Pooja Aggarwal

Trends in the epidemiology of oral squamous cell carcinoma in Western UP: An institutional study

OBJECTIVE The purpose of the study was to identify trends in incidence rates of oral squamous cell carcinoma (OSCC) at specific anatomic sites or within specific age or sex groups in the Western Uttar Pradesh population. MATERIALS AND METHODS The study covers the period from January 2004 through April 2009. OSCC cases were retrospectively analysed for site, age, gender and habits and the findings were formulated to chart the trends in Western U.P. RESULTS The study revealed a male to female ratio of 2.2:1 with the largest number of OSCCs developing in the fourth and fifth decades of life. Overall, the most common site was the buccal mucosa (63.75%), followed by retromolar area (15%), floor of the mouth (11.25%), lateral border of the tongue (3.75%), labial mucosa (3.75%), and palate (2.5%). Smokeless tobacco habit was more prevalent than smoking tobacco in both men as well as women. Karl - Pearsons correlation coefficient was calculated to find the degree of association between the two variables i.e. between gender to buccal mucosa and gender to smokeless and smoking tobacco habits, which were found to be positively correlated with respect to the age. CONCLUSION Oral cancer is an important cause of morbidity and mortality worldwide with an incidence rate that varies widely by geographic location. Even within one geographic location, the incidence varies among groups categorized by age, sex, site or habit.

Incremental lines in root cementum of human teeth: an approach to their role in age estimation using polarizing microscopy.

Age estimation is an important factor in the identification of an individual in forensic science. The hard tissues of the human dentition are able to resist decay and degradation long after other tissues are lost. This resistance has made teeth useful indicators for age calculation. Recent research indicates that tooth cementum annulations (TCA) may be used more reliably than any other morphological or histological traits of the adult skeleton for age estimation. The purpose of this study was to examine the correlation between age and the number of incremental lines in human dental cementum and to ascertain the best method of studying cementum with respect to different forms of microscopy. Thirty nonrestorable teeth were extracted from 20 people, and longitudinal ground section of each tooth was prepared. Photomicrographs of the area at the junction of apical and middle third of the root under light and polarized microscope were taken. The cementum was composed of multiple light and dark bands that were counted on the photomicrograph with the help of image analysis software and added to the average eruption time of individual tooth. The predicted age of the individual was thus obtained. Results showed a significant correlation between the predicted age and actual chronological age of the individual. These data indicate that quantitation of cementum annuli is a moderately reliable means for age estimation in humans and polarizing microscopy is a better means of visualizing incremental lines of cementum compared to light microscopy.

Unicystic ameloblastoma of the mandible

Unicystic ameloblastoma refers to those cystic lesions that show clinical, radiographic or gross features of a jaw cyst but on histologic examination show a typical ameloblastomatous epithelium lining the cyst cavity, with or without luminal and/or mural tumor proliferation unicystic ameloblastoma is a less encountered variant of the ameloblastoma and believed to be less aggressive. As this tumor shows considerable similarities with dentigerous cysts, both clinically and radiographically the biologic behaviour of this tumor group was reviewed. Moreover, recurrence of unicystic ameloblastoma may be long delayed and a long-term post-operative follow up is essential for proper management of these patients. Here we are presenting a case of unicystic ameloblastoma in a 18 year old female patient.

Incidence of central giant cell granuloma of the jaws with clinical and histological confirmation: an archival study in Northern India

To record the demographics, and correlate histological findings in central giant cell granulomas (CGCGs) of the jaws with their clinical behaviour, 30 paraffin-embedded samples of CGCG were retrieved from the archives of the Department of Oral Pathology and Microbiology, Subharti Dental College, Meerut, India. The diagnosis in each case was made on the basis of clinical, radiographic, and histological findings. Data about age, sex, anatomical site, presentation, radiological features, and laboratory investigations were analysed. Histomorphometric analyses were made in each case with respect to the number of giant cells, mean number of nuclei and giant cells, fractional surface area occupied by giant cells, index of relative size, and mitotic activity. The peak incidence of CGCG was during the second decade of life with a slight female predilection, and the mandible was the most common site. Of the 30 samples considered, 20 tumours were classified clinically as non-aggressive, and 10 as aggressive, based on their clinical behaviour. Histomorphometric analysis showed significant changes between the two groups with respect to the number of giant cells, the fractional surface area, and the mitotic activity. The data obtained showed clinical and histomorphometric features that may be reliable indicators for the differentiation between aggressive and non-aggressive CGCG. These data should be taken into consideration to improve planning of individual treatment and follow-up.

Mucormycosis of maxillary sinus

Mucormycosis is a fungal infection commonly affecting structures in the head and neck, such as air sinuses orbits and the brain. Common predisposing factors include diabetes and immunosuppression. One such case of mucormycosis associated with diabetes mellitus reported to Subharati Dental College, Meerut.

Aggressive growth and neoplastic potential of dentigerous cysts with particular reference to central mucoepidermoid carcinoma.

Epidermoid carcinoma and mucoepidermoid carcinoma that arise centrally within the jaws are often associated with dental cysts. Central mucoepidermoid carcinoma of the jaws is rare, and usually presents in the fourth to eighth decades; we know of only 7 cases that have been described in children younger than 16. Here we describe a central mucoepidermoid carcinoma in an 8-year-old girl that arose from a dentigerous cyst associated with an unerupted mandibular molar.

Primary intraosseous squamous cell carcinoma in odontogenic keratocyst: A rare entity.

Squamous cell carcinoma (SCC) arising from the wall of an odontogenic cyst (also known as primary intraosseous carcinoma) is a rare tumor which occurs only in jaw bones. This tumor was first described by Loos in 1913 as a central epidermoid carcinoma of the jaw. Primary intraosseous carcinomas (PIOC) may theoretically arise from the lining of an odontogenic cyst or de novo from presumed odontogenic cell rests. According to the new histological classification of tumors of the World Health Organization, odontogenic keratocyst is nowadays considered a specific odontogenic tumor and the PIOC derived from it is considered as a specific entity which is different from other PIOCs derived from the odontogenic cysts. The following report describes a case of such extremely rare entity that is primary intraosseous SCC of the mandible derived from an OKC in a 60-year-old male patient with brief review of literature.

Assessment of age of majority by measurement of open apices of the third molars using Cameriere's third molar maturity index

Aims and Objectives: Evaluation of biological age of a living subject around the legal cutoff age for adulthood has become a grave concern for forensic experts in India, mainly due to the consequences of criminal obligations in judicial proceedings. Thus, this study was planned to examine the open apices of third molars in discriminating between individuals who are aged 18 years or older and who are not 18 years or older and to assign a cutoff for estimation of the age of 18 years. Materials and Methods: Orthopantomographs of 1062 individuals (14 and 23 years) were assessed, to verify Camerieres third molar maturity index (I3M). The apical ends of the roots of the left mandibular third molar were analyzed. If the apical ends of the roots are completely closed, then I3Mis zero; otherwise, it is calculated as the sum of the distances between the inner sides of the two open apices divided by the tooth length. Results and Conclusion: The sensitivity of the test for 0.08 value was 74.7% for males and 66% for females. Specificity was 83.6% for males and 79.6% for females. The probability that an Indian individual with an I3M<0.08 in 18 years or older is 78% for males and 70.3% for females. I3Mis efficacious to determine age in Indian population.

Tuberculosis, the culprit behind nonhealing oral lesions: Report of two cases

Nonhealing painless lesions of long duration that did not respond to conventional therapy are the diagnostic challenge to clinician. Two such atypical cases of nonhealing oral lesions manifesting as gingival swelling and odontogenic cyst diagnosed histopathologically as primary oral tuberculosis are presented here. The purpose of this presentation is to point out that, in the absence of any apparent systemic infection the oral tuberculous lesions in the mouth may be discovered before the diagnosis of systemic tuberculosis and the histopathological finding of a persistent nonhealing oral lesion is an important aid in arriving at a diagnosis of this underlying condition.

Basaloid squamous cell carcinoma: Report of two cases with review of literature

Basaloid squamous cell carcinoma is a rare distinct histologic variant of squamous cell carcinoma of the head and neck region. Majority of them can be differentiated from squamous cell carcinoma by their aggressive clinical course and their histological features: the usual site of occurrence of basaloid squamous cell carcinoma is the upper areodigestive tract, floor of mouth and base of tongue. We hereby present two cases of a rare but aggressive basaloid squamous cell carcinoma, both affecting mandible.