Background:The role of tumour inflammation and the dysplastic epithelial-stromal interactions on the nature of collagen fibres in the extracellular matrix of dysplastic epithelium is not fully understood. The present study was aimed to evaluate and compare the inflammation and pathological stromal collagen (loosely packed thin disorganized collagen) present in mild, moderate and severe epithelial dysplasias with that of inflammatory fibrous hyperplasias. The basement membrane intactness of epithelial dysplasias was also evaluated to determine if dysplastic epithelial mesenchymal interaction has any role in the integrity of stromal collagen in epithelial dysplasia.Methods:Oral epithelial dysplasias, inflammatory fibrous hyperplasia and normal oral mucosal samples were used for the study. Packing, thickness and orientation of collagen fibres in mild, moderate and severe grades of oral epithelial dysplasias (n = 24), inflammatory fibrous hyperplasia (n = 8) and normal oral mucosal samples (n = 8) were analysed based on the polarisation of collagen fibres in picrosirius red polarising stain under polarising microscope.Results:All the grades of epithelial dysplasias showed greenish yellow birefringence confirming the presence of loosely arranged pathological collagen in the presence of moderate inflammation. All the cases of inflammatory fibrous hyperplasia showed red polarisation hue and moderate inflammation. A statistically significant difference was found in the packing and orientation of collagen when epithelial dysplasias and inflammatory fibrous hyperplasia were compared (P < 0.01). When the intactness of basement membrane integrity was compared in all the groups of epithelial dysplasia, a statistically significant result was obtained (P < 0.05).Conclusions:Presence of significant amount of loosely packed thin disoriented collagen even in mild epithelial dysplasia suggests that tumourigenic factors are released to connective tissue stroma much earlier than expected. Hence we suggest considering the integrity of extracellular matrix collagen, intactness of basement membrane and inflammation associated with dysplasia along with the anaplasia of epithelial cells in the microscopic assessment of dysplastic epithelium.

Introduction:The newer preventive approach to caries has resulted in the increased use of remineralizing agents. The remineralizing ability of green tea and black tea is under research. Materials and methods:Two hundred premolar teeth were collected and a buccal window was exposed on the tooth sample by coating the rest of the teeth with nail varnish. The samples were artificially demineralized using Featherstone pH cycling technique. The test solutions of green tea and black tea were prepared by dissolving 2 gm of the prepared extract in 180 mL of water; 0.05% NaF solution was prepared by dissolving 5 gm of NaF in 1 L of distilled water. A total of 50 samples each were treated with the four test solutions, green tea, black tea, NaF and distilled water (control) for 4 minutes per day for 1 week. The samples were excited using diode laser and the fluorescence spectra were measured using laser-induced fluorescence spectroscopy. Results:The highest remineralization was shown by samples treated with green tea, followed by NaF. Black tea showed lower remineralization than both green tea and NaF and the least remineralization was shown by the control, distilled water. The difference in remineralization shown by the test solutions was statistically significant except for the difference between black tea and distilled water. Conclusion:All the three test groups, green tea, black tea, and NaF, showed remineralization. Green tea induced the highest remineralization in the tooth samples, followed by NaF. Black tea produced the least amount of remineralization. Green tea may have a potential role as a remineralizing agent for daily intake.

Dental caries is an irreversible microbial disease of the calcified tissues of the teeth, characterized by demineralization of the inorganic portion and destruction of the organic substance of the tooth, which often leads to cavitation (Shafer-1993). Organic acids produced as a by-product of fermentable carbohydrate metabolism plays a key role in the disease. The caries process is a continuous, involving various cycles of demineralization and remineralization. Demineralization begins at the atomic level on the crystal surface in enamel or dentine and can continue to cavitation. However currently there are many treatment modalities to intervene this continuing process, to arrest or reverse the progress of the lesion. Remineralization is the natural repair process for non-cavitated or incipient carious lesion.

Gustafson's age estimation includes six age related changes of teeth. He then calculated the regression formula to estimate the age. Six criteria are level of attrition, secondary dentine deposition in pulp, changes in periodontium, root resorption, cementum apposition and root translucency. The aim of the study was to study the physiological changes of teeth according to the Gustafson's criteria and to access the age of the patient according to Gustafson's formula, Maples and Rice and to derive a new formula for age estimation from teeth in Kerala population. The score was calculated from physiological changes in the teeth and a graph was plotted with actual age on one axis and the score calculated on the other. Regression formulae were derived from the obtained graph. 36 extracted anterior teeth were selected. Patient's age and periodontal status was noted at the time of extraction. Teeth were longitudinally trimmed to about 25 micrometer and microscopically evaluated. All parameters of Gustafson's formula were accessed and graded. A regression line was drawn from known age and the total score. A mean error of 4.32 ± 2.80, 3.84 ± 2.65 and 4.00 ± 2.84 was obtained with Gustafson's formula, Maples formula and newly derived formula respectively. ANOVAs test was done was done to estimate the ages and it is found to be significant.

Radicular cysts are the most common cystic lesions affecting the jaws. They arise from the epithelial remnants in the periodontal ligament as a result of the stimulus from periapical infection following pulpal necrosis. Treatment options to manage large periapical lesions range from nonsurgical root canal treatment or apical surgery to extraction. New approaches involve the use of local drug delivery systems based on microparticles/ nanoparticles made from biocompatible polymers along with surgical intervention. Such devices enable the introduction of antimicrobial agents or other drugs directly in the periradicular area or inside the root canal, and the prolonged release of constant concentrations of these agents for fast and better healing. The present case report illustrates the combined endodontic and surgical management of a large periapical cyst with local drug delivery as an adjunct.