Akhilesh Chandra

Determination of sex by radiographic analysis of mental foramen in North Indian population

Aim: Identification and determination of sex of unknown human skeletal remains has been one of the most challenging tasks for forensic dentistry. The purpose of this study was to determine the gender from the analysis of mental foramen on panoramic radiographs in a north Indian population. Materials and Methods: One hundred radiographs were selected for the analysis of mental foramen. Tangents were drawn to the superior and inferior borders of the foramen and perpendiculars were drawn from the tangents to the lower border of the mandible (S-L and I-L). The data obtained were tabulated and subjected to statistical analysis. Results: The average values of S-L and I-L were significantly higher in males than in females, while the distances for the right and left sides of an individual were almost similar in both the male and the females group, and the results were non-significant. Conclusion: The distances from the mental foramen to the lower border of the mandible exhibit sexual dimorphism in the north Indian population.

Contemporary practice in forensic odontology

Forensic odontology plays a major role in the identification of those individuals who cannot be identified visually or by other means. The unique nature of dental anatomy and placement of custom restorations ensure accuracy when the techniques are correctly employed. It is evident that identification of victims in accidents and natural calamities is of utmost importance and is a challenging task. The teeth may also be used as weapons and under certain circumstances; they may provide information regarding the identity of the biter. Dental professionals play a major role in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractices, negligence, fraud child abuse and also, identify an individual. In this article, we will discuss such evolvement of the subject.

Association of Ki-67 antigen and p53 protein at invasive tumor front of oral squamous cell carcinoma.

AIM Studies reveal that invasive tumor front may be the best field for quantification of proliferative and apoptotic markers. The current study assessed the expression of Ki-67 antigen and p53 protein at invasive tumor front of oral squamous cell carcinoma (OSCC) and correlated the immunostaining with the histologic grades of malignancy. MATERIALS AND METHODS A total of 80 slides sample was prepared for the study, one each from ten normal oral mucosa cases and two each from 30 OSCC cases. The OSCC patients were biopsied along invasive tumor front, and samples were immunohistochemically analyzed for the expression of both Ki-67 antigen and p53 protein. RESULTS Of the total 30 OSCC cases, the expression of p53 was found positive in 20 cases (66.6%), while Ki-67 expression was found positive in 21 cases (70%). All the cases in the control group were negative. A higher p53 and Ki-67 expression were seen in OSCC group as compared to normal mucosa. On comparing the control group with various grades of OSCC a statistically significant result was obtained. CONCLUSION Higher and statistically significant expression was noted for both p53 and Ki-67 antigen. The results emphasize the potential of Ki-67 and p53 as biomarkers of carcinogenesis in OSCC. Ki-67 expression was comparatively higher when compared with p53 except in poorly differentiated squamous cell carcinoma and signifies actively proliferating malignant cells at invasive tumor front.

Clinical evaluation of the role of tulsi and turmeric in the management of oral submucous fibrosis: A pilot, prospective observational study.

The aim of the present study was to investigate the clinical efficacy of herbal medicines (1 gm tulsi and 1 gm turmeric mixed in glycerine base) for the treatment of oral submucous fibrosis (OSMF). Forty-one patients in the age group of 17- 56 years without any systemic complications were included in the study. The patients were treated with medicines, which were to be applied 3-4 times a day. Blood samples were collected before and after treatment to screen for any systemic changes due to these medications. Burning sensation and mouth opening were recorded before and after treatment. Patients were followed up on monthly subsequent visits for three months. Changes in the burning sensation on visual analogue scale (VAS) scale and difference in the mouth opening were analyzed statistically. A statistically significant improvement was seen in both burning sensation and mouth opening. Tulsi and turmeric offers a safe and efficacious combination of natural products available for symptomatic treatment of OSMF.

Oral squamous cell carcinomas in age distinct population: a comparison of p53 immunoexpression.

AIMS The study aimed to assess the diffused expression of p53 protein in patients with OSCC and its association with age at diagnosis (using 50 years as a cut point). STUDY DESIGN Ten normal oral mucosa and sixty OSCC lesions from age-distinct patient populations were immunohistochemically analyzed for the expression of p53 protein. RESULTS In OSCC cases, 31 out of total 60 cases (51.67%) showed positive expression for p53 protein and it was more common in older study group (56.67%) than in younger study group (46.67%) but the difference was not statistically significant. Moreover, there was also no significant difference in the p53 indices (percentage of p53 positive cells) between the two study groups (P = 0.827). CONCLUSION The alteration rates were found to be slightly higher in older patients although not statistically significant.

Immunohistochemical analysis of plasmacytoid myoepithelioma of minor salivary glands: A case report with review of literature

Myoepithelioma (ME) is a rare benign neoplasm of salivary gland, which commonly originates from parotid gland. Limited number of cases originating from the minor salivary gland tissue have been reported. MEs have characteristic histopathologic and immunohistochemical features, helping in its definitive diagnosis. Here, we present a case of plasmacytoid ME of the palate with review of literature. To the best of our knowledge, only 19 such cases have been reported in literature till date.

Immunohistochemical analysis of tenascin expression in different grades of oral submucous fibrosis

Aim: Tenascin, a glycoprotein, is one of the major constituents of extracellular matrix, which may function in organizing the stroma in normal and pathological conditions. The study aimed to correlate the structural organization of tenascin with the pathological progression of disease from early, moderate and advanced changes in oral submucous fibrosis (OSMF). Study Design: A retrospective cross-sectional immunohistochemical (IHC) analysis of OSMF cases was performed. Total 70 slide samples were prepared for the study from 35 formalin-fixed paraffin-embedded tissue blocks with 10 each from histologically proven and graded as early, moderate and advanced OSMF and 5 of normal oral mucosa. The IHC sections were analyzed for the intensity and pattern of tenascin expression at the junction of epithelium and connective tissue (ECJ) and deeper connective tissue (CT), as well as presence or absence of staining around inflammatory cells, fibroblast and endothelial cells using anti-human tenascin. Result: Most of the OSMF cases showed retention of antigen at ECJ and in deeper CT. Its expression varied in different grades as well as around inflammatory cells, fibroblast and endothelial cells in same tissue section. Highly significant P values of 0.001 and 0.003 were obtained for tenascin intensity and pattern, respectively, at ECJ in different OSMF grades. In addition, for the expression of tenascin pattern in deeper CT among different OSMF grades, a significant P value of 0.018 was obtained. Conclusion: A differential expression of tenascin was observed with the progression of disease. The expression of tenascin as bright and continuous deposition at ECJ in early and moderate stages of OSMF signifies either proliferative organization within the overlying epithelium or an epithelial-mesenchymal interaction. However, a weak immunoreactivity of tenascin at ECJ was observed in advanced stage of OSMF.

Oral squamous cell carcinoma pathogenesis and role of p53 protein

Development and progression of human cancers is a multistep process of genetic alterations. Mutation in the TP53 gene is the most common genetic change found in oral squamous cell carcinoma (OSCC). Tumor suppressor genes encode proteins that typically transduce negative growth regulatory signals. TP53 is tumor suppressor gene located on the short arm (p) of chromosome 17. The p53 protein which is encoded by this gene is one of the proteins which regulate the cell cycle. Once activated, the p53 protein can induce the growth arrest, as well as cell death. Mutation and subsequent inactivation of a tumor suppressor gene causes ′loss of function′. This can damage its deoxyribonucleic acid (DNA) binding properties and transcription factor function, thus, inhibiting its normal function in cell cycle control and in cell proliferation.

Cystic lesion creating radiographic dilemma: An unusual case report

Dentigerous cyst is caused by fluid accumulation between the epithelium and the crown of an unerupted tooth. It grows by expansion of the follicle and is attached to the neck of the tooth. The radicular cysts are inflammatory jaw cysts at the apices of teeth with infected and necrotic pulps. These arise from the epithelial residues in the periodontal ligament as a result of inflammation, usually following death of the pulp. We present a case of a cystic lesion creating dilemma between radicular and dentigerous cyst.

Apoptosis in normal oral tissues and odontogenesis

Programmed cell death or apoptosis is considered a vital component of various processes including normal cell turnover, proper development and functioning of the immune system, hormone-dependent atrophy, embryonic development, and chemical-induced cell death. Inappropriate apoptosis (either too little or too much) is a factor in many human conditions including neurodegenerative diseases, ischemic damage, autoimmune disorders, and many types of cancers. The process of apoptosis is generally characterized by distinct morphological characteristics and energy-dependent biochemical mechanisms. An understanding of its role in the pathophysiology of oral tissues is pertinent to the development of novel therapeutic approaches. The developing tooth passes through the various morphologic stages and apoptosis is observed selectively in certain locations. This review focuses on the current knowledge of apoptosis emphasizing its role in normal oral tissues and odontogenesis.