Oral and Maxillofacial Pathology Journal

Editor-in-chief: Dr.Radhika.M.Bavle
ISSN: 0973-029X (Print), 1998-393X (Online)

Frequency: Annual

Language: English

Open Access Peer-reviewed journal

Web site: https://www.jomfp.in/

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Recent Submissions

Now showing 1 - 20 of 74
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    Evaluation of the effects of Albizia lebbeck bark extracts on the cariogenic properties of Streptococcus mutans
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Raju, S; Krishnan, AV; Nair, MR; Richard, A.
    Introduction: Oral diseases continue to be a major and common health problem worldwide and affect the quality of life by causing considerable pain and discomfort. While the mechanistic methods of caries prevention and treatment are in vogue, the concern about adverse effects of the constituents of these methods persists. Thus, there has always existed a need to develop effective and safe strategies to combat oral pathogens such as Streptococcus mutans (S. mutans). Aim: To examine the action of Albizia lebbeck (A. lebbeck) bark extracts on the growth and virulence factors of S. mutans such as- biofilm formation, surface adherence, cell surface hydrophobicity and acid production. Materials and Methods: Ethyl acetate, hexane, and chloroform extracts of the bark of A. lebbeck was prepared and tested for their activity against the ATCC 25175 S. mutans. The phytochemical constituents of the extracts were determined by biochemical assays and the MIC (Minimum Inhibitory Concentration) and MBC (Minimum Bactericidal Concentration) were obtained using the well diffusion assay. The effect of the sub-MIC concentrations of extracts on biofilm formation & eradication, microbial growth, adherence of the strain to glass surfaces, cell surface hydrophobicity and acid production were also determined. Results: All extracts inhibited the organism’s growth, and MIC was determined as 25 mg/ml. the sub-MIC concentrations of the extracts were found to- inhibit the formation of biofilms, eradicate formed biofilms and interfere with the adherence and acid production of S. mutans. Conclusion: The ethyl acetate and ethanolic extracts were found to be active at low concentrations (0.02mg/ml) and demonstrate a potential to be used in the formulation of anti-caries preparations.
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    Clarified Butter as Xylene Substitute in Routine Histopathology of Oral and Maxillofacial Biopsies
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Sushanthi, CL.
    Introduction: An ideal clearing agent should remove alcohol from the tissue specimens to enable the penetration of paraffin wax which provides sturdiness to the tissue specimen. Xylene has toxic effects and is still used because of its accurate clearing property and maintaining the staining quality. Natural alternatives to xylene provide a less toxic environment for histopathological technicians. Aim: The study is to evaluate the accuracy of clarified butter as xylene substitute in routine histopathological tissue processing procedure. Materials and Methods: 40 paired soft tissue specimens were obtained from the Department of Oral pathology and microbiology and subjected to routine histopathological tissue processing with xylene and ghee as clearing agents. Post processing, the tissue specimens were immersed in paraffin wax overnight, embedded, sectioned and stained using hematoxylin and eosin. Histopathological criteria namely nuclear staining, cytoplasmic staining, artefacts and background staining were evaluated and the scores were tabulated and statistical analysis was done using SPSS version 20 by IBM. Results: Our study results showed that tissue specimens processed in xylene and ghee had similar nuclear staining. In cytoplasmic staining, tissue specimens processed in ghee had superior results than xylene processing. Artefacts were present more in xylene processing than ghee processing. Background staining was more appreciated in xylene processed tissue specimens than ghee processing. Conclusion: Substituting xylene with ghee showed better results as a clearing agent in routine histopathological tissue processing. Ghee as a clearing agent is non toxic, cost effective compared to xylene and a safer alternative.
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    A Non-Classical Presentation of Oral Pyogenic Granuloma with Actinomycosis
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Protyusha, GB; Sivapathasundharam, B; Prabhakar, M.
    Introduction: Pyogenic granuloma is a rather confusing reactive lesion of the oral mucosa, considering it is neither a bacterial infection nor does it produce any pus. In fact, even histologically, there is no formation of granulomas to substantiate the name. Intraoral actinomycosis is another interesting lesion due to its unique ability to masquerade itself as a swelling, abscess, or even a neoplasm. The occurrence of the two lesions separately is common in the oral cavity, however, their co-existence is extremely rare. Case Presentation: A 65-year-old female patient was referred from a private dental clinic with the chief complaint of a growth on her left posterior region of mouth, at the occlusal level of 15, 18 tooth regions for past 1 month. Conclusion: Clinicians should be aware about the occurrence of such rare combination of intraoral lesions, in order to make an accurate diagnosis and in turn, tailor a correct treatment protocol for these patients.
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    Mucormycosis in a Typhoid Treated Patient: A Case Report with Review of Literature
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Pillalamarri, M; Pasupuleti, S; Manyam, R; Moturi, K; Tatapudi, R.
    Introduction: Mucormycosis is an opportunistic fungal infection which is a rapidly progressing disease, and often fatal. Various predisposing factors including uncontrolled diabetes mellitus, immunosuppression, and prolonged use of steroids influence the disease pathology. Case Presentation: In this article, we present a case of mucormycosis of the palate in a patient treated with prolonged dose of steroids for typhoid fever which led to the appearance of exposed maxillary bone, and subsequent histopathological examination showed mucor hyphae. The treatment included antifungal therapy of Amphoterecine B. Management: Treatment of typhoid fever with corticosteroids, leading to immunosuppression, may result in patients harbouring opportunistic infections. An insight into the changes of oral cavity caused by corticosteroids is necessary for better diagnosis of the disease and improved patient care. In addition, early diagnosis is critical in the treatment of patients with mucormycosis
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    Awareness of Oral Cancer among Patients Attending a Cancer Trust Hospital in East Godavari District, Andhra Pradesh
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Kommalapati, V; Gogineni, T; Rajkumar, NG; Kumar, AS; Karri, RL; Ashok, S; Vinnakota, P.
    Introduction: Oral cancer (OC) is associated with various risk factors and high mortality rates, and contributes significantly to the worldwide cancer burden. Objectives: To assess and evaluate patients’ current knowledge, awareness, and behavior regarding OC risk in a cancer trust hospital. Materials and Methods: The study involved 600 patients who attended cancer trust hospital, East Godavari district, from September 2021 to October 2021. A self- administered questionnaire of 20-questions was given to each patient that included socio-demographic and disease-specific information and their answers evaluated. Results: The data was examined using descriptive statistics, and the connection between the variables, education, family income, and other factors was assessed using a chi-square test (with a 5% significance threshold). The results were analysed with reference to their implications for interventions aimed at patient’s awareness for oral cancer symptoms. Conclusion: According to the findings of this study, people lacked information and awareness about identified risk factors for oral cancer. Knowledge of maintaining a healthy lifestyle that eliminates the consumption of established oral cancer risk factors was low. At the community and individual levels, health education linked to primary prevention of oral cancer must be improved.
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    Systematic Analysis of Artificial Intelligence in Pathology
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Uppala, D; Smyrna, O; Lavanya, L; Gadam; Kumar, TV.
    Introduction: Artificial intelligence (AI) is an emerging modern technology within the health care sectors in the current era and it is the ability of computer software to mimic human judgment. Artificial intelligence (AI)-based modern image analysis methods have significant promise for enhancing the accuracy and efficacy of pathology diagnostic processes as well as for the discovery of new biomarkers. Objectives: In this article, we will discuss Artificial Intelligence, its usage in pathology in various ways such as for screening of various diseases, detection of prognostic markers or biomarkers, and various treatment modalities. Materials and Methods: Data were collected and analyzed from the recently published literature and electronic database searches of Cochrane and included the articles the year 2017 to 2021 by reading the title and the abstract. Artificial intelligence (AI), has a lot of potential for aiding in diagnosis with the advancement of information technology. For this purpose, few machine learning algorithms have been created to date. Given their capacity to evaluate complicated data in a quantitative and standardised manner to further improve the precision and scope of diagnoses, artificial intelligence (AI) or machine learning technologies hold great promise for the field of pathology. Conclusion: The application of Artificial Intelligence tools in pathology has sharply increased in this era and it is anticipated to revolutionize the pathology field in the years ahead and can change the way the field of pathology is managed and make them not only more systematic but also effective in meeting the needs of the current age of precision medicine.
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    Peripheral squamous odontogenic tumor associated with an impacted mandibular third molar: A case report
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Thankappan, P; Manivannan, S; Augustine, PI; Narayana, PY; Angelin, D; Mary, SJ
    Introduction: Squamous odontogenic tumor is a benign but locally infiltrative, epithelial odontogenic tumor. This case report presents a case of a peripheral variant of squamous odontogenic tumor. Case Presentation: A 29-year-old male patient presented with pain in the left posterior mandible region for one month. Radiographic examination revealed an impacted left mandibular third molar with no other abnormalities. Management and Prognosis: The impacted tooth was removed under local anaesthesia. Histopathological examination of the abnormally thick pericoronal tissue, covering the impacted tooth revealed islands of bland squamous epithelium in a background of mature fibrous connective tissue. The prognosis was good with no signs of recurrence after one year of follow- up. Conclusion: Squamous odontogenic tumor should be considered in the differential diagnosis of pericoronal pathoses, although it is rare in this location.
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    Melkersson Rosenthal Syndrome: A Case Report
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Azamulla, M; Sen, S; Khan, S; Singh, S
    Introduction: Melkersson-Rosenthal Syndrome (MRS) is a rare neuro-mucocutaneous condition. It mainly includes three triads as orofacial swelling, facial palsy and fissured tongue. All of the classical triad may not be seen at the same time, as symptoms may appear in different interval of time and has a recurrence. MRS is diagnosed based on oligosymptomatic when two or more clinical features are present or monosymptomatic cases when there evidence of a non-necrotising, granulomatous cheilitis in patients with isolated facial or lip edema can be noted in biopsy. Case Presentation: In this case report a 18 year old male patient all the three classic clinical characteristic features as granulomatous cheilitis, unilateral facial muscle palsy and a fissured tongue are seen. The clinical features of this rare condition along with treatment procedure are presented. Conclusion: Oral corticosteroids are the mainstay in the treatment of MRS. Intralesional triamcinolone acetonide used in oro-facial edema. In recurrent cases of MRS need second-line immunosuppressants like methotrexate and thalidomide. In refractory recurrent facial nerve palsies Surgical decompression of the facial nerve may be considered.
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    Mucormycosis an Emerging Fungal Infection Associated with COVID-19- A Case Report
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Bhattacharyya, A; Kumar, H; Panda, A; Mahapatra, N.
    Introduction: Mucormycosis is an exceptional but rising fungal infection correlated with the COVID-19 disease. COVID-19 positive patients exhibiting severe symptoms admitted in the ICU have an increased susceptibility to develop bacterial and fungal infection. We hereby report a case of oral mucormycosis that is seen in a patient in post COVID-19 infection. Case Presentation: A 65-year-old woman presented to our institution, with the chief complaint of ulceration in her right palate region for the past 7 days along with pyrexia and generalised malaise. The patient reported to have recovered from COVID-19 infection recently. She presented with medical history of diabetes and hypertension for past 8 years. Post recovery from COVID-19 infection the patient developed an ulcer in the hard palate. Treatment: Surgery was done under General anesthesia. Maxillectomy was done with aggressive debridement of necrotic tissue. Bilaterally periosteal flap was approximated and suture was placed. Conclusion: The extensive use of steroids and broad-spectrum antibiotics in COVID-19 treatment may raise the risk of fungal infections. Medical practitioners should be aware of the possibility of invasive secondary fungal infections in patients with COVID-19 infection.
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    Analysis of Various Histopathological Patterns in Pleomorphic Adenoma - An Institutional Case Study
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) K, Monica; Sandhya; Ramani, P.
    Introduction: Pleomorphic adenoma, the most common benign mixed salivary gland tumor which accounts for 70-80%, is a biphasic tumor with dual origin from epithelial and myoepithelial elements. It shows a malignant transformation rate of 6%. Microscopically, pleomorphic adenoma characteristically displays vast morphologic diversity. This present study is done to analyze prevalence rates and histomorphological variations to better elucidate the pattern of occurrence, diagnosis and treat- ment plan of pleomorphic adenoma. Materials and Methods: This are a retrospective study which was conducted in a private institution, Chennai. Based on the proportion of parenchymal and stromal tumor components, the cases were classified into four subtypes as proposed by Foote and Frazell. Morphological patterns, cellular patterns, capsular alterations and Stromal components were analyzed and statisti- cally evaluated. Results: Our analysis showed an overall 0.87% of pleomorphic adenoma cases being reported were associated with minor salivary glands followed buccal mucosa and palate. All the reported cases showed Type II pattern with histological cellular pat- tern of spindle cells and ductal morphological pattern. Conclusion: We observed the great diversity of morphological aspects of the stroma in pleomorphic adenoma, in which many cases showed variation in morphology and cellularity associated with tumor location.
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    Sex Determination in Kerala Population Using Morphometric Analysis of Orbital and Mandibular Height: An Institutional Based Study
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Sabarad, P; Shalinipriya, N; Prabhu, S; Miqdad, SM.
    Introduction: Measurement of orbital space and height of the mandible are used as tools for estimation of sex, which can be done by using different radiographic techniques like CT, MRI, frontal and lateral skull view, which gives superior accuracy and reproducibility. Aims: To determine the sex of the individual using orbital and mandibular height. Materials and Methods: A cross sectional retrospective study was conducted using a study group consisting of 100 lateral cephalograms both male and female of 18-30 years of age. Lateral cephalograms available in orthodontics department ar- chives were used. In the lateral cephalogram height of orbit was measured by marking the points at supra orbital and infra orbital margin & height of mandible was measured by marking the points at condylion superior (the most superior point on the mandibular condyle) and gonion with the help of GIMPS (GNU Image Manipulation Program) software. The data obtained were analyzed by descriptive statistics, discriminant function analysis using Wilk’s Lambda test. Results: Discriminant function analysis was used to describe the data with appropriate method of presentation. Descriptive statistics showed that mandibular height was statistically significant between males and females. However, the orbital height difference was not statistically significant. Conclusion: Mandibular height can be used in sex determination, which can be utilized as an adjunct in forensic identification
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    Evaluation of Connective Tissue Changes in Different Histological Grades of Oral Squamous Cell Carcinoma: A Histochemical Study
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Jose, J; Heera R; Cherian, LM; Beena, VT; Paul, S; Arun, TJ.
    Introduction: In squamous cell carcinoma, cells invade the stroma in the form of islands, strands or sheets, which are surrounded by an extracellular matrix, thus producing reactive changes in the stroma. These reactive changes in the stroma may alter the biological behavior of oral cancer which convey some diagnostic and prognostic significance. Objective: This study was to compare staining intensity of various components of connective tissue such as collagen, elastin and glycoprotein among three histological grades of oral squamous cell carcinoma and normal oral mucosa. Materials and Methods: A total sample of 48 in which 36 cases of histologically diagnosed oral squamous cell carcinoma, 12 each of well, moderate and poorly differentiated squamous cell carcinomas and 12 sections of normal mucosa as the control group were selected for the present study. The sections of tissue blocks were stained with connective tissue specific stains such as Verhoeff’s -VanGieson stain and PAS for collagen, elastin and glycoprotein respectively. Results: Staining intensity of collagen, elastin and glycoprotein around tumor island among different grades of OSCC and normal mucosa revealed statistically significant changes (P value <0.001). Collagen and glycoprotein degradation and elastosis are more prominent in poorly differentiated squamous cell carcinomas. Conclusion: Observable changes were seen in the stroma, in all the three grades of OSCC’s compared to normal mucosa. There was an increased stromal response in poorly differentiated carcinomas, when compared to the other grades. Role of the stroma is like a double-edged sword, at times helping in tumor invasion and otherwise warding off the tumor cells.
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    Basal Cell Adenocarcinoma - 2 Case Series of a Rare Entity
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Meyyappan, Arunachalam; Kumar, Sathish; Jeyapriya, Mary Tresa; Sankar Pradeep.
    Introduction: Basal cell adenocarcinoma is a rare well recognized low grade malignant salivary gland tumor often resembles basal cell adenoma. the infiltrating growth pattern and likelihood of vascular and perineural involvement distinguishes basal cell adenocarcinoma with basal cell adenoma. Case presentation: Here we present histopathological and immune histochemical analysis of two such rare cases of basal cell adenocarcinoma and review of literature is discussed. Conclusion: Basal cell adeno carcinoma is a low grade malignancy and doesn’t metastasize. With only few hundreds of cases that has been reported in literature, basal cell adeno carcinoma should be included as differential diagnosis in salivary gland tumors in order not to miss the diagnosis
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    A Case Report of Mucormycosis in a Patient with a Recent History of COVID-19 Infection in India
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Bose, S; Saha, A; Chatterjee, D; Chattopadhyay, J.
    Introduction: Mucormycosis is an angio-invasive fungal infection that increased significantly during the 2nd wave of the Covid-19 pandemic in India. The rise of cases was attributed to inflammatory changes, poor quality oxygen, immune suppression, and corticosteroid therapy. Case Presentation: This case study reports the history, treatment, and rehabilitation of a case of post-Covid-19 mucormycosis infection. The patient was admitted to the hospital following respiratory distress, at the beginning of the 2nd Covid-19 wave in India. Intravenous antibiotics, steroids, and moist O2 were administered, intensive support was provided and the patient was discharged after 13 days. Following extraction of 17, the patient reported signs of oro-antral communication which was managed by performing antral lavage and buccal advanced flap closure. Histopathological investigation of tissue salvaged during the procedure revealed the presence of fungal hyphae. Management and Prognosis: Following diagnosis, anti-fungal medication was prescribed, and a maxillectomy was performed to remove the affected tissue. On follow-up, the tissue healed with no further complications or symptoms, and rehabilitation was performed using an obturators and are movable complete denture. Histopathological investigations were carried out on the tissue salvaged during maxillectomy which confirmed Mucormycosis infection. Conclusion: The importance of histopathological investigation in the diagnosis of any infectious disease is enumerated in this paper
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    Determination of ABO Blood Grouping from Dentin and Pulp from Freshly Extracted Teeth and Teeth Stored in Sea Water Using Absorption Elution and Absorption Inhibition Method
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Dineja, R; Siva, Kumar G; Sri, Chinthu KK; Prasad, H; Rajmohan, M; Prema, P.
    Introduction: Forensic Odontology plays a role in discerning a deceased individual in any disaster condition. In highly necrotised bodies, ABO blood group antigens can be found from teeth. Aim: We studied ABO blood grouping from dentin and pulp in freshly extracted teeth and also from the teeth stored in sea water. Materials and Methods: A total of 60 samples were selected & divided into 3 groups with 20 samples each. Group I analyzed within period of a week without any storage medium, group II, III were analyzed after 1 and 2 month of storage in sea water. Results: Statistical analysis was done using chi square test. By Absorption –Elution, pulp in group I, II, III, gave 90%,75%,75% of positivity. In dentin, Group I, II, III showed 55%, 45%, 20% of positivity. By Absorption -Inhibition method pulp in group I, II, III showed 45%, 20%, 0% of positivity. In dentin, group I, II, III showed 20%,5%,5% of positivity. Conclusion: This study concluded that pulp is most reliable than dentin even in sea water storage and absorption elution is most effective method in blood group identification in teeth than absorption inhibition method. ==================================== Introduction: Oral cancer (OC) is associated with various risk factors and high mortality rates, and contributes significantly to the worldwide cancer burden. Objectives: To assess and evaluate patients’ current knowledge, awareness, and behavior regarding OC risk in a cancer trust hospital. Materials and Methods: The study involved 600 patients who attended cancer trust hospital, East Godavari district, from September 2021 to October 2021. A self- administered questionnaire of 20-questions was given to each patient that included socio-demographic and disease-specific information and their answers evaluated. Results: The data was examined using descriptive statistics, and the connection between the variables, education, family income, and other factors was assessed using a chi-square test (with a 5% significance threshold). The results were analysed with reference to their implications for interventions aimed at patient’s awareness for oral cancer symptoms. Conclusion: According to the findings of this study, people lacked information and awareness about identified risk factors for oral cancer. Knowledge of maintaining a healthy lifestyle that eliminates the consumption of established oral cancer risk factors was low. At the community and individual levels, health education linked to primary prevention of oral cancer must be improved.
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    A Case Report of Fanconi Anemia: A Literature Review and Dental Perspective of Rare Disease
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Mathirat, A; Ejas, M; Devan, A; Sham, SB; Hegde, SK; Sargod, SS.
    Introduction: Fanconi Anaemia (FA) is a very rare genetic disease characterised by genetic alterations, which causes con- genital abnormalities in individuals. This clinical case report of Fanconi anaemia, will review classical signs of the disease in detail. The various aspects of this rare condition are examined, with an emphasis on oral manifestations and their impact on af- fected patients overall health. Since this group is more likely to acquire cancers, paediatric dentists must be aware of common oral symptoms and possibly malignant lesions in order to make an early diagnosis and provide thorough care and maintenance of oral health to those who are affected. Case Presentation: A four-year-old female patient was brought by her parents to the Department of Pediatric and Preventive Dentistry, Yenepoya Dental college, with a chief complaint of pain in the upper back tooth region. The child had already been diagnosed with FA. Conclusion: Patients with FA are more prone to get infections, so proper precautions should be taken to avoid any situation that might put them at risk of infection or bleeding. Patients should be motivated to have regular follow-ups and encourage them to maintain good periodontal health, to help prevent the incidence of caries and to monitor their overall oral wellbeing.
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    Multiple Osteomas of Mandible in a Patient with Gardner’s Syndrome - Report of a Case
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) George, A; Vichattu, SV; Das, RJ; Thomas, A; James, JE.
    Introduction: Osteomas are benign tumors of the bone usually seen in craniofacial bones which arise from either the cortex or medulla. They are usually asymptomatic with slow painless growth. Multiple osteomas are often associated with Gardners syndrome. Solitary osteomas are typically non syndromic. Case Presentation: The patient presented with remarkable facial asymmetry following the growth in the mandible. Multiple os- teomas were noted which invoked suspicion of a syndrome. On endoscopic evaluation the patient was found to have multiple intestinal polyps, pathgnomonic for Gardners syndrome. Management and prognosis: The lesion was surgically removed under local anaesthesia. as an excisional biopsy and the asymmetry was rectified. Histopathologic examination revealed it to be ivory osteoma with dense compact bone and less mar- row spaces. The jaw lesions would precede the development of colonic polyps and therefore may contribute to early diagnosis of Gardner’s syndrome. There is also a chance of malignant evolution associated with the polyps Conclusion: People with the condition have a higher risk of developing other family adenomatous polyp (FAP)related cancers including pancreatic cancer and liver cancer. The patient should be in close follow up
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    Case Analysis and Systematic Review of Aspergilloma
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Benitha, G; Ramani, P; Krishnan, RP; Gheena, S; Abhiasha, R
    Introduction: Aspergillus fumigatus is the most prevalent fungal pathogen reported to cause diseases such as aspergilloma or aspergillosis in humans. Aspergillomas are commonly seen in a poorly drained and avascular cavitary space. Paranasal sinuses are most commonly involved, especially maxillary sinus. In the past two decades, the incidence of aspergillosis has increased substantially. Aims: To evaluate cases reported as aspergilloma of the maxillary sinus and to determine the percentage of cases involving aspergilloma of the maxillary sinus in healthy individuals. Materials and Methods: After the final full-text review,16 articles were included in this systematic review. Data extracted from these full-text articles was reviewed. Results: 83 % of cases had a history of dental procedures, with 42 % of those being due to infection from previous extraction sockets and 41 % due to root canal therapy (RCT). About 43% of the patients were immunocompromised, while 56% were healthy without any predisposing conditions. Conclusion: Aspergillus fungal infections of the paranasal sinuses are common and can occur in apparently healthy as well as immunocompromised individuals. Aspergilloma is the most common fungal infection involving the maxillary sinus with iatrogenic-dentogenic factors being predominant for initiation and progression of the infection. About 43% of the patients in this review were immunocompromised patients whereas 56% of the patients were healthy without any known predisposing condi- tions. The progression and prognosis of this disease depends on the location and immunologic status of the patient. So, it is very important for dentists to be cautious while performing any dental procedures so as not to initiate any iatrogenic infections.
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    Unique Cytomegalovirus Tongue Ulcer in an Older Adult Patient with Prolonged Systemic Steroid Treatment
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) Pesis, M; Shaco-Levy, R; Appel, D; Givol, N.
    Introduction: Cytomegalovirus (CMV) is a member of the Herpesviridae family that infects humans. It infects approximately 90% of adults. It is an opportunistic pathogen, common among immunosuppressed patients and can affect multiple organs. To date, there has been only one reported case of a CMV-related tongue ulcer that occurred during steroid treatment. Case Presentation: We report a case of CMV tongue ulcer in an elder, immunodeficient patient under prolonged steroid treatment. Management and Prognosis: A 67-year-old man under chronic steroidal treatment due to severe chronic obstructive pulmonary disease (COPD), with chronic ischemic heart disease (CIHD) and poorly treated diabetes mellitus (DM) was hospitalized in Soroka university medical center. He suffered from an ulcerative wound about 10 mm in its greater diameter with raised margins on the left lateral tongue. Daktarin Oral Gel treatment showed no improvement. On histopathological examination, a diagnosis of CMV-related tongue ulcer was given. Conclusion: To the best of our knowledge, this is the most detailed case report of CMV tongue ulcer due to prolonged steroid treatment. An early diagnosis of CMV infection in patients with oral lesions is crucial because CMV infection can increase immunosuppression, and is associated with opportunistic infections.
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    Boon that Resolves Microscopic Puzzle
    (Kairali Society of Oral and Maxillofacial Pathologists, 2023-06) WK, Banu; Thanka, J; Meenakshi, S.
    Introduction: Immunohistochemistry plays a major role to confirm the accurate diagnosis of non-Hodgkin lymphoma B cell type -Tonsillar fossa. Case Presentation: A 65 year old male presented with blocking sensation in the throat, dysphagia and loss of appetite with loss of weight since 2 months. Video laryngoscopic examination revealed a growth in the right tonsil. Contrast enhanced CT neck showed well defined mass in the tonsillar fossa with multiple enlarged lymph nodes in right submandibular and para tracheal region. Biopsy showed predominantly necrotic tonsillar tissue with lymphoid cells showing angiocentric distribution along with few bizarre cells. The differential diagnosis was Lymphoma and Poorly differentiated carcinoma. Immunohistochemistry was done which showed the neoplastic cells positive for CD 20 and negative for CD 3 and cytokeratin. A diagnosis of non-Hodgkin lymphoma B cell type-Right tonsillar fossa was made. The patient was referred to medical oncology for chemotherapy. Conclusion: We present this case to highlight the role of immunohistochemistry to arrive at the accurate diagnosis and management of the patient.