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  1. Pandarathodiyil AK, Sivapathasundharam B
    J Oral Maxillofac Pathol, 2023;27(4):616-621.
    PMID: 38304527 DOI: 10.4103/jomfp.jomfp_470_23
    A superficial mucocele is a unique variant of a mucocele of the oral cavity that was described by Eveson for the first time in 1988. It occurs due to subepithelial extravasation of sialomucin at the epithelial-connective tissue interface and is related to damage of the minor salivary gland ducts. Clinically, they appear as small, asymptomatic, clear, tense vesicles with a predilection for the soft palate, retromolar pads, and posterior buccal mucosa. They are reported to occur more frequently in women than in men. Before Eveson endeavoured to describe these rather peculiar lesions, they were often misdiagnosed as vesiculobullous lesions such as bullous lichen planus, mucous membrane pemphigoid, and the like. It is incumbent on the present-day pathologist to be cognizant of the presence of these entities as it could present a formidable diagnostic challenge otherwise. This review gives an updated account on the etiology, prevalence, clinical features, differential diagnosis, and management of superficial mucoceles.
  2. Vijayan SP, Pandarathodiyil AK
    J Contemp Dent Pract, 2021 Apr 01;22(4):325-326.
    PMID: 34266997
    In March 2020, the world that we know irrevocably changed forever. It feels like "Groundhog Day" all over again, and it seems that the nightmare is here to stay. It all began on the January 8, 2020, when China grimly announced that coronavirus disease-2019 (COVID-19) pandemic is caused by the "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2)1 but it was not until March 2020 that the situation swiftly careened out of control and is unequivocally posing the greatest challenge to humanity worldwide since the end of the Second World War. While the scientific community heroically galvanized itself and raced against time to provide viable solutions to this formidable foe in the form of vaccines, the worldwide dental fraternity has had to grapple with an extraordinary situation evolving in real-time and ensure that we responded robustly to this daunting health emergency that has spared no corner of our beloved planet. Initially, COVID-19 ensured cessation of all non-urgent dental care in most parts of the world but with increasingly significant inputs about the nature of the pathogen from the scientific community, the dental community has been able to cobble together a workable plan in reconfiguring and restructuring the dental practice in consonance with the situation at hand. It is fiendishly arduous to estimate the massive impact on the dental profession, but it is safe to assume it to be substantial.
  3. Pandarathodiyil AK, Vijayan SP, Sivapathasundharam B
    J Oral Maxillofac Pathol, 2023;27(2):254-256.
    PMID: 37854909 DOI: 10.4103/jomfp.jomfp_65_23
    A 'Letter to the Editor' is an abbreviated form of communication where 'readers' can express their carefully considered scientific opinion about a recently published article in a journal. It is considered as 'post-publication peer review'. There are certain things that a letter writer and the 'editor' need to keep in mind while writing a 'Letter' for a journal. The 'editor' needs to curate the contents of the 'Letter' and make sure that there are no misinformation shared. The formatting, type, scope and the scientific quality of the 'Letter' depend on the journal that publishes them, and hence, different publications may require their 'letter writers' to present the information that they want in a certain way. The following article reflects an overview of the role of editors and writers, guidelines, scope, and format of the 'Letter to the Editor'.
  4. Obade AY, Pandarathodiyil AK, Oo AL, Warnakulasuriya S, Ramanathan A
    Clin Oral Investig, 2021 Sep;25(9):5411-5419.
    PMID: 33629155 DOI: 10.1007/s00784-021-03849-0
    OBJECTIVE: This study aims to examine the ability of optical coherence tomography (OCT) to differentiate ex vivo epithelial structure of benign disorders, dysplastic, and oral squamous cell carcinoma (OSCC) in comparison with the structure of normal marginal mucosa of oral biopsies. As a secondary objective, we examined the inter- and intra-observer variations of OCT measurements of two calibrated assessors.

    MATERIALS AND METHODS: Oral biopsies (n = 44) were scanned using the swept source OCT (SSOCT) and grouped by pathology diagnosis to benign, dysplasia or carcinoma. Two trained and calibrated assessors scored on the five OCT variables: thickness of keratin layer (KL), epithelial layer (EL), homogeneity of lamina propria (LP), basement membrane integrity (BMI), and the degree of reflection of the epithelial layer (Ep Re). Chi-square tests and Fischer's exact method were used to compare the data.

    RESULTS: The OCT images showed breached BM status in all the OSCC samples (100%). Epithelial reflection was noted to be hyper-reflective in all the OSCC and oral dysplasia samples (100%). An increase in KL in 66.67% of the OSCC and 100% of the oral dysplasia samples was found. EL was increased in all the OSCC samples (100%) and 85.72% of the oral dysplasias. Kappa values showed that there was very good agreement (over 0.7) when scoring individual parameters between the two assessors.

    CONCLUSION: The study showed that the BM status was a key parameter in the detection of SCC and for differentiating SCC from oral dysplasia or benign disorders.

    CLINICAL RELEVANCE: OCT is a non-invasive and non-radioactive adjunct diagnostic tool that can provide immediate results on the structure of oral mucosa. The BM status measured ex vivo was a key parameter in the detection of SCC and for differentiating SCC from oral dysplasia or benign disorders.

  5. Pandarathodiyil AK, Ramanathan A, Garg R, Doss JG, Abd Rahman FB, Ghani WMN, et al.
    Asian Pac J Cancer Prev, 2021 Oct 01;22(10):3227-3235.
    PMID: 34710999 DOI: 10.31557/APJCP.2021.22.10.3227
    BACKGROUND: We examined the lactate dehydrogenase (LDH) enzyme levels in the saliva of vapers (e-cigarette users) and compared the data with cigarette smokers and a control group of non-smokers and non-vapers.

    METHODS: Subjects were recruited among those responding to a social media announcement or patients attending the SEGi Oral Health Care Centre between May and December 2019, and among some staff at the centre. Five ml of unstimulated   whole saliva was collected and salivary LDH enzyme activity levels were measured with a LDH colorimetric assay kit. Salivary LDH activity level was determined for each group and compared statistically.

    RESULTS: Eighty-eight subjects were categorized into three groups (control n=30, smokers n=29, and vapers n=29). The mean ± standard deviation (SD) values for salivary LDH activity levels for vapers, smokers, and control groups were 35.15 ± 24.34 mU/ml, 30.82 ± 20.73 mU/ml, and 21.45 ± 15.30 mU/ml, respectively. The salivary LDH activity levels of smoker and vaper groups were significantly higher than in the control group (p = 0.031; 0.017). There was no significant difference of salivary LDH activity level in vapers when compared with smokers (p= 0.234).

    CONCLUSION: Our findings showed higher LDH levels in the saliva of vapers when compared with controls, confirming cytotoxic and harmful effects of e-cigarettes on the oral mucosa.

  6. Pandarathodiyil AK, Mani SA, Ghani WMN, Ramanathan A, Talib R, Zamzuri AT
    Eur J Dent Educ, 2023 Feb;27(1):78-86.
    PMID: 35100466 DOI: 10.1111/eje.12779
    INTRODUCTION: Dental education involves performing clinical procedures on patients under expert supervision. The COVID-19 pandemic has disrupted routine face-to-face teaching-learning-assessment dynamics world over. This study assessed the self-perceived preparedness of dental undergraduate students for practice, whose clinical training was interrupted by the COVID-19 pandemic from dental schools across Malaysia.

    MATERIALS AND METHODS: This cross-sectional web-based questionnaire survey was done among new dental graduates of the academic year 2019-2020 and the final year undergraduate students (academic year 2020-2021) from dental schools in Malaysia, using the Dental Undergraduates Preparedness Assessment Scale (DU-PAS), from 6th to 26th April 2021. The questionnaire addressed clinical skill competence, and cognitive and behavioral attributes. The number of respondents needed to achieve a confidence level of 95% with margin of error of 5% was 306.

    RESULTS: A total of 453 (243 final year students and 210 new graduates) responded from dental schools nationwide, with a response rate of 30.6%. The overall mean score for preparedness for dental practice was 76.3±14.7, for clinical skills 39.7±7.3, and behavioral and cognitive attributes 36.5±9.1. New graduates had significantly higher mean preparedness score (78.6±14.4) as compared to students in their final year (74.2±14.7). Performing endodontic treatment on multi-rooted teeth had the lowest perceived competency (29.8%), followed by assessing treatment needs of patients requiring orthodontics (37.1%), prescribing drugs (46.6%) and providing crowns using principles of tooth preservation (48.1%).

    CONCLUSIONS: Satisfactory scores were obtained for most attributes. The final-year cohort was significantly less prepared for dental practice compared to the newly graduated cohort.

  7. Muthukrishnan A, Nagi R, Ashok L, Sujatha GP, Rao RS, Lakshminarayana S, et al.
    J Contemp Dent Pract, 2022 Dec 01;23(12):1267-1279.
    PMID: 37125526 DOI: 10.5005/jp-journals-10024-3450
    BACKGROUND: Betel quid (BQ) is the fourth most commonly used psychoactive substance and its use is highly prevalent among southeast Asian countries due to the influence of psychosocial, behavioral, and environmental factors. As a result, even young children and women are becoming addicted and find it difficult to achieve long-term abstinence. Systematic research addressing the influence of behavioral and psychosocial factors on BQ chewing is scarce, hence pointing to the need for understanding the interplay of these factors to develop tailored intervention strategies for BQ cessation.

    OBJECTIVE: The objective of this systematic review is to assess various behavioral and psychosocial risk factors from pre-existing literature that lead individuals to initiate and/or maintain BQ chewing in developed and developing countries.

    MATERIALS AND METHODS: The electronic retrieval systems and databases PUBMED [MEDLINE], EMBASE, SCOPUS, WEB OF SCIENCE, GOOGLE SCHOLAR, and SCIENCE DIRECT were searched independently by two authors for relevant articles from January 2011 to July 2021 using combinations of keywords. Primary studies published in English focusing on the behavioral and psychosocial risk factors for BQ chewing were included.

    RESULTS: Out of the initial 264 articles searched, 12 articles met the selection criteria. Included studies addressed the influence of behavioral and psychosocial factors toward the initiation and/or maintenance of BQ chewing. Included studies reported that dependent BQ was not able to quit BQ chewing due to habituation, addiction, and withdrawal symptoms. Few social BQ chewers in Southeast Asian countries were not willing to initiate quitting as they considered AN as an important social and cultural identifier and claimed that they could not resist chewing in a peer group, and it has become part of their social life.

    CONCLUSION: In the future, studies should take into consideration behavioral and psychosocial risk factors, which are major barriers toward successful quitting. These factors should be integrated into areca nut cessation guidelines, and there is a need to develop more comprehensive culture-specific intervention approaches to achieve long-term abstinence.

  8. Veerabhadrappa SK, Pandarathodiyil AK, Ghani WMN, Termizi Bin Zamzuri A
    Eur J Dent Educ, 2023 Nov;27(4):1011-1022.
    PMID: 36626271 DOI: 10.1111/eje.12893
    INTRODUCTION: Professionalism and academic integrity are important components of dental education as they influence not just the present-day learning process, but also the practice of dentistry in future. This study evaluated self-reported professional lapses, academic dishonesty behaviours among peers and recommended sanctions for such lapses.

    MATERIALS AND METHODS: Dundee Polyprofessionalism Inventory I: Academic Integrity questionnaire was administered to BDS students of a private dental institution in Malaysia. Differences in the level of recommended sanctions were assessed by Mann-Whitney U and Kruskal-Wallis test.

    RESULTS: There was unanimous agreement that all 34 statements of lapses of academic integrity as unacceptable. The highest agreement (95.6%) was related to threatening or abusing university employees or students and involvement in paedophilic activities, whereas the lowest agreement was observed for getting or giving help for coursework against rules (47.3%). The most frequent behaviours observed among peers were lack of class punctuality (55.1%) and providing and receiving proxy attendance services (49.3%). About 36% admitted to not being punctual themselves, 26.8% for accepting or providing help for course work and 22.9% for receiving and providing proxy attendance. Female students displayed stricter recommended sanctions, with the most significant difference relating to joking disrespectfully about body parts (p 

  9. Hii EPW, Ramanathan A, Pandarathodiyil AK, Wong GR, Sekhar EVS, Binti Talib R, et al.
    Head Neck Pathol, 2023 Mar;17(1):218-232.
    PMID: 36344906 DOI: 10.1007/s12105-022-01481-2
    BACKGROUND: Homeobox genes play crucial roles in tooth morphogenesis and development and thus mutations in homeobox genes cause developmental disorders such as odontogenic lesions. The aim of this scoping review is to identify and compile available data from the literatures on the topic of homeobox gene expression in odontogenic lesions.

    METHOD: An electronic search to collate all the information on studies on homeobox gene expression in odontogenic lesions was carried out in four databases (PubMed, EBSCO host, Web of Science and Cochrane Library) with selected keywords. All papers which reported expression of homeobox genes in odontogenic lesions were considered.

    RESULTS: A total of eleven (11) papers describing expression of homeobox genes in odontogenic lesions were identified. Methods of studies included next generation sequencing, microarray analysis, RT-PCR, Western blotting, in situ hybridization, and immunohistochemistry. The homeobox reported in odontogenic lesions includes LHX8 and DLX3 in odontoma; PITX2, MSX1, MSX2, DLX, DLX2, DLX3, DLX4, DLX5, DLX6, ISL1, OCT4 and HOX C in ameloblastoma; OCT4 in adenomatoid odontogenic tumour; PITX2 and MSX2 in primordial odontogenic tumour; PAX9 and BARX1 in odontogenic keratocyst; PITX2, ZEB1 and MEIS2 in ameloblastic carcinoma while there is absence of DLX2, DLX3 and MSX2 in clear cell odontogenic carcinoma.

    CONCLUSIONS: This paper summarized and reviews the possible link between homeobox gene expression in odontogenic lesions. Based on the current available data, there are insufficient evidence to support any definite role of homeobox gene in odontogenic lesions.

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