Publications by authors named "Kannan Ranganathan"

49 Publications

Implications in the quantification of SARS-CoV2 copies in concurrent nasopharyngeal swabs, whole mouth fluid and respiratory droplets.

Virus Res 2021 10 30;303:198442. Epub 2021 Apr 30.

Chennai Dental Research Foundation, Chennai, India; Department of Oral Pathology, Ragas Dental College and Hospital, Chennai, India; Faculty of Oral, Dental & Craniofacial Sciences, King's College London, UK; Menzies Health Institute Queensland, Griffith University, Queensland, Australia.

Objective: Association of SARS-CoV2 burden in the aerodigestive tract with the disease is sparsely understood. We propose to elucidate the implications of SARS-CoV2 copies in concurrent nasopharyngeal swab (NPS), whole mouth fluid (WMF) and respiratory droplet (RD) samples on disease pathogenesis/transmission.

Methods: SARS-CoV2 copies quantified by RT-PCR in concurrent NPS, WMF and RD samples from 80 suspected COVID-19 patients were analysed with demographics, immune response and disease severity.

Results: Among the 55/80 (69 %) NPS-positive patients, SARS-CoV2 was detected in 44/55 (80 %) WMF (concordance with NPS-84 %; p = 0.02) and 17/55 (31 %) RD samples. SARS-CoV2 copies were similar in NPS (median:8.74 × 10^5) and WMF (median:3.07 × 10^4), but lower in RD (median:3.60 × 10^2). The 25-75 % interquartile range of SARS-CoV2 copies in the NPS was significantly higher in patients who shed the virus in WMF (p = 0.0001) and RD (p = 0.01). Multivariate analyses showed that hospitalized patients shed significantly higher virus copies in the WMF (p = 0.01). Hospitalized patients with more severe disease (p = 0.03) and higher IL-6 values (p = 0.001) shed more SARS-CoV2 virus in the RD.

Conclusions: WMF may be used reliably as a surrogate for diagnosis. High copy numbers in the NPS probably imply early disease onset, while in the WMF and RD may imply more severe disease and increased inflammation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.virusres.2021.198442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086371PMC
October 2021

Intra-observer and inter-observer variability in two grading systems for oral epithelial dysplasia: A multi-centre study in India.

J Oral Pathol Med 2020 Oct 9;49(9):948-955. Epub 2020 Jul 9.

Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, WHO Collaborating Centre for Oral Cancer, London, UK.

Background: The presence and grading of oral epithelial dysplasia (OED) are considered the gold standard for predicting the malignant risk of oral potentially malignant disorders. However, inter-observer and intra-observer agreement in the context of reporting on OED grading has been reputedly considered unreliable.

Methods: We undertook a multi-centre study of six Indian oral pathologists to assess variations in reporting OED using the World Health Organization (WHO; 2005) system and also the recently introduced binary system. The observer variability was assessed with the use of kappa statistics.

Results: The weighted kappa intra-observer agreement scores improved (κ  = 0.5012) on grouping by two grades as no and mild dysplasia versus moderate and severe dysplasia compared to binary grading system (κ = 0.1563) and WHO grading system (κ  = 0.4297). Poor to fair inter-observer agreement scores were seen between the principal investigator (PI) and the other five observers using the WHO grading system (κ = 0.051-0.231; κ  = 0.145 to 0.361; 35% to 46%) and binary grading system (κ = 0.049 to 0.326; 50 to 65%).

Conclusions: There is considerable room for improvement in the assessment of OED using either system to help in standardised reporting. The professional pathology organisations in India should take steps to provide external quality assessment in reporting OED among oral and general pathologists who are engaged in routine reporting of head and neck specimens.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jop.13056DOI Listing
October 2020

Study of Hypoxia-inducible factor-2α expression in the malignant transformation of Oral submucous fibrosis.

J Oral Maxillofac Pathol 2020 Jan-Apr;24(1):33-39. Epub 2020 May 8.

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.

Context: Hypoxia-inducible factor (HIF)-2α is overexpressed in primary and metastatic human cancers, whose expression is correlated with tumor angiogenesis and patient mortality. HIF plays a role in the progression of fibrosis in oral submucous fibrosis (OSF).

Aim And Objective: The aim is to study and compare the expression of HIF-2α in OSF (a), oral squamous cell carcinoma (OSCC) with areca nut usage (b), OSCC without areca nut usage (c) and normal mucosa (d) by immunohistochemistry.

Subjects And Methods: Immunohistochemical detection of HIF-2α was done on 51 samples, which included 11 cases (a), 15 cases (b), 15 cases (c) and the expression was compared with that of (d).

Statistical Analysis: Data were analyzed using the SPSS™ software (ver. 21.0). Chi-square test and kappa analysis were performed to compare the intensity of staining between the groups and for inter-observer agreement, respectively. Value of ≤ 0.05 was considered statistically significant. The mean labeling index between the groups was studied by the Kruskal-Wallis test.

Results: All the cases of (d), (a), (b) and (c) showed HIF-2α expression ( = 0.329). About 13% cases of (c) showed intense expression ( = 0.406) and 27% of (a) cases showed expression only in the connective tissue ( = 0.023). The number of positively stained nuclei in both (b and c) cases reduced as the tumor progression was from well to poorly differentiated.

Conclusion: Areca nut initiates fibrosis and subsequent hypoxia in OSF which triggers HIF-2α expression in the epithelium. HIF-2α could be a surrogate marker for cancer initiation and progression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_42_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7269270PMC
May 2020

COVID - 19 fact sheet for the dental professional.

J Oral Maxillofac Pathol 2020 Jan-Apr;24(1):8-10. Epub 2020 May 8.

Department of Oral and Maxillofacial Pathology, V S Dental College and Hospital, Bengaluru, Karnataka, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_149_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7269301PMC
May 2020

Identification of in Saliva of Patients with and without Gastritis by Polymerase Chain Reaction.

J Pharm Bioallied Sci 2019 Nov;11(Suppl 3):S523-S529

Department of General Dentistry, Malla Reddy Institute of Dental Sciences, Suraram, Hyderabad, India.

Aims And Objective: The aim of this study was to identify the presence of in saliva of patients with and without gastritis by polymerase chain reaction (PCR) method.

Materials And Methods: The study comprised 20 patients in Group I presenting with various symptoms of gastritis and 10 asymptomatic subjects in Group II. The intestinal endoscopy antral biopsies were collected from 20 symptomatic patients with gastroduodenal disorders. The saliva specimens were taken from all patients before endoscopy. PCR was performed using genomic DNA, isolated from the saliva and the biopsies of the patients as the template to detect the presence of the 16S ribosomal RNA gene in .

Results: In Group I, 10 (50%) cases of clinical gastritis were positive for by endoscopy biopsy and 10 (50%) were negative. Of the 10 endoscopy biopsy positive cases for , eight were PCR positive in saliva and two were negative. Of the 10 endoscopy biopsy negative cases, three were PCR positive for in saliva and seven were negative. In Groups II, four were symptomatic for gastritis and six were negative. Of the six gastritis negative cases, three were PCR positive, four were gastritis positive, and three were PCR positive. Sensitivity and specificity of PCR were found to be 80% and 70%, respectively. The positive predictive and negative predictive values of PCR in saliva were 72.7% and 77.7%, respectively.

Conclusion: PCR analysis of saliva may be handy in identification of and serves as a noninvasive technique to diagnose and monitor the prognosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jpbs.JPBS_260_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6896576PMC
November 2019

Areca nut use disorder: A dynamic model map.

Indian J Dent Res 2019 Jul-Aug;30(4):612-621

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India.

Problem: Areca nut (AN) chewing is common among Southeast Asian population. Use of AN products (with or without tobacco) have a multifaceted effect on physical health, especially on cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. AN is a known group 1 carcinogen and carries addictive potential. Varying degrees of AN-related substance use disorder (SUD) have been reported among AN chewers. There is a lacuna in awareness of the health risk of AN use, prevention, and cessation programs among AN users, particularly in those who have developed SUD.

Existing Lacunae: The dynamic interaction of factors that promote AN use and later the risk of developing SUD at individual and community level has not been studied in depth. Understanding of the bio-psycho-socio-economic-cultural factors is necessary to identify the factors that prelude, promote, and reinforce AN usage. For managing AN-related conditions, including the several systemic disorders, there is a knowledge lacunae, among health care providers with respect to the pathophysiology of AN-related health issues, SUD, and nonavailability of structured, evidence-based cessation protocols.

Solutions/recommendations: This manuscript presents a model-map to study the dynamics of AN use and the impact of AN on health and health care system at individual as well as community level. The model proposed can help the health policymakers to create evidence-based awareness and cessation protocols for AN.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijdr.IJDR_947_18DOI Listing
November 2019

Evaluating and comparing the morphological and histopathological changes induced by erbium:yttrium-aluminum-garnet laser and diamond bur on enamel, dentin and pulp tissue.

J Investig Clin Dent 2019 Nov 22;10(4):e12475. Epub 2019 Oct 22.

Department of Oral Pathology, Ragas Dental College, Chennai, India.

Aim: Lasers are used for different types of dental treatments. Using the erbium:yttrium-aluminum-garnet (Er:YAG) laser to remove dental hard tissue is simple, advantageous and influences the type of cavity preparation, whether conventional or conservative in nature. The aim of the present study was to evaluate and compare the morphological and histopathological changes in the enamel, dentin and pulp tissue of the teeth treated by Er:YAG laser and conventional burs.

Methods: A conventional class I cavity was prepared in orthodontic patients by laser and bur. The teeth were extracted and analyzed for morphological changes using a scanning electron microscope, ground sections and histopathological changes under a light microscope.

Results: The time with laser was longer than the conventional methods. The lased cavity showed irregular appearance with absence of smear layer which is suitable for the resin restoration. The ground section and the histopathological study showed no differences between the groups.

Conclusion: The Er:YAG laser is effective in the removal of dental hard tissue without damaging the pulp when coupled with ideal energy output. It is widely used in different dental fields. It needs time to be accepted by dentist and patients and further studies are required to explore its advantages.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jicd.12475DOI Listing
November 2019

Characterization of oral fibroblasts: An model for oral fibrosis.

J Oral Maxillofac Pathol 2019 May-Aug;23(2):198-202

Department of Periodontics, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates.

Background: Oral submucous fibrosis (OSMF) is a chronic debilitating condition of the oral mucosa that has been classified as a potentially malignant disorder with a malignant transformation rate of 2%-8%. Several and experiments have been performed to formulate a treatment modality for OSMF, yet no ideal primary oral fibroblast model has been developed.

Aim: To establish an primary oral fibroblast model.

Setting And Design: laboratory setting.

Materials And Methodology: Primary cell culture protocol was performed after obtaining normal oral tissue. Karyotyping was performed to rule out chromosomal abnormalities. Immunofluorescence staining was carried with a panel of fibroblast-specific markers (vimentin, phalloidin, transforming growth factor-β receptor 1 [TGFβR1] and s100a4) and Masson trichrome staining (MTS) to demonstrate the presence of extracellular matrix (ECM) qualitatively.

Results: A monolayer of oral fibroblasts was observed on the 9-day postseeding. No chromosomal abnormality was observed in the patient samples. Positive staining was observed with vimentin, phalloidin, TGFβR1 and s100a4, thereby confirming the cell type. MTS revealed fibroblasts with spindle morphology and scanty ECM.

Conclusion: The present study lays down a protocol to design and characterize primary buccal fibroblast cell culture model that would aid researchers in performing preliminary experiments in areas concerning fibrosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_28_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714264PMC
September 2019

Oral epithelial dysplasia: Classifications and clinical relevance in risk assessment of oral potentially malignant disorders.

J Oral Maxillofac Pathol 2019 Jan-Apr;23(1):19-27

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.

After more than a decade, the World Health Organization (WHO) published the revised grading system for oral epithelial dysplasia in 2017. The revised classification has changes reflecting our evolution of understanding of the dysplastic process. Although the WHO 2017 three-tier grading system is the gold standard for histological diagnosis of oral potentially malignant disorders, it has certain limitations. Suggestions to overcome these limitations include the use of clinical determinants and molecular markers to supplement the grading system. It has also been suggested that a two-tier system may be more reproducible and clinically translatable for better management. These advances in the understanding of epithelial dysplasia are very important globally and for us in the Indian subcontinent, given the prevalence of habits (tobacco/areca nut) and burden of oral cancer in this part of the world. The following review traces the evolution of the grading system of dysplasia, its relevance and clinical utility.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_13_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503768PMC
May 2019

Common oral opportunistic infections in Human Immunodeficiency Virus infection/Acquired Immunodeficiency Syndrome: Changing epidemiology; diagnostic criteria and methods; management protocols.

Periodontol 2000 2019 06;80(1):177-188

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India.

There were 36.9 million in the world living with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) as of 2017, and new infections have seen a reduction by 18% since 2010. But this rate of decline is not sufficient for the goal of eradication of AIDS by 2030. Only 21.7  million people infected with HIV have accesses to antiretroviral therapy, with the rest at risk of the potential complications of HIV infection. It has been shown that oral lesions are diagnostic and prognostic of HIV infection, and many oral opportunistic infections continue to be a major problem, particularly in developing countries. It is therefore important that dental surgeons be aware and updated to recognize and manage the oral effects of HIV infection/AIDS. This chapter describes the classification, diagnosis, and management of oral lesions in these patients, based on our current understanding of the infection. This review also discusses the standardization of diagnosis of oral lesions in HIV infection/AIDS patients, immune reconstitution inflammatory syndrome case definition, and the research priorities formulated at the 7th World Workshop on Oral Health and Disease in AIDS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/prd.12274DOI Listing
June 2019

A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient's Awareness.

J Orofac Sci 2018 Jul-Dec;10(2):86-95. Epub 2019 Jan 2.

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University.

Objective: Schizophrenia is a psychiatric disorder that requires long-term treatment. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD), the severity of which is measured by Abnormal Involuntary Movement Scale (AIMS). This study examined the relationship among TD, orofacial musculature activity, and patient's awareness of AIM. The knowledge would help dentists to deliver oral care for schizophrenics with TD.

Materials And Methods: We identified 317 patients from a standard, data sharing initiative, of whom 38.3% exhibited AIM score of 2 to 15. The patient demographics, drug history, details of AIMS were subjected to descriptive and inferential statistical analysis using SPSS with ≤0.05 as significance.

Results: The mean of only orofacial features ( = 56) was 3.43 ± 2.68. Muscles of facial expression was involved in nine (7.9% of all TD), lip/perioral area in 27 (23.68%), jaw in 52 (45.61%), and tongue in 77 (67.54%). The patient's perception of AIM precipitated stress when involving jaw, tongue, limbs, and trunk was statistically significant (≤0.05). The multiple regression model statistically significantly predicted TD for factors considered.

Conclusion: Around 1% of global population is being diagnosed with schizophrenia, carry an inherent risk of developing TD. They might have orodental care requirements, including prosthodontic and restorative services. Primary physicians and dentists need to be aware of TD and its mechanism for appropriate patient management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333421PMC
January 2019

Loss of heterozygosity as a marker to predict progression of oral epithelial dysplasia to oral squamous cell carcinoma.

J Oral Maxillofac Pathol 2018 May-Aug;22(2):155-160

Department of Oral and Maxillofacial Pathology and Microbiology, Ragas Dental College and Hospitals, Affiliated to the Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India. E-mail:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_151_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6097375PMC
August 2018

"Burden of the Triumph:" Burden of peri-implantitis in Indian population - A mathematical model.

Indian J Dent Res 2018 Jul-Aug;29(4):497-506

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Affiliated to The Tamil Nadu Dr. M.G.R Medical University, Chennai, Tamil Nadu, India.

Context: India suffers from a heavy burden of oral diseases. Dental implants (DIs) are prescribed widely by the dental practitioners to replace lost natural teeth. There is no estimate, however, to determine the number of DIs or the number of people with peri-implantitis or the failure of implants after placement. In this modeling study, we attempted to estimate the prevalence of adult Indians who would choose DI in the near future and to calculate the peri-implantitis and failure of DI.

Materials And Methods: Using the Global Burden of Disease database (2016), the number of dental caries in permanent dentition, periodontal diseases, and edentulism was obtained. Empirical assumptions of patients with anodontia in urban and rural areas who opted for DI, percentage of implants placed, the affordability factors, and mathematical models for DI were formed and executed. Peri-implantitis and survival data from literary evidence were collated.

Results: Based on assumptions, 909,643 Indians, (830,231-858,703) would choose DI. Estimated number of peri-implantitis would be 145,543-254,700 and estimated number of failures should be 50,940-79,412 in the near future.

Conclusions: In spite of the high economic challenge and the risks or complications of peri-implantitis, DIs are gaining prominence. It is the dentists' burden to face the renewed challenges due to emerge and provide remedial measures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijdr.IJDR_715_17DOI Listing
February 2019

Tobacco use, oral cancer screening, and oral disease burden in Indian women.

Indian J Dent Res 2017 Nov-Dec;28(6):706-710

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.

Introduction: India lacks data on national level adaptation of oral cancer screening measures and burden of oral diseases. We intend to address the issue through a secondary data analysis of existing data and reports.

Materials And Methods: Data were acquired from the National Family Health Survey-4 (2015-2016). Of the 699,686 responses, representing 99% of India's women population living in all of India, the following data from the age group of 15-49 years were mined - any tobacco use, desire to quit tobacco use, and oral cavity screening for cancers. Data from Central Health Intelligence Bureau 2016 was used to identify population served by dentists in each state. The state-level data of the District Level Household and Facility Survey-4 (2012-2013) were mined for household population having symptoms of chronic illness including mouth/dental illness persisting for more than 1 month and had sought treatment.

Statistical Analysis Used: SPSS version 20; Descriptive statistics for values in proportions; Pearson's correlation test assessed between the various factors.

Results: Tobacco use in any form was highly prevalent among the North Eastern states, and there was also a lack of willingness to quit the habit. There was unequal distribution of dentists in different states. No significant statistical correlation was found between the proportions.

Conclusion: There is disparity existing in treating seeking behavior of the general population as well as the need for dental treatment. The skewedness in dentists' distribution among the nation as compared with oral burden of diseases needs to be correlated before oral health policies are planned.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijdr.IJDR_330_17DOI Listing
September 2018

Interference RNA in immune-mediated oral diseases - minireview.

Cent Eur J Immunol 2017 30;42(3):301-304. Epub 2017 Oct 30.

Aimst Dental Institute, Aimst University, Bedong, Malaysia.

Immune-mediated oral disorders are characterised by their chronicity, and some are refractory to treatment. Interference RNA (iRNA) has been implicated in the underlying mechanism of such immune-mediate oral and refractory inflammatory oral diseases. iRNA-based understanding of the mechanism in these diseases may help to produce non-invasive diagnostic methodologies and treatment modalities of such drug non-responsive diseases. Oral lesions in these immune-mediated diseases can precede the occurrence of lesions in other regions of the body. The early diagnosis and treatment of these drug non-responsive diseases might benefit the patient by reducing chronicity and probably even resolving the disease. This aim of the present minireview is to give an overview of the possible implications of iRNA on the pathogenesis, diagnosis, and treatments of immune-mediated and inflammatory oral diseases. The manuscript can form the framework for research on iRNA in these immune-mediated oral disorders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/ceji.2017.70974DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708212PMC
October 2017

Influence of legislations and news on Indian internet search query patterns of e-cigarettes.

J Oral Maxillofac Pathol 2017 May-Aug;21(2):194-202

Director of Research, Rural Clinical School, Faculty of Medicine, The University of Queensland, Brisbane, Queensland.

Background: There is a paucity of data on the use of electronic nicotine delivery systems (ENDS) in India. In addition, the Indian internet search pattern for ENDS has not been studied. We aimed to address this lacuna. Moreover, the influence of the tobacco legislations and news pieces on such search volume is not known. Given the fact that ENDS could cause oral lesions, these data are pertinent to dentists.

Methods: Using a time series analysis, we examined the effect of tobacco-related legislations and news pieces on total search volume (TSV) from September 1, 2012, to August 31, 2016. TSV data were seasonally adjusted and analyzed using time series modeling. The TSV clocked during the month of legislations and news pieces were analyzed for their influence on search pattern of ENDS.

Results: The overall mean ± standard deviation (range) TSV was 22273.75 ± 6784.01 (12310-40510) during the study with seasonal variations. Individually, the best model for TSV-legislation and news pieces was autoregressive integrated moving average model, and when influence of legislations and news events were combined, it was the Winter's additive model. In the legislation alone model, the pre-event, event and post-event month TSV was not a better indicator of the effect, barring for post-event month of 2 legislation, which involved pictorial warnings on packages in the study period. Similarly, a news piece on Pan-India ban on ENDS influenced the model in the news piece model. When combined, no "events" emerged significant.

Conclusions: These findings suggest that search for information on ENDS is increasing and that these tobacco control policies and news items, targeting tobacco usage reduction, have only a short-term effect on the rate of searching for information on ENDS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_23_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596668PMC
September 2017

Trends in oral squamous cell carcinoma: Diagnosis for effective, evidence-based treatment 2017.

J Oral Maxillofac Pathol 2017 May-Aug;21(2):189-191

Department of Oral Pathology, Ragas Dental College and Hospital, 2/102, East Coast Road, Uthandi, Chennai - 600 119, Tamil Nadu, India. E-mail:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jomfp.JOMFP_97_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596666PMC
September 2017

Fat Free Pleomorphic Lipoma of Oral Cavity: A Rare Entity.

J Clin Diagn Res 2017 Mar 1;11(3):ZD01-ZD03. Epub 2017 Mar 1.

Reader, Department of Oral Pathology, Ragas Dental College and Hosptal, Chennai, Tamil Nadu, India.

Pleomorphic lipoma is a rare, benign, soft tissue neoplasm that characteristically occurs as a subcutaneous mass in the posterior neck or upper back and rarely in the tonsillar fossa and oral cavity. Histologically, pleomorphic lipoma contains varying amounts of mature fat, areas of spindle and pleomorphic cells, floret giant cells and thick rope - like collagen in a myxoid stroma. Pleomorphic lipoma with scanty fatty elements is called the fat free variant of pleomorphic lipoma. The combination of meagre amount of fat and presence of pleomorphic elements gives a pseudosarcomatous picture under the microscope leading to misdiagnosis and over treatment. Here, we report a case of fat free pleomorphic lipoma, first of its kind in the oral cavity and discuss the diagnostic features and differential diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7860/JCDR/2017/24609.9357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427444PMC
March 2017

Issues related to diagnosing oral lichen planus among oral pathologists in South India: A pilot survey.

J Investig Clin Dent 2017 Nov 26;8(4). Epub 2016 Oct 26.

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India.

Aim: In the present study, we simulated clinical scenarios by explicitly describing the history and clinical and histological features of hypothetical patients presenting with oral lichen planus (OLP), oral lichenoid lesion, and epithelial dysplasia in a self-designed questionnaire. By doing so, we aimed to elicit a diagnosis from oral pathologists and trainees, analyze their responses, appraise issues, and propose solutions regarding the diagnosis of OLP.

Methods: The questionnaire was distributed to 100 oral pathologists and trainees in South India. Six questions were designed to assess awareness of the diagnostic aspects of OLP. Ten questions were hypothetical clinical scenarios (HCS) devised to evaluate respondents' knowledge of diagnostic guidelines and the criteria used by the respondents to render a diagnosis.

Results: There were 60 of 100 responses to the questionnaire. More than half the respondents were aware of the World Health Organization and modified guidelines of OLP. We observed considerable variations in diagnoses for the HCS.

Conclusions: Our study illustrates the ambiguity in rendering an accurate diagnosis, despite adequate guidelines. Based on the responses for the HCS, we hypothesized that changes in the distribution (unilateral or bilateral) and clinical characteristic of OLP, and habits of patients, have a significant bearing on the clinical and final diagnoses of the lesion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jicd.12246DOI Listing
November 2017

Screening for oral cancer-a perspective from the Global Oral Cancer Forum.

Oral Surg Oral Med Oral Pathol Oral Radiol 2017 Jun 9;123(6):680-687. Epub 2016 Sep 9.

Faculty of Dentistry, Piracicaba, University of Campinas, Piracicaba, São Paulo State, Brazil.

Screening for oral cancer should be defined as the application of a test to people who are apparently free of disease to identify those who may have oral cancer and to distinguish them from those who may not. The aim of the test is not to be diagnostic but to identify changes that may be the earliest signs of impending disease. Defined in this way, screening is an ongoing public health measure, often funded by governments. A screening program must do no harm and must be cost effective. Governments demand that strict evidence of benefits and cost effectiveness be met before a program may be implemented. Although many studies have investigated the utility of potential screening tests, there have been few evaluations of screening programs and only one randomized controlled trial. Systematic reviews have concluded that there is insufficient evidence to show that oral cancer screening can reduce mortality from oral cancer, and to date, no country has implemented a formal oral cancer screening program. This paper reviews this evidence and tries to identify the barriers to screening and suggests areas of focus for future research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oooo.2016.08.021DOI Listing
June 2017

Malignant transformation of oral submucous fibrosis: overview of histopathological aspects.

Oral Surg Oral Med Oral Pathol Oral Radiol 2016 Aug 19;122(2):200-9. Epub 2016 Apr 19.

Adj. Professor of Oral Medicine, Case Western Reserve University, School of Dental Medicine, Cleveland, OH, USA. Electronic address:

Oral submucous fibrosis (OSF), first described in 1952, is a potentially malignant disorder associated with betel quid and areca nut chewing, mostly prevalent in the population of the Indian subcontinent and South East Asia. Malignant transformation of OSF to squamous cell carcinoma (SCC) has been estimated to be between 2% and 8%. Our study aimed to review the histopathologic changes that contribute to the understanding of the malignant transformation of OSF. Changes in epithelial thickness and dysplasia characterized by micronuclei, altered AgNOR counts and distribution, keratin protein alteration, and alteration of P63 and E-cadherin characterize the epithelial changes during the transformation of OSF to SCC. Common mechanisms have been proposed to be involved in OSF and SCC, through collagen maturation and their interaction with myofibroblasts and mast cells. Fibrosis-driven vascular constriction that results in epithelial hypoxia has also been proposed as an important mechanism for the malignant transformation of OSF. However, reassessment of the classical view is required, because with demonstration of large blood vasculature in the connective tissue stroma of OSF, the hypothesis associated with tissue hypoxia-induced malignant transformation of OSF can be questioned.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.oooo.2015.11.024DOI Listing
August 2016

A Randomized Double-Blind Placebo-Controlled Phase IIB Trial of Curcumin in Oral Leukoplakia.

Cancer Prev Res (Phila) 2016 Aug 7;9(8):683-91. Epub 2016 Jun 7.

Rajiv Gandhi Center for Biotechnology, Thiruvananthapuram, India.

Oral leukoplakia is a potentially malignant lesion of the oral cavity, for which no effective treatment is available. We investigated the effectiveness of curcumin, a potent inhibitor of NF-κB/COX-2, molecules perturbed in oral carcinogenesis, to treat leukoplakia. Subjects with oral leukoplakia (n = 223) were randomized (1:1 ratio) to receive orally, either 3.6 g/day of curcumin (n = 111) or placebo (n = 112), for 6 months. The primary endpoint was clinical response obtained by bi-dimensional measurement of leukoplakia size at recruitment and 6 months. Histologic response, combined clinical and histologic response, durability and effect of long-term therapy for an additional six months in partial responders, safety and compliance were the secondary endpoints. Clinical response was observed in 75 (67.5%) subjects [95% confidence interval (CI), 58.4-75.6] in the curcumin and 62 (55.3%; 95% CI, 46.1-64.2) in placebo arm (P = 0.03). This response was durable, with 16 of the 18 (88.9%; 95% CI, 67.2-96.9) subjects with complete response in curcumin and 7 of 8 subjects (87.5%) in placebo arm, demonstrating no relapse after 6 months follow-up. Difference in histologic response between curcumin and placebo was not significant (HR, 0.88, 95% CI, 0.45-1.71; P = 0.71). Combined clinical and histologic response assessment indicated a significantly better response with curcumin (HR, 0.50; 95% CI, 0.27-0.92; P = 0.02). Continued therapy, in subjects with partial response at 6 months, did not yield additional benefit. The treatment did not raise any safety concerns. Treatment of oral leukoplakia with curcumin (3.6 g for six months), thus was well tolerated and demonstrated significant and durable clinical response for 6 months. Cancer Prev Res; 9(8); 683-91. ©2016 AACR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1158/1940-6207.CAPR-15-0390DOI Listing
August 2016

Epithelial atrophy in oral submucous fibrosis is mediated by copper (II) and arecoline of areca nut.

J Cell Mol Med 2015 Oct 6;19(10):2397-412. Epub 2015 Aug 6.

Department of Molecular Reproduction, Development and Genetics, Indian Institute of Science, Bangalore, India.

Exposure of oral cavity to areca nut is associated with several pathological conditions including oral submucous fibrosis (OSF). Histopathologically OSF is characterized by epithelial atrophy, chronic inflammation, juxtaepithelial hyalinization, leading to fibrosis of submucosal tissue and affects 0.5% of the population in the Indian subcontinent. As the molecular mechanisms leading to atrophied epithelium and fibrosis are poorly understood, we studied areca nut actions on human keratinocyte and gingival fibroblast cells. Areca nut water extract (ANW) was cytotoxic to epithelial cells and had a pro-proliferative effect on fibroblasts. This opposite effect of ANW on epithelial and fibroblast cells was intriguing but reflects the OSF histopathology such as epithelial atrophy and proliferation of fibroblasts. We demonstrate that the pro-proliferative effects of ANW on fibroblasts are dependent on insulin-like growth factor signalling while the cytotoxic effects on keratinocytes are dependent on the generation of reactive oxygen species. Treatment of keratinocytes with arecoline which is a component of ANW along with copper resulted in enhanced cytotoxicity which becomes comparable to IC(50) of ANW. Furthermore, studies using cyclic voltammetry, mass spectrometry and plasmid cleavage assay suggested that the presence of arecoline increases oxidation reduction potential of copper leading to enhanced cleavage of DNA which could generate an apoptotic response. Terminal deoxynucleotidyl transferase dUTP Nick End Labeling assay and Ki-67 index of OSF tissue sections suggested epithelial apoptosis, which could be responsible for the atrophy of OSF epithelium.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jcmm.12622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594681PMC
October 2015

Growth characteristics and expression of CD73 and CD146 in cells cultured from dental pulp.

J Investig Clin Dent 2016 Aug 2;7(3):278-85. Epub 2015 Jun 2.

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.

Aim: Dental pulp stem cells (DPSCs) in permanent teeth and stem cells from human exfoliated deciduous (SHED) teeth are unique sources of mesenchymal stem cells. The aim of this study was to compare the growth characteristics and morphology of DPSCs and SHED and their immuno-phenotype using CD73 and CD146 in the 1st, 3rd, and 5th passage of cell culture.

Methods: Growth characteristics, morphology, and colony forming efficiency were assessed for SHED and DPSCs. Immunocytochemistry and flow cytometry using CD146 and CD73 was performed for SHED and DPSCs in the 1st, 3rd and 5th passage of culture. Data was analyzed using SPSS™ software (version 17.0.0).

Results: The seeding efficiency and colony forming unit efficiency was higher in SHED than in DPSCs. Flow cytometry analysis using CD73 and CD146 showed an increase in CD73 expression with increase in passage number in SHED and a decrease in CD73 expression with increase in passage number in DPSCs. There was a decrease in CD146 expression from passage one through five in SHED and DPSCs.

Conclusion: Cells isolated from the pulp of deciduous teeth and permanent teeth show difference in their growth characteristics and phenotype and are a viable source of stem cells.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jicd.12155DOI Listing
August 2016

Immunohistochemical study of polycystin-1 in dentigerous cysts.

Indian J Dent Res 2014 Nov-Dec;25(6):762-6

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Uthandi, Chennai, Tamil Nadu, India.

Background: The alterations involved in step-wise transformation of a dental follicle to dentigerous cyst (DC) is not clearly known. Primary cilium and its protein have been hypothesized to be associated with DC. Mutation of a ciliary protein, polycystin-1 (PC1) is associated with autosomal dominant polycystic kidney disease. This study was performed to assess the immunohistochemical expression of PC1 between DC and postfunctional follicular tissue (PFFT).

Materials And Methods: Thirty-one consecutive PFFT and 15 DC formed the study group. The PFFT and DC tissues were stained with antibody against PC1. Statistical Package for Social Service was used to analyze data. Descriptive statistics and Student's Chi-square test were appropriately used. P≤0.05 was taken as significant.

Results: Fifteen DC (100%) and 7 (22.58%) PFFT were positive for PC1. The difference was statistically significant (P=0.000). PC1 expression was observed in the cytoplasm with varying intensity.

Discussion And Conclusion: All PC1 positive epithelial cells' cytoplasm stained diffusely. Abnormal cytoplasmic expression of PC1 in all positive epithelial lining indicates that the PC1 probably is associated with cystic transformation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0970-9290.152198DOI Listing
October 2015

Awareness of Forensic Odontology among Legal Professionals, Chennai, India.

N Am J Med Sci 2014 Nov;6(11):553-7

Department of Oral and Maxillofacial Pathology, Ragas Dental College, Uthandi, Chennai, Tamil Nadu, India.

Background: The forensic discipline of law is a multidisciplinary team comprising of specialists in forensic medicine, forensic odontology, security and law.

Aim: The study was to find the awareness level of scope and utility of forensic odontology among lawyers in Chennai, South India.

Materials And Methods: A cross-sectional study using a self administered structured questionnaire was conducted in 200 lawyers between August and September of 2013. The data was analyzed depending on age, gender, type and years of practice.

Results: Lawyers above 40 years of experience were more aware of palatal rugae analysis (P = 0.02), and those with more than 20 years were aware of lip print (P = 0.001) and bite mark analysis (P = 0.001). Males were more aware of forensic odontology with respect to criminal identification (P = 0.001). The knowledge of bite mark analysis was higher among male lawyers (P = 0.001), civil and criminal practicing lawyers (P = 0.004). All participants were aware that loss or fracture of tooth constitutes a grievous injury under Indian Penal Code (IPC) 320 clause 7(5).

Conclusion: This study highlighted the knowledge of forensic odontology among legal professionals and also identified the areas in which they need further appraisal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/1947-2714.145459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264289PMC
November 2014

MicroRNAs - Biology and clinical applications.

J Oral Maxillofac Pathol 2014 May;18(2):229-34

Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Uthandi, Chennai, Tamil Nadu, India.

MicroRNAs are a highly conserved group of small, non-coding RNA molecules, which are 19-25 nucleotides in size. Previously thought to be evolutionary debris with no evident function, these small RNAs have been found to control gene expression primarily by silencing the gene. MicroRNAs are critical to cell physiology and development. They are also implicated in pathological processes such as autoimmune diseases, viral infections and carcinogenesis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0973-029X.140762DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196292PMC
May 2014

Immunohistochemical study of p53 and proliferating cell nuclear antigen expression in odontogenic keratocyst and periapical cyst.

J Pharm Bioallied Sci 2014 Jul;6(Suppl 1):S52-7

Raagas Dental College, Chennai, Tamil Nadu, India.

Introduction: p53 protein is a product of p53 gene, which is now classified as a tumor suppressor gene. The gene is a frequent target for mutation, being seen as a common step in the pathogenesis of many human cancers. Proliferating cell nuclear antigen (PCNA) is an auxiliary protein of DNA polymerase delta and plays a critical role in initiation of cell proliferation.

Aim: The aim of this study is to assess and compare the expression of p53 and PCNA in lining epithelium of odontogenic keratocyst (OKC) and periapical cyst (PA).

Materials And Methods: A total of 20 cases comprising 10 OKC and 10 PA were included in retrospective study. Three paraffin section of 4 μm were cut, one was used for routine hematoxylin and eosin stain, while the other two were used for immunohistochemistry. Statistical analysis was performed using Chi-square test.

Results: The level of staining and intensity were assessed in all these cases. OKC showed PCNA expression in all cases (100%), whereas in perapical cyst only 60% of cases exhibited PCNA staining. (1) OKC showed p53 expression in 6 cases (60%) whereas in PA only 10% of the cases exhibited p53 staining. Chi-square test showed PCNA staining intensity was more significant than p53 in OKC. (2) The staining intensity of PA using p53, PCNA revealed that PCNA stating intensity was more significant than p53.

Conclusion: OKC shows significant proliferative activity than PA using PCNA and p53. PCNA staining was more intense when compared with p53 in both OKC and PA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0975-7406.137388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157281PMC
July 2014

Keratinizing dentigerous cyst.

Contemp Clin Dent 2014 Jan;5(1):127-9

Chennai Dental Research Foundation, Dr. R. K. Salai, Mylapore, Chennai, Tamilnadu, India.

Keratinizing dentigerous cyst is a rare entity. This article reports a case of keratinizing dentigerous cyst associated with an impacted mandibular canine. Clinical and radiological features, cone-beam computed tomography findings and histological features of the case are reported along with a discussion on keratinizing odontogenic cysts and the need for follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0976-237X.128691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012105PMC
January 2014
-->