Sunitha Carnelio

Oxidative stress and antioxidant defense in oral lichen planus and oral lichenoid reaction

Abstract Background. Oral Lichen Planus (OLP) is an inflammatory disease of unknown etiology while Oral Lichenoid Reaction (OLR) is a condition mimicking OLP. As these conditions are exposed to oxidative stress, they could release reactive oxygen species (ROS) which are implicated in the pathogenesis of a plethora of inflammatory conditions to lethal diseases. We evaluated and compared the levels of a series of oxidative stress markers in patients with OLP and OLR with that of normal controls and tried to identify the role of these oxidative stress markers in these conditions. Methods. Protein thiol oxidation, malondialdehyde (MDA) and total antioxidant activity were estimated in both the groups (OLP and OLR) and compared with that of normal subjects. Results. There were significantly lower levels of serum protein thiols in OLP (p < 0.005) while in patients with OLR the difference was not statistically significant (p < 0.489) when compared with controls. Serum MDA levels were significantly higher in OLP (p < 0.001) and OLR (p < 0.001) than in controls. However, there was no significant difference in serum MDA levels between OLP and OLR patients (p >0.05), but with a significant difference in serum thiol levels between the two (p < 0.047). Total antioxidant levels were lower in OLP (p < 0.016) and OLR (p < 0.017) when compared to normal subjects, while between the study group total antioxidant levels were not significantly different (p < 0.632). Conclusions. The findings from the present study demonstrate involvement of ROS in the pathogenesis of OLP and OLR, though both these disease conditions have a different clinical course.

Definite, probable or dubious: antioxidants trilogy in clinical dentistry

Recent years have shown the presence of free radicals in causation and progression of various dental diseases and antioxidant usage in dental therapeutics. Antioxidant micronutrients are important not only for limiting oxidative and tissue damage, but also in preventing increased cytokine production, which is a result of prolonged activation of the immune response. There has been a widespread availability and clinical claims on the safety and efficacy of antioxidants. However, lack of randomised controlled trials in dental research limits their usage. There is a substantial gap between these clinical claims and efficacy/safety of antioxidants in dental therapeutics which needs to be addressed. This article highlights the clinical significance of antioxidant therapy in dental practice and touches upon controversial areas and research lacunae. An evidence based approach for making recommendations about antioxidant usage and efficacy in routine dental practice seems to be the need of the hour.

A Brief Review of Common Oral Premalignant Lesions with Emphasis on Their Management and Cancer Prevention

Long-term outcomes associated with oral cancer and its management over the past several decades has caused concern and the value of mass oral cancer screenings has come under scrutiny. Though not all oral carcinomas are preceded by premalignant lesions as clinically visible morphological alterations occur secondary to the cellular or molecular changes, certain high risk lesions have been identified. Their management remains controversially polarized between surgical excision to prevent malignant change and conservative medical or surveillance techniques. Though oral cancer is one of the “major killers” of modern times, there seem to be no widely accepted criteria for decision making in clinical practice, the evidence base is scanty and uncertainty persists throughout investigation, diagnosis, and treatment. In this article, we have briefly discussed the common premalignant lesions, with an emphasis on their evidence based management and prevention.

Role of Immunomarkers in the Clinicopathological Analysis of Unicystic Ameloblastoma

Purpose. The clinical behavior of unicystic ameloblastoma varies according to its subtype. The assessment of its proliferative capacity, neovascularization, and invasiveness using relevant immunomarkers may aid in appropriate surgical therapeutic protocol. Methods. 18 cases of clinically and histologically confirmed unicystic ameloblastoma, categorized as luminal, intraluminal, or mural subtypes, were analyzed retrospectively. Immunomarkers such as Ki-67, CD34, MMP-2, and MMP-9 were studied to evaluate their behavior. Results. Labeling index of Ki-67 was 4.25% in the intraluminal subtype, compared with 2.14% in the luminal and 4.04% in the mural variant (P = 0.3). CD34 immunostaining was significantly higher in the mural variant (43 per high power field) than the other two subtypes (P = 0.04). MMP-2 and MMP-9 were strongly expressed in mural, moderately in intraluminal, and weakly to absent in luminal variant. Conclusions. High proliferative index, angiogenesis, and protease activity in the mural ameloblastoma, ascertained by the expression of these markers, confirm its aggressive phenotype. The intraluminal and luminal subtype exhibiting decreased expression are compatible with their indolent clinical behavior.

Expression of tenascin and nucleolar organizer region in ameloblastoma and ameloblastic fibroma

BACKGROUND The aim of this study was to assess the expression, distribution and comparison of tenascin, a glycoprotein of the extracellular matrix in ameloblastoma and ameloblastic fibroma, both odontogenic neoplasms with diverse biological behavior and to understand the proliferative activity by using the morphometric analysis. METHODS Paraffin embedded tissue from 25 cases of odontogenic tumors i.e., ameloblastoma (n = 15) and ameloblastic fibroma (n = 10) were used. The expression of tenascin was evaluated using immunohistochemistry. Morphometric analysis of nucleolar organizer regions (NORs) from ameloblastoma and ameloblastic fibroma was carried out by silver staining. RESULTS A heterogeneous expression of tenascin was found in ameloblastoma which was mainly localized at the epithelial-mesenchymal interface and a patchy distribution was observed in the stroma (80%), while strong positivity was observed in the stroma and at the basement membrane zone of ameloblastic fibroma (100%). argyrophilic nucleolar organizer regions (AgNORs) revealed higher mean counts in ameloblastoma (3.093 +/- 0.902) when compared with those of ameloblastic fibroma (1.553 +/- 0.250). Ameloblastoma presented more than two NORs (two to five) per nucleus in majority of the cells, while ameloblastic fibroma exhibited only one NORs per nucleus. CONCLUSIONS Expression of tenascin in these neoplasms suggest that it could play a role in epithelial- mesenchymal interaction, while AgNORs reveal that ameloblastomas are more aggressive when compared with ameloblastic fibromas.

Expression of epithelial cell adhesion molecule (EpCAM) in oral squamous cell carcinoma

To study the expression of epithelial cell adhesion molecule (EpCAM) in oral squamous cell carcinoma (OSCC) by immunohistochemistry and investigate its association with various clinicopathological parameters, including patient survival.

Oral Candida carriage among individuals chewing betel-quid with and without tobacco: an observation

To the Editor: The study by Javed et al. was aimed at assessing oral Candida carriage and comparing the prevalence of different Candida species present among individuals chewing betel-quid with and without tobacco use. It is an interesting and unique study that gives us significant data on Candida speciation among the patients. There are a few items in the article on which we would like clarification. Therefore, I humbly request that the following points be addressed:

Fascin in tooth germs: an immunohistochemical analysis

Abstract Development of a tooth is a complex process that involves three stages namely bud, cap and bell which results from the interaction of cells of oral mucosa and neural crest. During this process, oral and neural crest cells undergo various changes resulting in proliferation, apoptosis, morphological, and cyto-differentiation, which in turn would have changes in the cytoskeletal framework of the cell that includes actin and tubulin. Fascin is an actin-bundling protein that cross-links individual actin filaments into straight, compact, stiff bundles, which are crucial for the formation of finger-like membrane protrusions and aids in cell migration but is less explored in tooth germs. The aim of this study was analyze the expression and distribution of fascin in various stages of human tooth germs. Twenty human tooth germs were stained with hematoxylin and eosin and with immunohistochemical staining for fascin. Strong membranous expression for fascin was observed in various stages with decreased expression in stellate reticulum from cap stage to bell stage. Also, outer enamel epithelial cells had a weak fascin expression. Although cells of dental papilla did not express fascin in early cap stage of tooth development, strong expression of fascin was observed in later bell stages. It was also observed the inner enamel epithelium close to areas of calcification showed a decreased expression. Thus, the expression of fascin in various stages of tooth development being site and time specific may play an important role in cell remodulation.

A LINGUOVERTED IMPACTED TOOTH WITH OROCUTANEOUS FISTULA – A RARE CASE REPORT

The orocutaneous fistulous tract of odontogenic origin is often a diagnostic challenge, due to its rare manifestation and absence of dental signs and symptoms. The odontogenic cutaneous fistula is often misdiagnosed as a superficial skin lesion of non-odontogenic origin delaying the treatment. The diagnosis and treatment must be precise and swift to improve the clinical outcome and minimize the complications. This article presents a rare case of odontogenic keratocyst involving a linguoverted impacted third molar presenting as orocutaneous fistula. The patient was initially treated with empirical antibiotic therapy with no resolution of the cutaneous fistula and thickening of the skin around the sinus opening resulting in cosmetic deformity. Once the fistula was attributed to the underlying odontogenic cyst, treatment was done by cyst enucleation along with the extraction of tooth and fistula excision. The purpose of the paper is to emphasize the importance of early and accurate diagnosis and prompt management of the orocutaneous fistula due to the odontogenic origin.