Histopathological analysis of soft tissue changes in gingival biopsied specimen from patients with underlying corona virus disease associated mucormycosis (CAM)

Corona Virus Disease-2019 (COVID-19) is perhaps the disastrous medical emergencies that has ever hit globally with multiple strains. Amongst various sequelae, mucormycosis may be considered as the most debilitating one. Post COVID-19 mucormycosis is formally regarded as corona virus disease associated mucormycosis (CAM). The aim of the current paper is to present twelve cases of CAM with unique clinical presentation with a detailed histopathological correlation of the gingival biopsied material. Twelve cases of CAM were included in the study who presented initially with non-purulent swelling of the gingiva. The clinic-demographic data pertaining to age, gender, location, laterality and presence of co-morbidities was collected along with histopathological examination of biopsied specimen. The patients ranged from 31-65 years (mean age 47.33 years). There was a male predominance. Clearly, maxillary right gingiva was mostly affected and all cases presented with non purulent, non tender swelling of the gingiva. The incisional biopsy from the gingiva consistently showed pseudoepitheliomatous hyperplasia of the surface epithelium along with vacuolar degeneration, extensive stromal edema, massive mixed inflammatory reaction, congested blood vessels, hemorrhage and abundant multinucleated giant cells. Potassium hydroxide (10% KOH) mount served no additional diagnostic advantage. After two initial biopsies any suspected case of CAM with these features was treated with appropriate antifungal therapy and conservative excision. Gingival swelling with aforementioned histopathological features resembling post COVID-19 histological alterations could be alarming early signs of CAM and are candidate of prompt antifungal therapy rather than repeat biopsy for confirmation

Correlation of Bony Invasion With Nodal Metastasis, Pattern of Invasion and Survival in Oral Squamous Cell Carcinoma: A Retrospective Analysis of 122 Primary Cases From Oral Cancer Centre of South India

Oral squamous cell carcinoma (OSCC) is considered to be the most common epithelial malignant neoplasm of the oral cavity. Despite advancements in diagnosis and therapeutics the clinical outcome of the disease has not improved much which may be attributed to tumor biology and heterogeneity. Bone invasion by cancer cells is currently staged as a moderately advanced disease. However, many low-grade carcinomas such as verrucous carcinoma and carcinoma cuniculatum show body invasion but less nodal metastases and better overall survival. The present study was orchestrated to analyze if bone invasion in OSCC has any impact on regional nodal metastases and survival

UTILIZATION OF SAMANYA SHODHANA IN THE PURIFICATION OF EXCESS MERCURY OBTAINED FROM DENTAL OPERATORY- A PRELIMINARY STUDY

Background: Concerns about toxicity of mercury and disposal of excessive mercury has led to decreased usage of mercury in dental profession but still tooth colored restorative materials are not affordable by all the classes of any society. The disposal of excess mercury has always been a matter of concern. Thus, in the present study, we attempted to evaluate a simple procedure from Rasa Shastra using lime powder, garlic and rock salt for recycling of excess mercury obtained from dental operatory.Materials and methods: The excess mercury was recycled by the standard procedure explained in Ayurveda texts (Samanya shodhana) using Sudha churna (lime powder), Lashuna kalka (paste of Allium sativum L.) and Saindhava lavanaa (rock salt). The commercially available mercury and recycled mercury was analyzed by inductively coupled plasma mass spectrometry (ICP-MS) for the detection of elements in ppm level.Results: It was found that the excess impure mercury contained 5138 ppm, 2866.1 ppm and 0.371 ppm of Silver, Copper and Tin respectively. After Shodhana, the level of silver, tin and copper were markedly reduced. Purified mercury showed a level of 119.5ppm silver, 0.5324 ppm copper and 0.3233 ppm tin.Conclusion: Samanya shodhana is a simple promising procedure which can be used for mercury recycling. The procedure doesnot require sophisticated equipments and maneuver. Further, the materials used in the procedure are easily available and affordable at low cost

Correlation between Vascularity and Advancing Histological Grades of Oral Submucous Fibrosis with a Plausible Role in Malignisation: Systematic review of a persisting matter of conflict

Objectives: Recent studies showed that as the stage advances there is no significant change in the vascularity as opposed to the conventional concept, thus, the present was designed to quantify the vascularity in histological grades of OSMF and to assess if there is any connection between vasculogenesis and malignisation. Methods: A comprehensive database search was done for published articles on vascularity in oral submucous fibrosis following PRISMA guidelines without date constrains; the search was done till December 2022. The review was registered in Prospero. After screening 607 articles, a total of 13 studies were finally included for systematic evaluation. Results: A total of 607 cases were included, with a definite predilection for the male gender. 11/13 studies evaluated mean vascular density; in more than half, the vascularity decreased as the stage advanced. Similar results were obtained for endothelial cells /square μm, mean vascular area percentage & mean vascular area. Conclusion: The present review supports the prevailing concept that vascularity decreases with advancement of the stage of OSMF, denying systemic absorption of carcinogens into the circulation with resultant longer exposure of compromised epithelium and malignisation. Keywords: Malignisation; Mean Vascular Density; Oral Submucous Fibrosis; OSMF; Vascularity

Soft-Tissue Chondroma of Anterior Gingiva: A Rare Entity

Soft-tissue chondroma is a rare, benign, slow-growing tumor made up of heterotopic cartilaginous tissue. It occurs most commonly in the third and fourth decades in the hands and feet. Oral soft-tissue chondromas are uncommon and soft-tissue chondroma of gingiva is extremely uncommon. Here, we report an unusual case of soft-tissue chondroma of gingiva in a 50-year-old woman

Amelanotic Melanoma Masquerading as a Granular Cell Lesion

Amelanotic melanoma (AM) presents a diagnostic challenge due to its wide clinical presentations, lack of pigmentation, and varied histological appearances. Immunohistochemistry plays a crucial role in the diagnosis of these lesions. Amelanotic melanoma of oral mucosa is an uncommon lesion. We report a case of a 50-year-old male patient with a growth on the anterior mandibular gingiva of seven-month duration. In the present case, histologically, the tumour resembled a granular cell lesion, which has not been reported previously in AM. Diagnosis was possible by a sequential panel of immunohistochemical markers, of which finally vimentin, S100, HMB45, and Melan-A were positive. The tumor was surgically excised, and postsurgical radiotherapy was given