Dentinogenic ghost cell tumor (DGCT), a variant of the calcifying odontogenic cyst, is considered to be a benign epithelial and mesenchymal neoplasm containing aberrant epithelial keratinization, ghost cells, and spherical calcifications. While there can be peripheral and central variants of this entity, the extraosseous type is rarer and usually innocuous in its clinical presentation. The aim of this article is to report a case of peripheral DGCT on the maxillary anterior region in a 14-year-old female evolving for 5 years and to emphasize the importance of histopathologic examination of gingival growths to avoid diagnostic pitfalls. A compilation of all reported cases in the English literature till date with details on the site, size, age sex, symptoms radiographic features, treatment follow-up, and recurrences has been attempted for better understanding of the biologic nature of this rare neoplasm.

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a poorly understood entity and is probably a misnomer too. Although this lesion is thought to be predominantly found in young children, a significant number of cases have also been reported in adults. A 41-year-old female patient presented with an erythematous, velvety-appearing gingival mass in the mandibular anterior region. The lesion was recurrent in nature, although it was asymptomatic. A diagnosis of LJSGH was made after correlating the clinical and histopathological features. A literature search revealed that a large number of cases have been reported in adults, some as old as 87 years old. There seems to be no gender predilection, and the lesion is frequently noticed in relation to maxillary anterior gingiva. Recurrence is a characteristic feature of this lesion, although its etiology and pathogenesis are poorly understood till date. Since it has a unique behavior in terms of high recurrences, dentists and periodontists need to be made aware about spongiotic gingival hyperplasia since the lesion may be mistaken for common reactive lesions.

The aim of the present article is to present the clinical case of a large peripheral ossifying fibroma that evolved from a previously diagnosed pyogenic granuloma in a 50-year-old woman. The patient was referred for treatment of a lesion over the buccal and palatal gingiva close to the left upper first molar. It was purplish-red in color, approximately 3 cm in diameter, having a smooth surface, a pedicled and bleeding base, with seven years of evolution, and diagnosed as pyogenic granuloma. After three years of evasion, the patient returned reporting an increase in the lesion and difficulty in eating. Clinically the nodule was lobular in appearance, pink in color and smooth, pediculated, firm in consistency, non-bleeding, about 5 cm in its greatest extension, extending to the maxillary tuberosity. The lesion was excised and referred for histopathological examination, which led to the diagnosis of peripheral ossifying fibroma. The patient was followed for approximately 18 months, prosthetically rehabilitated, with satisfactory healing and no clinical signs of recurrence. The possible evolution of a pyogenic granuloma to a peripheral ossifying fibroma was observed in this case, based on the histopathological changes that occurred, with the development of calcified material, fibrous maturation, and decreased vascular content of the initial lesion after three years.

The purpose of this study was to evaluate the prevalence of dental caries and gingivitis and its relation to various determinants like dietary habits, habits related to oral health, and oral hygiene practice among private and government school children of age 6-12 years in Kanpur City. A total of 1,550 children (775 from government school and 775 from private school) were selected. Overall, 60% children presented with caries. Prevalence of caries was significantly more associated with government school children (63.1%) compared with private school children (56.9%). The mean deft scores were high in government school children (1.08 ± 1.91) compared with private school children (0.93 ± 1.53). This was statistically significant (p < 0.05). The DMFT scores were also high among government school children (0.84 ± 1.25) compared with private school children (0.67 ± 1.19). This was statistically significant (p < 0.05). On the whole, out of 1,550 children only 17.8% children presented with gingivitis, in which majority had mild form of gingivitis when compared with moderate and severe forms. The prevalence of gingivitis was relatively high among government school children (55%) compared with private school children (45%). This was statistically significant (p < 0.05). Summing up, a conclusion could be drawn that the prevalence of both dental caries and gingivitis depends on the state of the oral hygiene habits and practices, correspondingly, due to schoolchildren\'s knowledge of individual oral hygiene and skills.
UNASSIGNED: Singh N, Gaur S, Kumar M, et al. Comparative Study of Dental Health Status and Its Determinants among Children Attending Government and Private Schools in Kanpur City. Int J Clin Pediatr Dent 2021;14(5):666-673.

The present clinical case reports an increased zone of keratinized gingiva that was generated following surgical excision of the gingiva during periodontally accelerated osteogenic orthodontics. The present case consists of angle Class I with mal-aligned teeth and impacted #11. The patient was evaluated up to 2 years and 1 month (2.1) showing a stable increased zone of keratinized tissue. Possible causes for this event are discussed in this case report. Additional long-term clinical studies are necessary to support these results.

We report a rare and unusual case of a Peripheral Ameloblastic Fibro-Dentinoma (PAFD) occurring in a 3 year old Indian boy. The boy presented to the hospital complaining of swelling in anterior maxillary region with a history of trauma. Periapical radiography of the area did not reveal any bone resorption. The entire mass was excised under local anesthesia, and the histological examination revealed a diagnosis of PAFD. The postoperative course was satisfactory and the excised area has remained free of recurrence for 9 months. PAFD is a rare entity and only 5 cases have been reported in literature. The present case is one of the youngest in the group. The mode of differentiation of the odontogenic lesion is a pointer in the diagnosis and histogenesis has been discussed.

Oral focal mucinosis (OFM) is a rare connective tissue disorder characterized by myxoid degeneration of submucosal connective tissue. It usually presents as gingival or mucosal overgrowth. Due to its uncommon occurrence and lack of pathognomonic clinical or radiological features, diagnosis mainly relies on histopathological evaluation. The paper reports a rare case of large OFM in a 58-year-old female patient involving the posterior maxilla and hard palate. Diagnosis of the lesion was established based on histopathological and immunohistochemical analysis. The lesion was excised surgically and showed no recurrence at 1 year follow-up. The cases presented intend to bring OFM to the attention of oral pathologists and clinicians while considering the differential diagnosis of myxoid lesions of oral cavity.

Connective tissue growth factor (CCN2/CTGF) mediates transforming growth factor-β (TGF-β)-induced fibrosis. Drug-induced gingival overgrowth is tissue specific. Here the role of the phosphoinositol 3-kinase (PI3K) pathway in mediating TGF-β1-stimulated CCN2/CTGF expression in primary human adult gingival fibroblasts and human adult lung fibroblasts was compared. Data indicate that PI3K inhibitors attenuate upregulation of TGF-β1-induced CCN2/CTGF expression in human gingival fibroblasts independent of reducing JNK MAP kinase activation. Pharmacologic inhibitors and small interfering (si)RNA-mediated knockdown studies indicate that calcium-dependent isoforms and an atypical isoform of protein kinase C (PKC-δ) do not mediate TGF-β1-stimulated CCN2/CTGF expression in gingival fibroblasts. As glycogen synthase kinase-3β (GSK-3β) can undergo phosphorylation by the PI3K/pathway, the effects of GSK-3β inhibitor kenpaullone and siRNA knockdown were investigated. Data in gingival fibroblasts indicate that kenpaullone attenuates TGF-β1-mediated CCN2/CTGF expression. Activation of the Wnt canonical pathways with Wnt3a, which inhibits GSK-3β, similarly inhibits TGF-β1-stimulated CCN2/CTGF expression. In contrast, inhibition of GSK-3β by Wnt3a does not inhibit, but modestly stimulates, CCN2/CTGF levels in primary human adult lung fibroblasts and is β-catenin dependent, consistent with previous studies performed in other cell models. These data identify a novel pathway in gingival fibroblasts in which inhibition of GSK-3β attenuates CCN2/CTGF expression. In adult lung fibroblasts inhibition of GSK-3β modestly stimulates TGF-β1-regulated CCN2/CTGF expression. These studies have potential clinical relevance to the tissue specificity of drug-induced gingival overgrowth.

The gingiva is often the site of localized growths that are considered to be reactive rather than neoplastic in nature. Many of these lesions are difficult to be identified clinically and can be identified as specific entity only on the basis of typical and consistent histomorphology. Peripheral ossifying fibroma is one such reactive lesion. It has been described with various synonyms and is believed to arise from the periodontal ligament comprising about 9% of all gingival growths. The size of the lesion is usually small, located mainly in the anterior maxilla with a higher predilection for females, and it is more common in the second decade of life. A clinical report of a 12-year-old girl with a large peripheral ossifying fibroma in the posterior maxilla showing significant growth and interference with occlusion is presented.

A 17-year-old male patient presented for the evaluation of his nonhealing interdental deep pocket in relation to the mandibular second premolar and mandibular first molar. He denied any history of pain. Excessive food lodgment, salty taste, and smell related to the specific region were his chief complaints. The periapical radiograph exhibited well-defined interradicular unilocular radiolucency with sclerotic margins between the vital mandibular second premolar and mandibular first molar. The lesion was completely enucleated with deep curettage and root planning. Histopathologic reports showed a heavy inflammatory infiltrate. Successive radiographs showed excellent bone healing. Teeth were endodontically treated for severe sensitivity to cold. Step-by-step radiographic follow-up showed osseous repair with no evidence of disease till 25 months.