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Osteosarcoma (OS) comprises 2.1% of all malignant oral and maxillofacial tumors. OS arising from the jaw OS differs from OS of the long bones in its biological behavior, presenting a lower incidence of metastasis and a better prognosis. The morphologic and behavioral heterogeneity observed in OS and the perplexity of the varied histological features mimicking other primary and metastatic bone tumors has emphasized the need of advanced molecular techniques in its diagnosis. Hereby, we present a case of OS which was diagnosed by immunohistochemical analysis, aiding in establishing its histogenetic origin.

Palisaded encapsulated neuroma (PEN) is a benign cutaneous or mucosal neural tumor which, usually, presents as a solitary, firm, asymptomatic, papule or nodule showing striking predilection for the face. It occurs commonly in middle age, and there is no sex predilection. Oral PEN are not common, and these lesions must be distinguished from other peripheral nerve sheath tumors such as the neurofibroma, neurilemma (schwannoma), and traumatic neuroma. The major challenge in dealing with lesions of PEN is to avoid the misdiagnosis of neural tumors that may be associated with systemic syndromes such as neurofibromatosis and multiple endocrine neoplasia syndrome type 2B. Here, we present a case of benign PEN of the gingiva in the left anterior mandibular region, laying importance on immunohistochemical staining in diagnosing such lesions.

Lymphomas are a group of malignant blood cell tumors that develop from lymphocytes representing 2.2% of all malignant neoplasms of the head and neck. Two main categories of lymphomas are Hodgkin's lymphoma and non-Hodgkin's lymphoma (NHL) of which 90% are of the NHL type. Several classification systems have existed for lymphomas, the objectives of which are to help in identification of homogeneous group of well-defined entities and facilitating the recognition of uncommon diseases that require further classification as it affects prognosis and therapeutic implications. Diffuse large B-cell lymphoma (DLBCL) is the most common NHL in the oral cavity involving Waldeyer's ring, base of the tongue, buccal mucosa and hard palate. DLBCL can be divided into germinal center B-cell-like, activated B-cell-like or type 3 gene expression profiles. This paper highlights a case report of DLBCL revisiting the intricacies and difficulties involved in establishing a diagnosis.

Lymphomas are a group of malignant blood cell tumors that develop from lymphocytes. Two main categories of lymphomas are Hodgkin and non-Hodgkin lymphomas (NHL), of which 90% are of the NHL type. The objectives of classifying is to help in the identification of homogenous group of well-defined entities and facilitating the recognition of uncommon diseases that further require classification as it affects prognosis and therapeutic implications. Nodal marginal zone lymphoma, also known as monocytoid B–cell lymphoma (MBCL), is an uncommon form of lymphoma representing 1.5%–1.8% of lymphoid neoplasms, with only rare reports in the literature that have attempted morphologic or immunophenotypic characterization. Specific markers for MBCLs are still lacking, so its diagnosis is based on exclusion of other small B-cell lymphomas. This article illustrates a case report of MBCL highlighting the intricacies and difficulties involved in establishing a diagnosis.

Malformations of vascular nature originate as anomalies caused due to errors in vasculogenesis. These tumors are generally broadly classified into vascular tumors (hemangiomas) and vascular malformations (venous malformations, arteriovenous malformations, lymphatic malformations). These descriptive tumors and malformations have been categorized based on the architectural assembly of vessels. Lymphangiomas are further subclassified microscopically into capillary, cavernous, cystic and lymphangioendothelioma, depending upon their histopathological features. Lymphatic malformations or lymphangiomas are uncommon congenital malformations of the lymphatic system, usually occurring in the head and neck region, characterized by collections of ectatic lymph vessels that form endothelial lined cystic spaces. Advancements in the knowledge of pathogenesis of such vascular malformations are continuously changing their treatment protocols. Early recognition is of utmost importance for initiation of proper treatment and avoiding serious complications. Hemangiolymphangioma is a variant of lymphangioma showing vascular component. Herewith, we present a case of vascular malformation diagnosed as hemangiolymphangioma histopathologically in a 9-year-old girl, along with a review of literature regarding its categorization.

Introduction: Human identification is based on scientific principles, mainly involving dental records, fingerprints, estimation of age, postmortem reports, differentiation by blood groups, and DNA comparisons. Sex assessment is one of the prime factors employed to assist with the identification of an individual. Aims and Objective: To investigate univariate sex differences in the dimensions of permanent first molars and to assess sex, based on buccolingual (BL) and mesiodistal (MD) dimensions of permanent first molars in a population of north India. In addition, the study intended to evaluate the reliability of dimensional variation of these teeth in assessment of sex among the population. Materials and Methods: The study sample consists of 410 adult individuals (200 males and 210 females), from a north Indian population. The BL and MD diameters of the permanent first molars were measured using digital vernier callipers. Results: It was observed statistically significant difference between males and females with P < 0.05, in maxillary casts in both BL and MD dimensions; but only in the MD dimension in mandibular casts. A high level of sexual dimorphism of 7.7% was found in the BL dimension of the maxillary right first molar. The accuracy of sex assessment by each dimension was deliberated by univariate analyses with an overall accuracy ranging from 67.5 to 88% for various dimensions. Conclusion: Sexual dimorphism of teeth is population specific and among north Indian population, BL and MD dimensions in maxillary first molar and MD dimension in mandibular first molar can be used for sex assessment.

Objective The primary objective of this study was to estimate and secondary objective was to compare the serum calcium levels and serum parathyroid hormone (PTH) levels in post-menopausal women with and without oral dryness (OD). Materials and Methods A case–control study was carried out on 80 selected post-menopausal women. Salivary flow was assessed by flow rate; serum calcium concentrations were assessed through Semi Autoanalyzer by Arsenazo III reaction. The serum PTH concentration was measured by the enzyme-linked immunosorbent assay. Severity of OD was assessed by a questionnaire through which the xerostomia inventory (XI) score could be measured. Statistical analysis of Student's t-test, Mann–Whitney test and Pearson's correlation was used. Results There was a significant difference in mean values of both serum PTH concentration and XI score in post-menopausal women with/without OD (p

The aim of this study was to determine awareness of biomedical waste (BMW) management policies and practices among dental professionals and auxiliary staff in a dental hospital/clinics in Amritsar, India, to inform the development of future policies for effective implementation of BMW rules.The study involved 160 staff members at the Amritsar hospital/clinics (80 dentists and 80 auxiliary staff) to whom a questionnaire was distributed regarding policies, practices and awareness relating to BMW. The questionnaire was first piloted. Completed questionnaires were returned anonymously. The resulting data were statistically tested using the chi-square test for differences between the dentists and auxiliary staff.In respect of BMW management policies, there was a highly significant difference in the responses of the dentists, whose answers suggested far greater knowledge than that of the auxiliaries (P0.001). Regarding BMW management practices, the dentists were significantly more aware (P0.001) of the method of waste collection in the hospital and the disposal of various items into different colour-coded bags. As for employee education/awareness, there was a significant difference (P0.05) between the dentists and the auxiliaries on the question regarding records of BMW maintained in the hospital and the other responses to questions on these topics had a highly significant (P0.001) difference between the two groups in favour of the dentists.The results of this study have demonstrated a lack of awareness of most aspects of BMW management among dental auxiliary staff in the dental hospital/clinics in Amritsar and a lack of awareness of some aspects among dentists who work in the hospital/clinics. The results provide the hospital authorities with data upon which they can develop a strategy for improving BMW management.

Objective: To assess inter and intra observer variability in grading oral epithelial dysplasia (OED) using Smith and Pindborg grading system, WHO classification system and Brothwell DJ et al. classification system. Study design: In the study 45 histological tissues of dysplasia, 15 each of mild, moderate and severe dysplasia were coded and blindly graded by three observers in three grading systems. Further on the same observers graded 15 slides again of the previous 45 for analyzing the reproducibility in the three grading systems. The individual significance of various indicators of dysplasia among various grades of dysplasia was also assessed. Result: Inter observer agreement was significantly higher in Brothwell system as compared to WHO and Smith and Pindborg system. Intra observer agreement was significantly higher in Smith and Pindborg system, but the predictability and the probability index was distributed over a larger range in this system. Each indicator of dysplasia was also found to be statistically significant (P

Herpes zoster (HZ) infection of the maxillary and mandibular divisions of the trigeminal nerve manifests orally as unilateral vesicular eruption localized to the skin and mucus membrane of the dermatome innervated by the trigeminal nerve. Herpes zoster infection has been observed in immunocompromised states like uncontrolled diabetes, cancer chemotherapy, lymphoproliferative diseases, and recently in HIV-positive patients. There are only a few case reports of osteonecrosis due to HZ in an HIV-positive patient in an Indian population, this being the first in a North Indian population. We propose that osteonecrosis should be considered as a strong indicator of HIV infection, especially in a developing country like India. The present case highlights the complexities which can arise in an HIV-inflicted individual suffering from HZ infection. Early diagnosis of such infections can lead to effective treatment and prevention of complications.

Background: Sexual dimorphism has been of great interest to anthropologists and odontologists. Dental measurements are important in anthropology for the study of sexual dimorphism with most common being the traditional linear odontometric measurements. Apart from these, alternative dental measurements have been developed such as the crown and cervical diagonal diameters and mesiodistal and buccolingual cervical diameters of teeth. Aims and Objective: The primary objective of the following study is to assess the degree of sexual dimorphism in teeth of a North Indian population using the crown diagonal diameters and secondary is to evaluate the applicability of diagonal measurements in sex determination by means of discriminant functional analysis. Materials and Methods: The study sample comprised 200 individuals (100 males and 100 females) of an age group ranging from 18 to 57 years, in a North Indian population. The mesiobuccal-distolingual (MBDL) and distobuccal-mesiolingual (DBML) crown diameters of seven maxillary and seven mandibular teeth on the study models were measured using digital Vernier calipers. Results: The most dimorphic teeth amongst all for crown diagonal diameters are the maxillary central incisors and the least dimorphic are the maxillary second premolars. The mean diagonal crown dimensions in all but one tooth (DBML of maxillary lateral incisor) of males exceeded that of females. The difference was statistically significant in MBDL dimensions of maxillary and mandibular central incisor, canine, first and second molar and DBML dimensions of maxillary central incisor and maxillary and mandibular canine, first molar and second molar (P < 0.05). The accuracy of determination of sex by MBDL crown dimension ranges from 55% to 75% in males and 47-84% in females, while by DBML crown dimension ranges from 55% to 80% in males and 65-80% in females with the overall accuracy of sex determination ranging from 51% to 80% respectively. Conclusion: MBDL and DBML crown dimensions are reliable indicators and can be used along with or/and instead of linear measurements in sex determination. In situations in which it is difficult to take correct measurements of linear dimensions of teeth, these alternative odontometric measurements can be used consistently to determine sex.

Background: Peripheral ossifying fibroma (POF) is a lesion of gingival tissue that predominantly affects women and is usually located in maxilla, anterior to molars. The definitive diagnosis is established by histopathological examination, which reveals the presence of cellular connective tissue with focal calcifications. Objective: This study hypothesizes the histogenesis of POF by analyzing the diverse spectrum of mineralized components with a polarizing microscope. Materials and Methods: A retrospective study was undertaken which involved a detailed review of clinical, radiographic and histopathological features of 22 cases of POF, retrieved from departmental archives. These cases were subsequently stained with a histochemical stain (van Gieson) and observed under a polarizing microscope. Results: The study revealed that the most common age of occurrence was in second and third decades with a strong female predilection (73%), Interdental papilla of the maxillary anterior region was the most commonly afflicted site. About 90% cases showed no radiographic features.Histopathological examination showed that 73% cases consisted of a fibrocellular connective tissue stroma surrounding the mineralized masses. 50% mineralized masses comprised of woven bone, 18% showed combination of lamellar bone and cellular cementum, 18% showed only cementum (cellular and acellular), and remaining 13.6% exhibited a mixture of woven and lamellar bone under polarizing microscope. Conclusion: The study supports the theory that POF develops from cells of periodontal ligament (PDL)/periosteum as undifferentiated mesenchymal cells having an inherent proliferative potential to form bone or cementum, whose nature can be confirmed by polarizing microscope.

Aim: Radiographic interpretation of a disease requires knowledge about normal structures. The calcifying jaw diseases can range from radiolucent areas to varying degrees of calcification. Therefore, it is vital to differentiate radiographically between various hard tissues. Materials and Methods: We have illustrated the use of computed tomography scan to quantify the calcified structures as dentin and enamel in a case of ameloblastic fibro-odontoma. Results: The enamel, dentin and cementum showed different values. Conclusion: The Dentascan can be used to distinguish the hard tissues in a variety of calcifying diseases of jaws.

Introduction: Giant cell granulomas (GCGs) of the jaws are lesions that arise either peripherally in periodontal ligament, mucoperiosteum, or centrally in the bone. Histologically, both peripheral and central giant cell granuloma (CGCG) are characterized by the presence of numerous multinucleated giant cells (MGCs) in a prominent fibrous stroma. CGCG are further categorized into aggressive and non aggressive variant. Case Report: The present case highlights the difficulty in diagnosing aggressive CGCGs from Giant cell tumors (GCT), with which they share similar histopathology, behaviour and prognosis. Discussion: The recurrent nature of the present case and the extensive destruction caused in the hard and soft tissues suggests the possibility of true ‘tumors’ (Giant cell tumors) existing in the jaw.