Rima A. Safadi

Prevalence of recurrent aphthous ulceration in Jordanian dental patients

BackgroundReviewing the literature, no studies were cited to report the prevalence of recurrent aphthous ulceration in Jordan. The aim of this study is to report the prevalence of recurrent aphthous ulceration in Jordanian subjects.MethodsA total of 684 dental patients who attended Jordan University of Science and Technology interviewed and administered to fill questionnaires related to history, size, shape, and duration of recurrent aphthous ulceration. Other related questions were also asked.ResultsAbout 78% of subjects experienced recurrent aphthous ulceration. Approximately 85% of ulcers were less than one cm in diameter, 66% were circular in shape, 92% were painful, 82% interfered with eating, and 55% located in lips and buccal mucosa. Only 50%of participants related ulcers to stress. Sixty eight percent reported no association with tiredness and 85% no association with types of food ingested. Of the 39% who had blood tests carried out, 7% had vitamin B12 and 4% hemoglobin deficiency.ConclusionRecurrent aphthous ulceration is a common problem in Jordanian adults.

Oral lichen planus shows higher expressions of tumor suppressor gene products of p53 and p21 compared to oral mucositis. An immunohistochemical study

OBJECTIVE Oral lichen planus (OLP) has been speculated to be a chronic inflammatory disease with potential for malignant progression. The aim of this study was to establish a hypothesis on the difference between OLP and oral mucositis (OM) in terms of tumor suppressor gene expression. DESIGN Computer based image analysis of immunohistochemical expressions of p53 and p21 was investigated in 18 samples of OLP, 10 normal oral epithelium (NOE), 10 oral squamous cell carcinoma (OSCC), 13 OM, 20 oral focal keratosis (OFK), and 30 samples of oral epithelial dysplasia (OED). Representative fields were digitized and analyzed. RESULTS Using independent samples Students t-test, p53 and p21 the mean percentages of positive nuclei (MPPN) of p53 (40.27%) and of p21 (39.98%) in OLP were significantly higher than that of NOE, OFK and OM (15.06%, 27.87%, 30.08% and 16%, 31.09%, 33.92% respectively, p<0.001). MPPN of p53 in OLP was not different from that of mild OED (40.5%, p=0.85) but lower than of moderate and severe OED, and OSCC (49.78%, 61.36%, 78.16% respectively; p<0.001). MPPN of p21 in OLP was lower than that of moderate and severe OED, and OSCC (47.72%, 57.9%, 85.44% respectively; p<0.001) but slightly higher than that of mild OED (39.86% p=0.81). CONCLUSIONS As the expression of p53 and p21 in OLP was significantly higher than that of oral mucositis with no significant difference from mild epithelial dysplasia, OLP might need to be followed up and monitored more closely to detect early features of transformation, if any, compared to non-specific oral mucositis which needs no close follow-up.

Prevalence of talon cusps in Jordanian permanent teeth: a radiographic study

BackgroundThe aim of the study is to investigate the prevalence of talon cusps in a sample of Jordanians dental patients and their distribution among different types of teeth.MethodsThe data were collected from radiographic examination of 3,024 periapical films showing 9,377 teeth from a random sample of 1,660 patients. A tooth was considered having talon cusp if there was a V-shape radiopaque structure superimposed the tooth structure.ResultsTalon cusps were detected in 52 teeth (tooth prevalence = 0.55%). Maxillary canines were the most commonly affected teeth (46% of cases), followed by maxillary lateral incisor teeth (39% of cases) and maxillary central incisors teeth (15% of cases). Teeth with talon cusps were found in 40 subjects (person prevalence = 2.4%). Bilateral talon cusps were seen in 12 patients.ConclusionsAttention should be paid to the presence of talon cusp and the treatment problems associated with it.

Immunohistochemical expression of K6, K8, K16, K17, K19, maspin, syndecan-1 (CD138), α-SMA, and Ki-67 in ameloblastoma and ameloblastic carcinoma: diagnostic and prognostic correlations

OBJECTIVE To identify cutoff values of markers that correlate with the histopathologic diagnosis of ameloblastic carcinoma (AC) and/or the increased recurrence potential of ameloblastoma (AB). STUDY DESIGN Immunohistochemical expression (IHCE) of 9 selected markers were investigated in 18 non-recurrent ameloblastomas (NRABs), 6 recurrent ameloblastomas (RABs), and 5 ACs. RESULTS No significant difference in IHCE of K6, K8, K16, K17, K18, K19, maspin, or syndecan-1 was observed among study groups. α Smooth muscle actin (α-SMA)-positive area in central epithelial cells significantly differentiated between AB and AC (P = .017; t -test). Ki-67 score significantly differentiated between AB and AC (P < .005; t -test) and between AC and RAB (P = .015; ANOVA/post hoc). CONCLUSIONS Ki-67 score of 75 cells/HPF (ROC curve) is a potential indicator of AC. Clinical recurrence of AB may be predicted by α-SMA expression pattern. Syndecan-1 and α-SMA may indicate a higher aggressive potential of AB when expressed in the stroma.

Immunohistochemical expression of keratins 6, 7, 8, 14, 16, 18, 19, and MNF-116 pancytokeratin in primary and metastatic melanoma of the head and neck.

OBJECTIVE To investigate the immunohistochemical expression (IHCE) of selected keratins in primary cutaneous and mucosal melanoma (pM), and metastatic melanoma (metsM) of the head and neck and to compare their expression to a group of undifferentiated/poorly differentiated tumors of the same anatomic region. STUDY DESIGN IHCE of K6, K7, K8, K14, K16, K18, and K19 were studied in 29 melanomas and 70 cases of non-melanoma tumors of the same anatomic region (neuroendocrine carcinoma, neuroblastoma, olfactory neuroblastoma, sinonasal undifferentiated carcinoma, undifferentiated nasopharyngeal carcinoma, anaplastic large cell lymphoma, poorly differentiated squamous cell carcinoma (PDSCC), and Ewing sarcoma). MNF-116 pancytokeratin was investigated in melanoma. RESULTS All studied keratins, except K6, were expressed in melanoma. IHCE of MNF-116, K8, and K18 was higher in metsM compared with pM. K14 and K16 expression was highest in PDSCC. CONCLUSIONS metsM expresses keratins more than pM, specifically K8, K18, and MNF-116. Keratin positivity in an undifferentiated or poorly differentiated neoplasm does not necessarily exclude the diagnosis of melanoma.

The significance of age group, gender and skin complexion in relation to the clinical distribution of developmental oral mucosal alterations in 5–13 year-old children

INTRODUCTION To describe the relationship and impact of age group, gender and skin complexion on the prevalence and clinical distribution of oral mucosal alterations of developmental origin (OMA-DO) among school children aged 5-13 years. METHODS A randomized representative national survey of Jordanian school children including all Country geographic areas was performed. Cut-off age that significantly correlated with presence and distribution of OMA-DO was identified (ROC curve). Skin complexion was classified into light/fair, intermediate/tan, dark/brown based on skin complexion index. Chi square test with P value≤0.05 was used for significance of correlations. RESULTS Two thousand two hundred and fifty one children were clinically examined. The average age that significantly correlated with prevalence and distribution of OMA-DO was 9.9 years. Female gender was significantly correlated with four OMA-DO: leukoedema (L), linea Alba (LA), Fordyces granules (FG), commissural lip pits (CLP) and wider distribution of racial pigmentations (RP) (P<0.05, χ2 test). Older age group (9.9-13 years) was significantly correlated with 7 OMA-DO: L, LA, FG, frenal tag, CLP, mandibular and maxillary tori (MT) as well as wider clinical distribution of RP, FG, L (P<0.05 χ2 test). Dark skin complexion significantly correlated with 5 OMA-DO: L, LA, FG, RP, MT and wider clinical distribution of RP (P<0.02, χ2 test). CONCLUSIONS Increased prevalence and wider clinical distribution of OMA-DO are significantly associated with older age group of 9.9-13 years, female gender, and dark skin complexion. Oral health care provides are encouraged to be familiar with these correlations. This knowledge is expected to improve OMA-DO diagnosis and clinical management. Continuous education programs in this field are recommended.

Sex determination using discriminant function analysis in Indigenous (Kurubas) children and adolescents of Coorg, Karnataka, India: A lateral cephalometric study

Aim: To test the validity of sex discrimination using lateral cephalometric radiograph and discriminant function analysis in Indigenous (Kuruba) children and adolescents of Coorg, Karnataka, India. Methods and materials: Six hundred and sixteen lateral cephalograms of 380 male and 236 females of age ranging from 6.5 to 18 years of Indigenous population of Coorg, Karnataka, India called Kurubas having a normal occlusion were included in the study. Lateral cephalograms were obtained in a standard position with teeth in centric occlusion and lips relaxed. Each radiograph was traced and cephalometric landmarks were measured using digital calliper. Calculations of 24 cephalometric measurements were performed. Results: Males exhibited significantly greater mean angular and linear cephalometric measurements as compared to females (p < 0.05) (Table 5). Also, significant differences (p < 0.05) were observed in all the variables according to age (Table 6). Out of 24 variables, only ULTc predicts the gender. The reliability of the derived discriminant function was assessed among study subjects; 100% of males and females were recognized correctly. Conclusion: The final outcome of this study validates the existence of sexual dimorphism in the skeleton as early as 6.5 years of age. There is a need for further research to determine other landmarks that can help in sex determination and norms for Indigenous (Kuruba) population and also other Indigenous population of Coorg, Karnataka, India.

Odontogenic myxoma with diffuse calcifications: a case report and review of a rare histologic feature

Calcifications have been rarely reported in odontogenic myxoma. We describe here an additional case and review all reported cases. A 45-year-old female patient presented with a gingival swelling around a mobile mandibular left second molar. Radiographic investigation revealed a large multilocular radiolucent lesion of the posterior mandible. Microscopic examination revealed an odontogenic myxoma with numerous newly formed trabeculae of bone or cementum-like material present throughout the specimen, reminiscent of those seen in fibro-osseous lesions of the jaws. After total excision, regular follow-up of the patient showed gradual healing of the surgical defect. To our knowledge, only a few documented cases of odontogenic myxoma with calcifications have been reported in the literature. This histopathologic finding is rare but should not lead to the misdiagnosis of a central odontogenic fibroma, cemento-ossifying fibroma, fibro-osseous lesion, or low-grade osteosarcoma.