates via HIF-1α either by up- or down-regulation of various such molecules. Therefore, the main objective of this study was to investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF. Aim: To investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF. Materials and Methods: The study group consists of histopathologically diagnosed 20 cases of OSCC, oral submucous fibrosis and OSCC with OSMF each. The immunohistochemistry was carried out on neutral buffered formalin-fixed paraffin-embedded tissue sections by using the monoclonal antibody of HIF-1α. Results: A rise in the expression of HIF-1α from OSMF to OSCC to OSCC with OSMF is observed.

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Mantle cell lymphoma (MCL) is a subtype of B-cell non-Hodgkin's lymphoma seen predominantly in males. Common extra-nodal sites of involvement of MCL are Waldeyer's ring, gastrointestinal tract, bone marrow and peripheral blood. The extra-nodal palatal localization of MCL is quite uncommon. MCL is seen in predominantly older patients, therefore undiagnosed MCL patients are likely to have total prosthesis. In this study, a case of MCL, initially presenting as palatal swelling was reported with relevant literature review and the possible role of dental professionals in the diagnosis of this rare entity was discussed.

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Polymorphous low-grade adenocarcinomas (PLGA) are distinctive salivary gland neoplasms, with an almost exclusive propensity to arise from the minor salivary glands. PLGA frequently manifests as an asymptomatic, slow-growing mass within the oral cavity, which must be separated from adenoid cystic carcinoma and benign mixed tumor for therapeutic and prognostic considerations. We report a case of a 67-year-old male, who presented with a long-standing mass in the palate. This lesion was diagnosed as PLGA based on histopathological findings, which was further confirmed by the immunohistochemical marker.

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Oral squamous cell carcinoma (OSCC) is the most common epithelial malignant neoplasm affecting the oral cavity; early detection is an important criterion for achieving high cure rate. Occasionally, it may be misdiagnosed because of its variable and innocuous clinical appearance. Carcinomas of the gingiva are a unique subset of OSCC, constituting approximately 10% of OSCCs and can mimic a multitude of oral lesions especially those of inflammatory origin with benign features, often leading to delay in the diagnosis and hence delayed treatment. This article reports a rare case of gingival OSCC in a 62-year-old female patient mimicking an inflammatory gingival mass.

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Calcifying epithelial odontogenic tumor (CEOT) is a locally aggressive, rare benign odontogenic neoplasm that accounts for <1% of all odontogenic tumors. It was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955. It is most often located in the posterior mandible. The tumor usually appears between the second and sixth decade of life and has no gender predilection. It is slow-growing neoplasm with a recurrence rate of 10-15% and with rare malignant transformation. Early diagnosis is essential to avoid oro-maxillofacial deformation and destruction. CEOT is rarely reported in India. We, herewith present a rare case of CEOT with unusual features associated with an impacted right third molar in the posterior mandible of 35 years male, with an emphasis on clinical, radiographic, histopathology and immunohistochemical features.

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Goltz-Gorlin syndrome (GGS) is an infrequent multisystemic disease with an autosomal dominant trait, with complete penetrance and variable expressivity, though sporadic cases have been described. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, keratocystic odontogenic tumor and treatment modalities.

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We present a case of oro-facial-digital syndrome type II (Mohr's syndrome) which is characterized by malformations of the oral cavity, face and digits. The facial and oral features include tongue nodules, cleft or high-arched palate, missing teeth, broad nose; cleft lip. The digital features include clinodactyly, polydactyly, syndactyly, brachydactyly and duplication of the hallux.

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Desmoplastic fibroma (DF) is a benign intra-osseous neoplasm, that is, recognized as the intra-osseous counterpart of soft tissue fibromatosis in both gnathic and extra-gnathic sites. It has a propensity for locally aggressive behavior and local recurrence. An occurrence of intra-osseous lesion other than that of odontogenic origin is rare in the jaws. In this case report, we define the clinico-pathological and radiographic features of DF of the mandible in a 35-year-old female, who presented to the Outpatient Department with a 3-year history of a slowly expanding painless mass in the left mandibular posterior region. Thus, we present a classic case of DF exhibiting characteristic features along with a review of the literature.

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Background: Candidiasis is the most common opportunistic infection in human immunodeficiency virus (HIV) seropositive patients, starting from asymptomatic colonization to pathogenic forms and gradual colonization of non-albicans in patients with advanced immunosuppression leads to resistance for azole group of antifungal drugs with high rate of morbidity and mortality. Objectives: To isolate the Candida species and determine of antifungal drug susceptibility against fluconazole, itraconazole, nystatin, amphotericin B, and clotrimazolein HIV seropositive and control individuals, with or without clinical oropharyngeal candidiasis (OPC). Materials and Methods: Includes samples from faucial region of 70 subjects with and without clinical candidiasis in HIV seropositive and controls were aseptically inoculated onto Sabaraud's Dextrose Agar media and yeasts were identified for the specific species by Corn Meal Agar, sugar fermentation and heat tolerance tests. Antifungal drug susceptibility of the isolated species was done against above-mentioned drugs by E-test and disc diffusion method. Results: The commonly isolated species in HIV seropositive and controls were Candida albicans, Candida glabrata and Candida tropicalis Candida guilliermondii and Candida dubliniensis isolated only in HIV seropositive patients. Susceptibility against selected antifungal drugs was observed more in HIV-negative individuals whereas susceptible dose-dependent and resistance were predominant in HIV-positive patients. Conclusion: Resistance is the major problem in the therapy of OPC, especially in HIV seropositive patients due to aggressive and prolonged use of antifungal agents, therefore, our study emphasizes the need for antifungal drug susceptibility testing whenever antifungal treatment is desired, especially in HIV-infected subjects.

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Background: Oral submucous fibrosis (OSMF) is a high-risk precancerous condition that predominantly affects Indians due to prevalent gutka chewing. Changes in the salivary flow rate and its effect on candidal carriage in patients suffering from OSMF have not been extensively explored. Aim: The aim of this study is to compare the salivary flow rate and salivary candidal carriage in OSMF patients and healthy individuals. Materials and Methods: This pilot study included a total of 30 OSMF patients and 30 healthy individuals. Salivary flow was estimated using preweighed cotton rolls placed at the openings of major salivary duct for 5 min. The cotton rolls were then removed from the oral cavity and weighed again. The difference in weight was recorded. Salivary samples were collected by the oral rinse technique and cultured on Sabouraud agar medium. The cultured yeast colonies were identified based on Gram's staining, periodic acid-Schiff (PAS) and germ tube formation. Result: There was statistically significant (P < 0.001) decreased salivary flow rate in OSMF individuals as compared to the control. Salivary flow rates constantly reduced with different grades of OSMF patients, although candidal carriage was seen in grade II and grade III OSMF patients. Conclusion: A higher incidence of Candida was observed in OSMF patients when compared to the healthy individuals. The results of our study suggest that a higher candidal carriage in grade II and grade III OSMF patients could be related to decreased salivary flow rate.

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Context: Oral submucous fibrosis (OSF) is a multi-causal inflammatory reaction to the chemical or mechanical trauma caused due to exposure to arecanut containing products with or without tobacco (ANCP/T). Arecanut and additional components such as lime and chewing tobacco render ANCP/T highly alkaline. Fibrosing repair is a common reaction to an alkaline exposure in the skin. OSF may be related to the alkaline exposure by ANCP/T in a similar manner. Aims: The study was aimed at establishing the relationship of habit-associated salivary pH changes and OSF. Settings and Design: The study design was controlled cross-sectional. Materials and Methods: Base line salivary pH (BLS pH), salivary pH after chewing the habitual ANCP/T substance, post chew salivary pH (PCSpH) for 2 min and salivary pH recovery time (SpHRT) were compared in 30 OSF patients and 30 sex-matched individuals with ANCP/T habits and apparently healthy oral mucosa. Results: The group's mean BLSpH values were similar and within normal range and representative of the population level values. The average PCSpH was significantly higher (P ˂ 0.0001) than the average BLSpH in both groups. There was no significant difference (P = 0.09) between PCSpH of OSF patients and controls. OSF patients had a significantly longer (P = 0.0076) SpHRT than controls. Factors such as age, daily exposure, cumulative habit years, BLSpH and PCSpH, had varying effects on the groups. Conclusions: Chewing ANCP/T causes a significant rise in salivary pH of all individuals. SpHRT has a significant association with OSF. The effect of salivary changes in OSF patients differs with those in healthy controls.

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Background: Diabetes mellitus is the fifth most common chronic condition and the sixth most frequent cause of death among the elderly. The objective of this research was to develop a new method for diabetes diagnosis by analysis of the glycogen content of the oral epithelial cells. Materials and Methods: Ten control subjects and ten diabetic patients (study group) were taken, four oral smears for both control and study group from the buccal mucosa were taken and stained with hematoxylin and eosin stain, Papanicolaou (PAP) stain, periodic acid Schiff (PAS) stain and PAS-Diastase (PAS-D) stain. Results: The results showed that in the diabetic group: (i) The epithelial cells stained with PAP stain exhibited figures of binucleation and occasional karyorrhexis, (ii) the epithelial cells treated with PAS-D showed that glycogen containing cells did not take up the stain as compared to the other cells. Conclusion: The results associated with clinical and histological observations suggest that diabetes mellitus can produce alterations of oral epithelial cells as well as in their glycogen content.

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Premature exfoliation of primary teeth is an important diagnostic event warranting urgent investigation. The majority of conditions presenting with early loss of teeth are serious and in some cases could be fatal. The most common causes of premature tooth loss are Papillion-Lefevre syndrome, Chediak-Higashi syndrome, hypophosphatasia, neutropenia, leukemia and in some cases Langerhans cell histiocytosis (LCH). LCH is a disorder of unknown cause, characterized by abnormal proliferation of histiocytes. The disease has a predilection for children, although LCH may occur in adults. Owing to the relative rarity of the condition, it remains a disease in which the diagnosis is often delayed or missed and in which many questions remain unanswered, ranging from etiology and pathogenesis to therapy. The purpose of the review is, therefore, to raise awareness of the disease and to highlight the clinical findings that should make the odontologist or primary caregiver suspect the diagnosis.

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Background: Lipids play a key role in the maintenance of cell integrity. These are major cell membrane components essential for various biological functions, including cell growth and division of normal and malignant tissues. Abnormal changes have long been associated with alterations in lipid profile. Aim: The aim of this study was to evaluate the alterations in lipid profile in oral submucous fibrosis (OSMF) patients and to compare the levels with respect to the clinical staging and histological grading. Materials and Methods: Fifty patients of OSMF, diagnosed clinically and histopathologically, were included as the study subjects. A group of 50 age and sex matched normal subjects without any oral pernicious habits were taken as controls. The serum lipid profile consisting of total cholesterol (TC), triglycerides (TGs), high density lipoprotein (HDL), very low density lipoprotein (VLDL) and low density lipoprotein (LDL) were analyzed using Erba Chem-5 Plus Analyzer. Results: Serum TC, HDL and LDL levels were significantly decreased in OSMF patients as compared to controls. As the clinical stage progresses, the TC and HDL levels were gradually reduced. All the lipid profile parameters such as TC, TG, HDL, VLDL and LDL progressively reduced as the histological grade advanced. Conclusion: The results of the present study showed that there is an inverse relationship between lipid profile and the presence of OSMF. The decreased serum lipid profile may be considered as a useful indicator for initial changes occurring in the cells of potentially malignant disorders like OSMF.

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Diverse environmental and physiological factors are known to induce the transcription of a set of genes encoding special protective molecules known as "molecular chaperones" within our cells. Literature abounds in evidence regarding the varied roles; these "guides" can effectively perform in our system. Highly conserved through evolution, from the prokaryotes to the eukaryotes, these make perfect study tools for verifying their role in both the pathogenesis as well as the therapeutics of varied neurodegenerative, autoimmune and potentially malignant disorders and varied cancer states. We present a concise review of this ever dynamic molecule, highlighting the probable role in a potentially malignant disorder, oral lichen planus.

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Numb chin syndrome (NCS), also known as mental nerve neuropathy, is characterized by facial and oral numbness restricted to the distribution of the mental nerve. Although not a common neuropathy, the clinical importance of this syndrome is its frequent association with malignancies. A 56-year-old Indian female reported with a complaint of numbness on the left side of chin. She had undergone a radical mastectomy with axillary lymph node dissection for invasive ductal carcinoma of the right breast 4 years ago. Biopsy revealed tumor cells showing pleomorphic hyperchromatic nuclei arranged in cord and nests leading to a diagnosis of metastatic carcinoma of breast origin. Bone scan showed increased uptake in multiple areas in skull, left hemimandible, multiple vertebrae, multiple ribs on either sides, right clavicle both scapulae and sternum, both humeri, multiple pelvic bones and trochanteric region of left femur. The patient was referred to a tertiary cancer institute where she received palliative hormonal and chemotherapy, which helped with her pain and halted the progression of the metastatic disease for past 22 months. The present case depicts the importance of proper recognition of NCS as it may often be the only symptom of an underlying malignancy or the first evidence of dissemination from a primary site as evident in this case.

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We present two unusual cases of carcinoma of palatine tonsil in elderly patients. Both the cases were initially diagnosed as squamous cell carcinoma of the tonsil, second case, in addition, showed lung metastasis. On subsequent follow-up, the first case developed cutaneous metastasis in the right frontoparietal region while second case showed granulocytosis as paraneoplastic manifestation. The association of cutaneous metastasis and paraneoplastic granulocytosis with carcinoma of tonsil is rare. Cutaneous metastasis has been described only once in the literature while paraneoplastic granulocytosis is being reported for the first time. Both the conditions need long-term follow-up as they manifest at the extreme edges of the neoplastic process.

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Dental anomalies of number, shape and size are the most common to dental literature, the most common being the agenesis and morphologic dental anomalies. However, very few cases have been reported regarding the presence of single root in primary molars. The purpose of this article was to present a rare case of single root in primary mandibular first molar associated with nonsyndromic hypodontia.

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A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. Nevertheless, such tumors have been reported in the literature for academic and research interest. However, it is still obscure whether they behave as a new entity or they solely present separate histopathologic patterns. Here, we present a true hybrid neoplasm of combined ameloblastoma and calcifying epithelial odontogenic tumor showing intermixed histopathologic patterns of both the tumors.

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Lymphomas are the group of neoplasms originating from lymphoreticular system mainly from lymph nodes, among them up to 40% of non-Hodgkin's lymphomas present extra nodally. In oral cavity, lymphomas are least common and account for 3-5% of all malignancies, presenting mainly in older age groups with male predominance. According to Revised European-American Lymphoma classification, among B-cell and T-cell subtypes of non-Hodgkin's lymphomas, diffuse large B-cell lymphoma (DLBCL) is the most common, characterized by diffuse proliferation of large neoplastic B lymphoid cells. Here we present a case report of DLBCL affecting oral cavity involving left buccal vestibule and extending onto the palate, along with its clinical, histopathologic and immunohistochemical features.

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Background: Secretor status may possibly be one of the factors in the etiopathogenesis of oral precancerous lesions and subsequently cancer. Studies have shown the relationship between the pathogenesis of disease and secretor status. They have made known that secretor status is a possible factor influencing disease status. Studies have revealed the association between blood groups and specific diseases. Aims: To assess any association of ABO blood grouping with oral potentially malignant disorders (OPMDs) and to examine whether there is any difference in the saliva secretor status in the patients with OPMDs and healthy controls. Materials and Methods: The study consisted of 90 subjects, with 45 patients assigned to two groups (a) Patients with potentially malignant disorders and (b) healthy controls. ABO blood grouping was done and 1 ml of unstimulated saliva was collected in a sterile test tube.The Wiener agglutination test was performed to analyze the secretor status in both the groups. Chi-square test and odd ratio were used to assess the relationship between ABO blood group and OPMDs. Chi-square test was performed to assess the relationship between secretor status and OPMDs. Probability level was fixed at <0.05. Results: The results demonstrated a statistically significant relation between OPMDs and secretor status (P = 0.00). Eighty-seven percent of patients with OPMDs were nonsecretors, while in the control group sixteen percent of them were nonsecretors. There was no statistically significant relationship between ABO blood groups and OPMDs (P > 0.05). Conclusions: The study confirms the inability to secrete blood group antigens in the saliva of patients with OPMDs which could be regarded as a host risk factor. Results could  not propose a relationship between ABO blood group and OPMDs.

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Background: Regional lymph nodes play an important role in acting as anatomic barriers to systemic dissemination of tumor cells. This reflects in the host immunologic response. Oral squamous cell carcinoma, is known to be associated with early deficiencies of cell-mediated immunity, the pathology of which is reflected in the histology of the regional lymph nodes. Aim : The goal of this study was to study the different immunity reactions in the lymph nodes and to correlate it with the histopathology of tumor proper. Materials and Methods: Out of 40 head and neck dissections, 30 were male and 10 females within the age range of 21-72 years. According to Tumor Node Metastasis classification, there were 12 cases of stage II and stage III, respectively while 16 were of stage IV. A total of 372 nodes were histologically evaluated. The harvested lymph nodes were categorized into metastatic and non-metastatic nodes exhibiting four patterns as: Lymphocyte predominance pattern, germinal center predominance pattern, lymphocyte depleted pattern and unstimulated pattern. Results: The predominant pattern of lymph node reactivity was of lymphocyte predominance (199 nodes) followed by germinal center predominance (117 nodes); lymphocyte depleted (17 nodes) and unstimulated node pattern (39 nodes). Twenty-seven nodes were positive for metastasis. A statistically significant relationship (P = 0.0019 and P = 0.0290, chi square, respectively) was observed between the number of nodes harvested and stage and level of lymph nodes. A brief follow-up period of 3 years was carried out. Conclusion: Further studies relating the immuno-morphologic assessment of the lymph nodes in conjunction with other factors may be helpful in assessing the metastases risk of the individual.

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Background: One of the most important risk factors for oral precancer and cancer in India is the use of tobacco. In chronic tobacco users, the mucosa may appear clinically healthy, however, changes are observed histologically. Screening of such tobacco users for an early diagnosis is, therefore, of paramount importance. Several adjunctive diagnostic modalities have been used in the past, but none has been conclusively validated as confirmative and cost-effective screening methodology. The aim of this study was to evaluate the use of 5% acetic acid as a vital staining agent in tobacco-associated oral lesions. Materials and Methods: The study subjects were divided into two groups. Group I (n = 40) subjects with a history of chronic tobacco use and clinically apparent normal mucosa. Group II (n = 40) subjects suspected of having oral cancer, 5% acetic acid was applied to the mucosa/lesions, followed by incisional biopsy for confirmatory diagnosis. Results: The sensitivity and specificity for Groups I and II were 97%, 50% and 95%, 60%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of Group I were 0.95 and 0.66. Group II showed PPV and NPV of 0.95 and 0.60. Conclusion: The results of this study suggest that acetic acid holds promise for future. Hence, further studies are needed to be undertaken on a large scale to assess its potential as a screening tool for high-risk individuals and oral cancer.

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Background: Flexibility of digital photography enables it to be an integral part of pathology practice. An assessment of guidelines of imaging is essential for proper usage of photographs. Objectives: The purpose of the study was to assess awareness of oral pathologists about various aspects of medical photography. Methods: Questionnaire based on the availability of facilities, usage, technical details and ethical issues of medical photography was sent to postgraduate students and teaching faculties of Oral Pathology in various localities in India. Results: Photographs were taken mostly for the purposes of publication, medical documentation and education. Significant number of postgraduate students and faculties of Oral Pathology didn't receive any training or hadn't gone through any publications/books (P = 0.000) about medical photography. Consent for patient photography was taken by significant number of respondents (P = 0.000) but in a verbal form. Majority of people used image editing software, but 19.0% of faculties and 21.1% of postgraduate students were unaware of deleterious effect of image editing. Firm and sensible instructions concerning image storage, sharing and accessibility were not yet created. Conclusion: This survey drew attention towards lack of proper understanding about the technical details, medical protocols and ethical issues related to medical photography. These findings recommend implementation of basic training for medical photography and policy for image management for students and faculties in every health care institution.

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The oral cavity is an uncommon site for metastatic tumor cell colonization and is usually evidence of a widespread disease, with an incidence of about 1% of all oral cancers. The jawbones, particularly the mandible, are more frequently affected than the oral soft tissues (2:1). Small cell carcinoma (SCC) of the uterine cervix is a rare tumor characterized by a highly aggressive clinical course and poor prognosis. The purpose of this report is two-fold: To present a case of metastatic SCC of the uterine cervix to post extraction site in oral cavity, which is the first reported case in the literature, as per our knowledge and to analyze the possible mechanism of metastasis from the lower part of the abdomen to the post-extraction site and to gain additional knowledge in this phenomenon.

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Odontoameloblastoma (OA) is an extremely rare odontogenic tumor that contains an ameloblastomatous component together with odontoma-like elements. Till date, very few cases have fulfilled the criteria of the current World Health Organization classification of odontogenic tumors. It is characterized by slow, progressively growing lesion with growth pattern similar to solid multi-cystic ameloblastoma. The majority of the tumors are associated with unerupted teeth and commonly seen in males. It is usually asymptomatic and may occur in either maxilla or mandible, but shows a slight predilection for mandible. As this tumor is extremely rare, there exists controversy regarding its treatment. Here, we present a case of OA in 17-year-old female patient resembling a fibro-osseous lesion and a brief review of the related literature.

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Palate sialolipomas are rare. Less than 10 cases located in the hard palate are reported to our knowledge. We report a case of hard palate sialolipoma, peculiar by the intratumor vascular patterns. A 67-year-old man presented with a 1.5 cm lesion of the oral hard palate. The lesion was surgically resected. On microscopy, the lesion, partly encapsulated, consisted of a proliferation of mature adipocytes containing normal minor salivary gland tissue and branching intratumoral vessels of varied size with irregularly thickened wall and papillary projections or tufts. The microscopic features of the tumor we report suggest that vascular malformation-like patterns may occur in sialolipomas of the hard palate. This morphological vascular peculiarity should be acknowledged since it may represent source of hemorrhage.

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Infantile fibrosarcoma of head and neck is rare and the presence of this tumor in ethmoid sinus is even more uncommon. To the best of our knowledge, <5 cases have been reported in the last 20 years in the English literature, so far, only one of which has been infantile type in a 15 months old girl. In this case report, we will explain our experience with a rare case of infantile fibrosarcoma originating from ethmoid sinus in a 5-year-old boy who presented with dyspnea and epistaxis. After biopsy, it was diagnosed as fibrosarcoma of sinus origin.

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Context: Assessment of potential for malignant transformation of oral submucous fibrosis (OSF) through clinical or light microscopic examination of hematoxylin and eosin stained tissue sections is not totally satisfactory. The search is for such a tissue marker that will differentiate those cases of OSF, which carry a higher risk for malignant transformation. During the past few years, numerous workers have validated the usefulness of enumerating argyrophilic nucleolar organizer regions (AgNORs) in predicting the malignant potential of lesions. The present study was carried out to validate the diagnostic potential of this marker. Objectives of the Study: Quantitative and qualitative assessment of AgNORs in different grades of OSF and to compare the count of AgNORs in different grades of OSF and normal mucosa. Materials and Methods: AgNORs were investigated in tissue specimens from 90 patients diagnosed with different histopathological grades of OSF. AgNORs were identified in tissue specimens stained with silver nitrate, using light microscope. AgNORs were counted as small, large and total count to analyze them both quantitatively and qualitatively. Statistical Analysis Used: Results were subjected to statistical analysis for obtaining significance value (P value) by unpaired Student's t-test. Results: The mean total count of AgNORs was 2.464 ± 0.101, 4.358 ± 0.108, 3.704 ± 0.106 and 3.279 ± 0.161 in normal mucosa, Grades I, II and III of OSF, respectively. A qualitative difference was observed in the presentation of AgNORs in different grades of OSF. Mean value of small nucleolar organizer regions (NORs) decreased while the mean of large NORs increased as the grade of OSF increased. Conclusions: The study findings suggest that AgNORs are increased in OSF and they can serve as a reliable tool adjunct to histopathological diagnosis. Their ease of demonstration and high specificity to cellular proliferation make them the best available histopathological marker in the arsenal of an oral pathologist.

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