Publications by authors named "Hiba Qari"

10 Publications

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Thirteen Synchronous Multifocal Calcifying Epithelial Odontogenic Tumors (CEOT): Case Report and Review of the Literature.

J Oral Maxillofac Surg 2021 May 18. Epub 2021 May 18.

Assistant Professor, Department of Diagnostic Sciences, West Virginia University School of Dentistry, Morgantown, WV. Electronic address:

Background: Calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor) is a rare, benign, locally aggressive neoplasm of the jaws that accounts for approximately 1% of all odontogenic tumors. It was first defined by Pindborg in 1955 and has been reported approximately 350 times in the literature; 7 reported multiple (up to 4) synchronous lesions.

Materials And Methods: We report an individual with the largest number of CEOTs reported to date and provide a literature review of multifocal CEOT cases.

Results: A 30-year-old male presented to the Oral and Maxillofacial Surgery Department of the West Virginia University School of Dentistry (WVU SoD) to extract multiple impacted teeth previous to construction of a complete denture. A pantograph showed 15 impacted teeth, almost all associated with well-demarcated cyst-like radiolucencies, some with small, ill-defined radiopaque flecks. Microscopically, the lesions showed sheets and strands of polygonal epithelial cells with eosinophilic cytoplasm. Spread throughout the epithelium and connective tissue were small, spherical, amorphous, pale purplish calcifications. Each lesion was similar and consistent with a diagnosis of CEOT.

Conclusion: We report a patient with 13 independent CEOTs scattered throughout all quadrants. This case represents the largest number of Pindborg tumors or any other type of odontogenic tumor yet reported in a single individual.
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May 2021

Should dental schools adopt teledentistry in their curricula? Two viewpoints.

J Dent Educ 2021 Jul 15;85(7):1238-1244. Epub 2021 Apr 15.

Division of Oral and Maxillofacial Pathology, West Virginia University School of Dentistry, Morgantown, West Virginia, USA.

Introduction: Teledentistry is a cutting edge technology that could be used to improve access to care to underserved populations and those in remote areas.

Objectives: To discuss the advantages and disadvantages of adopting teledentistry into the predoctoral dental curriculum.

Methods: Two teams of dentists reviewed the pros and cons of introducing teledentistry into the predoctoral dental curriculum.

Results: Viewpoint 1 produced evidence that teledentistry is a cutting-edge technology that can improve access to care for underserved populations in a practical, cost-effective manner. Viewpoint 2 showed evidence that teledentistry is too new to have an evidence base to support its widespread use, legal and regulatory requirements have not been established and there is no precedent for third party payers to reimburse for this service.

Conclusion: The authors feel that a national teledentistry policy should be developed starting at the state level with stakeholders from the dental profession, dental education, government, patient advocates, and third party payers working together to determine the best way forward.
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July 2021

The pararadicular radiolucency with vital pulp: Clinicopathologic features of 21 cemental tears.

Oral Surg Oral Med Oral Pathol Oral Radiol 2019 Dec 2;128(6):680-689. Epub 2019 Aug 2.

Adjunct Professor and Past Chair, Department of Diagnostic & Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, TX, USA; Department of Diagnostic Sciences, West Virginia University School of Dentistry, Morgantown, WV, USA.

Objective: The investigation was conducted to better characterize the clinical, radiographic, and histopathologic features of cemental tears from a review of 21 cases.

Study Design: This was a retrospective review of consecutive cases collected from patient records of the investigators.

Results: Twenty-one cases were identified during an 8-year period. Maxillary incisors were most often affected (47.6%). All lesions presented with pain. They occurred as radiolucencies along the root of a vital or endodontically treated tooth and were classified as D-shaped (38.1%), thin-vertical-line (23.8%), thick-vertical-line (14.3%), J-shaped (19.0%), or periapical radiolucencies (4.8%). All lesions showed focal destruction of the lamina dura, with 66.7% exhibiting extension into the medullary bone. Histopathologic diagnoses included intramedullary fibrous scar (28.6%) and chronic fibrosing osteomyelitis (71.4%), all associated with embedded cemental fragments. Five associated teeth were also examined: All showed tears beneath the remaining cementum. Four cases were successfully treated with curettage without tooth extraction; endodontic therapy was performed, probably mistakenly, in 8 cases.

Conclusions: Cemental tears produced symptomatic, localized chronic inflammation characterized usually by a vertical radiolucency adjacent to a root. These lesions may not be as rare as previously thought and extraction may not be the best treatment.
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December 2019

Symmetric multiquadrant isolated dentin dysplasia (SMIDD), a unique presentation mimicking dentin dysplasia type 1b.

Oral Surg Oral Med Oral Pathol Oral Radiol 2017 May 7;123(5):e164-e169. Epub 2016 Dec 7.

University of Nebraska Medical Center College of Dentistry, Lincoln, NE, USA.

Dentin dysplasia (DD) is a rare developmental dentin disorder that causes root malformation. It is divided into radicular DD type 1 (DD-1) and coronal DD type 2 (DD-2). Recently, a new entity causing localized root malformation of permanent first molars that resembles DD-1b has been described as molar-incisor malformation (MIM). We report and compare 4 new cases that exhibit similar clinical, histologic, and radiographic features to the new entity, MIM. We believe MIM and our 4 cases to be the same entity, which is nonhereditary and, because of the isolated but bilaterally symmetric pattern of involvement, may be caused by a short-duration environmental insult that disrupts normal development/function of Hertwig's epithelial root sheath. We propose the name symmetrical multiquadrant isolated dentin dysplasia as the most appropriate descriptive designation for this unusual but highly distinctive anomaly.
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May 2017

Phosphaturic Mesenchymal Tumor: 2 New Oral Cases and Review of 53 Cases in the Head and Neck.

Head Neck Pathol 2016 Jun 14;10(2):192-200. Epub 2015 Nov 14.

Department of Diagnostic Sciences, Texas A&M University Baylor College of Dentistry, 3302 Gaston Avenue Room # 214, Dallas, TX, 75246, USA.

Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm that secretes fibroblast growth factor-23 (FGF-23) and causes oncogenic osteomalacia. It occurs in adults with equal gender distribution and the most common location is the lower extremities, followed by the head and neck. Besides osteomalacia, the clinical presentation includes bone pain and multiple bone fractures. Microscopic features consist of spindle cells, multinucleated giant cells, and calcifications embedded in a chondromyxoid matrix. Laboratory findings indicate normal calcium and parathyroid levels, hypophosphatemia, and increased levels of FGF-23 that usually revert to normal after surgical removal. Due to its rarity, the purpose of the study was to report 2 new oral cases of PMT and to review the literature in the head and neck. The first case occurred in the gingiva and had been present for 6 years. The second case was a recurrence of a previously diagnosed PMT in the right mandible that metastasized to the lung and soft tissue. The literature review included 53 cases in the head and neck. There was a predilection for extra-oral sites (76%) compared to intra-oral sites (24%) with paranasal sinuses considered the most common location (38%) followed by the mandible (15%). There were 9 recurrences that included 3 malignant cases indicating a potentially aggressive tumor. Due to the indeterminate biological behavior of PMT and its rarity, a comprehensive evaluation of medical, laboratory, radiographic, and histological findings are crucial for a definitive diagnosis and treatment.
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June 2016

The diagnostic challenges of separating chronic ulcerative stomatitis from oral lichen planus.

Oral Surg Oral Med Oral Pathol Oral Radiol 2015 Nov 22;120(5):622-7. Epub 2015 Jul 22.

Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA.

Objective: To attempt to establish criteria to differentiate between chronic ulcerative stomatitis (CUS) and oral lichen planus (OLP) with hematoxylin and eosin (H&E) staining alone.

Study Design: Ten confirmed cases of CUS were reviewed from the Stomatology Clinic at the Texas A&M University Baylor College of Dentistry.

Results: The original diagnosis on H&E evaluation was OLP, chronic mucositis, or mucositis with lichenoid features, but subsequent direct immunofluorescence (DIF) revealed a positive speckled intranuclear deposition of immunoglobulin G (IgG) in the basal and parabasal layers of the epithelium, confirming a diagnosis of CUS.

Conclusions: No consistent histopathologic features were present that would allow recognition of CUS from H&E analysis alone. DIF remains the gold standard for diagnosis.
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November 2015

Massive, mixed, cystic lesion of the mandibular midline.

Oral Surg Oral Med Oral Pathol Oral Radiol 2014 Jul 16;118(1):9-15. Epub 2014 Jan 16.

Department of Diagnostic Sciences, Baylor College of Dentistry, Dallas, TX, USA; Department of Diagnostic & Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, TX, USA.

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July 2014

iPSC-derived fibroblasts demonstrate augmented production and assembly of extracellular matrix proteins.

In Vitro Cell Dev Biol Anim 2012 Feb 19;48(2):112-22. Epub 2012 Jan 19.

Program in Cell, Molecular and Developmental Biology, Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA 02111, USA.

Reprogramming of somatic cells to induced pluripotent stem cells (iPSC) provides an important cell source to derive patient-specific cells for potential therapeutic applications. However, it is not yet clear whether reprogramming through pluripotency allows the production of differentiated cells with improved functional properties that may be beneficial in regenerative therapies. To address this, we compared the production and assembly of extracellular matrix (ECM) by iPSC-derived fibroblasts to that of the parental, dermal fibroblasts (BJ), from which these iPSC were initially reprogrammed, and to fibroblasts differentiated from human embryonic stem cells (hESC). iPSC- and hESC-derived fibroblasts demonstrated stable expression of surface markers characteristic of stromal fibroblasts during prolonged culture and showed an elevated growth potential when compared to the parental BJ fibroblasts. We found that in the presence of L: -ascorbic acid-2-phosphate, iPSC- and hESC-derived fibroblasts increased their expression of collagen genes, secretion of soluble collagen, and extracellular deposition of type I collagen to a significantly greater degree than that seen in the parental BJ fibroblasts. Under culture conditions that enabled the self-assembly of a 3D stromal tissue, iPSC- and hESC-derived fibroblasts generated a well organized, ECM that was enriched in type III collagen. By characterizing the functional properties of iPSC-derived fibroblasts compared to their parental fibroblasts, we demonstrate that these cells represent a promising, alternative source of fibroblasts to advance future regenerative therapies.
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February 2012