Evaluation of Cyclin D1 Expression in Aggressive and Nonaggressive Central Giant Cell Granuloma of the Jaws

Statement of the Problem: Central giant cell granuloma of the jaws is comprised of two types namely aggressive and nonaggressive. Controversy exists regarding the histogenesis of this lesion. Up to now, there are no reliable histologic or molecular methods to differentiate aggressive from nonaggressive central giant cell granuloma of the jaw. Moreover, because of different treatment of two groups, correct diagnosis is needed. Purpose: The purpose of this study was to evaluate and compare the expression of cyclin D1 between aggressive and nonaggressive central giant cell granulomas of the jaws. Materials and Method: This retrospective study was performed on 16 paraffin blocks of aggressive central giant cell granuloma, and 16 nonaggressive central giant cell granulomas from Shahid Beheshti Oral Pathology Department and evaluated the expression of cyclin D1 on giant cells and mononuclear cells of the lesions. T-test was used for quantitative evaluation and comparison of cyclin D1 expression between two groups. Results: Overexpression of cyclin D1 in giant cells and mononuclear cells of the lesions of both groups was apparent, but no significant statistical difference was seen. Cyclin D1 positivity was seen predominantly in the nuclei of giant cells. When a giant cell was positive, all the nuclei showed immunoreactivity. In each group mean percentage of the positive giant cells were higher than positive mononuclear cells and significant statistical difference (p= 0.000) was seen between them. Conclusion: Probably overexpression of cyclin D1 implicates in the pathogenesis of the central giant cell granulomas but it seems that this protein could not be used as a marker for identifying the clinical behavior of these lesions. The term giant cell lesion (GCL) describes a group of intraosseous nonodontogenic benign lesions containin

Central Giant Cell Granuloma of the Jaws: Correlation between Vascularity and Biologic Behavior

Introduction: Giant cell lesions of the bone comprise a group of jaw bone pathologies. Different pathogeneses such as reactive, vascular or neoplastic have been proposed for these lesions. In addition, differentiating between aggressive and nonaggressive central giant cell granuloma (CGCG) of the jaws based on histopathologic features is still impossible and due to different treatment protocols for the two groups, correct diagnosis is necessary. The purpose of this study was to compare the expression of CD34 between aggressive and nonaggressive CGCGs of the jaws. Methods & Materials: This retrospective study was carried out on 16 paraffin blocks in each aggressive and nonaggressive CGCGs group. The expression of CD34 was evaluated with immunohistochemical technique. Afterwards, t-test was used for quantitative evaluation and comparison of CD34 expression among the two groups. Eventually, statistical analysis was performed using Spss20 software. Significance was assigned at p < 0.05. Results: In the present study, the average age of patients in aggressive and nonaggressive groups was 20.93±8.08 and 26.18±16.97, respectively. In both groups, female predilection was observed. Mandible was the most common site of involvement in the aggressive group and the distribution of nonaggressive lesions was equal between both jaws. Although the expression of CD34 in the aggressive group was higher than the nonaggressive group, no statistically significant difference was seen (p=0.15). Conclusion: According to the results of the current study, it appears that CD34 protein cannot be used for identifying the clinical behavior of CGCGs

Predictive Factors of Potential Malignant Transformation in Recurrent Calcifying Cystic Odontogenic Tumor: Review of the Literature

Calcifying cystic odontogenic tumor (CCOT) demonstrates considerable diversity in histopathology and clinical behavior. Ghost cell odontogenic carcinoma (GCOC) is the rare malignant counterpart of CCOT and it frequently arises from malignant transformation of a recurrent CCOT. In this paper, we present a case of CCOT and discuss its distinct histopathologic features in recurrence. Then, we will have a review on clinical, histopathological, and immunohistochemical aspects of GCOC in the literature. Predictive factors of malignant transformation in a benign CCOT will also be discussed

Demographic Profile of Non-Odontogenic Jaw Lesions in an Iranian Population: A 30-Year Archive Review

Objectives: The frequency of non-odontogenic lesions of the jawbones is lower than that of odontogenic lesions; however, study of the epidemiologic data of these lesions is required for health care programs. This study aimed to assess the relative frequency and demographic profile of non-odontogenic jaw lesions in an Iranian population over a 30-year period. Materials and Methods: This archive review was performed using demographic and biopsy information of all patients with non-odontogenic lesions of the jawbones submitted to the Oral Pathology Department of Dental School of Tehran University of Medical Sciences from 1984 to 2014. Demographic data included in the study were: age at diagnosis, gender and location of lesion. The lesions were divided into three groups of group 1: cystic lesions, group 2: tumors and tumor-like lesions, and group 3: infectious/ inflammatory/reactive lesions. Frequency and clinical data were analyzed using SPSS 22. Results: Of 972 non-odontogenic jaw lesions, the ratio of mandibular to maxillary lesions was 1.63:1. Female to male ratio was 1.33:1 and the mean age of patients was 29.09±16.90 years. The most common non-odontogenic jaw lesion was central giant cell granuloma (CGCG). In groups 1, 2 and 3, nasopalatine duct cyst, CGCG, and osteomyelitis were the most frequent lesions, respectively. Conclusions: Non-odontogenic lesions of the jawbones are a diverse group of lesions with different frequency and behavior. This study demonstrated that tumors and tumor-like lesions of the jaws were more common than cystic and infectious/ inflammatory/reactive lesions. Overall, the most common non-odontogenic jaw lesion was CGCG.

Evaluation of the presence of myofibroblasts and matrix metalloproteinase 1 expression in the stroma of oral verrucous hyperplasia and verrucous carcinoma

Background: Oral verrucous carcinoma is a low-grade subtype of oral squamous cell carcinoma that should be differentiated from oral verrucous hyperplasia, a premalignant lesion. Stromal activated myofibroblasts known as cancer-associated fibroblasts have an active role in the initiation and progression of the cancers via secretion of different molecules including matrix metalloproteinases. Aims: This study is designed to understand the differences in the presence of myofibroblasts and expression of matrix metalloproteinase-1 in the adjacent stroma of verrucous carcinoma and oral verrucous hyperplasia (OVH). Settings and Design: Cross-sectional study. Material and Methods: Twenty-seven OVH, 19 oral verrucous carcinoma (OVC), and 8 cutaneous verrucous carcinoma (CVC) specimens were analyzed for immunohistochemical (IHC) expression of alpha-smooth muscle actin (alpha SMA) and MMP-1. Results: IHC studies for alpha SMA expression in nonvascular stromal cells of the adjacent stroma revealed mild or no expression in 81.4%, 73.7%, and 62.5% of the cases of OVH, OVC, and CVC groups, respectively. No significant difference was seen in alpha SMA expression index between OVH and OVC groups (Adj. Sig. = 0.220) and between OVC and CVC groups (Adj. Sig. = 1.00). Pairwise analysis revealed a significant difference in MMP-1 expression index between the groups. No significant correlation was observed between MMP-1 expression index and aSMA expression index in OVH (pv = 0.358) and OVC (pv = 0.388) groups. Conclusion: The differences in MMP-1 expression between OVH and OVC can be used as an adjunctive aid in challenging cases including disoriented or inadequate samples

Distraction osteogenesis for cleft palate closure: A finite element analysis

Background: Current methods of closure of the cleft palate result in the formation of scars and impairment of growth. Distraction osteogenesis (DO) might be an effective means to repair or at least reduce the size of wide clefts. This study investigates the biomechanical aspects of this process. Materials and Methods: DO simulation was applied to reduce the size of a unilateral hard palate cleft on a three-dimensional (3D) model of the maxilla. For the position of osteotomy lines, two different models were assumed, with the osteotomy line on the affected side in model A and on the intact side in model B. In each model, DO screws were placed on two different positions, anteriorly (models A1 and B1) and posteriorly (models A2 and B2). Displacement pattern of the bony island in each of the four models, reaction forces at DO locations, and von Mises stress were estimated. Mesh generation and data processing were carried out in the 3D finite element analysis package (ABAQUS V6.7-1; Simulia Corp., Providence, RI, USA). Results: In model B2, the island moved almost evenly, assuring a more complete closure of the cleft. The most uniform stress distribution was found in model B1. Conclusion: The results suggest that the best positions for the DO screw and the osteotomy line for closure of the cleft palate are posteriorly and on the intact side, respectively