Correlation of vascularization and inflammation with severity of oral Leukoplakia

Background & objective: Changes in submucosal vascularization and inflammation, determined by immunohistochemistry staining, were shown to be correlated with the development of dysplasia and invasiveness of epithelial cells in premalignant and malignant lesions. This study evaluated changes in sections routinely stained with Hematoxylin and Eosin (H&E) in order to investigate vascular density and intensity of inflammatory cells infiltration during the progression of oral leukoplakia with mild dysplasia to Squamous Cell Carcinoma (SCC).The aim of the research was to determine whether changes in sub-mucosal vascularity and inflammatory infiltration of leukoplakia in routine H&E-stained sections could contribute to the assessment of severity of the lesion. Methods: In this cross-sectional, comparative and descriptive study, vascular density and inflammation intensity of 125 available samples of H&E-stained sections, consisting of 35 cases of mild and moderate dysplasia, 38 severe dysplasia and carcinoma in situ, and 52 SCC, were investigated. To analyze the data, chi-square test, Mann-Whitney test, Kruskal-Wallis test, Tukey’s post hoc test, and cumulative ordinal logistic regression were conducted. Results: There was a significantly higher vascular density in cases with severe dysplasia, in situ carcinoma, and SCC compared to those with mild to moderate dysplasia (P<0.0001). However, the difference in vascularity was not statically significant between severe dysplasia, carcinoma in situ, and SCC (P=0.78). Intensity of inflammatory cells infiltration in the underlying connective tissue was significantly different among the three groups (P<0.0001), and the highest intensity of inflammatory cells infiltration was seen in the SCC group. Conclusions: Increased submucosal vascularization and inflammatory cells infiltration can contribute further to predicting more aggressive epithelial dysplasia

Role of Apoptotic Biomarkers in Ameloblastoma and Dental Follicle

Objectives Ameloblastoma is an odontogenic neoplasm with locally aggressive behavior. Fas and FasL play important roles in apoptotic pathways. The aim of this study was to determine the possible role of expression of apoptotic pathways (Fas and FasL) in human ameloblastoma and the relationship of apoptosis with the clinical biological characteristics of ameloblastoma. Methods In this descriptive retrospective study, we investigated the anti-Fas and anti-FasL antibody expression in 11 dental follicles and 56 ameloblastoma specimens (35 conventional, 15 unicystic and 6 ameloblastic carcinoma samples) by immunohistochemical (IHC) staining and polymerase chain reaction (PCR). The percentage of positive cells was calculated by using the Mann-Whitney U test and Kruskal-Wallis test. Results The rate of expression of markers was significantly lower in dental follicles than all subtypes of ameloblastoma (P=0.01 for Fas, and P=0.0001 for FasL). The FasL proportional score was significantly higher in conventional ameloblastoma than in unicystic ameloblastoma and ameloblastic carcinoma (P=0.003). There was no significant relationship between the type of ameloblastoma and expression of Fas. Conclusion This study shows that the process of apoptosis in ameloblastomais a sign of behavioral change in odontogenic epithelial cells especially in conventional ameloblastoma and that the apoptotic factors may not play an effective role in the malignancy of ameloblastoma

Report of an Uncommon Case of Huge Neurofibroma in the Buccal Mucosa

Objectives Neurofibroma (solitary or multiple) is a benign neurogenic jaw tumor with peripheral nerve origin. It is commonly found in the skin and the head and neck region but its occurrence in the oral cavity is rare. Case: This report presents a case of huge solitary neurofibroma in the maxillary vestibular mucosa in a 60-year-old male without any medical or family history of neurofibromatosis type 1. The diagnosis was made based on histopathological findings and IHC staining for the S-100 protein. No recurrence was noted at the 6-month follow-up after surgical excision of the lesion. Conclusion We reported a case of neurofibroma, which is a relatively rare benign tumor of the oral cavity, in the buccal mucosa in an elderly man based on histopathological and immunohistochemical findings. The propensity of neurofibromas to progress to neurofibromatosis or the primary disease undergoing malignant transformation (6-29%) has been reported in the literature. Therefore, a close follow-up of patients presenting initially only with neurofibroma is necessary. &nbsp

Keratoacanthoma: A Case Report, An Update, and Review of Literature

Objectives This study aimed to review and briefly discuss the literature about keratoacanthoma (KA) and present a case of KA of the facial skin under the right eye with over 6-months of follow-up after removal. Case: An 86-year-old healthy man was referred to a private clinic with a 5-6-week history of a rapidly growing, crateriform nodule with a central hemorrhagic crust on the facial skin under the right eye. Surgical excision was the treatment chosen to differentiate the lesion from squamous cell carcinoma (SCC). Thereafter, the lesion was completely excised. Histopathological analysis confirmed the diagnosis of KA. During over 6 months of follow-up after removal of the lesion, the patient was completely satisfied with the process of treatment, and no recurrence occurred. Conclusion Solitary KA lesions are commonly found on sun-exposed skin in older adults, similar to our case. Early diagnosis and treatment could reduce the risk of malignancy and recurrence. Moreover, close follow-up of patients with a history of KA is needed, because the possibility of developing a new KA lesion, due to trauma or medical and cosmetic procedures, especially on the UV damaged skin, still exists

Evaluation of Pulp Tissue Following Direct Pulp Capping with Propolis versus Calcium Hydroxide: A Clinical Trial

Objectives Direct pulp capping may result in formation of a dentinal bridge and preservation of pulp vitality. This randomized controlled clinical trial sought to histologically assess and compare pulp tissue following pulp capping with propolis and calcium hydroxide. Methods In A cavity was prepared at the center of the occlusal surface of 10 third molars scheduled for extraction by using a cylindrical bur. The pulp chamber was exposed with a round bur. Samples were randomly divided into two groups (5 teeth in each group). The first group underwent direct pulp capping with propolis and the second group with calcium hydroxide. Auto-polymerizing glass ionomer was then applied to seal the cavity. The teeth were extracted after 45 days, and histologically evaluated. The obtained data were analyzed using the Fisher’s exact test. Results The quality (P=0.048) and quantity (P=0.008) of dentinal bridge were significantly different between the two groups. Propolis resulted in formation of a continuous dentinal bridge with irregular tubular dentin; whereas, calcium hydroxide resulted in formation of osteodentin (low quality dentin). Conclusion Propolis induced the formation of tubular dentin with higher quality compared with calcium hydroxide

Expression of CK8 and CK17, specific epithelial markers, by oral squamous cell carcinoma cell lines

Objectives Oral squamous cell carcinoma (OSCC) is among the most common cancers worldwide. This study aimed to assess the expression of CK8 and CK17 by OSCC cell lines in Iranian patients.Methods This observational study was conducted on three OSCC cell lines with a minimum of 45 passages. Cells isolated from three patients with OSCC were cultured and passaged. Expression of CK8 and CK17 epithelial markers was assessed using reverse-transcription polymerase chain reaction. Data were presented qualitatively.Results The results confirmed the expression of CK8 and CK17 mRNA in three groups. Expression of these markers was different in the three specimens based on their degree of malignancy.Conclusion Since CK8 and CK17 were expressed in different superficial and basal layers in the three specimens, epithelial origin of these cells was confirmed. This study can pave the way for further cancer research and designing new treatment

Excision of different oral benign exophitic lesions with diode laser: A clinical Case Series

Introduction: Lasers are becoming the standard of care for many dental procedures, and are being introduced as a high-tech instrument. They are also becoming more routine in dentistry through the advent of office-based lasers, which are also simple to use within the oral cavity. Many studies have shown the competencies of laser technology for the management of benign oral lesions as these techniques allow for painless and bloodless oral surgery.Cases Report:&nbsp;Nine patients attending the Department of oral and maxillofacial Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran, underwent laser outpatient procedures for the surgical removal of a wide range of benign oral lesions. Regarding the history, present illnesses and clinical figures of all reported cases, the clinician ensured that the lesions were benign and after taking informed consent from every patient, he did complete the excision of lesions with diode lasers. Following the injection of local anesthesia, an 810 nm diode laser was applied for the excisional biopsy of oral lesions. The specimens were sent for histopathological evaluations and the patients were assessed on intraoperative and postoperative complications. The patients were followed up for postoperative complications at one week and 2 weeks post-treatment.Conclusions: According to our findings, a diode laser can be a choice for the outpatient treatment of oral mucosal benign lesions as this technique provides the painless and almost bloodless treatment

Correlation of CA19-9 and P57 (KiP2) Expression with Tumor Grade and Invasive Front in Oral Squamous Cell Carcinoma

Statement of the Problem: Oral squamous cell carcinoma (OSCC) is one of the most widely occurring cancers worldwide. Early diagnosis of primary tumors is the key to improve treatment outcome. Detecting cancer, determining prognosis, and monitoring disease progression or treatment response can be done based on molecular markers. CA19-9 is an isolated form of Lewis antigen. It is widely used for detecting pancreatic cancer in the clinical setting. P57 (KiP2) is a tumor suppressor gene. It is a positive regulator of cell proliferation, regulating proliferation through G1 phase by inhibiting cyclin dependent kinases. Its expression decreases in most malignancies. OSCC has variable differentiation grades and local invasion potential. Purpose: The aim of this study was to evaluate and assess the correlation of CA19-9 and P57 expression with invasive front and grade of OSCC. Materials and Method: This cross-sectional study was performed on forty paraffin blocks in three histologic grades; well, moderate, and poorly differentiated SCC. The two markers were assessed by immunohistochemistry methods (En vision). Proportional and total scores and staining intensity were measured for all samples. Results: CA19-9 staining was low in all three grades. The Kruskal Wallis test showed no significant correlation between tumor grade and CA19-9 expression; however, there was a significant difference between tumor intensity and margin intensity (p= 0.003). P57 staining was high in all three grades. The Kruskal Wallis test showed no significant correlation between tumor grade and P57 expression. There were no significant differences in total intensity of staining in margins of tumor (p= 0.85). Conclusion: Within the limitations of this study, it may be concluded that expression of CA19-9 and P57 cannot be used as determinants of tumor grade. Higher expression of CA19-9 in invasive front of SCC can be representative of local invasion and higher activity of tumor cells in the margins

Langerhans' cell histiocytosis with multiple radiolucent lesions in the body of the mandible,report of a case

Introduction: Langerhans cell histiocytosis (LCH) refers to a group of rare reticuloendothelial system disorders and it occurs most often in young adults and children. A 57-year-old edentulous female patient who complained of dull pain in the posterior region of the mandible referred to the dental office, with a complaint of dull pain in the posterior region of the mandible. The lesion was diagnosed as LCH. Oral manifestations could be the first signs of Langerhans' cell histiocytosis. Therefore, the dentist must be aware of the oral symptoms so in order that the disease is not overlooked

P53 Protein Expression in Dental Follicle, Dentigerous Cyst, Odontogenic Keratocyst, and Inflammatory Subtypes of Cysts: An Immunohistochemical Study

Objectives: An odontogenic keratocyst (OKC) is a developmental odontogenic cyst with aggressive clinical behavior. This cyst shows a different growth mechanism from the more common dentigerous cyst and now has been renamed as a keratocystic odontogenic tumor (KCOT). Inflammation can assist tumor growth via different mechanisms including dysregulation of the p53 gene. This study aims to assess and compare the expression of tumor suppressor gene p53 in inflamed and non-inflamed types of OKC and dentigerous cyst. Methods: Immunohistochemical expression of p53 was assessed in 14 cases of dental follicle, 34 cases of OKC (including 18 inflamed OKCs), and 31 cases of dentigerous cyst (including 16 inflamed cysts). Results: The mean percentage of p53 positive cells was 0.7% in dental follicles, 5.4% in non-inflamed OKCs, 17.3% in inflamed OKCs, 1.2% in non-inflamed dentigerous cysts, and 2.2% in inflamed dentigerous cysts. The differences between the groups were statistically significant (p < 0.050) except for the difference between inflamed and non-inflamed dentigerous cysts, and between dental follicle and non-inflamed dentigerous cyst. Conclusions: The difference in p53 expression in OKC and dentigerous cyst can explain their different growth mechanism and clinical behavior. Inflammation is responsible for the change in behavior of neoplastic epithelium of OKC via p53 overexpression