Sudeendra Prabhu

Odontometric sex assessment from logistic regression analysis

Odontometric sex assessment is considered a useful adjunct to more robust predictors such as pelvic and cranial bones, and discriminant function analysis (DA) has been widely applied in dental sex assessment. Logistic regression analysis (LRA) is considered a better alternative, although still untested in odontometric sex prediction. This study examines the use of LRA in dental sex assessment and compares its success to DA. Mesiodistal and buccolingual dimensions of all teeth, except third molars, were obtained on dental stone casts of 105 young adults (52 females, 53 males) using digital caliper. Application of LRA to teeth of both jaws combined and to maxillary and mandibular teeth separately yielded correct sex allocation rates ranging from 76% to 100%, which proved superior to sex assessment using DA (∼52–71%). LRA enabled optimal sex prediction (100%) when all teeth in both the jaws were included. Results were not as accurate when only maxillary (76.2%) or mandibular (84.8%) teeth were used. To assess and compare the use of these multivariate techniques in practical forensic casework, >25% of tooth variables were randomly deleted. LRA still performed better (∼91% sex allocation accuracy vs. 62.9% for DA), indicating that LRA may be superior in its ability to predict sex irrespective of the presence of complete or incomplete sets of dentitions and should be preferred in dental sex assessment. The 100% success rate of LRA in correctly assigning sex is also noteworthy considering that, in general, tooth measurements have yielded sub-optimal sex prediction levels. However, unambiguous sex assessment is possible only when the entire dentition is available and correct sex allocation levels decreases when teeth are missing.

Glandular odontogenic cyst mimicking central mucoepidermoid carcinoma

Glandular odontogenic cyst (GOC) is a rare developmental cyst of the jaws. The most common site of occurrence is the anterior mandible, and it is most commonly seen in middle-aged people. It is a destructive lesion with a high rate of recurrence. A predilection for men is observed. Clinical and radiographic findings are not specific, and it can mimic as any other destructive lesion of the jaw. The histopathological features of GOC and those of low-grade central mucoepidermoid carcinoma (MEC) are similar. Often, they are misdiagnosed as MEC. We present a case of GOC in the posterior maxilla, which is a rare site. The similarities and differences between GOC and central MEC are also discussed.

Fibro-osseous lesions of the oral and maxillo-facial region: Retrospective analysis for 20 years

Background: Fibro-osseous lesions (FOLs) are one of the commonest entities reported in the head and neck region. However, studies on these groups of lesions on Indian population were not carried out before. So this motivated us to analyze the clinico-pathologic correlation of fibro-osseous lesions reported at our hospital. Materials and Methods: A retrospective review was made of all the lesions surgically treated in our hospital. A total of 6,175 biopsies were performed during the study period. All the cases which were histopathologically diagnosed as FOLs were included in the study. The demographic data, radiographic features, and histopathologic findings were analyzed and compared with similar studies on other races. Results and Conclusion: We could find 80 cases diagnosed as fibro-osseous lesions and information about them was documented. The most common FOL reported in the region was cemento-ossifying fibroma (COF) (75%) than fibrous dysplasia (FD) (25%). These were commonly occurring in 2nd decade without any sex or site predilection. However, COF was showing a slight female predominance and FD with a definite male predominance. COF was commonly seen in mandible (posterior region) whereas FD mainly confined to the maxilla (as a whole bone). Radiographically, most of COF showed well-defined mixed opaque and lucent areas whereas FD showed diffuse borders. Cortical plate expansion and resorption of associated teeth was a frequent finding in COF when compared with FD. Histopathologically, stroma was fibrocellular in many cases of COF, whereas most FDs showed fibrous stroma, interspersed with mainly woven bone.

Are teeth useful in estimating stature

Estimating stature is an important step in reconstructive identification of skeletonized and dismembered human remains. While numerous body parts such as the skull and long bones have been used for the purpose, the dentition has seldom been applied. The present study has ventured to ascertain the usefulness of tooth crown measurements in stature prediction. Buccolingual and mesiodistal dimensions of all teeth (except third molars) and stature measurements were obtained from 95 living adults (47 females, 48 males). Correlation analysis revealed that 21 of the 56 tooth crown variables had a low albeit statistically significant correlation to stature (p < 0.05); correlation matrix computed for the crown variables showed significant inter-correlations between most teeth (problem of multi-collinearity). Therefore, instead of regular least square regression analysis, ridge regression was performed for the dentition, which revealed a moderate but statistically significant correlation to stature (R = 0.68; p < 0.0001). The ridge regression equation derived had a standard error of estimate (SEE) of 8.09 cm. The multiple correlation for tooth dimensions is lower to, and the SEE larger than, most other body parts. The moderate correlation is probably due to early completion of growth of tooth crowns vis-à-vis other parameters such as long bones that mature later and have a higher stature-correlation. This indicates that the dentition may be used only as a supplement to more robust indicators of stature.

Etiopathogenesis of orofacial clefting revisited

The cleft anomaly may be more ancient than the man himself. It is one of the most common developmental malformations reported in the literature. There are number of intriguing theories regarding its etiopathogenesis, each of which has some evidence in its favor. This review highlights all the genetic and environmental etiologic factors and focuses on its pathogenesis.

Inflammatory pseudotumor of maxillary sinus: Mimicking as an aggressive malignancy.

Inflammatory pseudotumor is a rare entity in the head and neck region. Clinically it behaves as an aggressive lesion with extensive destruction but considered to be a benign reactive process. Because of its extensive involvement and infiltrative nature, it is confused as a malignancy. Most of them respond very well to corticosteroid and surgical excision.

Comparing the efficacy of coconut oil and xylene as a clearing agent in the histopathology laboratory

Background: The commonly used clearing agent, xylene is supposed to be highly toxic and carcinogenic. As previous research studies have shown the effectiveness of different vegetable oils as clearants, this study was designed to evaluate the efficacy of coconut oil. Materials and Methods: Two equal halves of 60 soft tissue specimens were processed simultaneously in xylene and coconut oil as clearing agents. The Xylene-treated specimens (XY-S) and Coconut oil–treated specimens (CO-S) were checked for gross and histological features and comparison was done between the two groups. Results: Significant shrinkage was noted in XY-S compared to that in CO-S. No difference was found in either of the sections when checked for cellular details and staining quality. Morphometrically, there was significant reduction in the mean cell area in XY-S compared to that in CO-S. Conclusion: Coconut oil may be substituted for the highly hazardous xylene as a clearing agent without compromising the quality of histological details.

Immunohistochemical Expression of Calretinin in Ameloblastoma, Adenomatoid Odontogenic Tumor, and Keratocystic Odontogenic Tumor: A Comparative Study

Calretinin is expressed primarily in the central and peripheral nervous system and extensively studied in colon adenocarcinoma and mesotheliomas. Calretinin is known to be expressed in the odontogenic epithelium and odontogenic tumors. However, the role of calretinin in the pathogenesis of odontogenic tumors is yet to be confirmed. Hence, the aim of the present study was to evaluate the expression and role of calretinin in selected odontogenic tumors. The study included 30 ameloblastomas, 30 adenomatoid odontogenic tumors, and 30 keratocystic odontogenic tumors. Staining intensity, pattern, and localization of the immunopositive cells were determined. Statistical analysis was performed using Mann-Whitney U test and Kruskal-Wallis analysis of variance test. P-values <0.05 were considered to be statistically significant. Results showed that 90% ameloblastomas and 80% keratocystic odontogenic tumors were immunopositive to calretinin, whereas none of the adenomatoid odontogenic tumors showed reactivity. Intensity was higher in the ameloblastomas compared with the keratocystic odontogenic tumors. Statistically significant differences were observed when the expression of calretinin was compared, except between the ameloblastoma and keratocystic odontogenic tumor. However, the intensity of calretinin was significantly higher in the ameloblastoma when compared with the keratocystic odontogenic tumor. On the basis of these results, it is suggested that calretinin might be used as a specific immunohistochemical marker for the ameloblastomas and could play an important role in the differentiation of aggressiveness of different odontogenic tumors. Depending on the cell regulatory processes, we suggest a possible role of calretinin in the pathogenesis of ameloblastomas and have to be further studied along with other proliferative cell cycle and apoptotic markers with larger sample size.

Heat shock protein (HSP70) as a marker of epithelial dysplasia in oral dysplastic lesions: A clinicopathological study

Objective: In the present study, expression of heat shock protein (HSP70) was evaluated and compared in oral dysplastic lesions, in particular leukoplakia (study group) and in normal mucosal tissues (control group). Additionally, correlation of HSP70 expression with clinical disease status was investigated. Subjects and Methods: A total of 60 fresh tissue specimens were obtained from the oral cavity, consisting of 30 dysplastic cases and 30 normal mucosal tissues. The presence of epithelial dysplasia and its histologic grading was evaluated. Immunohistochemistry was carried out with the monoclonal HSP70 antibodies and expression of cytoplasmic HSP70 within the epithelium was compared between dysplastic and normal mucosal samples using Students t-test. Results: Expression of HSP70 was detected in 93% of the oral dysplastic tissues and 20% of the normal mucosal tissues. Statistical significant difference in the HSP70 expression was seen between oral dysplastic tissues and normal oral mucosal tissues (P < 0.000). The interexaminer reliability was 93.3%. Statistical significant difference was seen in the HSP70 expression between controls and different grades of dysplasia (mild, moderate and severe). There was no relationship of HSP70 expression with clinical parameters like age, sex, site of the lesion, history of adverse habits and duration of adverse habits. Conclusion: In the present study, HSP70 activity was significantly higher in oral dysplastic (leukoplakia) group than in the control group. Further, as the grade of dysplasia increased, the staining intensity and/or distribution increased, indicating that enhanced HSP70 expression occurs during oral carcinogenesis. Hence, it is concluded that increased HSP70 immunoexpression could be an objective marker for the presence of epithelial dysplasia.

Recurrent cystic hygroma with calcification in an adult

Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in infants or children younger than 2 years. Herein, we present a case of recurrent cystic hygroma in a 22-year-old woman. History revealed that she had a similar lesion in the left submandibular region when she was 2 years old and in the thyroid region seven years back. This case has been reported for its unusual occurrence in an adult, showing recurrences at different sites and presence of calcification.