Journal of Oral and Maxillofacial Pathology最新文献

Polymorphous adenocarcinoma (PAC) is a low-grade malignant tumour of minor salivary glands of the oral cavity, which rarely presents with invasive features. Low metastatic and excellent survival rates are some of its favorable features. A 36-year-old woman reported with swelling, pain, and mobility of teeth in the left upper inner cheek region. Contrast enhanced computed tomography (CECT) revealed a large, lobulated, heterogenous mass in the left retro-maxillary region with a few enlarged left cervical lymph nodes (levels IB and II). After surgery, the final histopathology report gave a definitive diagnosis of PAC with certain invasive characteristics - perineural invasion, infiltration into skeletal muscle, and depth of invasion of 10 mm, which recurred in a different location 1.5 years later. A few predictable features of PAC include incidence in elderly women, asymptomatic presentation, occurrence in the posterior hard of soft palate, very low incidence of nodal or distant metastases, perineural spread, skeletal muscle infiltration, and low rates of recurrence with good survival outcomes. However, in our case, the patient appeared to present with a relatively aggressive form of PAC, considering her young age, symptomatic presentation, uncommon anatomic location in the retro-maxilla, cervical nodal metastasis, perineural and skeletal muscle infiltration, and local recurrence within a short period. Although PAC is a low-grade tumour with excellent prognosis, it may occasionally present with invasive characteristics, and early diagnosis and prompt management with strict adherence to post-operative regimens and follow-up is of prime importance to prevent any untoward outcomes.

Opportunistic fungal infections are associated with patients having compromised systemic health. In India, a slow rise in cases of mucormycosis has been observed as the country has seen a rising number of diabetes mellitus cases in the recent decades. This apart, an enormous increase in case numbers was seen in association with COVID-19 infections in the Asian subcontinent, Southeast Asia, markedly in India. Many cases of mucormycosis were reported in association with COVID-19 positive history and post-treatment for COVID-19. They were presented in the form of rhino-cerebral-mucormycosis, in patients with and without diabetes. The presentation of the disease differed at different times of the pandemic to some extent. Some of the cases initially came in an acute format, but at the later end of the epidemic, they presented in an indolent form. A compilation of cases is provided to illustrate the variation in presentations and findings of mucormycosis cases diagnosed at different times of infection of the COVID-19 waves.

The human body can utilize light for a broad range of pathophysiological responses, such as circadian rhythm, Vitamin D metabolism, and vision, among others. The therapeutic use of light has spanned many ancient health practices. Recent advances in using low-dose light therapy, termed photobiomodulation (PBM), have made tremendous progress in unravelling precise biological mechanisms and clinical dosimetry, enabling this treatment modality's clinical safety and effectiveness. The evidence for PBM has received its strongest endorsement via recent systematic reviews and meta-analyses recommending its routine use to address various acute and chronic side effects associated with cancer treatment. Carefully done studies have noted unequivocal evidence demonstrating its effectiveness in managing oral mucositis in patients undergoing radiotherapy for head and neck cancer, chemotherapy, or hematopoietic stem cell transplantation. This brief narrative review will explore the therapeutic benefits of PBM therapy, supported by recent research findings, to provide a comprehensive understanding of its potential in clinical settings. Additionally, the review will highlight our current understanding of molecular mechanisms underlying PBM and the importance of novel harmonized dosing that enables its optimal clinical implementation and utilization.

The agenesis of teeth is the most common developmental anomaly in humans. Although third molars, mandibular second premolars, maxillary lateral incisors and maxillary second premolars are frequently found to be missing, the absence of all premolars has never been reported in the literature. This case report highlights the first-ever case of the complete agenesis of premolars in a 10-year-old male patient. It also discusses related definitions; commonly missing teeth and their prevalence; associated dental and skeletal features; genetic, drug-related and pathogenic etiological factors; and considerations for the future management of such cases.

Introduction: The study aims to investigate the antifungal efficacy of albedo extract of Punica grantum on candida albicans by evaluating the inhibitory capacity of alcoholic albedo extracts by disc diffusion method and by comparing the antifungal efficacy of alcoholic extract of albedo with clotrimazole and ethanol.

Methods: Using a conventional disc diffusion method, the effectiveness of Punica Granatum albedo extract against Candida albicans was assessed and evaluated depending on the presence or absence of inhibition zones, as well as the average diameter of inhibition zones. Albedo extract of Punica granatum serial dilutions were prepared ranging from 1%, 5%, 10%, 15%, 20% and 25% and its antifungal efficacy was tested against Candida albicans in comparison with clotrimazole and ethanol.

Results: When compared to clotrimazole, the albedo extract of punica granatum showed significant anticandidal activity. The mean zone of inhibition of extract was recorded at 27.6 mm whereas clotrimazole was 21.6 mm and no zone of inhibition was recorded for ethanol. Statistically significant p value 0.015 was recorded within the different dilutions of albedo extract of Punica grantum which is less than 0.05.

Conclusion: The present investigation found that Punica Granatum albedo extract had greater potent antifungal activity when compared to clotrimazole and ethanol.

Background: Oral squamous cell carcinoma (OSCC) accounts for nearly 90% of oral malignancies and represents a major global health care problem. It is often preceded by oral potentially malignant disorders (OPMD). Although regular clinical examination forms the backbone for oral cancer screening, subtle lesions go unnoticed and there is a need for more sensitive and specific molecular biomarkers in mass screening of population. Salivary proteomics offer an attractive alternative to serum and tissue testing.

Aims: To find the diagnostic utility of salivary interleukin-6 (IL-6) in the differential diagnosis of OSCC, OPMD from healthy controls.

Study design: In vivo study.

Methods: After approval from the Institutional Review Board, unstimulated whole saliva was collected from 90 subjects, 30 in each group of OSCC, OPMD and controls after ethical clearance. Salivary IL-6 was measured by ELISA, and the results were statistically analysed.

Results: Significant difference in salivary IL-6 was seen between OSCC, OPMD and controls. Receiver operating characteristic curve analysis showed the highest area under a curve of 0.982 in distinguishing OSCC from controls. It showed a sensitivity of 71% and specificity of 100% at a cut-off value of 33.4 pg/mL (P = 0.000). Moderately differentiated OSCC (MDSCC) showed a significant increase in salivary IL-6 concentration compared to well-differentiated OSCC (WDSCC).

Conclusion: Results of the present study showed strong predictive power of salivary IL-6 in distinguishing OSCC from controls. Its levels also increased with tumor aggressiveness from WDSCC to MDSCC. Thus, salivary IL-6 could have a diagnostic and/or prognostic significance in identifying high-risk groups in mass screening of the population.

Neuroendocrine tumours (NETs) primarily affect the lungs and larynx. Primary neuroendocrine carcinomas (NECs) rarely occur in the oral cavity. The classification of these tumours is ambiguous; however, the literature acknowledges their aggressiveness. Merkel cell carcinoma (MCC) is rare and more common in the skin but could occur intraorally. MCC and NECs are aggressive neoplasms and recommend intensive treatment. In this case report, a 22-year-old female presented with an ulceroinfiltrative lesion in the left buccal mucosa of the cheek, which was diagnosed as primary NEC in the oral cavity. This patient underwent wide local lesion excision of oral cavity mass, ipsilateral selective neck node dissection of levels 1-4 and postoperative chemotherapy. This aggressive tumour type requires large local excisions with margins like Merkel cell skin carcinomas. To our knowledge, this is the youngest oral cavity primary neuroendocrine cancer patient to date in the literature.

Objectives: Grading of oral epithelial dysplasia (OED) has been plagued with intra-observer and inter-observer variations. To overcome this subjectivity, a more objective digital image analysis is obligatory using computer-aided software. The use of open-source software like QuPath, which is a new bio-image evaluation software program, may fulfil this growing need in virtual pathology. This study used the QuPath software for automatic analysis of morphometric parameters in hematoxylin and eosin (H and E)-stained digital images of oral epithelial dysplasia.

Methodology: 150 H and E digital images of varying grades of OED captured under 40x magnification were processed using QuPath software for automatic analysis of cellular and nuclear parameters.

Results: The parameters that showed statistical significance included nuclear hematoxylin OD, nuclear eosin OD, cellular hematoxylin OD, cellular eosin OD, cytoplasm hematoxylin OD, and cytoplasmic eosin OD (P < 0.05), while none of the other parameters showed statistically significant differences. A prediction accuracy of 76%, 74%, and 70% for mild, moderate, and severe dysplasia was obtained, respectively.

Conclusion: The quantitative results outlined in this paper are encouraging to indicate that the use of this technique may improve the diagnostic reliability of OED. Morphometric analysis of OED using Qupath software can be fast and reproducible and can be quantitated automatically.