Fibrosarcoma of Mandible: A Case Report

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the oral cavity and can cause local recurrences or metastasis. In this paper, a case of fibrosarcoma in the posterior area of mandible in a 44-year-old woman is described. Clinical examination revealed a growth on right mandibular third molar region extending on the buccal and the lingual side. There was history of extraction of posterior teeth. Radiologically, there was a diffuse bone loss. Microscopically, the tumor showed an intense proliferation of fibroblasts of variable size and shape. These cells were arranged in parallel bands and partly crossing each other. The cells exhibited increased mitotic activity and nuclear pleomorphism. Immunohistochemically the cells showed immunoreactivity only for vimentin while they exhibited negativity towards S-100 protein, cytokeratin cocktail, HMB-45, desmin, smooth muscle actin, and epithelial membrane antigen (EMA). Based on findings the final diagnosis of fibrosarcoma was made

Ki67 Labelling Index predicts clinical outcome and survival in oral squamous cell carcinoma

Objective: To investigate the Ki 67 expression and its correlation with clinicopathological features and 3 years as well as 5 years survival rate in oral squamous cell carcinoma (OSCC). Methodology: Total 217cases of OSCC primarily treated with surgery with or without radiation were included. All patients were followed up for 3 years and 150 were followed up of 5 years for disease free survival. The immunohistochemistry was carried out on neutral buffered formalin fixed paraffin embedded tissue to evaluate the expression of Ki67. Results: The Ki67 labeling index (LI) was significantly higher with respect to adverse clinicopathological parameters such as histopathological grading (p<0.001), clinical TNM staging (p<0.001) and nodal metastasis (p<0.001). The OSCC patients survived for less than 3 and 5 years were showed significantly higher Ki67 LI as compared to diseases free survived more than 3 and 5 years(p<0.001). The three years survival rate of OSCC patient significantly higher with low Ki67 LI (≤45) 96.2%, followed by moderate Ki67 LI (46 to 60) 60.7% and high Ki67 LI (≥61) 37.7% (p<0.001). The five years survival rate of OSCC patient statistically significantly higher with low Ki67 LI (≤45)93.3%, followed by moderate Ki67 LI (46 to 60) 46.8% and Ki67 LI (≥61) 23.3% (p<0.001). Conclusion: The measurement of cell proliferative activity by using Ki67 antigen expression in individual OSCC might provide unique, predictive information on clinical outcome, prognosis and deciding treatment modalities in OSCC

Role of oral foci in systemic diseases: An update

Background: A current research disagreement middles about a theorized connection between chronic oral infections and the progress of adverse systemic health conditions. However, the gap between general and dental medicine is quickly closing, due to significant findings supporting the association between dental infections and systemic conditions such as cardiovascular diseases, type 2 diabetes mellitus, respiratory diseases, stroke, adverse pregnancy outcomes, osteoporosis, renal diseases, and gastrointestinal diseases. Relentless efforts have brought light on numerous advances in illuminating their etiopathological links. However, the majority of data about possible role or interlink between the infection and systemic disease is available in the form of case report or summary. As case reports are not the acceptable to many indexed scientific magazines, many these findings undergo unnoticed to researchers. The currently minimal accessible data provide only an indication of the actuality. Aim: This article highlights the Role of oral foci in systemic diseases. Conclusion: There is need of sincere work efforts on genetic relatedness of organisms, rather than their phenotypes, sophisticated sampling, detection, and analytical techniques to create the associations. To give insight to recent apprises of different systemic diseases as a consequence of primary oral infections and the pathogenesis link. The odontogenic bacteremia is likely to cause systemic and end organ infections, but such infections can easily resist by body defenses. It is important that role of good oral health and the risks associated with poor oral health should told to the individuals. Clinical significance: Dentists and medical practitioners should work together to provide comprehensive health care, thereby reducing the morbidity and mortality associated with oral infections

Evaluation of oral health awareness among public school children – A school-based study from Bhopal

Background: Oral diseases such as tooth caries, gingivitis, and bad breath are still major dental health-care concern, especially in children in the developing countries. Oral disease prevalence is high in school-going children, and there is inadequate information regarding the awareness among them. To evaluate the level of oral awareness among school children, a study was carried out in middle school. Materials and Methods: The present questionnaire study included middle school children from different socioeconomic background of the socioeconomic group. The consent from the school as well as the parents/guardians of children was taken. The trained dental surgeon distributed questionnaire among the children. Completely answered questionnaire was collected. The observations were reviewed and analyzed. Results: The response rate for school children was 81.27%. It was observed the age group of 11–14 years was very well aware of oral hygiene care and maintenance 67% and 55%, respectively. Seventy percent were sure about dietary food items causing dental decay. Toothbrush and paste are the best teeth cleaning aids as per this study group analysis. Conclusion: The findings of the present study reveal different aspects specifically directed toward the current scenario of oral health awareness among middle school children. There is a need for comprehensive dental care plan for school children. School-based educational intervention should be established with a focus on oral self-care and oral health education

An aggressive presentation of adenomatoid odontogenic tumor associated with calcifying epithelial odontogenic tumor: A hybrid variant

The adenomatoid odontogenic tumor (AOT) was formerly considered to be a variant of the ameloblastoma and was designated as adenoameloblastoma. It represents 3-7% of all odontogenic tumor and over 750 cases have been reported in the literature. Though this lesion shows pathognomic histological features, few overlapping patterns of the odontogenic tumors may be seen. AOT may infrequently show additional areas resembling to calcifying epithelial odontogenic tumor. Long-term follow-up research is need of the hour for such hybrid histological combination effect on the locally aggressive nature of the lesion. We present a case of a follicular variant of AOT in a 22 years male presenting with swelling on anterior maxilla associated with impacted canine

Comparative study on the efficacy of tissue autofluorescence (visually enhanced lesion scope) and toluidine blue as a screening method in oral potentially malignant and malignant lesions

Objective and Study Design: Early identification of high-risk disease could greatly reduce both mortality and morbidity due to oral cancer. Hence, screening of such lesions and their early detection could improve prognosis. Metachromatic dye toluidine blue, which stains nuclear material in dysplastic epithelium, is widely used for screening of potentially malignant lesions. Visually enhanced lesion scope (VELscope) that identifies reduction in tissue fluorescence in dysplasia can also prove to be effective in screening for potentially malignant lesions. Hence, this study was done to compare the reliability of VELscope and toluidine blue as a screening tool in the diagnosis of malignant and potentially malignant lesions as compared to histopathological diagnosis which is gold standard. Materials and Methods: 90 patients with tobacco associated hyperkeratotic red and white lesion, ulcerative lesion, and frank malignancy included in study. Patients were subject to Tissue Autofluorescence (Visually Enhanced Lesion Scope) and Toluidine Blue stain tests. Nature of Autofluorescence and Toluidine Blue staining of tissue was recorded. Based on findings tissue was biopsied and examined under microscope from confirmatory diagnosis. Results: In this study, ninety patients with malignant and potentially malignant lesions were studied, VELscope showed 85.36% sensitivity and 75% specificity as compared to toluidine blue which showed 83.13% sensitivity and 87.5% specificity. The results were statistically significant (P < 0.001) with a mean deviation of ± 3. Conclusion: From the study, we concluded that VELscope was more effective as a screening tool for the detection of oral malignant lesions as compared to toluidine blue

Impact of Oral Lichen Planus on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis

Oral health-related quality of life (OR-QoL) measurement in patients with oral lichen planus (OLP) can provide valuable information for the optimal management of their clinical conditions. The main objective of the present study was to assess the OR-QoL of patients with OLP as measured by the short-form Oral Health Impact profile-14 (OHIP-14) questionnaire. PubMed/MEDLINE, ISI/Web of Science, clinical trial registry, Embase, Scopus, and grey literature (via Google Scholar and Scilit) were searched. Reviewers independently screened titles/abstracts, assessed full-text articles, extracted data, and appraised their quality. Random effect analysis along with subgroup analysis for age, gender, and clinical type was performed. Seventeen studies were included. Mean overall OH-QoL was 15.20, [95% CI 12.176, 18.231]; a higher OHIP-14 score was seen in OLP patients, resulting in poor OH-QoL. The impact of OLP on OH-QoL life was moderate as compared to healthy subjects. However, medical treatment of the disease improved the OH-QoL and thus reduced the impact of OLP on it. OH-QoL among patients with OLP is generally poor. Clinicians and physicians should consider the OH-QoL of these patients as part of patients’ evaluation and modulate the administered treatment based on the OH-QoL response