Keya Sircar

Gorlin-Goltz syndrome

Gorlin-Goltz syndrome is an autosomal dominant inherited disorder characterized by the presence of multiple odontogenic keratocysts along with various cutaneous, dental, osseous, ophthalmic, neurological, and sex organ abnormalities. Early diagnosis is essential as it may progress to aggressive basal cell carcinomas and neoplasias. Gorlin-Goltz syndrome has rarely been reported from India. We report here one such patient, diagnosed at a rural hospital.

Sex determination using mesiodistal dimension of permanent maxillary incisors and canines.

Background: Sexual dimorphism refers to the differences in size, shape, etc., between males and females. The dentitions use in sex assessment has been explored and advocated owing to its strength and resistance to peri- and post-mortem insults. Objectives: The study evaluated permanent maxillary incisors and canines for sexual dimorphism and estimated the level of accuracy with which they could be used for sex determination. Materials and Methods: The study was conducted on 100 subjects (50 males, 50 females). The mesiodistal dimension of permanent maxillary incisors and canines was measured and the data were subjected to statistical analysis. Result: Univariate analysis revealed that all permanent maxillary incisors and canines exhibited larger mean values of mesiodistal dimension in males compared to females but only canines were found to be statistically significant for sexual dimorphism. Conclusion: The study showed maxillary canines exhibiting significant sexual dimorphism and can be used for sex determination along with other procedures.

Role of mast cells in pathogenesis of oral lichen planus

Recent attention has been directed toward the role of mast cells in the pathogenesis of oral lichen planus. Mast cells are responsible for trafficking inflammatory cells into the connective tissue that in turn helps in progression and maintenance of chronicity of oral lichen planus (OLP). OLP is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology, and lesions contain few B-cells or plasma cells and minimal deposits of immunoglobulin or complement. Hence, OLP is ideally positioned for the study of human T-cell-mediated inflammation and autoimmunity. This study was done to evaluate the mast cell count using toluidine blue stain in OLP and compares it with oral lichenoid reaction (OLR), and to propose the possible role of mast cells in the pathogenesis of OLP and OLR. Ten cases each of OLP and OLR and five cases of normal buccal mucosa were taken from the archives of Department of Oral Pathology. The samples were stained with toluidine blue using standard toluidine blue method by Wolman 1971. An increase in mast cell count was observed in OLP and OLR in comparison to normal oral mucosa. However, no significant differences in mast cell count were noted between OLP and OLR.

Image manipulation: Fraudulence in digital dental records: Study and review.

Introduction: In present-day times, freely available software allows dentists to tweak their digital records as never before. But, there is a fine line between acceptable enhancements and scientific delinquency. Aims and Objective: To manipulate digital images (used in forensic dentistry) of casts, lip prints, and bite marks in order to highlight tampering techniques and methods of detecting and preventing manipulation of digital images. Materials and Methods: Digital image records of forensic data (casts, lip prints, and bite marks photographed using Samsung Techwin L77 digital camera) were manipulated using freely available software. Results: Fake digital images can be created either by merging two or more digital images, or by altering an existing image. Discussion and Conclusion: Retouched digital images can be used for fraudulent purposes in forensic investigations. However, tools are available to detect such digital frauds, which are extremely difficult to assess visually. Thus, all digital content should mandatorily have attached metadata and preferably watermarking in order to avert their malicious re-use. Also, computer alertness, especially about imaging softwares, should be promoted among forensic odontologists/dental professionals.

Determination of the biometric characteristics of palatine rugae patterns in Uttar Pradesh population: a cross-sectional study.

BACKGROUND Identification is the establishment of identity of an individual. The basis of dental identification is based on the observation that no two individuals can have same dentition. Palatal rugae are irregular, asymmetric ridges of the mucous membrane extending laterally from the incisive papilla and the anterior part of the palatal raphe. The location of palatal rugae inside the oral cavity confers them with stability even when exposed to high temperatures or trauma. Their resistance to trauma and their apparent unique appearance has suggested their use as a tool for forensic identification. AIMS To record the biometric characteristics of shape, size, direction, number and position of palatal rugae and analyze whether palatal rugoscopy can be used as a tool for personal identification and for sex determination. SETTINGS AND DESIGN A cross-sectional study. MATERIALS AND METHODS The sample consisted of 100 subjects (50 males, 50 females) between 18 and 25 years. Maxillary impressions were made with elastomeric impression material and dental stone was used to make models. The palatal rugae patterns were traced and analyzed with a magnifying hand lens. The biometric characteristics of number, size, shape, and direction were analyzed using Thomaz and Kotz classification (1983). The casts were coded to blind the examiners about the identity of the subjects. STATISTICAL ANALYSIS USED Unpaired t-test and one-way ANOVA using SPSS 19.0 statistical program for Windows. RESULTS The average number of rugae was slightly more in females. Wavy (44.9%) and curved (41.8%) shapes were more prevalent. Maximum number of rugae was found in E quadrant (40.73%). The average size was 9.221 mm. Most rugae were forwardly directed in both groups. CONCLUSION This study concluded that rugae pattern are highly individualistic and can be used as a supplementary method for personal identification and sex determination. Further inter-observer and intra-observer variability were not found to be significant, which further validates the use of rugoscopy as a forensic tool.

Four odontometric parameters as a forensic tool in stature estimation.

Objective: The study was conducted to investigate the possibility of predicting the height of an individual using selected odontometric parameters as a forensic tool. Materials and Methods: The study sample consisted of 100 subjects (50 male and 50 female). Measurements of intercanine width (IC), interpremolar width (IP), mesiodistal dimension of six permanent maxillary anterior teeth (CW), and arch length (AL, canine to canine) were made directly on the subject. The data collected were subjected to statistical analysis and a linear regression formula was obtained against each odontometric parameter. Results: Highly significant correlation was observed between height and intercanine width, interpremolar width (P < 0.0001), whereas correlation between height and the combined width of six anterior teeth and arch length was found to be not significant. The linear regression equation using formula y = c + mx was obtained for each odontometric parameter and also for combined parameters. Conclusion: Hence the study concludes that the two odontometric parameters such as intercanine width and interpremolar width can be used successfully to calculate the stature of an individual from fragmentary remains.

Salivary duct cyst on lower lip: A rare entity and literature review

Mucocele forms because of salivary gland mucous extravasation or retention and is usually related to trauma in the area of the lower lips. Salivary duct cyst, however, is a type of mucous retention cyst which is almost never located on the lower lip. The aim of this paper is to report this extremely rare salivary duct cyst present on the lower lip and to critically review the literature to build important concepts that would help clinicians in the diagnosis and treatment of this pathology.

HPV involvement in OSCC: Correlation of PCR results with light microscopic features

Objectives: The study evaluated pathognomic histopathological features with the help of light microscopy for detecting the integration of human papillomavirus (HPV) (type 16 and 18) in oral squamous cell carcinoma (OSCC). Materials and Methods: Forty-five histopathologically diagnosed cases of OSCC were evaluated for the presence of E6/E7 protein of HPV (16 + 18) with the help of nested multiplex polymerase chain reaction. Both HPV-positive and -negative cases were evaluated for four histological features: Koilocytes, dyskeratosis, invasion, and alteration of collagen. Results: Fischers exact test showed significant difference (P < 0.01%) for the presence of koilocytes and dyskeratosis, whereas no difference was observed for invasion and alteration in collagen between HPV-positive and -negative OSCC. Conclusion: The presence of koilocytes and dyskeratosis at light microscopic level can be used as a marker for the presence of HPV (type 16 and 18) in OSCC.

Telomerase: An exploration toward the end of cancer

Background: The distinguishing feature of cancer cells is their ability to proliferate indefinitely, which is in contrast to the restricted cell multiplication potential for somatic cells. A better understanding of this contrasting behavior was provided in the early 1990s with the discovery of a relationship between telomeres, telomerase, aging, and cancer. Telomeres (tandem repeat DNA sequence TTAGGG) are protective caps at the ends of human chromosomes. Normal human cells experience telomere shortening with each successive cell division. However, in tumor cells, an overexpression of telomerase confers limitless replicative potential to tumor cells by continuous elongation of telomeres. The objective of this review was to systematically assess the data available on telomerase expression in oral cancer, with special reference to its role in diagnosis, prognosis, and treatment. Materials and Methods: A systematic review of studies that investigated the telomerase expression in oral squamous cell carcinoma (OSCC) was registered with PROSPERO. Subsequent to registration, a predetermined search strategy in accordance with PRISMA guidelines was formulated, and a literature search was conducted using online databases along with hand searching. Results: Eighty-nine articles from PubMed, 83 from Scopus, 5 from BioMed Central, 43 from Google Scholar, and 2 from hand search were identified. A total of 21 articles were shortlisted that met strict inclusion and exclusion criteria and quality assessment. Each study was evaluated for the markers under study, type of sample used, study design/methodology, and statistical analysis. The studies were then grouped into three subheads depending on their implications in the diagnosis, prognosis, and treatment of OSCC. Conclusion: This review explains the basic biology and the clinical implications of telomerase-based diagnosis and prognosis, the prospects for its use in anticancer therapy, in the context of oral cancer.

Role of heat shock proteins in oral squamous cell carcinoma: A systematic review

BACKGROUND Environmental and patho-physiologic stresses stimulate synthesis of heat shock proteins (HSPs) which enable the cell to survive and recover from stressful conditions, by as yet incompletely understood mechanisms. Heat shock proteins show an increased expression in a wide range of human cancers and have been associated with tumor cell proliferation, differentiation, invasion, metastasis, death, and recognition by the immune system. Yet the role of heat shock proteins in oral cancer is ambiguous. The objective of this review was to systematically assess the data available on the role of HSP expression in oral cancer with special reference to its role in diagnosis, prognosis and treatment. METHODS AND RESULTS A systematic review of studies that investigated the HSP expression in oral squamous cell carcinoma using Scopus, Medline, Embase and Google scholar databases from their inceptions to 2013, without language restrictions was conducted. We selected 24 studies from which data extraction and validations were performed. CONCLUSION The literature search revealed differential expression of HSPs during oral tumorigenesis with implications for the specific role of HSPs in the pathogenesis of oral cancer. HSP expression has been regarded as an independent prognostic factor for oral squamous cell carcinoma patients and HSPs are being explored as potent vehicles for delivery of preventive and treatment vaccines in cancer and other diseases.