- Email: [email protected]
Poster Presentation
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Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/jobcr
Poster Presentation Oral cancer awareness among general dental practitioners in Amritsar district Neha Amitoz Multania, Sandeep Kaurb, Shantun Malhotrac, Shakeen Singhd, Lakhwinder Singhe a Student, Department of Pedodontics & Preventive Dentistry, Himachal Institute of Dental Sciences, Paonta Sahib, Sirmour, Himachal Pradesh, India; bProfessor, Department of Pedodontics & Preventive Dentistry, Himachal Institute of Dental Sciences, Paonta Sahib, Sirmour, Himachal Pradesh, India; cReader, Department of Endodontics & Conservative Dentistry, Sri Guru Ram Das Institute of Dental Sciences & Research, Amritsar, Punjab, India; dProfessor & Head, Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences & Research, Amritsar, Punjab, India; eSenior Medical Consultant, Department of Internal Medicine, ESI Hospital, Amritsar, Punjab, India
Introduction & aim: To assess the general dental practitioner’s awareness of prevention and early detection of oral cancer in the Amritsar district. Materials & methods: A cross-sectional questionnaire based survey was conducted between February 2013 to May 2013, among a random sample of 100 general dental practitioners (GDPs’) in the Amritsar district. The GDPs’ knowledge about the risk factors of oral cancer, diagnostic concepts and the current diagnostic practices followed by them was assessed and responses were analyzed. Results: Of the 100 general dental practitioners surveyed, 84 responded (84% response rate). 100% of participants considered tobacco use as the highest risk factor for oral cancer. Majority of the GDPs’ (98.8%) agreed that early detection of oral cancer improves its five year survival rate, 88% of the GDPs’ affirmed that they routinely performed systematic examination of the oral mucosa. Despite being proficient in the knowledge of risk factors of oral cancer, only 44% of GDPs’ regularly advised patients about the risk factors. Oral and maxillofacial surgeons (94.6%) were their preferred points of referral in case of suspected lesions. Erythroplakia and leukoplakia were identified as the most common types of lesions associated with oral cancer by 85.6% of GDPs’, with 80.9% GDPs’ considering tongue and floor of the mouth as the two most common sites for intra-oral lesions. Conclusions: Though the survey findings suggest that the GDPs’ appear to be generally knowledgeable about the risk factors and diagnostic concepts associated with oral cancer, yet current knowledge and skills must be regularly updated and reinforced by continuing professional education.
http://dx.doi.org/10.1016/j.jobcr.2014.02.002
Looking at the epithelial connective tissue interface e“fractal geometry: A hope to provide adjuvant aid in diagnostic histopathology” Neha Upadhyayaa, Shubhangi Khandekarb, Alka Divec P. G Student, V.S.P.M.D.C.R.C, Nagpur, Maharashtra, India; bProfessor, V.S.P.M.D.C.R.C, Nagpur, Maharashtra, India; cProfessor & Head, V.S.P.M.D.C.R.C, Nagpur, Maharashtra, India
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Introduction: Fractal geometry has the ability to quantify the irregularity and complexity of objects with a measurable value called the fractal dimension. The irregularities of basement membrane can be estimated quantitatively by the use of fractal geometry principles. The aim of this study is to use fractal geometry to compare the morphometric complexity in normal and pathological (squamous cell carcinoma and verrucous carcinoma) basement membrane of the oral mucosa and hence find an objective criteria to describe both physiological and pathological changes in the basement membrane of the oral mucosa. Aim: This study is an approach to compare the morphometric complexity in normal and pathological basement membrane of the oral mucosa and hence find an objective criteria to describe both physiological and pathological changes in the basement membrane of the oral mucosa. Material & method: H&E Stained histological images at 4 X (Scanner View) for: Group 1 : Normal Epithelium 30 Group 2 : Verrucous Carcinoma 30 Group 3: Squamous cell carcinoma Well differentiated Squamous cell carcinoma 10 Moderately differentiated Squamous cell carcinoma 10 Poorly differentiated Squamous cell carcinoma 10 Image analysis will be performed to separate the epithelium from the connective tissue using an edge detecting filter software. Irregularity profile image will be divided into boxes (box count 2 -12) by the software and Fractal Dimension (F.D) will be regenerated by the slope of the regression line in the graph generated from the software. The procedure will be repeated at five randomly selected places of equal box size, along the epithelial connective tissue interface. Average of all five F.D will be calculated and tabulated as F. D of that image. Comparison of F.D for the three study groups will be done to find objective morphometrical differences. Results & Conclusion: Awaited
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Ultrasonography: As a diagnostic step towards the detection in oral submucous fibrosis Samiksha Acharya Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India Introduction: Oral submucous fibrosis (OSMF) is a precancerous condition associated with the use of areca nut in various forms. This study is to evaluate oral submucous fibrosis (OSMF) by clinical examination, and compare the peak systolic velocity and mucosal changes throughout the oral cavity with those from ultrasonographic technique. Aims: Ultrasonography as a micro diagnostic step towards the detection in oral submucous fibrosis. Materials & methods: A total 24 patients are included in study, in which 08 patients with clinically diagnosed OSMF with adverse habit and 16 patients with no OSMF as a control group. Thorough clinical history was taken and proper clinical examination was carried out in the department of Oral Medicine and Radiology. All 24 patients were then subjected to ultrasonographic examination to compare the peak systolic velocity (PSV) and mucosal changes throughout the oral cavity with those by clinical examination. Results: All the 24 patients subjected to ultrasonography, revealed the OSMF changes throughout the oral cavity. Conclusion: Ultrasonography is a non-invasive micro diagnostic tool for Oral Submucous Fibrosis.
Role of p16INK4a protein expression in HPV-positive and HPV-negative squamous cell carcinoma of head and neck Priyanka Shilpia, Madhu Mati Goela, Vikram Bhatiaa, Annu Makkera, Seema Nayaka, Saumya Chandraa, S.P. Agarwalb, M.L.B. Bhattc, S.K. Goeld, Sandeep Kumard a Department of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh, India; bDepartment of Otolaryngology, King George’s Medical University, Lucknow, Uttar Pradesh, India; cRam Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; dAll India Institute of Medical Science, Bhopal, Madhya Pradesh, India
Introduction: Squamous cell carcinoma of head and neck (SCCHN) is the sixth most common type of cancer worldwide with 600,000 new cases diagnosed every year. In about 20-25% of SCCHN, a high-risk human papilloma virus (Hr-HPV) has been identified as an etiologic agent. Among over 100 different HPV types, HPV-16 and HPV-18 have been detected in the majority of HPV Positive SCCHNs. P16INK4a, a cyclin-dependent kinase inhibitor and G1/S cell cycle phase checkpoint regulator and a thwarted surrogate marker of HPV E7emediated functional inactivation of retinoblastoma gene protein (pRB), which is often mutated in SCCHN. Aims: Aim of the present study was to determine the role of P16INK4a expression as an indicator of HPV induced SCCHN. Material and methods: The study group comprised of 157 histologically proven SCCHN tumor tissues. HPV status was detected by step one real time PCR (Applied Biosystem) using consensus primers MY09 and MY011. Genotyping was performed by using primers specific for HPV16 and HPV18 on a step one real time PCR (Applied-Biosystem). Immunohistochemical (IHC) expression of p16INK4a was assessed using anti p16 antibody (Santa Cruz,
Biotechnology) and a polymer based secondary antibody kit (Novocastra, Leica Biosystem New Castle Ltd, UK). Results: Out of 157 SCCHN tumors 22(14%) were HPV positive. On genotyping, 10 (45%) of these HPV (þve) cases were found to be positive for Hr-HPV (16/18). P16INK4a expression was significantly higher in HPV positive cases (p¼0.001). While, 77% (17/22) of HPV (þve) cases were positive for p16INK4a, only 40.7% (55/135) of HPV (-ve) cases were found to be positive on IHC. In the Hr-HPV (þve) group, all the 10 cases showed p16 immunopositivity. Among the Hr-HPV (-ve) cases, 75% (9/12) of tumors were positive for p16. Conclusion: In conclusion, our data shows strong p16INK4a protein expression in HPV positive cases. Genotyping of HPV positive cases for Hr-HPV (16/18) in combination with immunohistochemical detection for P16INK4a, might serve as a reliable surrogate indicator of HPV infections in SCCHN.
Salivary analysis of lipid peroxides in oral submucous fibrosis Shruti Sood Department of Oral Medicine & Radiology, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India Introduction: Human saliva is an attractive diagnostic fluid because saliva collection is less invasive than the collection of blood for serum or plasma analysis. Therefore the developments of simple, accurate, rapid and cost effective methods to detect neoplastic lesions are required. Lipid peroxides are the important free radical, which includes polyunsaturated fatty acids, which leads to membrane destruction. Hence lipid peroxides in turn generate lipid hydroperoxides and causes membrane damage. Lipid peroxides levels were estimated in osmf patients. Aim: To estimate lipid peroxides level in saliva of oral submucous fibrosis. Materials & method: 20 clinically diagnosed oral submucous fibrosis patients were included in the study. Additionally 20 patients were taken in Control group and 20 patients were taken with habit and without any lesion. Thorough clinical history was taken and proper clinical examination was carried out in the department of Oral Medicine and Radiology. All 60 patients were then subjected to salivary examination to evaluate the lipid peroxides level. Results: All the 60 clinically diagnosed Oral Submucous Fibrosis patients subjected to salivary analysis of lipid peroxides. Conclusion: Salivary Analysis is a non-invasive diagnostic tool for Oral Submucous Fibrosis.
The cancer journey-delayed arrival causing early departure Chanchal Moolrajani, Shruti Singh Department of Oral Pathology and Microbiology, Hkes’s S.Nijallingappa Institute of Dental Sciences & Research, Gulbarga, Karnataka, India Introduction: Oral cancer ranks third most common cancer in India is responsible for about 40 % deaths. Etiology wise, oral cancer is dominated by consumption of tobacco, areca nut and alcohol. The high mortality rate has been attributed to the diagnosis of the disease in advanced stages. This is, in part, due to lack of awareness, delay in seeking medical care and limited health care services. The intensity of this public health challenge can be
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meliorated through habit intervention, increasing the knowledge and awareness among the public and health professionals, and improving the health services, especially in rural areas. Aim: To enhance the awareness about oral cancer, its associated risk factors and to strengthen the existing screening programmes, this would help health professionals to restrict the disease at an early and treatable stage. Materials & methods: Reviewing the current trends of incidence, mortality and survival of oral cancer in India, we also thoroughly investigated the determinants of the disease and current prevention strategies including the screening programs from the various printed articles and existing online literature. Results: Despite the considerable measures taken by the Government of India to restrict the current trend of oral cancer, there is a slow decline in the incidence in India. For Screening and awareness programmes to be effective, more focus is required on the training of the primary health care personnel imparting adequate knowledge about the disease and the recent techniques for early detection followed by referrals to the concerned professional. Advocation of Mouth self examination (MSE) must be encouraged among the public. Conclusion: Despite the fact that oral cancer can be prevented, treated, and controlled, there exists a significant gap in the Indian public’s knowledge, attitudes, and behaviours. Thus, the emphasis should be on not only primary prevention, health education, early detection but also to prioritize cancer control making the optimal use of limited resources.
Ghost cells: Realities behind the shadow... S.H. Thippeswamya, Jiji Georgeb, Abhilasha Shuklac a
Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cReader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India Background: Ghost cells are pale anucleate cells with homogeneous pale eosinophilic cytoplasm with very pale to clear central areas in place of a basophilic nucleus; which are seen in small clusters or large masses. Few odontogenic and non odontogenic tumours exhibit the presence of these transparent or shadow cells as a typical feature. Many attempts have been made in the past by several investigators regarding the true characteristics of ghost cells in these lesions, inspite of which they seem to be mysterious. Conclusion: True nature of ghost cells remains elusive and controversial, though their most accepted nature is aberrant keratinization. Recent studies are directed towards the role of Wnt and Notch signaling pathways in tumorigenesis and assigning cells to particular fate. However, further extensive studies on these aspects will give us the possible clue in determining the role of these ‘shadow cells’ in many odontogenic as well as non odontogenic lesions. Here we have made an attempt to clear the illusions and controversies surrounding ghost cells.
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Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bReader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cSr. lecturer, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral mucosa is affected by number of lichenoid lesions, the etiology of which is attributed to infective, inflammatory, dysplastic and immune mediated conditions, resulting in distinct disease entity interns of diagnosis and prognosis. Yet, there clinical and histopathological features overlap each other and create a diagnostic dilemma for the clinician and pathologists. Overlapping of features is due to presence of intense inflammatory cells in the juxta epithelium. Conclusion: Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. Hence it is necessary for the clinician and pathologist to familiarize with the clinicopathologic patterns of oral lichenoid lesions to develop accurate diagnostic and prognostic assessment. The main aim of the poster is to segregate individual lichenoid lesions delineating clinical and histopathological variation among each other, which avoids diagnostic problems.
Viruses!!! Possible role in oral carcinogenesis. Abhilasha Shuklaa, Jiji Georgeb, Anuj Maheshwaric a Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cProfessor & Head, General medicine, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
Introduction: Oral squamous cell carcinoma is the disease with varied and complex etiology. Most common etiological factors have been indicated as tobacco (chewing and smoking), drinking, and genetic susceptibility. Recent studies suggest the role of viruses that produce changes in cellular DNA converting it into a malignant phenotype. Herpes simplex virus type 1 & human papilloma viruses have been seen to be associated with oral squamous cell carcinoma. Both of these viruses depend on other co factors for their carcinogenic effect. Conclusion: Oral carcinogenesis induced by viruses follows a different path leading to rearrangements and mutations. It is important to understand the process by which these changes are brought about in the cell so that treatment and prognosis may become better. Oral squamous cell carcinomas associated with viruses have been shown to have better prognosis as it is more responsive to radiotherapy. We herewith present a poster showing possible role of viruses in human oral carcinogenesis.
An aggressive variant of carcinoma: Basaloid squamous cell carcinoma e Review of literature and a case report. Amritaksha Bhattacharyyaa, Anil Singhb, Kunal Sahc, Vineet Rajc a
Clinicopathological patterns of oral lichenoid lesions
PG student, Saraswati Dental College, Lucknow , Uttar Pradesh, India; Professor & Head, Saraswati Dental College, Lucknow , Uttar Pradesh, India; cReader, Saraswati Dental College, Lucknow , Uttar Pradesh, India
Santhosh Kumar Hirematha, S.H. Thippeswamyb, Ahmed Danish Rehanc
Introduction: Basaloid squamous cell carcinoma is a histologically distinct variant of squamous cell carcinoma that mainly arises
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from the upper digestive tract. It occurs in various sites of the head and neck, palate being the rarest of all. Here we report a case of 60-year-old male presented with a painful swelling on the left side of the neck. Intra-oral examination revealed ulceroproliferative growth over the postero-lateral border of tongue, extending over the palate. Magnetic resonance imaging (MRI) showed extension of the lesion into the posterior wall of the pharynx and to the base of the skull. Debulking surgery was done to reduce the size of the tumor and patient was referred for chemotherapy and radiotherapy. Histopathological examination confirmed the diagnosis of basaloid squamous cell carcinoma. This paper discusses the clinico-pathological features and differential diagnosis of this rare and an aggressive variant of oral squamous cell carcinoma. Aim: To present a case of Basaloid Squamous Cell Carcinoma and review reported cases in English literature. Conclusion: Basaloid squamous cell carcinoma is an uncommon, high-grade bi-morphic variant of squamous cell carcinoma with a predilection for head and neck region which is needed to be differentiated from other tumors having basaloid component. Once the diagnosis is being made of basaloid squamous cell carcinoma, the treatment should be appropriately planned considering its aggressive clinical course and high rate of metastasis.
Nanotechnology in oral cancer “A Small Innovation with a Big Punch” Shruti Singh, Chanchal Moolrajani Department of Oral Pathology and Microbiology, Hkes’s S. Nijallingappa Institute of Dental Sciences & Research, Gulbarga, Karnataka, India Introduction: Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Oral cancer is the sixth most common malignancy in the world, with over 400,000 cases being reported worldwide. The high mortality rate in cancer is commonly attributed to the difficulties in detecting the disease at an earliest and treatable stage and thus, “war with cancer” is still on. Intense research has led to a more comprehensive understanding of cancer at the genetic, molecular and cellular levels, providing an avenue for early diagnosis and treatment of oral cancer which has overcome the limitations of traditional and conventional methods commonly used. Nanotechnology is a science used to manipulate the atoms and the molecules which lead to the production of structures in the nanometer size, which range from 100nm or even smaller, which attain their unique properties. Aims: To review with recent developments concerning cancer detection and treatment enabled by nanotechnology and its future implication. Materials & methods: A detailed study on nanotechnology and its application in diagnosing and treatment of oral cancer has been done from various articles printed on this topic in various national and international journals till the year 2013 and information has been gathered from them. Results: Nanotechnology provide innovative tools like nanocantilevers, nanopores, nanotubes, Nanoshells, Dendrimers and quantum dots which are prospective structures that can detect cancer cells, identify cancer signals and provide targeted delivery of anti cancer therapeutics and contrast agents to tumor cells. This new technology sheds newer light on the normal life cycle of cells at the molecular level and also enables us to detect changes if any, within cells that can be correlated with development and
progression of cancer. A large amount of information can be obtained from a small source the nano particles. Conclusion: Nano technology aids in analysis of parameters such as cellular mechanics, morphology and cytoskeleton which has been hard to achieve using conventional technology. Hence nanotechnology offers many opportunities for enhanced diagnostic and therapeutic medicine against cancer and other diseases.
Cancer epigenetics: From mechanism to therapy Neha Vermaa, Ranjitkumar Patilb a PG student, Department of Oral Medicine & Radiology, FODS, King George’s Medical University, Lucknow, India; bProfessor & Head, Department of Oral Medicine & Radiology, FODS, King George’s Medical University, Lucknow, India
Epigenetics is study of heritable changes in gene activity that are not caused by changes in DNA sequence as such. Epigenetics has been a topic of extensive research in past few years for better understanding of role of epigenome in pathophysiology of cancer and formulation of novel drugs targeting these epigenomes for treatment of various cancers. Here we are discussing basic principles of epigenetic pathways along with promising preclinical and clinical results seen with epigenetic drug which signifies importance of epigenetics in cancer.
Habit pattern and oral mucosal changes in 1000 tobacco users: An epidemiological study Babusha Tewari PG student, Saraswati Dental College, Lucknow, Uttar Pradesh, India Introduction: Tobacco consumption, smoked, chewed or dipped has become one of the larger health problems worldwide, to the degree that is considered by some a world epidemic. The unrestricted availability of tobacco especially in developing countries across various age groups & its addictive nature has resulted in a steep rise in tobacco related oral lesions. Objective: An attempt was made in this study to assess the tobacco habit patterns and its association with oral mucosal lesions in tobacco users. Materials & methods: A detailed tobacco related history was taken from 1000 tobacco users with the help of habit assessment questionnaire, which include general information related to subjects’ oral habits e type(chewing/smoking), form of tobacco, frequency, duration, manner of chewing/smoking, etc. The oral cavity was thoroughly examined and mucosal changes if present were recorded. Results: The result of our study showed that tobacco associated mucosal lesions were higher in combined chewers and smokers, khaini users, non quid tobacco users and bidi smokers and showed age peak in young adults.
Nanodentistry: A breakthrough in oral cancer management Devangi Dwivedi PG student, Saraswati Dental College, Lucknow, Uttar Pradesh, India Introduction: There is an unavoidable development in the progress of science, nanotechnology has been part of the mainstream
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scientific theory with potential medical and dental applications since the early 1990s. Dentistry is undergoing another change with the help of nanotechnology combined with nanomaterials, biotechnology and ultimately dental nanorobotics. Nanodentistry is an emerging field with significant potential to yield new generation of technologically advanced clinical tools and devices for oral healthcare. In particular, using Atomic force microscopy techniques- diseases such as oral cancer can be quantified based on morphological, biophysical and biochemical nanoscale properties from oral fluids, such as saliva. Diagnosis of oral cancer can be done using nanoscale cantilevers, nanopores nanotubes and quantum dots whereas; it can be treated with the help of nanomaterials for brachytherapy, nanovectors for gene therapy and nonviral gene delivery systems etc. Aims: The main aim of this paper is to describe in detail about the applications of nanotechnology in the management of oral cancer. Materials & methods: A thorough PubMed search was done using the following keywords: Nanodentistry, Atomic Force Microscopy, Nanorobots. Conclusion: Nanotechnology applications in cancer detection and treatment have the potential to replace highly invasive conventional cancer detection and treatment, which often includes biopsies, irradiation, and painful therapies. The ability to diagnose malignant disease at the earliest opportunity allows treatment options to be planned as early as possible and hence directly affects the morbidity and mortality of head and neck cancer.
Grading of epithelial dysplasia at molecular level e An addendum to cytological criteria of malignancy Mohd. Saleem, Balasundari Shreedhar, Mala Kamboj, Mudita Chaturvedi Department of Oral Pathology and Microbiology, Career Postgraduate Institute of Dental Sciences & Hospital, Lucknow Introduction: Oral Cancer is still diagnosed based on its morphology. However surprisingly, little is known about the molecular basis of defining the structural features. The cytologic criteria of malignancy are extremely varied, apparently reflecting many different pathophysiologies in specific micro environments. The histologic criteria to assess cellular and tissue changes (dysplasia) relates to alterations in kinetics of cellular proliferations and maturation of epithelium. Wide variations are seen in inter-and intra-examiner grading due to lack of well-defined and predictable set of criteria. To understand the criteria of malignancy at a molecular level would improve diagnosis, and likely point to novel cell physiologies that are not encompassed by current cell biology concepts. Aims: To review the current and future trends of various new methods of grading epithelial dysplasia and predicting oral cancer. Materials & methods: A thorough search from various printed articles as well as online literature from PubMed, Google Scholar and Medlars Online was performed using keywords as cancer, malignancy, dysplasia. Results: The criteria to assess epithelial dysplasia on the molecular basis appear to provide an independent means of describing dysplasia and predicting cancers. It may be useful for researchers to try to relate cancer genes to a particular cell structural change rather than to a particular histogenetic type of cancer.
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Conclusion: The current gold standard is the finding of epithelial dysplasia in a tissue biopsy. A maximum of 50% of severe dysplasias, 30% of moderate and a very few (<5%) mild dysplasia are thought to progress to cancer.
E-cigarettes: A miracle or menace? Kopal Mathur Manchester Business School Background: Electronic nicotine delivery devices (ENDD), popularly known as e-cigarettes, are the new replacement for traditional cigarettes. They are battery-powered devices which simulate tobacco smoking and use a heating element that vaporizes a liquid solution. However, there have been health and safety concerns with the ENDDs to classify them as completely safe for public health. Aim: The purpose of this study is to critically analyse the introduction of e-cigarettes for smokers, whether it is improving the habits of smoking and reducing its ill-effects or it jeopardises the carefully drawn distinctions between ‘good’ and ‘bad’ forms of nicotine. Material & methods: This study will aim to review literature to analyse the argument over ENDDs whether they can be considered as a glamorous and harmless replacement to cigarette smoking. It will explore the regulations regarding the manufacturing and selling of these ENDDs in most parts of the world and its impact on the people. Results: Neither there are any age restrictions in place nor have limitations to smoke ENDDs in public places, planes, hospitals been questioned. Since it resembles the visual spectacle and bodily pleasures of smoking traditional cigarettes, a substantial decrease in cigarette consumption without causing significant side effects in smokers who did not intend to quit previously has been shown with the use of ENDDs. These contain no tobacco and tar which is the harmful content in the traditional cigarettes. But there are debates over the standards of the chemical and a medicinal product it contains is controversial in considering it as completely non-hazardous. Conclusion: E-cigarettes have proven to improve the health effects caused by smoking traditional cigarettes. It is, however, necessary to implement policies to regulate their use among the population. This is a critical area of research as e-cigarettes highlight the complex status of nicotine and its other constituents as both a toxic and antidote in contemporary public health and tobacco control.
Tissue microarray Aanchal Tandon, Akansha Srivastava, V. Subhalakshmi PG Student, Department of Oral Pathology, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral squamous cell carcinoma is the most common debilitating disease of concern to oral health physicians. Aim: Identification of the molecular alterations in OSCC can help us in understanding the behavior of the tumor. Materials & methods: Online search was done using the keyword Tissue Microarray. Results: Tissue microarray (TMA) approach is a high throughput technology that enables analysis of multiple molecular targets
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simultaneously without causing any morphological alteration to tissue specimens. Tissue microarray enables analysis of multiple molecular targets simultaneously without causing any morphological alteration to tissue specimens. Tissue microarray technology is a promising way to analyse multiple biomarkers simultaneously. This poster aims at presenting the technique of tissue microarrays and its uses in identifying OSCC.
proliferation, antioxidant function and modulating effects on carcinogen detoxification. The advantages of phytochemicals are their pleiotropic effects and nontoxicity.
HPV infections associated with oral mucosa Garima Srivastava, Balasundari Shreedhar, S. Natarajan, Renuka Verma
Recent advances in diagnosis of oral cancer Shaikh Amjad Khan Munir, Md. Kalim Ansari, Mohammad Zavir Khan, Satish Rudhani JR-III, Department of Oral and Maxillofacial Surgery, Dr. Z A Dental College, Aligarh Muslim University, Aligarh (U.P) Introduction: Oral cancer is one of common cancer in India its prevalences increases day by day due to excessive use of different form of tobacco. The main treatment of oral cancer is surgical resection and reconstruction which leads to high morbidity and mortality. Aims: Accurate diagnosis of the disease at proper time is very important for optimum functional, aesthetics and survival. Materials & methods: This can be achieved by applying recent investigational technique, so in this poster we demonstrate recent diagnostic methods for oral cancer Results: In this poster we highlighted recent technical advancements helpful for early diagnosis of oral cancer. Conclusion: Early diagnosis oral cancer is important for long term survival of patients and to reduce surgical and reconstruction burdens of surgeons.
Role of chemoprevention in oral premalignant & malignant lesions Taseer Bashir, Md. Asdullah, Vijay Krishnan, K. Srinivas, Jyoti Gupta Department of Oral Medicine & Radiology, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral cancer is defined as the cancer of mouth and pharynx, including cancer of the lips, tongue and floor of the mouth, palate, gingiva, alveolar mucosa, buccal mucosa, oropharynx, tonsils, uvula, and salivary glands. Oral squamous cell carcinoma comprises 90% of all intra-oral cancers and is the fifth most frequent cancer worldwide. In India, oral cancer accounts for 40-50% of cancers. Aim: To review the literature on role of chemoprevention in oral precancer and cancer. Material & methods: Online and reputed journal search was conducted for the above terms. Results: External factors such as tobacco, chemicals, radiation, viruses and internal factors such as inherited mutations & immune status may act synergistically or in sequence to initiate or promote carcinogenesis. The various stages of carcinogenesis are initiation, progression and promotion. Cancer chemoprevention has a promising approach to prevent, inhibit or reverse the carcinogenic processes by intervention with natural products or synthetic chemical substances. Active principles derived from certain traditional medicinal plants have chemopreventive properties. Chemopreventive agents like curcumin, polyphenols act by antimutagenic, anticarcinogenic, inhibitory effects on cell
Department of Oral Pathology and Microbiology, Career Post Graduate of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India Introduction: Human papillomavirus (HPV), small non enveloped DNA tumor virus of papillomavirus family causes genital warts, common warts, plantar warts and flat warts. The World Health Organization estimates that between 9-13% (w630million) of the world population has an HPV infection in oral mucosa. Oral mucosa may play significant role in HPV transmission and its persistent infection in the oral mucosa increase the risk of developing carcinoma. Regular and scrupulous examination of it is most important tool in detecting HPV-associated changes in the oral mucosa. HPV16 being the most prevalent genotype other being HPV 2, 4, 6, 11, 13, 18 and 32. HPV positivity occurs in vermilion border, hard palate, labial mucosa and labial commissures. According to biologic behavior there are various lesions associated with it. Benign lesions being squamous papilloma, verruca vulgaris, condyloma acuminatum, focal epithelial hyperplasia and premalignant or malignant lesions are leukoplakia, squamous cell carcinoma, lichen planus, verrucous carcinoma. Aims: To review the current and future relevance of HPV and oral lesions, which are or can be used in the near future for detection of oral cancers. Materials & methods: A thorough search from various printed articles as well as online literature from PubMed, Google Scholar and Medlars Online was performed using keywords as HPV infection, oral mucosa, carcinoma, HPV vaccines. Results: HPVs and their role in the development of a range of oral mucosal lesions are briefly reviewed for the point of updating oral health professionals and raising the alertness of budding associations being established flanked by HPVs and some oral diseases counting oral cancer. Conclusion: From the dental practitioners’ point of view, where appropriate, patient education with regard to oral transmission of HPV and its possible role in the causation of a series of oral lesions including oral cancer should be built-in for protective strategy.
Dental DNA- tool in forensic dentistry Deepak Verma, Balasundari Shreedhar, S. Natarajan, Mudita Chaturvedi Department of Oral Pathology and Microbiology, Career Post Graduate Of Dental Sciences And Hospital, Lucknow, Uttar Pradesh, India Introduction: Forensic odontology is an integral part of forensic science and is widely utilized for the identification of living and deceased persons. DNA as a molecule encodes genetic instructions and can be used in identifying all organisms. DNA found in human cell is of two types: chromosomal DNA and mitochondrial DNA. It can be extracted from dental tissues like pulp, dentin and cementum. The tooth being hardest tissue in the body is one of the most valuable sources to extract DNA because
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DNA in the pulp is protected from extreme environmental conditions. Thus in this poster we focus on a comprehensive review on the milling method technique used in identifying individuals using DNA extracted from pulp. Aim: For identification of a deceased person by dental profiling. Material and method: A thorough search from various printed articles as well as online literature from PubMed, Google Scholar and Medlars Online was performed using Keywords as Dental DNA, Forensic Odontology, Dental Profiling. Result: There are various techniques involved in dental identification which include comparative dental identification, reconstructive post-mortem, dental profiling and DNA profiling. The different methods used to gain access to dental tissue for DNA analysis are hybridization-based methods, PCR-based assays, reverse e dot blot assays and microchip assays. These techniques provide accurate result in forensic science as DNA of an individual is unique. Conclusion: The application of DNA technology has revolutionized forensic identification procedures. Teeth represent an excellent source of DNA, which is protected by epithelial, connective, muscular and bone tissues in case of incineration. Additionally, the dental pulp cells are protected by enamel, dentin and cementum hard dental tissues. Therefore, dental professionals working on the field of Forensic Dentistry should incorporate these new technologies in their work, as several methods are available for DNA extraction from biological materials.
Ghost cells: Realities behind the shadow....
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Role of epigenetics in oral cancer: From mechanism to therapy Neha Vermaa, Ranjit Kumar Patilb a
PG student, Department of Oral Medicine & Radiology, King George’s Medical University, Lucknow, Uttar Pradesh, India; bProfessor & Head, Department of Oral Medicine & Radiology, King George’s Medical University, Lucknow, Uttar Pradesh, India Introduction: Cancer is a leading cause of death worldwide, oral squamous cell is one of the most common and aggressive malignancies. Epigenetics is study of heritable changes in gene activity that are not caused by changes in DNA sequence as such. Epigenetics has been a topic of extensive research in past few years for better understanding of role of epigenome in pathophysiology of oral cancer and formulation of novel drugs targeting these epigenomes for treatment of various cancers. Aim: To discuss basic principles of epigenetic pathways along with promising preclinical and clinical results seen with epigenetic drug which signifies importance of epigenetics in oral cancer management. Materials & methods: An electronic search was employed relevant studies and review of literature were utilized from PubMed, Google Scholar, Wiley’s online library. Result: More than 40 genes associated with initiation, progression and prognosis of oral sq cell carcinoma have been identified undergoing epigenetic alterations DNA hypermethylation being one of major alteration. Conclusion: Epigenetic changes provides a novel target to assess progression, prognosis and check responsiveness of cancer therapeutics and reversibility of epigenetic alteration being utilized for pharmacotherapy for oral cancer.
S.H. Thippeswamya, Jiji Georgeb, Abhilasha Shuklac a Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cReader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
Introduction: Many attempts have been made in the past by several investigators regarding the true characteristics of ghost cells in these lesions, inspite of which they seem to be mysterious. Here we have made an attempt to clear the illusions and controversies surrounding ghost cells. Aim: To undertake literature review on nature of ghost cells as ghost cells are observed in few odontogenic and non odontogenic tumours as transparent or shadow cells. Materials and method: PubMed search was carried using key words such as odontogenic ghost cells, ghost cell lesions, calcifying epithelial odontogenic cyst. Out of 398 available articles using key words search 24 articles were taken to study the true nature of ghost cells and with these articles a literature review on ghost cells was presented. Conclusion: True nature of ghost cells remains elusive and controversial, though their most accepted nature is aberrant keratinization. Recent studies are directed towards the role of Wnt and Notch signaling pathways in tumorigenesis and assigning cells to particular fate. However, further extensive studies on these aspects will give us the possible clue in determining the role of these ‘shadow cells’ in many odontogenic as well as non odontogenic lesions.
Title: Viruses!!! Possible role in oral carcinogenesis. Abhilasha Shuklaa, Jiji Georgeb, Anuj Maheshwaric a
Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cProfessor & Head, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral squamous cell carcinoma is the disease with varied and complex etiology. Most common etiological factors have been indicated as tobacco (chewing and smoking), drinking, and genetic susceptibility. Recent studies suggest the role of viruses that produce changes in cellular DNA converting it into a malignant phenotype. Herpes simplex virus type 1 & human papilloma viruses have been seen to be associated with oral squamous cell carcinoma. Both of these viruses depend on other co factors for their carcinogenic effect. Aim: Aim of the poster is to review literature regarding the viral oncogenesis, especially HPV 16 which is mostly seen to be responsible for oral squamous cell carcinoma. It is an interesting aspect to explore that how this virus produces changes leading to mutations in the otherwise normal cellular DNA which then attain immortality leading to malignancy. Material & method: PubMed search was done using keywords like HPV, oral squamous cell carcinoma, carcinogenesis, telomerase
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and it resulted in 27 articles out of which 12 articles were reviewed and included for the required information. Articles which stressed on how HPV leads to malignant transformation and its therapeutic considerations were mainly included. Conclusion: Oral carcinogenesis induced by viruses follows a different path leading to rearrangements and mutations. It is important to understand the process by which these changes are brought about in the cell so that treatment and prognosis may become better. Oral squamous cell carcinomas associated with viruses have been shown to have better prognosis as it is more responsive to radiotherapy. We herewith present a poster showing possible role of viruses in human oral carcinogenesis.
Apoptosis and oral cancer
described according to the type of tissue present; lipoma with cartilaginous metaplasia is a chondrolipoma which is a rare variant. Aim: This paper discusses clinical features, differential diagnosis and histogenesis of this rare histopathological variant of lipoma. Material & methods: Here we report a case of chondrolipoma in 35 year old male patient in posterior dorsal surface of tongue, present since 20 years. The lesion was treated with conservative surgical and histopathological examination to confirm the diagnosis. Results: Chondrolipomas are benign mesenchymal tumours characterized by the proliferation of mature adipocytes associated with variable amounts of mature cartilaginous tissue. Chondrolipoma are uncommon in the oral cavity, are identified mainly in lower lip and tongue. Only 14 cases of chondrolipomas in the oral cavity have been reported in English Literature (PubMed database).
Shilpi Chandela, Balasundari Shreedharb, Mala Kambojc a PG student, Departement of Oral pathology and Microbiology, Career Institute of Medical & Dental Sciences, Lucknow, Uttar Pradesh, India; b Professor & Head, Departement of Oral pathology and Microbiology, Career Institute of Medical & Dental Sciences, Lucknow, Uttar Pradesh, India; cProfessor, Departement of Oral pathology and Microbiology, Career Institute of Medical & Dental Sciences, Lucknow, Uttar Pradesh, India
Introduction: Apoptosis is generally characterized by distinct morphological characteristics and energy dependent biochemical mechanisms. Inappropriate (either too little or too much) is a factor in many human conditions including neurodegenerative diseases, ischemic damage, autoimmune disorders and many type of carcinomas. Tumours that exhibit less apoptosis tend to show aggressive behaviour and have a greater potential for metastasis. Aims: To review the current understanding in the field of apoptosis in oral cancer. Thus, this poster would emphasize on the importance of apoptosis in OSCC. Material & methods: A PubMed search was done using the keywords apoptosis and OSCC. Results: The apoptotic cells showed certain well defined features, which included cell shrinkage, condensation and deep eosinophilia of the cytoplasm and pyknotic, round too cresentric, irregular nucleus. Apoptotic bodies which appeared as tiny, round, pyknotic nuclear fragments, were seen scattered among tumour cell and occasional form a cluster. Potential pitfalls included the presence of mononuclear inflammatory cells, densely stained mitotic figures, necrotic cells and nuclear debris. In Oral Squamous Cell Carcinoma (OSCC), the co-operation of p53, Bcl-2, Bax results in the progression of OSCC. Apoptosis genes work independently or co-operatively. Apoptosis is said to occur frequently in the cornified areas of well differentiated OSCCs.
Lipoma with a cartilaginous metaplasia: A rare variant Kahkasha Khan PG student, Department of Oral Pathology, Saraswati Dental College, Lucknow, Uttar Pradesh, India Introduction: Lipoma can occur in any part of the body but are found infrequently in the oral cavity. Variants of the lipoma have been
Pedicled buccal fat pad (BFP) and dermal fat in the surgical management of oral submucous fibrosis (OSMF): A comparative study Kuldeep Vishwakarma, Ashish Singh, D. Mehrotra, S. Mohammad Department of OMFS, King George’s Medical University, Lucknow, Uttar Pradesh, India Introduction: Oral submucous fibrosis (OSMF) is a chronic, debilitating disease characterized by juxtaepithelial fibrosis of the oral cavity. It is regarded as a precancerous and potentially malignant lesion. OSMF is multifactorial in origin with a high incidence in people who chew areca-nut. The current protocol for the management of OSMF can be divided into 3 broad groups: surgical, physical, and medical treatments. Surgical treatment, used mainly to manage trismus, involves incising and releasing the fibrotic areas, and introduction of remote tissue (pedicled, such as a buccal fat pad, nasolabial or platysmal flaps or dermal fat transfer). Aims and objectives: The aim of this study was to evaluate the application of pedicled buccal fat pad (BFP) and dermal fat in the surgical management of oral submucous fibrosis (OSMF). Materials and methods: 10 clinically and histologically diagnosed cases of OSMF (Stage III and Stage IV) were randomly divided into 2 groups: group I (n ¼ 5) and group II (n ¼ 5). In group I the patients underwent incision of fibrotic bands and coverage of the buccal defect with a pedicled BFP flap. In group II the buccal defect was covered with dermal fat. Both groups were analyzed separately for mouth opening (interincisal distance in millimeters) preoperatively, intraoperatively, 7 days, 6 month postoperatively and time taken for epithelialization , time taken for establishment of normal contour, and changes in symptoms (painful ulcerations, burning sensation, and intolerance to spices). Results: The mean preoperative mouth opening was 5.2 mm in group I and 5.8 mm in group II. The mean postoperative mouth opening after 6 month was 28.2 mm in group I and 27.8 mm in group II. The time taken for epithelialization of BFP was 2 weeks in group I and 3 weeks in group II. There was improvement in symptoms like painful ulcerations, burning sensation and intolerance to spices in both groups. Conclusion: Both BFP and dermal fat are reliable for the treatment of OSMF with similar outcomes. However dermal fat graft is associated with additional donor site and surgical scar.
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/jobcr
Poster Presentation Oral cancer awareness among general dental practitioners in Amritsar district Neha Amitoz Multania, Sandeep Kaurb, Shantun Malhotrac, Shakeen Singhd, Lakhwinder Singhe a Student, Department of Pedodontics & Preventive Dentistry, Himachal Institute of Dental Sciences, Paonta Sahib, Sirmour, Himachal Pradesh, India; bProfessor, Department of Pedodontics & Preventive Dentistry, Himachal Institute of Dental Sciences, Paonta Sahib, Sirmour, Himachal Pradesh, India; cReader, Department of Endodontics & Conservative Dentistry, Sri Guru Ram Das Institute of Dental Sciences & Research, Amritsar, Punjab, India; dProfessor & Head, Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences & Research, Amritsar, Punjab, India; eSenior Medical Consultant, Department of Internal Medicine, ESI Hospital, Amritsar, Punjab, India
Introduction & aim: To assess the general dental practitioner’s awareness of prevention and early detection of oral cancer in the Amritsar district. Materials & methods: A cross-sectional questionnaire based survey was conducted between February 2013 to May 2013, among a random sample of 100 general dental practitioners (GDPs’) in the Amritsar district. The GDPs’ knowledge about the risk factors of oral cancer, diagnostic concepts and the current diagnostic practices followed by them was assessed and responses were analyzed. Results: Of the 100 general dental practitioners surveyed, 84 responded (84% response rate). 100% of participants considered tobacco use as the highest risk factor for oral cancer. Majority of the GDPs’ (98.8%) agreed that early detection of oral cancer improves its five year survival rate, 88% of the GDPs’ affirmed that they routinely performed systematic examination of the oral mucosa. Despite being proficient in the knowledge of risk factors of oral cancer, only 44% of GDPs’ regularly advised patients about the risk factors. Oral and maxillofacial surgeons (94.6%) were their preferred points of referral in case of suspected lesions. Erythroplakia and leukoplakia were identified as the most common types of lesions associated with oral cancer by 85.6% of GDPs’, with 80.9% GDPs’ considering tongue and floor of the mouth as the two most common sites for intra-oral lesions. Conclusions: Though the survey findings suggest that the GDPs’ appear to be generally knowledgeable about the risk factors and diagnostic concepts associated with oral cancer, yet current knowledge and skills must be regularly updated and reinforced by continuing professional education.
http://dx.doi.org/10.1016/j.jobcr.2014.02.002
Looking at the epithelial connective tissue interface e“fractal geometry: A hope to provide adjuvant aid in diagnostic histopathology” Neha Upadhyayaa, Shubhangi Khandekarb, Alka Divec P. G Student, V.S.P.M.D.C.R.C, Nagpur, Maharashtra, India; bProfessor, V.S.P.M.D.C.R.C, Nagpur, Maharashtra, India; cProfessor & Head, V.S.P.M.D.C.R.C, Nagpur, Maharashtra, India
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Introduction: Fractal geometry has the ability to quantify the irregularity and complexity of objects with a measurable value called the fractal dimension. The irregularities of basement membrane can be estimated quantitatively by the use of fractal geometry principles. The aim of this study is to use fractal geometry to compare the morphometric complexity in normal and pathological (squamous cell carcinoma and verrucous carcinoma) basement membrane of the oral mucosa and hence find an objective criteria to describe both physiological and pathological changes in the basement membrane of the oral mucosa. Aim: This study is an approach to compare the morphometric complexity in normal and pathological basement membrane of the oral mucosa and hence find an objective criteria to describe both physiological and pathological changes in the basement membrane of the oral mucosa. Material & method: H&E Stained histological images at 4 X (Scanner View) for: Group 1 : Normal Epithelium 30 Group 2 : Verrucous Carcinoma 30 Group 3: Squamous cell carcinoma Well differentiated Squamous cell carcinoma 10 Moderately differentiated Squamous cell carcinoma 10 Poorly differentiated Squamous cell carcinoma 10 Image analysis will be performed to separate the epithelium from the connective tissue using an edge detecting filter software. Irregularity profile image will be divided into boxes (box count 2 -12) by the software and Fractal Dimension (F.D) will be regenerated by the slope of the regression line in the graph generated from the software. The procedure will be repeated at five randomly selected places of equal box size, along the epithelial connective tissue interface. Average of all five F.D will be calculated and tabulated as F. D of that image. Comparison of F.D for the three study groups will be done to find objective morphometrical differences. Results & Conclusion: Awaited
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Ultrasonography: As a diagnostic step towards the detection in oral submucous fibrosis Samiksha Acharya Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India Introduction: Oral submucous fibrosis (OSMF) is a precancerous condition associated with the use of areca nut in various forms. This study is to evaluate oral submucous fibrosis (OSMF) by clinical examination, and compare the peak systolic velocity and mucosal changes throughout the oral cavity with those from ultrasonographic technique. Aims: Ultrasonography as a micro diagnostic step towards the detection in oral submucous fibrosis. Materials & methods: A total 24 patients are included in study, in which 08 patients with clinically diagnosed OSMF with adverse habit and 16 patients with no OSMF as a control group. Thorough clinical history was taken and proper clinical examination was carried out in the department of Oral Medicine and Radiology. All 24 patients were then subjected to ultrasonographic examination to compare the peak systolic velocity (PSV) and mucosal changes throughout the oral cavity with those by clinical examination. Results: All the 24 patients subjected to ultrasonography, revealed the OSMF changes throughout the oral cavity. Conclusion: Ultrasonography is a non-invasive micro diagnostic tool for Oral Submucous Fibrosis.
Role of p16INK4a protein expression in HPV-positive and HPV-negative squamous cell carcinoma of head and neck Priyanka Shilpia, Madhu Mati Goela, Vikram Bhatiaa, Annu Makkera, Seema Nayaka, Saumya Chandraa, S.P. Agarwalb, M.L.B. Bhattc, S.K. Goeld, Sandeep Kumard a Department of Pathology, King George’s Medical University, Lucknow, Uttar Pradesh, India; bDepartment of Otolaryngology, King George’s Medical University, Lucknow, Uttar Pradesh, India; cRam Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India; dAll India Institute of Medical Science, Bhopal, Madhya Pradesh, India
Introduction: Squamous cell carcinoma of head and neck (SCCHN) is the sixth most common type of cancer worldwide with 600,000 new cases diagnosed every year. In about 20-25% of SCCHN, a high-risk human papilloma virus (Hr-HPV) has been identified as an etiologic agent. Among over 100 different HPV types, HPV-16 and HPV-18 have been detected in the majority of HPV Positive SCCHNs. P16INK4a, a cyclin-dependent kinase inhibitor and G1/S cell cycle phase checkpoint regulator and a thwarted surrogate marker of HPV E7emediated functional inactivation of retinoblastoma gene protein (pRB), which is often mutated in SCCHN. Aims: Aim of the present study was to determine the role of P16INK4a expression as an indicator of HPV induced SCCHN. Material and methods: The study group comprised of 157 histologically proven SCCHN tumor tissues. HPV status was detected by step one real time PCR (Applied Biosystem) using consensus primers MY09 and MY011. Genotyping was performed by using primers specific for HPV16 and HPV18 on a step one real time PCR (Applied-Biosystem). Immunohistochemical (IHC) expression of p16INK4a was assessed using anti p16 antibody (Santa Cruz,
Biotechnology) and a polymer based secondary antibody kit (Novocastra, Leica Biosystem New Castle Ltd, UK). Results: Out of 157 SCCHN tumors 22(14%) were HPV positive. On genotyping, 10 (45%) of these HPV (þve) cases were found to be positive for Hr-HPV (16/18). P16INK4a expression was significantly higher in HPV positive cases (p¼0.001). While, 77% (17/22) of HPV (þve) cases were positive for p16INK4a, only 40.7% (55/135) of HPV (-ve) cases were found to be positive on IHC. In the Hr-HPV (þve) group, all the 10 cases showed p16 immunopositivity. Among the Hr-HPV (-ve) cases, 75% (9/12) of tumors were positive for p16. Conclusion: In conclusion, our data shows strong p16INK4a protein expression in HPV positive cases. Genotyping of HPV positive cases for Hr-HPV (16/18) in combination with immunohistochemical detection for P16INK4a, might serve as a reliable surrogate indicator of HPV infections in SCCHN.
Salivary analysis of lipid peroxides in oral submucous fibrosis Shruti Sood Department of Oral Medicine & Radiology, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, Maharashtra, India Introduction: Human saliva is an attractive diagnostic fluid because saliva collection is less invasive than the collection of blood for serum or plasma analysis. Therefore the developments of simple, accurate, rapid and cost effective methods to detect neoplastic lesions are required. Lipid peroxides are the important free radical, which includes polyunsaturated fatty acids, which leads to membrane destruction. Hence lipid peroxides in turn generate lipid hydroperoxides and causes membrane damage. Lipid peroxides levels were estimated in osmf patients. Aim: To estimate lipid peroxides level in saliva of oral submucous fibrosis. Materials & method: 20 clinically diagnosed oral submucous fibrosis patients were included in the study. Additionally 20 patients were taken in Control group and 20 patients were taken with habit and without any lesion. Thorough clinical history was taken and proper clinical examination was carried out in the department of Oral Medicine and Radiology. All 60 patients were then subjected to salivary examination to evaluate the lipid peroxides level. Results: All the 60 clinically diagnosed Oral Submucous Fibrosis patients subjected to salivary analysis of lipid peroxides. Conclusion: Salivary Analysis is a non-invasive diagnostic tool for Oral Submucous Fibrosis.
The cancer journey-delayed arrival causing early departure Chanchal Moolrajani, Shruti Singh Department of Oral Pathology and Microbiology, Hkes’s S.Nijallingappa Institute of Dental Sciences & Research, Gulbarga, Karnataka, India Introduction: Oral cancer ranks third most common cancer in India is responsible for about 40 % deaths. Etiology wise, oral cancer is dominated by consumption of tobacco, areca nut and alcohol. The high mortality rate has been attributed to the diagnosis of the disease in advanced stages. This is, in part, due to lack of awareness, delay in seeking medical care and limited health care services. The intensity of this public health challenge can be
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meliorated through habit intervention, increasing the knowledge and awareness among the public and health professionals, and improving the health services, especially in rural areas. Aim: To enhance the awareness about oral cancer, its associated risk factors and to strengthen the existing screening programmes, this would help health professionals to restrict the disease at an early and treatable stage. Materials & methods: Reviewing the current trends of incidence, mortality and survival of oral cancer in India, we also thoroughly investigated the determinants of the disease and current prevention strategies including the screening programs from the various printed articles and existing online literature. Results: Despite the considerable measures taken by the Government of India to restrict the current trend of oral cancer, there is a slow decline in the incidence in India. For Screening and awareness programmes to be effective, more focus is required on the training of the primary health care personnel imparting adequate knowledge about the disease and the recent techniques for early detection followed by referrals to the concerned professional. Advocation of Mouth self examination (MSE) must be encouraged among the public. Conclusion: Despite the fact that oral cancer can be prevented, treated, and controlled, there exists a significant gap in the Indian public’s knowledge, attitudes, and behaviours. Thus, the emphasis should be on not only primary prevention, health education, early detection but also to prioritize cancer control making the optimal use of limited resources.
Ghost cells: Realities behind the shadow... S.H. Thippeswamya, Jiji Georgeb, Abhilasha Shuklac a
Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cReader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India Background: Ghost cells are pale anucleate cells with homogeneous pale eosinophilic cytoplasm with very pale to clear central areas in place of a basophilic nucleus; which are seen in small clusters or large masses. Few odontogenic and non odontogenic tumours exhibit the presence of these transparent or shadow cells as a typical feature. Many attempts have been made in the past by several investigators regarding the true characteristics of ghost cells in these lesions, inspite of which they seem to be mysterious. Conclusion: True nature of ghost cells remains elusive and controversial, though their most accepted nature is aberrant keratinization. Recent studies are directed towards the role of Wnt and Notch signaling pathways in tumorigenesis and assigning cells to particular fate. However, further extensive studies on these aspects will give us the possible clue in determining the role of these ‘shadow cells’ in many odontogenic as well as non odontogenic lesions. Here we have made an attempt to clear the illusions and controversies surrounding ghost cells.
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Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bReader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cSr. lecturer, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral mucosa is affected by number of lichenoid lesions, the etiology of which is attributed to infective, inflammatory, dysplastic and immune mediated conditions, resulting in distinct disease entity interns of diagnosis and prognosis. Yet, there clinical and histopathological features overlap each other and create a diagnostic dilemma for the clinician and pathologists. Overlapping of features is due to presence of intense inflammatory cells in the juxta epithelium. Conclusion: Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. Hence it is necessary for the clinician and pathologist to familiarize with the clinicopathologic patterns of oral lichenoid lesions to develop accurate diagnostic and prognostic assessment. The main aim of the poster is to segregate individual lichenoid lesions delineating clinical and histopathological variation among each other, which avoids diagnostic problems.
Viruses!!! Possible role in oral carcinogenesis. Abhilasha Shuklaa, Jiji Georgeb, Anuj Maheshwaric a Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cProfessor & Head, General medicine, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
Introduction: Oral squamous cell carcinoma is the disease with varied and complex etiology. Most common etiological factors have been indicated as tobacco (chewing and smoking), drinking, and genetic susceptibility. Recent studies suggest the role of viruses that produce changes in cellular DNA converting it into a malignant phenotype. Herpes simplex virus type 1 & human papilloma viruses have been seen to be associated with oral squamous cell carcinoma. Both of these viruses depend on other co factors for their carcinogenic effect. Conclusion: Oral carcinogenesis induced by viruses follows a different path leading to rearrangements and mutations. It is important to understand the process by which these changes are brought about in the cell so that treatment and prognosis may become better. Oral squamous cell carcinomas associated with viruses have been shown to have better prognosis as it is more responsive to radiotherapy. We herewith present a poster showing possible role of viruses in human oral carcinogenesis.
An aggressive variant of carcinoma: Basaloid squamous cell carcinoma e Review of literature and a case report. Amritaksha Bhattacharyyaa, Anil Singhb, Kunal Sahc, Vineet Rajc a
Clinicopathological patterns of oral lichenoid lesions
PG student, Saraswati Dental College, Lucknow , Uttar Pradesh, India; Professor & Head, Saraswati Dental College, Lucknow , Uttar Pradesh, India; cReader, Saraswati Dental College, Lucknow , Uttar Pradesh, India
Santhosh Kumar Hirematha, S.H. Thippeswamyb, Ahmed Danish Rehanc
Introduction: Basaloid squamous cell carcinoma is a histologically distinct variant of squamous cell carcinoma that mainly arises
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from the upper digestive tract. It occurs in various sites of the head and neck, palate being the rarest of all. Here we report a case of 60-year-old male presented with a painful swelling on the left side of the neck. Intra-oral examination revealed ulceroproliferative growth over the postero-lateral border of tongue, extending over the palate. Magnetic resonance imaging (MRI) showed extension of the lesion into the posterior wall of the pharynx and to the base of the skull. Debulking surgery was done to reduce the size of the tumor and patient was referred for chemotherapy and radiotherapy. Histopathological examination confirmed the diagnosis of basaloid squamous cell carcinoma. This paper discusses the clinico-pathological features and differential diagnosis of this rare and an aggressive variant of oral squamous cell carcinoma. Aim: To present a case of Basaloid Squamous Cell Carcinoma and review reported cases in English literature. Conclusion: Basaloid squamous cell carcinoma is an uncommon, high-grade bi-morphic variant of squamous cell carcinoma with a predilection for head and neck region which is needed to be differentiated from other tumors having basaloid component. Once the diagnosis is being made of basaloid squamous cell carcinoma, the treatment should be appropriately planned considering its aggressive clinical course and high rate of metastasis.
Nanotechnology in oral cancer “A Small Innovation with a Big Punch” Shruti Singh, Chanchal Moolrajani Department of Oral Pathology and Microbiology, Hkes’s S. Nijallingappa Institute of Dental Sciences & Research, Gulbarga, Karnataka, India Introduction: Cancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues. Oral cancer is the sixth most common malignancy in the world, with over 400,000 cases being reported worldwide. The high mortality rate in cancer is commonly attributed to the difficulties in detecting the disease at an earliest and treatable stage and thus, “war with cancer” is still on. Intense research has led to a more comprehensive understanding of cancer at the genetic, molecular and cellular levels, providing an avenue for early diagnosis and treatment of oral cancer which has overcome the limitations of traditional and conventional methods commonly used. Nanotechnology is a science used to manipulate the atoms and the molecules which lead to the production of structures in the nanometer size, which range from 100nm or even smaller, which attain their unique properties. Aims: To review with recent developments concerning cancer detection and treatment enabled by nanotechnology and its future implication. Materials & methods: A detailed study on nanotechnology and its application in diagnosing and treatment of oral cancer has been done from various articles printed on this topic in various national and international journals till the year 2013 and information has been gathered from them. Results: Nanotechnology provide innovative tools like nanocantilevers, nanopores, nanotubes, Nanoshells, Dendrimers and quantum dots which are prospective structures that can detect cancer cells, identify cancer signals and provide targeted delivery of anti cancer therapeutics and contrast agents to tumor cells. This new technology sheds newer light on the normal life cycle of cells at the molecular level and also enables us to detect changes if any, within cells that can be correlated with development and
progression of cancer. A large amount of information can be obtained from a small source the nano particles. Conclusion: Nano technology aids in analysis of parameters such as cellular mechanics, morphology and cytoskeleton which has been hard to achieve using conventional technology. Hence nanotechnology offers many opportunities for enhanced diagnostic and therapeutic medicine against cancer and other diseases.
Cancer epigenetics: From mechanism to therapy Neha Vermaa, Ranjitkumar Patilb a PG student, Department of Oral Medicine & Radiology, FODS, King George’s Medical University, Lucknow, India; bProfessor & Head, Department of Oral Medicine & Radiology, FODS, King George’s Medical University, Lucknow, India
Epigenetics is study of heritable changes in gene activity that are not caused by changes in DNA sequence as such. Epigenetics has been a topic of extensive research in past few years for better understanding of role of epigenome in pathophysiology of cancer and formulation of novel drugs targeting these epigenomes for treatment of various cancers. Here we are discussing basic principles of epigenetic pathways along with promising preclinical and clinical results seen with epigenetic drug which signifies importance of epigenetics in cancer.
Habit pattern and oral mucosal changes in 1000 tobacco users: An epidemiological study Babusha Tewari PG student, Saraswati Dental College, Lucknow, Uttar Pradesh, India Introduction: Tobacco consumption, smoked, chewed or dipped has become one of the larger health problems worldwide, to the degree that is considered by some a world epidemic. The unrestricted availability of tobacco especially in developing countries across various age groups & its addictive nature has resulted in a steep rise in tobacco related oral lesions. Objective: An attempt was made in this study to assess the tobacco habit patterns and its association with oral mucosal lesions in tobacco users. Materials & methods: A detailed tobacco related history was taken from 1000 tobacco users with the help of habit assessment questionnaire, which include general information related to subjects’ oral habits e type(chewing/smoking), form of tobacco, frequency, duration, manner of chewing/smoking, etc. The oral cavity was thoroughly examined and mucosal changes if present were recorded. Results: The result of our study showed that tobacco associated mucosal lesions were higher in combined chewers and smokers, khaini users, non quid tobacco users and bidi smokers and showed age peak in young adults.
Nanodentistry: A breakthrough in oral cancer management Devangi Dwivedi PG student, Saraswati Dental College, Lucknow, Uttar Pradesh, India Introduction: There is an unavoidable development in the progress of science, nanotechnology has been part of the mainstream
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scientific theory with potential medical and dental applications since the early 1990s. Dentistry is undergoing another change with the help of nanotechnology combined with nanomaterials, biotechnology and ultimately dental nanorobotics. Nanodentistry is an emerging field with significant potential to yield new generation of technologically advanced clinical tools and devices for oral healthcare. In particular, using Atomic force microscopy techniques- diseases such as oral cancer can be quantified based on morphological, biophysical and biochemical nanoscale properties from oral fluids, such as saliva. Diagnosis of oral cancer can be done using nanoscale cantilevers, nanopores nanotubes and quantum dots whereas; it can be treated with the help of nanomaterials for brachytherapy, nanovectors for gene therapy and nonviral gene delivery systems etc. Aims: The main aim of this paper is to describe in detail about the applications of nanotechnology in the management of oral cancer. Materials & methods: A thorough PubMed search was done using the following keywords: Nanodentistry, Atomic Force Microscopy, Nanorobots. Conclusion: Nanotechnology applications in cancer detection and treatment have the potential to replace highly invasive conventional cancer detection and treatment, which often includes biopsies, irradiation, and painful therapies. The ability to diagnose malignant disease at the earliest opportunity allows treatment options to be planned as early as possible and hence directly affects the morbidity and mortality of head and neck cancer.
Grading of epithelial dysplasia at molecular level e An addendum to cytological criteria of malignancy Mohd. Saleem, Balasundari Shreedhar, Mala Kamboj, Mudita Chaturvedi Department of Oral Pathology and Microbiology, Career Postgraduate Institute of Dental Sciences & Hospital, Lucknow Introduction: Oral Cancer is still diagnosed based on its morphology. However surprisingly, little is known about the molecular basis of defining the structural features. The cytologic criteria of malignancy are extremely varied, apparently reflecting many different pathophysiologies in specific micro environments. The histologic criteria to assess cellular and tissue changes (dysplasia) relates to alterations in kinetics of cellular proliferations and maturation of epithelium. Wide variations are seen in inter-and intra-examiner grading due to lack of well-defined and predictable set of criteria. To understand the criteria of malignancy at a molecular level would improve diagnosis, and likely point to novel cell physiologies that are not encompassed by current cell biology concepts. Aims: To review the current and future trends of various new methods of grading epithelial dysplasia and predicting oral cancer. Materials & methods: A thorough search from various printed articles as well as online literature from PubMed, Google Scholar and Medlars Online was performed using keywords as cancer, malignancy, dysplasia. Results: The criteria to assess epithelial dysplasia on the molecular basis appear to provide an independent means of describing dysplasia and predicting cancers. It may be useful for researchers to try to relate cancer genes to a particular cell structural change rather than to a particular histogenetic type of cancer.
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Conclusion: The current gold standard is the finding of epithelial dysplasia in a tissue biopsy. A maximum of 50% of severe dysplasias, 30% of moderate and a very few (<5%) mild dysplasia are thought to progress to cancer.
E-cigarettes: A miracle or menace? Kopal Mathur Manchester Business School Background: Electronic nicotine delivery devices (ENDD), popularly known as e-cigarettes, are the new replacement for traditional cigarettes. They are battery-powered devices which simulate tobacco smoking and use a heating element that vaporizes a liquid solution. However, there have been health and safety concerns with the ENDDs to classify them as completely safe for public health. Aim: The purpose of this study is to critically analyse the introduction of e-cigarettes for smokers, whether it is improving the habits of smoking and reducing its ill-effects or it jeopardises the carefully drawn distinctions between ‘good’ and ‘bad’ forms of nicotine. Material & methods: This study will aim to review literature to analyse the argument over ENDDs whether they can be considered as a glamorous and harmless replacement to cigarette smoking. It will explore the regulations regarding the manufacturing and selling of these ENDDs in most parts of the world and its impact on the people. Results: Neither there are any age restrictions in place nor have limitations to smoke ENDDs in public places, planes, hospitals been questioned. Since it resembles the visual spectacle and bodily pleasures of smoking traditional cigarettes, a substantial decrease in cigarette consumption without causing significant side effects in smokers who did not intend to quit previously has been shown with the use of ENDDs. These contain no tobacco and tar which is the harmful content in the traditional cigarettes. But there are debates over the standards of the chemical and a medicinal product it contains is controversial in considering it as completely non-hazardous. Conclusion: E-cigarettes have proven to improve the health effects caused by smoking traditional cigarettes. It is, however, necessary to implement policies to regulate their use among the population. This is a critical area of research as e-cigarettes highlight the complex status of nicotine and its other constituents as both a toxic and antidote in contemporary public health and tobacco control.
Tissue microarray Aanchal Tandon, Akansha Srivastava, V. Subhalakshmi PG Student, Department of Oral Pathology, Sardar Patel Postgraduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral squamous cell carcinoma is the most common debilitating disease of concern to oral health physicians. Aim: Identification of the molecular alterations in OSCC can help us in understanding the behavior of the tumor. Materials & methods: Online search was done using the keyword Tissue Microarray. Results: Tissue microarray (TMA) approach is a high throughput technology that enables analysis of multiple molecular targets
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simultaneously without causing any morphological alteration to tissue specimens. Tissue microarray enables analysis of multiple molecular targets simultaneously without causing any morphological alteration to tissue specimens. Tissue microarray technology is a promising way to analyse multiple biomarkers simultaneously. This poster aims at presenting the technique of tissue microarrays and its uses in identifying OSCC.
proliferation, antioxidant function and modulating effects on carcinogen detoxification. The advantages of phytochemicals are their pleiotropic effects and nontoxicity.
HPV infections associated with oral mucosa Garima Srivastava, Balasundari Shreedhar, S. Natarajan, Renuka Verma
Recent advances in diagnosis of oral cancer Shaikh Amjad Khan Munir, Md. Kalim Ansari, Mohammad Zavir Khan, Satish Rudhani JR-III, Department of Oral and Maxillofacial Surgery, Dr. Z A Dental College, Aligarh Muslim University, Aligarh (U.P) Introduction: Oral cancer is one of common cancer in India its prevalences increases day by day due to excessive use of different form of tobacco. The main treatment of oral cancer is surgical resection and reconstruction which leads to high morbidity and mortality. Aims: Accurate diagnosis of the disease at proper time is very important for optimum functional, aesthetics and survival. Materials & methods: This can be achieved by applying recent investigational technique, so in this poster we demonstrate recent diagnostic methods for oral cancer Results: In this poster we highlighted recent technical advancements helpful for early diagnosis of oral cancer. Conclusion: Early diagnosis oral cancer is important for long term survival of patients and to reduce surgical and reconstruction burdens of surgeons.
Role of chemoprevention in oral premalignant & malignant lesions Taseer Bashir, Md. Asdullah, Vijay Krishnan, K. Srinivas, Jyoti Gupta Department of Oral Medicine & Radiology, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral cancer is defined as the cancer of mouth and pharynx, including cancer of the lips, tongue and floor of the mouth, palate, gingiva, alveolar mucosa, buccal mucosa, oropharynx, tonsils, uvula, and salivary glands. Oral squamous cell carcinoma comprises 90% of all intra-oral cancers and is the fifth most frequent cancer worldwide. In India, oral cancer accounts for 40-50% of cancers. Aim: To review the literature on role of chemoprevention in oral precancer and cancer. Material & methods: Online and reputed journal search was conducted for the above terms. Results: External factors such as tobacco, chemicals, radiation, viruses and internal factors such as inherited mutations & immune status may act synergistically or in sequence to initiate or promote carcinogenesis. The various stages of carcinogenesis are initiation, progression and promotion. Cancer chemoprevention has a promising approach to prevent, inhibit or reverse the carcinogenic processes by intervention with natural products or synthetic chemical substances. Active principles derived from certain traditional medicinal plants have chemopreventive properties. Chemopreventive agents like curcumin, polyphenols act by antimutagenic, anticarcinogenic, inhibitory effects on cell
Department of Oral Pathology and Microbiology, Career Post Graduate of Dental Sciences and Hospital, Lucknow, Uttar Pradesh, India Introduction: Human papillomavirus (HPV), small non enveloped DNA tumor virus of papillomavirus family causes genital warts, common warts, plantar warts and flat warts. The World Health Organization estimates that between 9-13% (w630million) of the world population has an HPV infection in oral mucosa. Oral mucosa may play significant role in HPV transmission and its persistent infection in the oral mucosa increase the risk of developing carcinoma. Regular and scrupulous examination of it is most important tool in detecting HPV-associated changes in the oral mucosa. HPV16 being the most prevalent genotype other being HPV 2, 4, 6, 11, 13, 18 and 32. HPV positivity occurs in vermilion border, hard palate, labial mucosa and labial commissures. According to biologic behavior there are various lesions associated with it. Benign lesions being squamous papilloma, verruca vulgaris, condyloma acuminatum, focal epithelial hyperplasia and premalignant or malignant lesions are leukoplakia, squamous cell carcinoma, lichen planus, verrucous carcinoma. Aims: To review the current and future relevance of HPV and oral lesions, which are or can be used in the near future for detection of oral cancers. Materials & methods: A thorough search from various printed articles as well as online literature from PubMed, Google Scholar and Medlars Online was performed using keywords as HPV infection, oral mucosa, carcinoma, HPV vaccines. Results: HPVs and their role in the development of a range of oral mucosal lesions are briefly reviewed for the point of updating oral health professionals and raising the alertness of budding associations being established flanked by HPVs and some oral diseases counting oral cancer. Conclusion: From the dental practitioners’ point of view, where appropriate, patient education with regard to oral transmission of HPV and its possible role in the causation of a series of oral lesions including oral cancer should be built-in for protective strategy.
Dental DNA- tool in forensic dentistry Deepak Verma, Balasundari Shreedhar, S. Natarajan, Mudita Chaturvedi Department of Oral Pathology and Microbiology, Career Post Graduate Of Dental Sciences And Hospital, Lucknow, Uttar Pradesh, India Introduction: Forensic odontology is an integral part of forensic science and is widely utilized for the identification of living and deceased persons. DNA as a molecule encodes genetic instructions and can be used in identifying all organisms. DNA found in human cell is of two types: chromosomal DNA and mitochondrial DNA. It can be extracted from dental tissues like pulp, dentin and cementum. The tooth being hardest tissue in the body is one of the most valuable sources to extract DNA because
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DNA in the pulp is protected from extreme environmental conditions. Thus in this poster we focus on a comprehensive review on the milling method technique used in identifying individuals using DNA extracted from pulp. Aim: For identification of a deceased person by dental profiling. Material and method: A thorough search from various printed articles as well as online literature from PubMed, Google Scholar and Medlars Online was performed using Keywords as Dental DNA, Forensic Odontology, Dental Profiling. Result: There are various techniques involved in dental identification which include comparative dental identification, reconstructive post-mortem, dental profiling and DNA profiling. The different methods used to gain access to dental tissue for DNA analysis are hybridization-based methods, PCR-based assays, reverse e dot blot assays and microchip assays. These techniques provide accurate result in forensic science as DNA of an individual is unique. Conclusion: The application of DNA technology has revolutionized forensic identification procedures. Teeth represent an excellent source of DNA, which is protected by epithelial, connective, muscular and bone tissues in case of incineration. Additionally, the dental pulp cells are protected by enamel, dentin and cementum hard dental tissues. Therefore, dental professionals working on the field of Forensic Dentistry should incorporate these new technologies in their work, as several methods are available for DNA extraction from biological materials.
Ghost cells: Realities behind the shadow....
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Role of epigenetics in oral cancer: From mechanism to therapy Neha Vermaa, Ranjit Kumar Patilb a
PG student, Department of Oral Medicine & Radiology, King George’s Medical University, Lucknow, Uttar Pradesh, India; bProfessor & Head, Department of Oral Medicine & Radiology, King George’s Medical University, Lucknow, Uttar Pradesh, India Introduction: Cancer is a leading cause of death worldwide, oral squamous cell is one of the most common and aggressive malignancies. Epigenetics is study of heritable changes in gene activity that are not caused by changes in DNA sequence as such. Epigenetics has been a topic of extensive research in past few years for better understanding of role of epigenome in pathophysiology of oral cancer and formulation of novel drugs targeting these epigenomes for treatment of various cancers. Aim: To discuss basic principles of epigenetic pathways along with promising preclinical and clinical results seen with epigenetic drug which signifies importance of epigenetics in oral cancer management. Materials & methods: An electronic search was employed relevant studies and review of literature were utilized from PubMed, Google Scholar, Wiley’s online library. Result: More than 40 genes associated with initiation, progression and prognosis of oral sq cell carcinoma have been identified undergoing epigenetic alterations DNA hypermethylation being one of major alteration. Conclusion: Epigenetic changes provides a novel target to assess progression, prognosis and check responsiveness of cancer therapeutics and reversibility of epigenetic alteration being utilized for pharmacotherapy for oral cancer.
S.H. Thippeswamya, Jiji Georgeb, Abhilasha Shuklac a Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cReader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
Introduction: Many attempts have been made in the past by several investigators regarding the true characteristics of ghost cells in these lesions, inspite of which they seem to be mysterious. Here we have made an attempt to clear the illusions and controversies surrounding ghost cells. Aim: To undertake literature review on nature of ghost cells as ghost cells are observed in few odontogenic and non odontogenic tumours as transparent or shadow cells. Materials and method: PubMed search was carried using key words such as odontogenic ghost cells, ghost cell lesions, calcifying epithelial odontogenic cyst. Out of 398 available articles using key words search 24 articles were taken to study the true nature of ghost cells and with these articles a literature review on ghost cells was presented. Conclusion: True nature of ghost cells remains elusive and controversial, though their most accepted nature is aberrant keratinization. Recent studies are directed towards the role of Wnt and Notch signaling pathways in tumorigenesis and assigning cells to particular fate. However, further extensive studies on these aspects will give us the possible clue in determining the role of these ‘shadow cells’ in many odontogenic as well as non odontogenic lesions.
Title: Viruses!!! Possible role in oral carcinogenesis. Abhilasha Shuklaa, Jiji Georgeb, Anuj Maheshwaric a
Reader, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; bProfessor, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India; cProfessor & Head, Oral Pathology & Microbiology, Babu Banarsi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India Introduction: Oral squamous cell carcinoma is the disease with varied and complex etiology. Most common etiological factors have been indicated as tobacco (chewing and smoking), drinking, and genetic susceptibility. Recent studies suggest the role of viruses that produce changes in cellular DNA converting it into a malignant phenotype. Herpes simplex virus type 1 & human papilloma viruses have been seen to be associated with oral squamous cell carcinoma. Both of these viruses depend on other co factors for their carcinogenic effect. Aim: Aim of the poster is to review literature regarding the viral oncogenesis, especially HPV 16 which is mostly seen to be responsible for oral squamous cell carcinoma. It is an interesting aspect to explore that how this virus produces changes leading to mutations in the otherwise normal cellular DNA which then attain immortality leading to malignancy. Material & method: PubMed search was done using keywords like HPV, oral squamous cell carcinoma, carcinogenesis, telomerase
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and it resulted in 27 articles out of which 12 articles were reviewed and included for the required information. Articles which stressed on how HPV leads to malignant transformation and its therapeutic considerations were mainly included. Conclusion: Oral carcinogenesis induced by viruses follows a different path leading to rearrangements and mutations. It is important to understand the process by which these changes are brought about in the cell so that treatment and prognosis may become better. Oral squamous cell carcinomas associated with viruses have been shown to have better prognosis as it is more responsive to radiotherapy. We herewith present a poster showing possible role of viruses in human oral carcinogenesis.
Apoptosis and oral cancer
described according to the type of tissue present; lipoma with cartilaginous metaplasia is a chondrolipoma which is a rare variant. Aim: This paper discusses clinical features, differential diagnosis and histogenesis of this rare histopathological variant of lipoma. Material & methods: Here we report a case of chondrolipoma in 35 year old male patient in posterior dorsal surface of tongue, present since 20 years. The lesion was treated with conservative surgical and histopathological examination to confirm the diagnosis. Results: Chondrolipomas are benign mesenchymal tumours characterized by the proliferation of mature adipocytes associated with variable amounts of mature cartilaginous tissue. Chondrolipoma are uncommon in the oral cavity, are identified mainly in lower lip and tongue. Only 14 cases of chondrolipomas in the oral cavity have been reported in English Literature (PubMed database).
Shilpi Chandela, Balasundari Shreedharb, Mala Kambojc a PG student, Departement of Oral pathology and Microbiology, Career Institute of Medical & Dental Sciences, Lucknow, Uttar Pradesh, India; b Professor & Head, Departement of Oral pathology and Microbiology, Career Institute of Medical & Dental Sciences, Lucknow, Uttar Pradesh, India; cProfessor, Departement of Oral pathology and Microbiology, Career Institute of Medical & Dental Sciences, Lucknow, Uttar Pradesh, India
Introduction: Apoptosis is generally characterized by distinct morphological characteristics and energy dependent biochemical mechanisms. Inappropriate (either too little or too much) is a factor in many human conditions including neurodegenerative diseases, ischemic damage, autoimmune disorders and many type of carcinomas. Tumours that exhibit less apoptosis tend to show aggressive behaviour and have a greater potential for metastasis. Aims: To review the current understanding in the field of apoptosis in oral cancer. Thus, this poster would emphasize on the importance of apoptosis in OSCC. Material & methods: A PubMed search was done using the keywords apoptosis and OSCC. Results: The apoptotic cells showed certain well defined features, which included cell shrinkage, condensation and deep eosinophilia of the cytoplasm and pyknotic, round too cresentric, irregular nucleus. Apoptotic bodies which appeared as tiny, round, pyknotic nuclear fragments, were seen scattered among tumour cell and occasional form a cluster. Potential pitfalls included the presence of mononuclear inflammatory cells, densely stained mitotic figures, necrotic cells and nuclear debris. In Oral Squamous Cell Carcinoma (OSCC), the co-operation of p53, Bcl-2, Bax results in the progression of OSCC. Apoptosis genes work independently or co-operatively. Apoptosis is said to occur frequently in the cornified areas of well differentiated OSCCs.
Lipoma with a cartilaginous metaplasia: A rare variant Kahkasha Khan PG student, Department of Oral Pathology, Saraswati Dental College, Lucknow, Uttar Pradesh, India Introduction: Lipoma can occur in any part of the body but are found infrequently in the oral cavity. Variants of the lipoma have been
Pedicled buccal fat pad (BFP) and dermal fat in the surgical management of oral submucous fibrosis (OSMF): A comparative study Kuldeep Vishwakarma, Ashish Singh, D. Mehrotra, S. Mohammad Department of OMFS, King George’s Medical University, Lucknow, Uttar Pradesh, India Introduction: Oral submucous fibrosis (OSMF) is a chronic, debilitating disease characterized by juxtaepithelial fibrosis of the oral cavity. It is regarded as a precancerous and potentially malignant lesion. OSMF is multifactorial in origin with a high incidence in people who chew areca-nut. The current protocol for the management of OSMF can be divided into 3 broad groups: surgical, physical, and medical treatments. Surgical treatment, used mainly to manage trismus, involves incising and releasing the fibrotic areas, and introduction of remote tissue (pedicled, such as a buccal fat pad, nasolabial or platysmal flaps or dermal fat transfer). Aims and objectives: The aim of this study was to evaluate the application of pedicled buccal fat pad (BFP) and dermal fat in the surgical management of oral submucous fibrosis (OSMF). Materials and methods: 10 clinically and histologically diagnosed cases of OSMF (Stage III and Stage IV) were randomly divided into 2 groups: group I (n ¼ 5) and group II (n ¼ 5). In group I the patients underwent incision of fibrotic bands and coverage of the buccal defect with a pedicled BFP flap. In group II the buccal defect was covered with dermal fat. Both groups were analyzed separately for mouth opening (interincisal distance in millimeters) preoperatively, intraoperatively, 7 days, 6 month postoperatively and time taken for epithelialization , time taken for establishment of normal contour, and changes in symptoms (painful ulcerations, burning sensation, and intolerance to spices). Results: The mean preoperative mouth opening was 5.2 mm in group I and 5.8 mm in group II. The mean postoperative mouth opening after 6 month was 28.2 mm in group I and 27.8 mm in group II. The time taken for epithelialization of BFP was 2 weeks in group I and 3 weeks in group II. There was improvement in symptoms like painful ulcerations, burning sensation and intolerance to spices in both groups. Conclusion: Both BFP and dermal fat are reliable for the treatment of OSMF with similar outcomes. However dermal fat graft is associated with additional donor site and surgical scar.