Dental Follicles Research Articles

Endothelial expression of c-kit and CD68 in dental follicles of human impacted third molars.

Periodontal tissue remnants of odontogenesis constitute the dental follicle (DF) which is actually considered a stem niche in adults. However, potentialities of local endothelia within this niche seem overlooked. We thus aimed at testing the endothelial cells expression of c-kit, the progenitor cells marker, and CD68, commonly regarded as a monocyte/macrophage marker, in human DFs. We performed an immunohistochemical study using these two markers which were applied on samples collected from ten adult patients. The markers were positively expressed in endothelial cells, as well as in spindle-shaped stromal cells of the DF. The origin of DF stem or progenitor cells needs reviewing in the light of these findings, as endothelium could be a donor site for niche inhabitants.

A Large Simple Bone Cyst in A Young Patient

A 21-year-old man attended the surgery service for a radiolucent lesion in the mandible region. He reported trauma in the region caused a year prior to presentation. Extra- and intraoral examinations showed no changes. Imaging examination showed radiolucency extending through the region of the mandibular body, involving the area of teeth #48 to #44; also, a fourth molar was evidenced. Aspiration puncture yielded a negative result, and it was followed by incisional biopsy, curettage of the lesion, removal of tooth #48 and the supernumerary tooth, both presenting dental follicles. The result suggested a dentigerous cyst. On the basis of the diagnosis and the clinical characteristics of the lesion, a new surgical approach was chosen, aiming at new material collection and lesion decompression. The result showed trabeculae involved in fibrovascular tissue compatible with a simple bone cyst. The patient has been under a 1 year of follow-up, showing regression of the lesion.

Histopathological evaluation of dental follicles associated with impacted third molars

Aim: To histologically evaluate dental follicles of impacted third molars with no radiographic evidence of pathology. Methods: We carried out both a quantitative and qualitative analysis of pericoronal follicles removed from impacted third molars and investigated the association with clinical data. The sample included 36 extracted dental follicles of impacted third molars, obtained from 28 patients, which presented with no radiographic evidence of pathologies. Results: None of the follicles analyzed showed any pathological entity. The epithelial lining was observed in 61.1% of samples, being identified as reduced enamel epithelium. We found a significant relation between the the presence of inflammatory infiltrate and the group aged over 21 years (64.3%; p<0.05). Conclusions: Considering the absence of pathological lesions, we suggest that impacted third molars should only be extracted in young-aged individuals due to specific pathologies or indications.

The Influence of Specific Growth Factors on the Jaw Development in Anodontia Patients ‐ Porcine Model

BACKGROUNDAnodontia is described as the absence of all dental buds in primary, permanent or in both generations of dentition. This is due to contemporary lack of dental follicles at the same time. The dental follicles are known as a very reach source of various growth factors as BMP1, PDGF and others. The role of these growth factors seems to be very essential in maxilla and mandible bone formation as well as surrounding tissue health status. Anodontia is a disorder, which affects patient from the earliest childhood. This is why the complications of the lack of stimuli from the dental follicle growth factors are very long lasting in child maturation process and untreated may lead to huge skeletal abnormalities. The great expression of them are very difficult for patients from the aesthetic point of view because of the huge disproportion between upper, middle and lower part of the face and are so‐called the bird profile. This is a very significant sign and there is no possibility to hide it, so it can cause the social isolation of the patients and multiple psychotic disorders. The main aim of this research is to prove the influence of dental follicles growth factors on the development of porcine mandible, second is to describe the animal model of anodontia disorders in human.METHODSExperiments was performed on 6 newborn piglets born at term and without complications. The surgical procedures were conducted under the general anesthesia on the second day of piglets life. The triangular mucoperiosteal flap was prepared and elevated in the vestibulum of the oral cavity in order to perform the germectomy procedure. Afterwards, the vestibular lamina of bone covering piglets the first and the second deciduous molar tooth buds was removed. The removal of these buds and theirs folliculi was the next step of surgery. The closing suture of the wound has finished the procedure. The recovery period was 10 days with the five‐day antibiotic cover. Following surgery, the animals were held with their biological mothers (with litter) all‐time for three months the experiment. After the full experimental procedure, all animals were euthanized. Cone Beam Computer Tomography scans was made before and just after germectomy surgery as well as before the animal euthanasia was conducted.RESULTSPreliminary results of the study showed that the methodology of the proposed project is feasible. Animals tolerate the surgery and they do not have a significant impact on the further life piglets. Piglets are accepted by her mother and siblings, and very quickly return to everyday life in the group. The most valuable are the preliminary results of the mandible CT animals from a group of animals removed tooth germs. It has been shown that the removal of two molar tooth germs in 2‐day pigs (n=6) after three month causes highly significant (p=0.0072) reduction of the mandible 3.35±0.11 cm to 2.66±0.12 cm.[Marg1] What can we conclude from the results?CONCLUSIONThese results support the premise of the research that growth factors teeth buds in a highly significant stimulate the growth and development of the jaw.Support or Funding InformationThis research was supported by National Science Center Grant no. 2015/17/B/NZ9/01447This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Immunohistochemical assessment of hypoxia-inducible factor-1α (HIF-1α) and carbonic anhydrase IX (CA IX) in ameloblastomas

ObjectiveTo investigate roles of hypoxia-related proteins in odontogenic tumors, we analyzed the immunohistochemical expression of hypoxia-inducible factor-1α (HIF-1α) and carbonic anhydrase IX (CA IX) and compared with angiogenesis. Methods10 dental follicles and 67 ameloblastomas were immunohistochemically examined with antibodies against HIF-1α, CA IX, and CD34. ResultsImmunohistochemical reactivity for HIF-1α and CA IX was detected in odontogenic epithelial cells, as well as in several macrophages and fibroblasts, in dental follicles and ameloblastomas. HIF-1α was positive in 8 of 10 dental follicles, 45 of 48 primary ameloblastomas, and all 19 recurrent ameloblastomas. Increased HIF-1α reactivity was often found in keratinizing cells in acanthomatous ameloblastomas. Immunoreactivity for CA IX was detected in all samples of dental follicles and primary and recurrent ameloblastomas. CA IX reactivity was significantly higher in ameloblastomas than in dental follicles, in solid ameloblastomas than in unicystic ameloblastomas, and in follicular ameloblastomas than in plexiform ameloblastomas. Acanthomatous ameloblastomas showed increased CA IX reactivity around keratinizing areas, while granular cell ameloblastomas showed increased reactivity in peripheral non-granular cells. Microvessel density (MVD) of CD34-positive capillaries in solid ameloblastomas was significantly higher than in unicystic ameloblastomas. MVD tended to be greater in follicular ameloblastomas than in plexiform ameloblastomas, in granular cell ameloblastomas than in other subtypes of ameloblastomas, and in mural unicystic ameloblastomas than in other types of unicystic ameloblastomas. ConclusionsOur data suggest that hypoxia-related molecules and angiogenesis play a role in tumorigenesis, tissue structuring, cell differentiation, and prognosis of ameloblastomas in the intraosseous microenvironment.

Gene expression profiles in dental follicles from patients with impacted canines

Animal studies suggest that the dental follicle (DF) plays a major role in tooth eruption. However, the role of the DF during tooth impaction and related root resorptions in adjacent teeth is not clear. The hypothesis for the present study is that expression of regulatory factors involved in the bone remodelling process necessary for tooth eruption may differ between dental follicles from teeth with different clinical situations. We have analysed the gene expression profiles in the DF obtained from impacted canines, with (N = 3) or without (N = 5) signs of root resorption, and from control teeth (normal erupting teeth, mesiodens) (N = 3). DF from 11 patients (mean age: 13 years) obtains at the time of surgical exposure of the tooth. Due to the surgical time point, all teeth were in a late developmental stage. Gene expression related to osteoblast activation/bone formation, osteoclast recruitment and activation was analysed by RTqPCR. Genes related to bone formation (RUNX2, OSX, ALP, OCN, CX43) were highly expressed in all the samples, but osteoclast recruitment/activation markers (OPG, RANKL, MCP-1, CSF-1) were negligible. No apparent patterns or significant differences in gene expression were found between impacted canines, with or without signs of root resorption, or when compared to control teeth. Our results suggest the DF regulation of osteoclastic activity is limited in the late pre-emergent stage of tooth development, irrespective if the tooth is normally erupting or impacted. We suggest that the follicle may have an important regulatory function for alveolar bone formation in the final eruption process and CX43-gap junction communication could be an important signalling pathway.

Evaluation of the osteoclastogenic process associated with RANK / RANK-L / OPG in odontogenic myxomas.

BackgroundOdontogenic myxoma (OM) is a benign intraosseous neoplasm that exhibits local aggressiveness and high recurrence rates. Osteoclastogenesis is an important phenomenon in the tumor growth of maxillary neoplasms. RANK (Receptor Activator of Nuclear Factor κappa B) is the signaling receptor of RANK-L (Receptor activator of nuclear factor kappa-Β ligand) that activates the osteoclasts. OPG (osteoprotegerin) is a decoy receptor for RANK-L that inhibits pro-osteoclastogenesis. The RANK / RANKL / OPG system participates in the regulation of osteolytic activity under normal conditions, and its alteration has been associated with greater bone destruction, and also with tumor growth.ObjectivesTo analyze the immunohistochemical expression of OPG, RANK and RANK-L proteins in odontogenic myxomas (OMs) and their relationship with the tumor size.Material and MethodsEighteen OMs, 4 small (<3 cm) and 14 large (> 3cm) and 18 dental follicles (DF) that were included as control were studied by means of standard immunohistochemical procedure with RANK, RANKL and OPG antibodies. For the evaluation, 5 fields (40x) of representative areas of OM and DF were selected where the expression of each antibody was determined. Descriptive and comparative statistical analyses were performed with the obtained data.Results There are significant differences in the expression of RANK in OM samples as compared to DF (p = 0.022) and among the OMSs and OMLs (p = 0.032). Also a strong association is recognized in the expression of RANK-L and OPG in OM samples.ConclusionsActivation of the RANK / RANK-L / OPG triad seems to be involved in the mechanisms of bone balance and destruction, as well as associated with tumor growth in odontogenic myxomas. Key words:Odontogenic myxoma, dental follicle, RANK, RANK-L, OPG, osteoclastogenesis.

Histopathological Evaluation of Dental Follicle Associated with Radiographically Normal Impacted Mandibular Third Molars.

Introduction:Removal of impacted mandibular third molar is a common procedure performed in oral surgery. Indications for removal of the third molar have generated much discussion in dentistry. The presence of pericoronal pathosis is generally accepted reason for the extraction of impacted mandibular third molars. Radiographic pathology is usually defined as a pericoronal radiolucency measuring about 2.5 mm or larger in any dimension.Purpose:This study aims to evaluate the histopathologic changes in radiographically normal dental follicles associated with impacted mandibular third molars.Methods:After extraction of 50 impacted mandibular third molars, dental follicle associated with extracted teeth was placed in 10% formalin solution. Histopathologic examination was done. The type of pathological changes was recorded based on histopathological reports. Patients’ gender, age, and radiographic parameters were recorded.Results:Cystic changes were found in 24% of radiographically normal impacted mandibular third molars. Significant cystic changes were observed in position A vertically impacted lower third molars (ILTMs). Male predominance for cystic change was seen with a male–female ratio of 2:1.Conclusion:The result of the present study shows that radiographic analysis may not be reliable technique for the diagnosis of cystic changes in ILTM. The presence of cystic changes can be found even in radiographically normal impacted mandibular third molars. Hence, we recommend that impacted mandibular third molars should be removed and histopathological analysis should be conducted on all surgically extracted dental follicles.

Dental Follicle Stem Cells Ameliorate Lipopolysaccharide-Induced Inflammation by Secreting TGF-β3 and TSP-1 to Elicit Macrophage M2 Polarization

Background/Aims: Increasing evidence has demonstrated the novel roles of mesenchymal stem cells (MSCs) in immunotherapy. However, difficulty in acquiring these cells and possible ethical issues limited their application. Recently, we have isolated a unique MSC population from dental follicles with potent stem cell-like properties. This study focused on the effects of dental follicle stem cells (DFSCs) on macrophage activation and polarization to determine their role in immunomodulation and to test if DFSCs are a promising cell source for MSC-based immunotherapy. Methods: Rat acute lung injury (ALI) models induced by Lipopolysaccharide (LPS) were applied to test the immune-modulatory effects of DFSC/DFSC-CM in vivo. The pulmonary permeability was determined by the dry / wet weight ratios of the left upper lung lobe. The lung histopathological damage was graded on a 0 to 4+ scale. And the inflammatory cytokines in bronchoalveolar lavage fluid (BALF) were tested by ELISA. Then we established LPS-induced inflamed macrophage models in vitro. Inflammatory cytokine production and polarization marker expression were measured by RT-qPCR, ELISA, western blot and flow cytometric analysis in macrophages following DFSC-CM treatment. The paracrine factors in DFSC-CM were revealed by a RayBiotech Protein Array. Thereafter, neutralization studies were performed to confirm the potential immune regulators in DFSC-CM. Results: The DFSC/DFSC-CM not only attenuated histopathological damage and pulmonary permeability, but also downregulated pro-inflammatory cytokines MCP-1, IL-1, IL-6 and TNF-α, and upregulated anti-inflammatory cytokine IL-10 in BALF. Immunofluorescence staining revealed the increased expression of macrophage M2 marker Arg-1. Further in vitro study revealed that macrophages switched to an anti-inflammatory M2 phenotype when co-cultured with DFSC-CM, characterized by suppressed production of pro-inflammatory cytokines MCP-1, IL-1, IL-6, TNF-α and M1-polarizing markers iNOS and CD86; and increased expression of the anti-inflammatory cytokine IL-10 and the M2-polarizing markers Arg-1 and CD163. A RayBiotech Protein Array revealed 42 differentially expressed (> 2-fold) paracrine factors in DFSC-CM compared with the serum-free Ham’s F-12K medium, among which TGF-β3 and Thrombospondin-1 (TSP-1) were upregulated by 18- and 105-fold, respectively. Neutralization studies confirmed the immunoregulatory roles of TGF-β3 and TSP-1 in macrophage activation and polarization. Conclusion: These results indicated that DFSCs can reprogram macrophages into the anti-inflammatory M2 phenotype, the paracrine factors TGF-β3 and TSP-1 may be one of the underlying mechanisms. This study supports the hypothesis that DFSCs are promising for MSC-based immunotherapy.

Dentigerous Cystic Changes in the Follicles Associated with Radiographically Normal Impacted Mandibular Third Molars.

Objective To assess the incidence of dentigerous cystic changes in the follicles of radiographically normal impacted mandibular third molars. Methods One hundred and thirteen follicles obtained after surgical removal of impacted mandibular third molars with radiolucency of less than 2.5 mm in the radiograph were sent for histopathologic evaluation to evaluate pathologic changes. Results The incidence of dentigerous cystic changes observed was 15.9%, that is, 18 out of 113 patients (51 males and 62 females), with the maximum incidence of cystic changes seen in the follicular space size of 0.5 mm. The mean age of the patients included was 27.8 ± 8.1. The most common indication for extraction among the patients in this study was recurrent pericoronitis (95%). There were no statistically significant differences in occurrence of cystic changes based on age, gender, angulation, relation to ramus, depth, side of impaction, and follicle size (P > 0.05). Conclusion Dental follicles obtained from surgically removed impacted mandibular third molars should be submitted for histopathologic examination irrespective of the radiographic size of the follicle.

Oral health status in patients with mucopolysaccharidoses.

Ballıkaya E, Eymirli PS, Yıldız Y, Avcu N, Sivri HS, Uzamış-Tekçiçek M. Oral health status in patients with mucopolysaccharidoses. Turk J Pediatr 2018; 60: 400-406. The aim of this study is to assess oral clinical and radiological findings of patients with mucopolysaccharidoses (MPS) which are a group of rare inherited disorders of glycosaminoglycan catabolism. In this retrospective and descriptive study, records of all patients with MPS over 3 years of age managed at Division of Pediatric Metabolism, who were all referred to Department of Pediatric Dentistry for evaluation of their oral health status were assessed. Oral examinations were performed in 30 patients with determination of DMFT/S, dmft/s, dental plaque and gingival indices and panoramic radiological assessment was performed in 12 patients. Twenty-seven (90.0%) patients had dental caries and 19/21 (90.5%) had gingival inflammation. Radiological examination in 12 patients with panoramic image showed short mandibular ramus (100.0%), enlarged dental follicles (83.3%), taurodontism (75.0%), flat mandibular notch (66.7%). In association with the bone structure and morphology of the jaws, 11 patients (91.7%) had trabecular variation similar to osteoporotic disease. Condylar defect was observed in all patients, which might lead to temporomandibular joint disorders. Pulp chamber with three horns, which had never been reported in MPS before, was observed in panoramic images of 2 of 7 patients with MPS-VI. Oral clinical and radiological changes are very common in this population of MPS patients. These changes may impair opening of the mouth, eating and chewing and thus affect their quality of life. Regular dental counseling, preventive applications and dental treatments must be included in multidisciplinary team approach of MPS patients to provide better oral health.

Harmine promotes molar root development via SMAD1/5/8 phosphorylation

Tooth and bone are major tissues involved in physiological calcification in the body, and they use similar molecular pathways for development, homeostasis, and regeneration. Harmine (HMN) is a natural small compound that stimulates osteoblast differentiation in vitro and in vivo. Here we examined the biological effect of HMN on the postnatal development of molar tooth roots and periodontal tissues. HMN supported the formation of tooth roots and periodontal tissues in developing tooth germs. In tooth germ organ culture, HMN promoted the elongation of Hertwig's epithelial root sheath (HERS) and stimulated cell proliferation in HERS and dental follicle-derived tissues, including dental papillae and dental follicles. HMN stimulated cell proliferation and cell movement of HERS-derived cells without mesenchymal cells in vitro and directly induced the phosphorylation of SMAD1/5/8 protein in HERS-derived cells. Our results indicated that HMN was the first natural small compound to stimulate postnatal development of tooth germs.

Bone Tissue Regeneration - Application of Mesenchymal Stem Cells and Cellular and Molecular Mechanisms.

The regeneration of damaged bone tissues to a pre-disease state has been a major goal for both clinicians and researchers worldwide. However, critical-sized bone defects which are unable to heal completely are a major clinical concern because effective, evidencebased regenerative therapy is still missing. Bone tissue engineering, aiming at providing novel and effective materials to promote bone regeneration, has been considered as a promising alternative to the traditional use of autografts, allografts and xenografts based on the fact that engineered bone tissue has limitless supply and has no disease transmission. Mesenchymal stem cells (MSCs) can be derived from various adult tissues such as adipose tissues, dental follicles of wisdom teeth, bone marrow, dental pulp, gingiva, etc., which do not raise any ethical concerns. Furthermore, the application of MSCs in bone tissue engineering has moved to the preclinical stage, and an ex vivo cell manufacturing procedure for obtaining high quality, bioactive MSCs from human bone marrow has been approved by the US Food and Drug Administration (FDA). In this review, we summarized the cell sources and biological characteristics of MSCs, discussed the in vivo functions of MSCs during bone regeneration, and briefly introduced the strategies for the application of MSCs in bone tissue engineering. Further research efforts are still needed to facilitate the application of MSCs in enhancing bone regeneration.

Immunohistochemical evaluation of podoplanin in odontogenic tumours & cysts using anti-human podoplanin antibody

BackgroundOdontogenic Cysts & tumors originate through some aberration from the normal pattern of odontogenesis. Ameloblastoma is one of the most frequent intraosseous odontogenic tumors. However it is no longer appropriate to use the diagnosis of ameloblastoma without specifying the type. Varied-clinical entities of ameloblastoma differ in their biologic behaviour. Odontogenic cysts like dentigerous and radicular cysts are less aggressive in nature than odontogenic tumors. Recently, podoplanin commonly used as a lymphatic endothelial marker in cancers has recently been found to play a possible role in odontogenic tumorigenesis also. Therefore the purpose of this study was to immunohistochemically analyse the expression of podoplanin in ameloblastomas, KCOTs, dentigerous cysts, radicular cysts & dental follicles. MethodsParaffin-embedded tissue specimens of 15 Ameloblastomas (7 follicular, 6 unicystic, 2 desmoplastic),10KCOTs, 5 dentigerous cysts, 5 radicular cysts & 5 dental follicles were immunohistochemically examined using antibody against podoplanin. ResultsAll ameloblastomas displayed podoplanin expression in ameloblast-like cells of the epithelial islands while the stellate-reticulum like cells exhibited no or weak immunostaining. Expression of podoplanin in KCOTs was strongly positive in the cells of the basal and suprabasal layers & odontogenic epithelial nests. Positive immunoreaction for podoplanin was observed in the inflammatory radicular cysts and inflamed dentigerous cyst only and negative or weak expression in the lining epithelium of uninflamed dentigerous cysts and dental follicles. ConclusionOur results suggest that podoplanin can be used as a potential proliferative marker to observe the aggressive behaviour of ameloblastomas and KCOTs.

DNA methylation pattern of apoptosis‐related genes in ameloblastoma

DNA methylation is an important mechanism of gene control expression, and it has been poorly addressed in odontogenic tumours. On this basis, we aimed to assess the methylation pattern of 22 apoptosis-related genes in solid ameloblastomas. Ameloblastoma fresh samples (n=10) and dental follicles (n=8) were included in the study. The percentage fraction of methylated and unmethylated DNA promoter of 22 apoptosis-related genes was determined using enzymatic restriction digestion and quantitative real-time PCR (qPCR) array. The relative expressions of the genes that showed the most discrepant methylation profile between tumours and controls were analysed by reverse-transcription quantitative PCR (RT-qPCR). Lower methylation percentages of TNFRSF25 (47.2%) and BCL2L11 (33.2%) were observed in ameloblastomas compared with dental follicles (79.3% and 59.5%, respectively). The RT-qPCR analysis showed increased expression of BCL2L11 in ameloblastomas compared with dental follicles, in agreement with the methylation analysis results, while there was no difference between the expression levels of TNFRSF25 between both groups. On the basis of our results, the transcription of the apoptosis-related gene BCL2L11 is possibly regulated by promoter DNA methylation in ameloblastoma. The biological significance of this finding in ameloblastoma pathobiology remains to be clarified.

Retracted: A Rare Pathological Entity of Multiple Calcified Hyperplastic Dental Follicles

[This retracts the article DOI: 10.1155/2016/4190827.].

P53 Protein Expression in Dental Follicle, Dentigerous Cyst, Odontogenic Keratocyst, and Inflammatory Subtypes of Cysts: An Immunohistochemical Study.

An odontogenic keratocyst (OKC) is a developmental odontogenic cyst with aggressive clinical behavior. This cyst shows a different growth mechanism from the more common dentigerous cyst and now has been renamed as a keratocystic odontogenic tumor (KCOT). Inflammation can assist tumor growth via different mechanisms including dysregulation of the p53 gene. This study aims to assess and compare the expression of tumor suppressor gene p53 in inflamed and non-inflamed types of OKC and dentigerous cyst. Immunohistochemical expression of p53 was assessed in 14 cases of dental follicle, 34 cases of OKC (including 18 inflamed OKCs), and 31 cases of dentigerous cyst (including 16 inflamed cysts). The mean percentage of p53 positive cells was 0.7% in dental follicles, 5.4% in non-inflamed OKCs, 17.3% in inflamed OKCs, 1.2% in non-inflamed dentigerous cysts, and 2.2% in inflamed dentigerous cysts. The differences between the groups were statistically significant (p < 0.050) except for the difference between inflamed and non-inflamed dentigerous cysts, and between dental follicle and non-inflamed dentigerous cyst. The difference in p53 expression in OKC and dentigerous cyst can explain their different growth mechanism and clinical behavior. Inflammation is responsible for the change in behavior of neoplastic epithelium of OKC via p53 overexpression.

FAK is overexpressed in keratocystic odontogenic tumor: a preliminary study.

Focal adhesion kinase (FAK) is an important mediator of cell adhesion, growth proliferation, survival, angiogenesis, and migration. FAK is overexpressed in many locally invasive and malignant lesions including oral cancer. Looking at the tumorigenic nature of keratocystic odontogenic tumor (KCOT), which involves local invasion, proliferation, and recurrence, we hypothesized strong expression of FAK in the epithelial lining of KCOT. 34 KCOTs, 11 orthokeratinized odontogenic cysts (OOCs), 25 radicular cysts (RCs), 17 dentigerous cysts (DCs), and 25 dental follicles (DFs) were retrieved from archives and subjected to the immunohistochemical analysis using FAK antibody. In KCOT, strong expression was observed in 22 (62.8%) cases followed by weak and negative expression in 9 (25.71%) and 4 (11.4%) cases, respectively. Negative expression was seen in 7 (63.63%) cases of OOC, while 4 (36.36%) showed weak expression. In case of RC, 20 (80%) cases displayed negative expression and 4 (16%) and 1 (4%) cases showed weak and strong expressions, respectively. In case of DC, negative expression was seen in 14 (82.35%) cases and weak expression in 3 (17.64%) cases. DF was characterized by negative [21 (84%)] and weak expression [4 (16%)]. Nuclear expression of FAK was seen only in KCOT (11 cases). There was statistically significant higher FAK expression in KCOT as compared to OOC, RC, DC, and DF (P < 0.00001). FAK molecule could be an important player in tumorigenesis of KCOT and thus is a potential target for future drug development.

Loss of taste due to clopidogrel; early recognition is rewarding

Hyperplastic dental follicles are very commonly seen associated with an impacted tooth. Multiple calcifying hyperplastic dental follicles (MCHDF), a term used for multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles is a rare entity. Varied pattern of calcifications have been observed in such follicles. We report one such case with four patterns of calcifications and odontogenic epithelium associated with bilaterally impacted canines.

Multiple calcifying hyperplastic dental follicles

Hyperplastic dental follicles are very commonly seen associated with an impacted tooth. Multiple calcifying hyperplastic dental follicles (MCHDF), a term used for multiple unerupted teeth with abundant calcifications and rests of odontogenic epithelium in enlarged dental follicles is a rare entity. Varied pattern of calcifications have been observed in such follicles. We report one such case with four patterns of calcifications and odontogenic epithelium associated with bilaterally impacted canines.