Bhari Sharanesha Manjunatha

Histochemical and polarization microscopic study of two cases of vegetable/pulse granuloma.

Vegetable granuloma (VG) or pulse granuloma (PG) results from the implantation of food particles of plant or vegetable origin. It is usually seen in the periapical or in the sulcus areas. These lesions have been described as a distinct entity and classified into central and peripheral lesions according to the location. Central lesions are asymptomatic, whereas peripheral lesions present as painless sub-mucosal swellings. Many authors have postulated that food particles in VG or PG get implanted and are rapidly digested, and sometimes partly get altered by host responses. The cellulose part of plant foods being indigestible persists in the form of hyaline material, whereas the starch matter gets digested. This cellulose moiety invokes chronic granulomatous response.

Adenomatoid Odontogenic Tumor (AOT) Arising from a Dentigerous Cyst: Literature Review and Report of a Case.

Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of odontogenic origin composed of odontogenic epithelium in a variety of histopathological patterns. These lesions are usually solid but are occasionally cystic. AOT has been reported to occur in association with odontogenic cysts. Very few cases have been described that arise in association with a dentigerous cyst. A systematic search of the English-language medical literature in PubMed and Medline search (keywords adenomatoid odontogenic tumor, dentigerous cyst) data bases revealed only ten such cases.The present case is very unique, exceptional and first of this kind that occurred in the posterior mandible associated with an impacted lower first premolar in a 19-year old female patient. The intraosseous follicular AOT, as this case reported here, frequently resemble dentigerous cysts. There is an uncertainty whether the lining of an associated cyst represents a true dentigerous cyst, cystic change within an AOT or may represent a distinct entity. We believe that this case represents an odontogenic cyst with neoplastic change. Hence, in such cases, the final diagnosis should be made on the basis of histological examination of extensive tissue sampling of entire excised tissue specimen. Further studies to determine whether the AOT derived from an odontogenic cyst could represent a distinct variant are to be done.

Histopathological evaluation of collagen fibers using picrosirius red stain and polarizing microscopy in oral squamous cell carcinoma

BACKGROUND Collagen is a part of structural connective tissue in every organ of the body. Study of collagen brings into focus the current knowledge of biosynthesis and degradation as a complex mechanism. One of the major aspects of tumor cell invasion and metastasis is the interaction between cancer cells and extracellular matrix component. Property of picrosirius red to enhance the birefringence is the result of basic protein nature of collagen molecules. There exists a direct relationship between the presence of type IV collagen and degree of differentiation in squamous cell carcinoma (SCC) cells as they lose their capability to form the basement membrane. MATERIALS AND METHODS Thirty cases of oral SCC (OSCC) were evaluated for standard staining protocol of picrosirius red to analyze collagen fibers in different grades of OSCC under polarizing microscopy. RESULTS In this study, moderately to poorly differentiated OSCC cases showed a gradual change in polarizing colors from yellowish orange to greenish yellow particularly in the vicinity of invading tumor islands. Thick collagen fibers forming bundles in parallel disposition were found around the neoplastic areas in discontinuous fashion. Type I collagen fibers of different lengths were strongly birefringent and swirl pattern, parallel orientation was evident. CONCLUSION An observable stromal change with the progression of neoplasm was evinced with picrosirius red stain in different thickness of collagens with a significant change in the arrangement from the early stage to the advanced stage according to tumorogenesis.

Drug Induced Erythema Multiforme: Two Case Series with Review of Literature

Erythema Multiforme, (EM) an uncommon, acute inflammatory reactive mucocutaneous disorder and primary allergies confined to the oral mucosa. However the subsequent attacks can produce more severe forms of EM involving the skin. Manifestations of EM are varied and present a diagnostic dilemma because infections (particularly herpes simplex and mycoplasma pneumoniae) and drugs seem to predispose towards development of EM. We report two cases of EM in which drugs (Dioclofenac sodium & Amoxycilline) seems to be precipitating factor. In addition, the article reviews various aspects of EM as relevant to dental practice and highlight the associated potential etiologic agents, pathogenic mechanisms and therapies.

Osteolipoma of floor of the mouth

Lipomas are benign soft tissue tumours composed mainly of mature adipose tissue. Histological variants of lipomas have been named according to the type of tissue present and they include fibrolipoma, angiolipoma, osteolipoma, chondrolipoma and others. Osteolipoma, a classic lipoma with osseous metaplasia, is a very rare histological variant. Owing to the rarity of oral osteolipomas, we report an uncommon case of osteolipoma located on the floor of the mouth of a 20-year-old female patient and include a review of the literature.

Estimation of age from development and eruption of teeth.

The developing dentition is used to assess maturity and estimate the age in many disciplines including anthropology, archeology, forensic science, pediatric dentistry and orthodontics. There is evidence that dental development is less effected than skeletal development by malnutrition and hormonal disorders. There are two methods of dental age assessment, radiographically and by clinically visualization of eruption of teeth. The clinical method to assess dental age is based on the emergence of teeth in the mouth. This method is more suitable since it does not require any special equipment, expertise and is more economical. Tooth formation is the best choice for estimating the age as variations are less as compared to other development factors. Eruption of teeth is one of the changes observed easily among the various dynamic changes that occur from the formation of teeth to the final shedding of teeth. The times of eruption of teeth are fairly constant and this can be made use of in ascertaining the average age of eruption of the tooth. Assessment of age of an individual by examination of teeth is one of the accepted methods of age determination.

Adenomatoid odontogenic tumor associated with a dentigerous cyst.

Adenomatoid odontogenic tumor (AOT) is a relatively uncommon benign lesion of odontogenic origin mainly affecting females in second decade of life, having a predilection for the anterior region of the maxilla. Histologically, it is composed of odontogenic epithelium in a variety of histopathological patterns in a mature, fibrous connective tissue stroma and characterized by slow but progressive growth. Very few cases of AOT associated with a dentigerous cyst have been reported in the literature. PubMed and Medline data showed a total of 11 cases of AOT associated with a dentigerous cyst in the literature. We present an additional case of an AOT arising from a dentigerous cyst around the crown of an unerupted upper canine in a 20-year-old female, which was clinically diagnosed as a dentigerous cyst. Histologically, the case showed proliferation of odontogenic epithelium in the form of whorls and islands typical of AOT associated with dentigerous cyst appearing thin reduced enamel like epithelium lining the cystic cavity, described previously. However, it is unclear whether this entity has a more aggressive potential.

Oral focal mucinosis: a rare case with literature review

Oral focal mucinosis (OFM) is an unusual disease that affects diverse localised areas of the mouth, where the connective tissue undergoes focal degeneration. It was described for the first time by Tomich in 1974. It presents as an asymptomatic pedunculated or sessile growth, commonly on the gingiva, with most cases being in women. Its pathogenesis is linked to overproduction of hyaluronic acid by fibroblasts during collagen production, ensuing in focal myxoid degeneration. It has no characteristic features and diagnosis depends on histological scrutiny. We report a rare case of oral focal mucinosis affecting a 54-year-old man who presented with a sessile gingival growth mimicking a common tumour-like lesion.

Unicystic ameloblastoma arising from a residual cyst.

Intraoral swellings involving alveolar ridges in edentulous patients are clinically diagnosed as residual cysts, traumatic bone cysts, Stafnes jaw bone cavity, ameloblastoma and metastatic tumours of the jaw. This case report describes a residual cyst in a 68-year-old edentulous male patient which was enucleated and histopathologically confirmed as a unicystic ameloblastoma.

Immunohistochemical evaluation of p63 and cyclin D1 in oral squamous cell carcinoma and leukoplakia

Objectives There are only a limited number of studies on cyclin D1 and p63 expression in oral squamous cell carcinoma (OSCC) and leukoplakia. This study compared cyclin D1 and p63 expression in leukoplakia and OSCC to investigate the possible correlation of both markers with grade of dysplasia and histological grade of OSCC. Materials and Methods The study included a total of 60 cases, of which 30 were diagnosed with OSCC and 30 with leukoplakia, that were evaluated immunohistochemically for p63 and cyclin D1 expression. Protein expression was correlated based on grades of dysplasia and OSCC. Results Out of 30 cases of OSCC, 23 cases (76.7%) were cyclin D1 positive and 30 cases (100%) were p63 positive. Out of 30 cases of leukoplakia, 21 cases (70.0%) were cyclin D1 positive and 30 (100%) were p63 positive (P<0.05). Conclusion The overall expression of cyclin D1 and p63 correlated with tumor differentiation, and increases were correlated with poor histological grades, from well-differentiated to poorly-differentiated SCC. Increased cyclin D1 and p63 expression was associated with the severity of leukoplakia. Based on these results cyclin D1 and p63 products can be a useful tool for improved leukoplakia prognosis.