Aadithya B. Urs

Treatment of Oral Mucosal Lesions by Scalpel Excision and Platelet-Rich Fibrin Membrane Grafting: A Review of 26 Sites

PURPOSEnOne of the preferred treatment options for oral mucosal lesions (eg, leukoplakia and lichen planus) is excision, with or without the use of a coverage agent. Platelet-rich fibrin (PRF) membranes are popular fibrin scaffolds with entrapped platelets that release various growth factors and cytokines to support and enhance wound healing. The aim of the present report was to describe the technique, postoperative wound care, and clinical results of PRF membrane grafting after excision of superficial potentially malignant oral lesions.nnnMATERIALS AND METHODSnAutologous PRF membrane was fabricated and grafted over 26 wounds created by excision of small, superficial, potentially malignant lesions of oral mucosa (or fiberotomy in cases of oral submucous fibrosis) and assessed clinically at 7, 15, 30, and 60 days.nnnRESULTSnHealing was satisfactory in all cases, with minimal and manageable complication at 1 site.nnnCONCLUSIONnThe results of the present study suggest that PRF membrane is a successful coverage agent that aids in the healing of superficial oral mucosal wounds. Additional comparative studies are required to establish its efficacy compared with that of other agents.

Rare pediatric presentation of aneurysmal bone cyst with trabecular juvenile ossifying fibroma and ossifying fibroma.

Aneurysmal bone cyst (ABC) is a benign intraosseous lesion characterized by blood filled spaces of varying sizes associated with a fibroblastic stroma containing multinucleated giant cells, osteoid and woven bone. ABC can present either singly or in association with osseous neoplasms such as ossifying fibroma (OF), giant cell granuloma etc. Juvenile ossifying fibroma has two variants: psammomatoid JOF (PJOF) and trabecular JOF (TJOF). ABC formation in TJOF is very rare in pediatric patients with only three cases reported in literature till date to the best of our knowledge. We hereby report three pediatric cases of ABC, two of which were associated with TJOF and one associated with OF.

Forensic considerations when dealing with incinerated human dental remains

Establishing the human dental identification process relies upon sufficient post-mortem data being recovered to allow for a meaningful comparison with ante-mortem records of the deceased person. Teeth are the most indestructible components of the human body and are structurally unique in their composition. They possess the highest resistance to most environmental effects like fire, desiccation, decomposition and prolonged immersion. In most natural as well as man-made disasters, teeth may provide the only means of positive identification of an otherwise unrecognizable body. It is imperative that dental evidence should not be destroyed through erroneous handling until appropriate radiographs, photographs, or impressions can be fabricated. Proper methods of physical stabilization of incinerated human dental remains should be followed. The maintenance of integrity of extremely fragile structures is crucial to the successful confirmation of identity. In such situations, the forensic dentist must stabilise these teeth before the fragile remains are transported to the mortuary to ensure preservation of possibly vital identification evidence. Thus, while dealing with any incinerated dental remains, a systematic approach must be followed through each stage of evaluation of incinerated dental remains to prevent the loss of potential dental evidence. This paper presents a composite review of various studies on incinerated human dental remains and discusses their impact on the process of human identification and suggests a step by step approach.

Clinicopathologic and radiologic correlation of ossifying fibroma and juvenile ossifying fibroma—an institutional study of 22 cases☆

To analyze the clinical, radiographic, and histopathologic features of ossifying fibroma (OF) and juvenile OF (JOF), an archival study of 17 cases of OF and 5 cases of JOF reported over a period of 4.5 years was undertaken to analyze the aforementioned features. Age incidence of OF varied from 8 to 53 years, and JOF was seen in a comparatively younger age of 8 to 28 years. Both tumors were almost equally distributed between men and women. Thirteen cases of OF were found to occur in posterior mandible, whereas JOF was predominant in the anterior maxilla. Radiographically, OF varied from completely radiolucent (n = 7), mixed (n = 5), to completely radiopaque (n = 5), whereas JOF was predominantly radiolucent. Microscopically, stroma in OF varied from fibrous to highly cellular with overlap between various types of calcification. Juvenile OF showed highly cellular stroma and 2 distinct patterns of mineralization-psammomatoid and trabecular with osteoid seams. The origin of OF and JOF seems to be distinct from each other with OF arising from periodontal ligament and JOF arising from precursor myxoid tissue of paranasal sinuses.

Infiltrating lipomatosis of the face: A case series

Infiltrating lipomatosis of the face is a very rare entity which is characterized by the collection of non-encapsulated mature adipocytes infiltrating local tissues, resulting in craniofacial deformities. Psychomotor development of the patients is normal, esthetics often being the primary concern to seek treatment. The presentation is always unilateral with hypertrophy of hard and soft structures on the affected side of the face. The pathogenesis of the condition is unclear. This condition shows a wide phenotypic range, uncertain prognosis with high rates of recurrence after surgery, and variable post-op cosmetic improvement. The condition shows no gender predilection, with most of the cases presenting in and beyond the second decade of life. Here, we present a series of four cases presenting in varying age groups with history of recurrence in three cases.

Intra-Osseous Jaw Lesions in Paediatric Patients: A Retrospective Study

OBJECTIVEnThis study was undertaken to comprehensively analyze the distribution of intra-osseous paediatric jaw lesions (0-16 years) and to correlate the same with the data which has been published in the literature.nnnSTUDY DESIGNnA total of 171 hard tissue paediatric pathologies obtained from the archives of Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, India were retrospectively reviewed over a period of 6 years. All the cases were analyzed for gender, site, radiographic findings, histopathological diagnosis, treatment modality and recurrence rate.nnnRESULTSnThe present study revealed 54/171 odontogenic cysts, 45/171 odontogenic tumours, 33/171 bone pathologies, 2 malignant tumours, 1 connective tissue pathology and 36/171 miscellaneous category cases. The highlights of this analysis showed a relatively higher incidence of odontogenic tumours (26.3%) as compared to those seen in other studies which have been published in literature. KCOT and ameloblastoma (solid and unicystic) were the most frequently diagnosed tumours. Also, one case of dentigerous cyst which was converted into calcifying ghost cell odontogenic tumour was a unique feature which was noted in the current study.nnnCONCLUSIONnIn the current study, a preponderance of odontogenic pathosis was seen in the paediatric age group which was studied.

Encapsulated Minimally Invasive Epimyoepithelial Carcinoma of Submandibular Gland - A New Entity?? With Review of Literature

Encapsulated Minimally Invasive Epimyoepithelial Carcinoma of Submandibular Gland - A New Entity?? With Review of Literature nEpimyoepithelial carcinoma (EMC) is a rare low-grade salivary gland malignancy comprising of 1% of all the salivary glands tumors. EMC is a rare tumor when involving submandibular gland (8.6%) as compared to parotid gland (62.1%). A thorough pubmed literature search retrieved only 17 cases of EMC involving submandibular gland since 1972. EMC can present in classical pattern characterised by biphasic cell population with inner layer of cuboidal to columnar cells and outer layer of myoepithelial cells. Encapsulated minimally invasive epimyoepithelial carcinoma is a recently coined terminology by Seethala et al. To the best of our knowledge, this is the first case of encapsulated minimally invasive EMC of submandibular salivary gland discussed in the literature. The present paper highlights the review of literature of EMC involving submandibular salivary gland, histomorphological spectrum and diagnostic differentiation from other salivary gland tumors.

Case report on cherubism: non-familial variant

Introduction: Cherubism is a rare, non-neoplastic, self-limiting, fibro-osseous disease, characterized by painless expansion of the maxilla, mandible or both. It usually develops in the first and second year of life. The radiographic appearance presentation is ordinarily bilateral, multilocular appearance in the mandible. To the best of our knowledge, very few cases (less than ten) of non-familial cherubism have been reported in the English literature. Objective: To describe non-familial case of cherubism in a 10-year-old child. Materials and methods: The current case was clinically, radiographically and histopathologically analysed for confirmatory diagnosis. Results: H & E stained section showed vascular and cellular stroma containing numerous multinucleated giant cells. Conclusion: Correlating radiographically and histopathologically the case was finally diagnosed as non-familial variant of cherubism.