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The amniotic membrane is the innermost layer of fetal membrane and is attached to the chorion in the placenta. This membrane has been used for nearly a century in varied fields such as ophthalmology, reconstructive surgery, and burn treatment. In this case report, we used a human amniotic membrane to repair an iatrogenic oroantral communication that occurred during the extraction of the patient's right upper second molar. A splint was given after the perforation was covered with human amniotic membrane and healing was clinically evaluated at various intervals. The outcome of the study revealed that the human amniotic membrane was an efficient graft material for repairing the defect caused by an iatrogenic oroantral communication following tooth extraction.

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BACKGROUND: Eradication of malignant tumors at the primary site with oncological safe margin is a critical requirement for obtaining better survival rate and less recurrence. Touch imprint cytology (TIC) has proven itself as a quick, simple, inexpensive, highly accurate and reliable intraoperative technique to assess surgical margins in squamous cell carcinomas of the oral cavity. However, it is still unclear how the mode of excision, i.e. by scalpel (SC) and electrocautery (EC), or the method of staining, i.e. Papanicolaou (PAP) and cytohaem, affect the diagnostic accuracy of TIC. OBJECTIVE: To study the influence of confounding factors like mode of excision (EC/SC) and staining (PAP/cytohaem) on the diagnostic accuracy of intraoperative TIC technique for assessing surgical margins in oral squamous cell carcinoma in comparison to paraffin-embedded HE-stained sections. MATERIALS AND METHODS: Thirty patients underwent surgical treatment for primary oral squamous cell carcinoma. Three hundred and forty-eight touch imprint slides were prepared from 174 margins of 30 resected tumor specimens. Two adjacent tissues from the margin to be evaluated were imprinted to observe differences between surfaces excised by EC and SC. The set of imprint from each margin tissue was stained with PAP and cytohaem. The TIC results of 180 EC-excised margins and 168 SC-excised margins were compared. Results of 174 imprints stained with RAPID-PAP were compared to their counterpart comprising of 174 cytohaem-stained imprints. The slides were diagnosed as positive, negative or suspicious for tumor. Finally, TIC results were checked against their respective histopathological sections. RESULTS: No statistically significant difference was found between the results of imprints from EC/SC-excised margins (Z = 0.44, p = 0.70) or the imprints stained with PAP/cytohaem (Z = 0.44, p = 0.70). CONCLUSION: Confounding factors like mode of excision and staining procedure do not significantly influence the results of imprint cytology.

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BACKGROUND: Presence of cervical metastasis is one of the factors influencing the outcome of patients with carcinoma of the head and neck, its early detection is potentially very important. Triplex ultrasonography technology have definitive role in detecting clinically undetectable involvement of lymph nodes (LNs). The purpose of this study was to evaluate, whether triplex ultrasonography characterization of cervical LNs could, with an acceptable degree of certainty, differentiate malignant from benign/reactive LNs, in order to prevent invasive diagnostic procedures. MATERIALS AND METHODS: A total of 50 patients with oral cancer, were subjected to ultrasonographic investigation of the neck for grayscale, color flow imaging, and pulsed Doppler. All the parameters were compared with histopathologic examination. Correlation was then made between ultrasound and Doppler investigation and histopathology results to evaluate the sensitivity specificity, positive predictive value (PPV) and negative predictive value (NPV) of color Doppler ultrasonography in detecting metastatic neck nodes. RESULTS: Study results showed that malignant LNs, especially metastatic nodes, are accompanied with significantly high resistive index (RI) and pulsatility index (PI) values, rounded shape, size, loss of central hilar echogenicity and peripheral vascularity. Among these sonographic findings, nodal shape (longitudinal nodal diameter to transverse diameter ratio or L/T ratio), RI and PI values were more accurate for differentiating benign from malignant LNs. CONCLUSION: In this study, triplex sonographic findings had relatively high accuracy in differentiating benign from malignant cervical LNs. Ultrasound hence can be recommended for initial non-invasive evaluation of the neck in patients with oral cancers with or without palpable cervical lymph nodes.