Comparative Efficacy of Modified Gallego’s Stain (MGS) in the Differential Diagnosis of Mineralized Components in Oral Pathologies

Abstract

Accurate diagnosis and early detection of oral pathologies are fundamental to effective treatment planning and determining prognosis. While Hematoxylin and Eosin (H&E) staining remains the gold standard for morphological analysis of formalin-fixed, paraffin-embedded (FFPE) tissues, its efficacy is often limited when faced with the complex, composite hard and soft tissue nature of many oral lesions. Specifically, the definitive identification and differentiation of various mineralized components—such as enamel, dentin, bone, and cementum—can be ambiguous with H&E alone, necessitating the use of specialized staining techniques. Immunohistochemistry (IHC), though highly specific, is constrained by its high cost, technical sensitivity, and potential for equivocal results. This study advocates for the use of Modified Gallego’s Stain (MGS), an economical, reliable, and differential staining method derived from Lille’s stain. MGS utilizes a combination of dyes (hematoxylin, carbol fuchsin, and aniline blue) that distinctly color hard tissue integrants: cementum as deep red, dentin and bone as green, and enamel as pink. Employing a retrospective design on 35 diverse oral lesions and 15 control samples (normal teeth and bone), this research aims to systematically validate MGS's role as an invaluable adjunct to H&E by distinctly delineating dissimilar hard tissue components. MGS has the potential to resolve diagnostic challenges, particularly in overlapping histomorphological spectra like the fibro-osseous lesions, thereby simplifying and confirming the precise nature of calcifications.