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Background/Objectives: The present study aimed to test the efficacy of the chair-side rapid salivary C-reactive protein assay kit in differentiating oral potentially malignant disorders (OPMDs) and oral cancer from normal mucosa using whole salivary samples. Methods: In this study, unstimulated saliva samples of cases (OPMDs and oral cancer) and controls (systemically healthy subjects) were used to detect CRP levels using a novel colorimetric, quantitative rapid assay kit. Kruskal–Wallis ANOVA with a post hoc Dunn’s test were applied to determine the difference in the mean and SD values between the case and control groups. ROC analysis was performed to identify the positive and negative likelihood ratios. Results: The mean calculated salivary CRP level in the oral cancer group was 4.21 ng/mL, in the OPMD group it was 2.51 ng/mL and in the healthy controls it was 0.7 ng/mL. Post hoc tests showed that the salivary CRP levels were significantly higher in the oral cancer and OPMD groups than in the controls. Conclusions: The present study showed that the novel rapid salivary test kit could significantly differentiate between the salivary CRP values of cases and controls but there was no significant difference between the OPMD and malignancy groups. It also showed higher sensitivity values, confirming the efficacy of this kit as a screening tool.

A patient with a successfully treated primary osteosarcoma of the tibia experienced an isolated maxillary metastasis, which is an extremely rare entity. Once the tumor was confirmed histopathologically, a total maxillectomy and adjuvant chemoradiation therapy were carried out. There has been no local recurrence or distant metastasis for 1 year. A multimodality therapeutic approach is essential when these patients are treated. Surgery is the gold standard of treatment in operable cases. Adjuvant treatment is required to prevent local recurrence and distant metastasis. [ABSTRACT FROM AUTHOR]

Background: E-cadherin plays an important role in cell-to-cell adhesion and cell motility and its loss is associated with oral squamous cell carcinoma (OSCC) progression. The aim of this study was to determine the expression of E-cadherin in various grades of OSCC and to correlate changes in the expression between these various grades and metastatic lymph nodes.Materials and Methods: Immunohistochemistry (IHC) was used to detect E-cadherin expression in normal oral mucosa, primary OSCC (n = 37), and metastatic lymph nodes (n = 10). E-cadherin immunoreactivity was correlated with grades of differentiation and with clinicopathological features.Results: E-cadherin immunoreactivity was found to inversely correlate with the loss of cell differentiation. The expression of E-cadherin decreased significantly in advanced cases of OSCC. However, increase in E-cadherin immunoreactivity was seen in early lesions, that is, in well differentiated (n = 9) and moderately differentiated OSCC (n = 13). Furthermore, E-cadherin was negative in majority of metastatic lymph nodes (7/10).Conclusions: Loss of the cell adhesion and E-cadherin plays an important role in progression of OSCC, that is, down regulation of its expression is associated with de-differentiation and metastasis. [ABSTRACT FROM AUTHOR]

Oral Squamous cell carcinoma is a serious oral health problem. The structure and behavior of this neoplasm varies greatly. Advances in scientific technology, has paved the way to comprehend the genetic changes a keratinocyte undergoes during carcinogenesis. The knowledge of the molecular mechanism underlying this neoplasm enables assessment of its behaviour and above all is the foundation for developing biologic therapeutics to target specific molecules. A few relevant diagnostic modalities are briefly described and their importance highlighted [ABSTRACT FROM AUTHOR]

Fibromatosis or desmoid tumors are locally aggressive neoplasms that have a propensity for local invasion and recurrence. The mainstay of treatment is excision with negative margins and the role of radiotherapy is controversial. Desmoids arising in the head and neck area are rare and pose a dilemma to the surgeon due to large number of vital structures that preclude resection with wide margins. This leads to a high incidence of recurrence. We present a case of a 24-year-old male who presented with an asymptomatic left sided facial swelling causing cosmetic deformity. A subcutaneous lipoma/fibroma/neuroma was suspected and a fine needle aspiration done was inconclusive. Computed tomography revealed a subcutaneous swelling that was excised. Histopathology revealed it to be a desmoid tumor. At the end of 4-year-follow-up, he has no local recurrence.

Background: Various stemness markers (SOX2, OCT4, and NANOG) have been studied in odontogenic cysts and tumors. However, studies on SALL4 having similar properties of stemness has not been documented. Additionally, insight into fascin as a migratory molecule is less explored. In this study, the expression of SALL4 and fascin were evaluated in ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst (DC), radicular cyst (RC), and calcifying odontogenic cyst (COC)., Methods: Semi-quantitative analysis of fascin and SALL4 immuno-positive cells was done in a total of 40 cases of ameloblastoma (11 plexiform, 12 follicular, 12 unicystic, and 5 desmoplastic) variants, 6 cases of AOT, 15 each of OKC, DC, RC and 5 of COC. Chi-square test was applied to evaluate the association between SALL4 and fascin expression in odontogenic cysts and tumors., Results: Fascin immunopositivity was observed in peripheral ameloblast-like cells, and the expression was weak or absent in stellate reticulum-like cells. A moderate to weak immune-reactivity to SALL4 was observed in the cytoplasm of ameloblastoma, epithelial cells of dentigerous and radicular cysts, having a marked inflammatory infiltrate, which was an interesting observation. COC and AOT had negative to weak expressions. No recurrence has been reported., Conclusions: Expression of fascin in ameloblastomas elucidate their role in motility and localized invasion. Its expression in less aggressive lesions like DC, COC, AOT will incite to explore the other functional properties of fascin. SALL4 expression in the cytoplasm of odontogenic cysts and tumors may represent inactive or mutant forms which requires further validation., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Kulkarni S et al.)

Nasopalatine duct cyst, which is also known as incisive canal cyst, is the most common developmental cyst of the maxilla. It arises from the proliferation of the remnants of the nasopalatine duct stimulated by trauma or infection. In this article, the authors report a rare case of an extensive nasopalatine duct cyst in a 57-year-old Male associated with non-vital tooth. Clinical examination revealed facial asymmetry associated with swelling that is painful and tender. Correlating clinical and radiological findings, a diagnosis of nasopalatine duct cyst was formed, and the histopathological examination confirmed the diagnosis of nasopalatine duct cyst. This case highlights the importance of knowing that nasopalatine duct cyst can be associated with non-vital teeth, challenging the assumption that they are exclusively associated with vital teeth., Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04513-1., Competing Interests: Conflict of InterestThe authors have no conflict of interest to declare that are relevant to the content of this article., (© Association of Otolaryngologists of India 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Giant cell fibroma is a benign oral fibrous tumour. The clinical appearance of majority of non-neoplastic fibrous growths is similar, but unique histopathological features of giant cell fibroma aid in its final diagnosis. It usually manifests as an asymptomatic, sessile or pedunculated mass usually less than 1 cm in diameter. In this case report, we highlight a case of giant cell fibroma in a 58-year-old male patient, which had an unusual size with associated pain. Although giant cell fibromas are benign lesions, it is important for dentists to be aware of this lesion based on its frequency of occurrence and need for its accurate diagnosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Oral and Maxillofacial Pathology.)

Myofibromas are fibrous tumours that could be of familial or non-familial origin, belonging to the fibroblastic and myofibroblastic subset with a wide spectrum of clinical behaviour. Oral myofibromas present with a broad range of differential diagnoses, including benign and malignant lesions. Histopathologically, these lesions may imitate many other soft tissue tumours of the oral cavity, such as spindle cell tumours of nerve, smooth muscle cell origin, and other myofibroblastic lesions, thus leading to misdiagnosis and mistreatment. In the present paper, we report a soft tissue lesion, which presented as a growth on the gingivobuccal sulcus in a 7-year-old child. We also emphasise the various differential diagnoses that need to be eliminated and the importance of immunohistochemistry to know the nature of tumour cells in establishing the accurate diagnosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Oral and Maxillofacial Pathology.)

Objective: A wide variety of mouth rinses are available to combat micro-organisms in the oral cavity. At the present global pandemic, the need of the hour is to control the viral infection due to the novel corona virus SARS-COV-2, as its port of entry is through the receptors located in the oral and pharyngeal mucosa. This systematic literature review focuses on the in vivo studies [randomized control trials (RCTs)] done on the efficacy of existing mouth rinses which have been used in reducing the viral loads., Methods: The electronic database which includes PubMed-MEDLINE, Google scholar, Scopus, Web of Science, EMBASE, ProQuest and CINAHL was searched from December 2019 to June 2021 with appropriate Medical Subject Headings (MeSH) terms and Boolean operators. Two reviewers independently reviewed the abstracts., Results: Of the 2438 retrieved titles, 905 remained after removing duplicates. Twelve articles were eligible to be included in this review of which seven were randomized with adequate sample size., Conclusions: Mouth washes containing povidone iodine and chlorhexidine decrease the viral load transiently. Large amount of in vivo studies are of paramount importance, especially RCTs, to prove the efficacy of these mouth rinses., (© 2021 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd.)

Autoimmune disorders occur either as a solitary lesion or in pairs, but it is unusual to find two autoimmune disease lesions in the oral cavity in a single patient, who has been previously treated for psoriasis. We present the case of a 30-year-old male who presented with complaints of severe burning in the oral cavity. Examination revealed the presence of co-occurrence of vitiligo with oral lichen planus with a history of psoriasis and was managed conservatively with good response to treatment., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Oral and Maxillofacial Pathology.)

Leishmaniasis, an endemic disease in several parts of India, is a parasitic disease caused by protozoa and transmitted by the sandfly. Although cutaneous and visceral varieties are common, isolated lymph nodal involvement is extremely rare, and the diagnosis is often delayed owing to its uncommon presentation and lack of awareness of this possibility. We present a 72-year-old woman with asymptomatic right facial lymphadenopathy which on biopsy revealed leishmaniasis and responded well to drug therapy.

Background: Spalt-like transcription factor 4 (SALL4) is a stem cell marker that plays a critical role in maintaining the pluripotency and self-renewal of embryonic and hematopoietic stem cells. Only a few studies have been done to apprehend the expression of SALL4 in the potentially malignant oral lesion (leukoplakia with dysplasia) and oral squamous cell carcinoma (OSCC)., Aim: The aim of this study is to evaluate the expression of SALL4 in leukoplakia with dysplasia and OSCC and to correlate the expression of the marker (SALL4) with the various clinicopathological parameters and patient outcome., Materials and Methods: Immunohistochemistry for SALL4 protein was performed on 140 cases: those histopathologically confirmed cases of leukoplakia with dysplasia ( n = 30) and OSCC ( n = 110). Ten cases of nonepithelial neoplasm (fibroepithelial hyperplasia and excised tissue surrounding impacted third molars) were taken as control. Statistical analyses were applied to evaluate correlations between SALL4 overexpression and clinicopathological features of leukoplakia and OSCC. Survival rates were analyzed using Kaplan-Meier method., Results: SALL4 positivity was observed to be higher ( P = 0.001) in the tumor cells of OSCC with Immuno Reactive Score (IRS) ranging from 0 to 9. Poorly differentiated squamous cell carcinoma (SCC) had paramount higher expression with a median IRS of 6. Similar IRS and above (IRS, 6-9) was observed in Stage I (five cases), which recurred and well-differentiated cases with metastasis (four cases) while in leukoplakia with dysplasia the SALL4 expression was weak with a range of 2-4., Conclusions: SALL4 being one of the cancer stem cell molecules plays an important role in the progression of oral cancer, which was evident in this study. This could also account for aggressive clinical behavior. Follow-up of these patients would relate this molecule could be responsible for cancer relapse. Patients diagnosed to have oral epithelial dysplasia had a low expression of SALL4, are under follow-up, although seven cases did transform to SCC. Thus, we conclude, SALL4 may be of prognostic relevance, but in oral epithelial dysplasia, it requires further investigations., (Copyright: © 2020 Journal of Carcinogenesis.)

Objectives: Oral epithelial dysplasia (OED) is characterized by cellular alterations which have the proclivity of progressing to squamous cell carcinoma. Excision repair cross-complement group 1 (ERCC1) is one of the key proteins involved in nucleotide excision repair (NER) pathway. The expression of ERCC1 has been studied in colorectal, esophageal, ovarian and oral squamous cell carcinoma; but, very few studies have been done to apprehend the expression of ERCC1 in OED and early invasive squamous cell carcinoma (EISCC). The goal of this study is to evaluate the role of ERCC1 in OED and EISCC., Materials and Methods: Histopathologically diagnosed cases of moderate dysplasia ( n = 10), severe dysplasia ( n = 10) and EISCC ( n = 10) were retrieved. 4 μ thick sections were cut from the formalin-fixed paraffin-embedded tissue blocks. The sections were immunohistochemically stained for ERCC1 following standard protocols. The expression of ERCC1 was evaluated semiquantitatively. Statistical analysis was carried out using Fischer's exact t -test., Results: The expression of ERCC1 was found to be strong (+3) in EISCC, moderate (+2) in severe dysplasia and mild (+1) in moderate dysplasia. Thus, the results were statistically significant between the three groups ( P < 0.001)., Conclusion: Disruption in the mechanisms that regulate cell cycle checkpoints and DNA repair mechanism results in genomic instability; these alterations might contribute to carcinoma. ERCC1 is essential to repair the DNA damage induced by various carcinogens. The present study shows significant difference in the expression of ERCC1 between EISCC and OED, which suggests ERCC1 could be used as one of the predictive markers., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Oral and Maxillofacial Pathology.)

Background: Matrix metalloproteinases (MMP) are being considered important mediators in cancer invasion, and plenty of research is in progress. Our objective was to evaluate the presence of MMP-2 and tissue inhibitor of metalloproteinase (TIMP-2) in oral lichen planus (OLP) and to assess its role in the pathogenesis of OLP and as an indicator of malignant transformation., Materials and Methods: Immunohistochemical analysis for MMP-2 and TIMP-2 was performed in thirty histopathologically confirmed, formalin-fixed, paraffin-embedded specimens of OLP (24 cases of reticular and 6 cases of erosive LP). A semi-quantitative analysis was done to assess the expression and distribution of this marker in these lesions., Results: In all cases of OLP, MMP-2 expression was seen mainly in areas of lymphocytic inflammatory infiltrate (100%) in the lamina propria within the overlying epithelium. TIMP-2 expression was seen more than 50% in the fibroblasts and basal and parabasal cells., Conclusion: The expression of MMP-2 and TIMP-2 was observed in all cases of OLP. However, a clinical 5-year follow-up of the lesion revealed no progression of the disease except for chronic exacerbation and regression of these lesions. Although our study considers MMP-2 and TIMP-2 as mediators in the pathogenesis of OLP, it still remains debatable whether they have a direct role to play in the disease process or whether they are suitable biomarkers to assess the disease progression., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Journal of Oral and Maxillofacial Pathology.)

Competing Interests: Competing interests: None declared.

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.

Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy. Preeclampsia, gestational hypertension and gestational diabetes mellitus (GDM) are linked with SDB. Preeclampsia and OSA share common pathological associations. It is unclear if one predisposes the other. Foetal morbidity includes intrauterine growth restriction (IUGR), preterm delivery, low birth weight, neonatal intensive care unit (NICU) admission and Apgar score of less than seven at one minute. Continuous positive airway pressure (CPAP) is a well-documented treatment of SDB in pregnancy and has been shown to reverse some of the adverse events. It becomes imperative to diagnose and manage this condition as OSA causes substantial morbidity in the untreated pregnant patient and foetus. Three short clinical cases and a literature review on SDB on pregnancy are presented.

Oral squamous cell carcinomas comprise a heterogeneous tumor cell population with varied molecular characteristics, which makes prognostication of these tumors a complex and challenging issue. Thus, molecular profiling of these tumors is advantageous for an accurate prognostication and treatment planning. This is a retrospective study on a cohort of primary locally advanced oral squamous cell carcinomas (n = 178) of an Indian rural population. The expression of EGFR, p53, cyclin D1, Bcl-2 and p16 in a cohort of primary locally advanced oral squamous cell carcinomas was evaluated. A potential biomarker that can predict the tumor response to treatment was identified. Formalin-fixed paraffin-embedded tumor blocks of (n = 178) of histopathologically diagnosed cases of locally advanced oral squamous cell carcinomas were selected. Tissue microarray blocks were constructed with 2 cores of 2 mm diameter from each tumor block. Four-micron-thick sections were cut from these tissue microarray blocks. These tissue microarray sections were immunohistochemically stained for EGFR, p53, Bcl-2, cyclin D1 and p16. In this cohort, EGFR was the most frequently expressed 150/178 (84%) biomarker of the cases. Kaplan-Meier analysis showed a significant association (p = 0.038) between expression of p53 and a poor prognosis. A Poisson regression analysis showed that tumors that expressed p53 had a two times greater chance of recurrence (unadjusted IRR-95% CI 2.08 (1.03, 4.5), adjusted IRR-2.29 (1.08, 4.8) compared with the tumors that did not express this biomarker. Molecular profiling of oral squamous cell carcinomas will enable us to categorize our patients into more realistic risk groups. With biologically guided tumor characterization, personalized treatment protocols can be designed for individual patients, which will improve the quality of life of these patients.

Aims: 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., Methods and Results: This cross-sectional study was carried out on 60 histologically confirmed cases of OSCC. EpCAM expression was evaluated by the indirect streptavidin-biotin method and was then assessed semiquantitatively in terms of staining proportion, staining intensity and total staining. The immunoprofile of EpCAM was correlated with clinicopathological parameters such as gender, habit, tumour size, site, regional lymph node and distant metastasis, clinical stage, histological grade, local tumour recurrence and patient survival. EpCAM expression was found to be absent in normal oral mucosa. However, positive staining was seen in 51 of 60 OSCC cases and EpCAM overexpression in 11 specimens. Overexpression of EpCAM was associated significantly with tumour size, histological grade, local recurrence of tumour and patient survival., Conclusions: EpCAM serves as a potential biomarker of prognostic significance that could be used to identify patients at high risk and to predict patient survival. Moreover, EpCAM antigen represents an attractive target for immunotherapeutic approaches in a subgroup of patients with EpCAM-positive OSCC., (© 2015 John Wiley & Sons Ltd.)

Introduction: The oral cavity is considered an easily accessible window to the body. The mouth is frequently involved in conditions that affect multiple organs. In many instances, oral involvement precedes the appearance of many other symptoms or lesions. A complete examination of the oral cavity provides a gateway for an accurate diagnosis and precise management of many systemic conditions. Gingival enlargement is one of the varied manifestations of many systemic diseases. Here, a case report of a gingival enlargement is presented that provided information for the diagnosis of post-primary pulmonary tuberculosis., Case Presentation: A 62-year-old female presented with a persistent gingival enlargement of 6-month duration, which was non-responsive to periodontal therapy. A complete general examination with the help of additional diagnostic aids provided the diagnosis of post-primary pulmonary tuberculosis., Conclusion: Clinicians should be aware of the unusual forms of common diseases, which will aid in early diagnosis and proper patient management., (© 2015 American Academy of Periodontology.)

Calcifying epithelial odontogenic tumor (CEOT) is a rare, benign, locally aggressive odontogenic epithelial tumor that affects the jaws. Although there are numerous reports on the variants of CEOT, occurrence of clear cells with complete absence of calcification has been a rarity. Histochemical analysis of tumor cells revealed glycogen granules with PAS staining, with absence of CD 1a staining in clear cells, while the amyloid-like deposit associated with clear cells showed green birefringence with Congo red. We report an unusual variant of CEOT occurring in a 27 years old male patient.

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.

Candida species are a normal commensal of the oral cavity in healthy individuals, but can become an opportunistic pathogen when the oral ecosystem is unbalanced. Several virulence attributes have been identified in candidal infection, among which are the hydrolases, including the secreted aspartyl proteinases (Saps). This study evaluated and compared the in vitro level of Saps from Candida albicans in nonsmokers, smokers, and patients with leukoplakia and oral squamous cell carcinoma (OSCC). Candida cell count (CCC) at 48 h was also assessed. The Sap level was measured by spectrophotometry in 38 clinical isolates of C. albicans obtained from the oral cavity of the four different groups. Culturing was done in yeast carbon base-bovine serum albumin. Speciation of Candida was performed by using a Candida identification kit, and CCC was measured by hemocytometer. Sap levels and CCC were higher in individuals with leukoplakia and OSCC than in nonsmokers or smokers (P = 0.001); however, there was no significant difference in Sap levels or CCC between smokers and nonsmokers (P = 0.529). Further, an intragroup correlation between CCC and Sap level was also observed. The higher level of Saps from C. albicans in individuals with leukoplakia and OSCC suggests that this pathogen plays a role in disease development and could aid in identifying the pathogenic commensal.

Unlabelled: 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., Electronic Supplementary Material: The online version of this article (doi:10.1007/s12262-011-0286-6) contains supplementary material, which is available to authorized users.

Developments in dental pharmacotherapeutics require dentists to constantly update their knowledge of new drugs, drug safety, and therapeutic trends. Recent incidents of bisphosphonateassociated poor healing, spontaneous intraoral ulceration, and bone necrosis in the oral and maxillofacial region stress the need for vigilant spontaneous reporting of adverse events. This article discusses the rationale for pharmacovigilance in dental practice using specific methods and reviews the pros and cons of adverse drug reporting among dental practitioners.

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.

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.

Osteochondroma of the mandibular condyle is fairly rare. We describe a case of this lesion in a 52-year-old woman who presented with symptoms of temporomandibular joint dysfunction. Although a panoramic radiograph demonstrated the bony exostosis, a pre-operative CT examination showed the relationship of the tumour to the condyle and also depicted soft-tissue changes secondary to the growth.

Free radicals and antioxidant therapy have attracted a great deal of attention in recent years. Current research reveals the potential applications of antioxidants in prevention or control of disease. However, controversy still exists due to lack of well controlled clinical trials and definitive conclusion on efficacy/safety. This article highlights the debatable issues related to this. Based on the available literature and clinician's experience, recommendation on antioxidant usage is mentioned at the end. There is a need to assimilate the known available information with extensive research to establish a positive role of antioxidant therapy in clinical practice and to use an evidence-based approach for summarizing data, drawing conclusions and making recommendations about antioxidant usage and efficacy. A substantial gap still exists between the claims and the efficacy/safety in this area of research.

Tuberculosis of the oral cavity is a rare event and when present is usually secondary to pulmonary tuberculosis. We present a case of a 33-year-old male patient who presented with symptoms of gingivitis. Local examination revealed multiple ulcers and a few nodules over the gingiva. A nodule biopsy was consistent with the diagnosis of gingival tuberculosis. The patient had no evidence of tuberculosis any where else in the body. Medical treatment was curative. As this condition is very rare, it is often over looked as it is never thought as a common clinical diagnosis. A biopsy is mandatory to establish diagnosis. The relevant literature is reviewed.

Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. Microscopy showed typical histologic features of multiple germinal centers with a rim of small mature lymphocytes together with a mixed, mainly mononuclear infiltrate which clinched the diagnosis of benign lymphoid hyperplasia. This diagnosis averted extensive investigations and major surgery. The etiology of these lesions is unknown. Their distinction from carcinoma and lymphoma is discussed.

A case of primary tuberculosis of the tongue, an extremely rare entity is presented. The clinical manifestation, diagnosis and the response to antituberculous treatment are considered. The literature is also reviewed.

Ameloblastic carcinoma is a rare odontogenic malignant tumour and has been a subject of great debate in literature. It does challenge the diagnostic acumen of pathologists, as this lesion needs to be detected at an early stage for adequate therapy. We present a case of the same with literature review.