{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T14:24:31Z","timestamp":1783347871901,"version":"3.54.6"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Distinguishing bone, cementum, and immature osteoid in maxillofacial fibro-osseous lesions (FOLs) can be challenging using routine haematoxylin and eosin (H&E) staining alone.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To quantitatively evaluate the comparative diagnostic utility of H&E, Alizarin Red, Von Kossa, and Modified Gallego\u2019s stains (MGS) in identifying mineralized components across FOL subtypes.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n In this pilot study, archival specimens of fibrous dysplasia (\n n<\/jats:italic>\n = 2), cemento-osseous dysplasia (\n n<\/jats:italic>\n = 2), cemento-ossifying fibroma (\n n<\/jats:italic>\n = 2), and juvenile ossifying fibromas (\n n<\/jats:italic>\n = 2) were stained. Independent pathologists scored structural feature visibility utilizing a semi-quantitative 0\u20133 scale. Visibility scores, inter-observer, and intra-observer reliability were analysed using Friedman, Wilcoxon signed-rank, and Gwet\u2019s AC1 tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Qualitatively, MGS provided consistent bone (green) versus cementum (red) differentiation, Alizarin Red isolated immature osteoid, and Von Kossa mapped mature, phosphate-rich calcifications. Quantitatively, inter-observer reliability demonstrated strong to perfect consensus, while intra-observer stability was moderate-to-perfect for MGS, slight-to-substantial for Alizarin Red, and poor-to-moderate for Von Kossa. Descriptively, MGS achieved the highest mean clarity score (2.93 \u00b1 0.25), followed closely by Alizarin Red (2.80 \u00b1 0.40) and Von Kossa (1.80 \u00b1 1.17). Global Friedman and post-hoc pairwise comparisons confirmed that these differences were statistically significant (\n P<\/jats:italic>\n = 0.0003), with both MGS (\n P<\/jats:italic>\n = 0.0069) and Alizarin Red (\n P<\/jats:italic>\n = 0.0057) yielding significantly superior diagnostic clarity over Von Kossa (\n P<\/jats:italic>\n < 0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Integrating a targeted special stain selection protocol significantly overcomes the descriptive limitations of routine H&E, reducing diagnostic ambiguity in maxillofacial FOL configurations.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jomfp.jomfp_11_26","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:00:38Z","timestamp":1783101638000},"page":"303-311","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Improving diagnostic clarity in fibro-osseous lesions using modified Gallego\u2019s, alizarin red, and von kossa stains: A pilot comparative study"],"prefix":"10.4103","volume":"30","author":[{"given":"Sharon","family":"Sam","sequence":"first","affiliation":[{"name":"Department of Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya Nirmala","family":"Subramani","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Ramanathan","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India"},{"name":"Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia"},{"name":"Department of Oral Cancer Research and Coordinating Centre, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamizhchelvan","family":"Harikrishnan","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology and Microbiology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"R1-20260706","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1007\/s12105-018-0992-5","article-title":"Benign fibro-osseous lesions of the head and neck","volume":"13","author":"Nelson","year":"2019","journal-title":"Head Neck Pathol"},{"key":"R2-20260706","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s12105-008-0057-2","article-title":"Benign fibro-osseous lesions of the craniofacial complex. 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