Efficacy of topical tulsi (Ocimum sanctum) paste for the management of oral submucous fibrosis – A clinical study

Context: Oral submucous fibrosis (OSMF) is a chronic insidious oral potentially malignant disorder characterized by increased collagen deposition and reduced collagen degradation causing burning sensation and difficulty in mouth opening. Aim: To assess the efficacy of topical Tulsi (Ocimum sanctum) paste for the management of OSMF. Settings and Design: Institution?based clinical trial. Materials and Methods: The study included a total of 60 OSMF patients categorized into three Groups A, B and C (20 in each) depending on the severity according to Lai DR et al. classification. The patients were advised for topical Tulsi paste application and were evaluated for the reduction in the burning sensation and improvement in mouth opening every month for 3 subsequent months using the numeric pain rating scale (NRS) and a Vernier calliper, respectively. Statistical Analysis: The baseline and 3?month recordings were subjected to inter? and intra?group statistical analysis using Kruskal–Wallis analysis of variance (ANOVA), Mann–Whitney U, one?way ANOVA, Tukey’s multiple post?hoc and Wilcoxon matched?pairs tests. Results: There was a reduction in the burning sensation and improvement in the mouth opening in all three groups. The reduction in the burning sensation was statistically significant among all the groups (P < 0.05) and the NRS scores after 3 months among the three groups were not statistically significant (P > 0.05). There was a statistically significant difference (P < 0.05) in the improvement of mouth opening between Group A and B; A and C; but not between B and C. Conclusion: Tulsi paste showed a significant reduction in the burning sensation and improvement of the mouth opening thereby proving to be a safe and promising medicament for OSMF

Superoxide dismutase, glutathione peroxidase, and catalase antioxidant enzymes in chronic tobacco smokers and chewers: A case–control study

Objective: Tobacco has a time dependent effect on the antioxidant system of the body. This study was designed to determine and compare alteration in levels of erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) in blood subgroups of tobacco smokers and chewers with controls. Materials and Methods: Blood samples were collected from 30 tobacco smokers (> 20 cigarettes daily), 30 tobacco chewers (> 10 packets gutka daily) and 30 controls. These groups were further divided into three subgroups (n=10) based on duration of habit (<5 yrs, 5-10 yrs, >10 yrs). The level of erythrocyte SOD, GPx and CAT were measured using standard procedures. Results: The SOD and CAT levels were significantly decreased in all subgroups of smokers and chewers whereas GPx level was significantly increased. Positive correlation was observed between SOD, GPx and CAT levels with change in duration of habit in all subgroups. No significant difference observed in SOD and CAT activity between tobacco smokers and chewers. Conclusions: The findings suggested that antioxidative enzyme activities have significant correlation with change in the duration of tobacco use. Measurement of markers of free radical activity might be useful for estimating the level of oxidative stress caused by tobacco use.

Bilateral Fusion of Permanent Mandibular Incisors: A Rare Developmental Anomaly.

Fusion is a rare developmental anomaly. Th e prevalence ranges from 0.5% to 5% based on geographic, racial, or genetic factors, which occur as a result of physical force or pressure leading to prolonged contact of the adjacent tooth follicles thus resulting in the fusion of tooth buds. Bilateral fusion of teeth has been reported to be very rare as compared to unilateral fusion which is around 0.05%. Although asymptomatic, they can be a predisposing factor for caries and cause periodontal problems due to malalignment in the arch. Th e aim of this article is to present a rare case of bilateral fusion of mandibular anterior teeth and discuss the possible histogenetic mechanism and future treatment prospectives.

Oral Presentation of Chronic Hyperplastic Candidiasis in Patient under Imatinib Mesylate: A Rare Case.

Candida albicans is the major human pathogen among Candida species. It is a commensal yeast of the oral, gastrointestinal, and vaginal mucosa in healthy individuals. The genus Candida has about 154 species, and different species show a different level of resistance to antifungal drugs and have a high degree of phenotypic similarity. Oropharyngeal candidiasis is the most common infection in oral cavity both pre- and post-treatment of cancer. Immunocompromised state in a cancer patient induces candidal species which get activated as a pathogen. It is found that in certain high-risk groups antifungal prophylaxis reduces the incidence and severity of infections. This case report discusses the occurrence of hyperplastic candidiasis in the patient under treatment by a chemotherapeutic agent imatinib mesylate for gastric tumor. We have discussed the probable cause for oral candidiasis in patients under imatinib mesylate and treatment advised for the oral hyperplastic candidiasis.

Bisphosphonate Related Osteonecrosis of Jaw in Female Patient: An Enigma.

Bisphosphonates are used in cases of osteoporosis, multiple myeloma, metastatic carcinoma to the skeleton, etc. The patients with nitrogen-containing bisphosphonates are a greater risk for osteonecrosis of the jaws. Osteonecrosis is considered to be one of the side effect of the bisphosphonate the most common affected jaw is mandible. The primary reason for the osteonecrosis of the jaw is basically due to the over suppression of bone turnover rate. Trauma, tooth extractions, and poor oral hygiene is also considered to be another co-factor which precedes the osteonecrosis of the jaw in the patients of bisphosphonate therapy. So, preventive measure as a reduction of oral microbial load and reduction foci of infection is mandatory step before the treatment of bisphosphonate therapy.

Effectiveness of transcutaneous electrical nerve stimulation and microcurrent electrical nerve stimulation in bruxism associated with masticatory muscle pain - A comparative study.

Objectives: To compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) and microcurrent electrical nerve stimulation (MENS) on masticatory muscles pain bruxism patient. Materials and Methods : A total of 60 subjects with the clinical diagnosis of bruxism were randomly allocated to two study groups. Group A received TENS (50 Hz, pulse width 0.5 mSec, intensity 0-60 mA for 20 minutes for a period of seven days) and Group B received MENS (0.5 Hz, intensity 1,000 μA for 20 minutes for a period of seven days). The outcome measures were assessed in term of Visual Analog Scale (VAS) and digital pressometer of 2 Kgf. Results : The study showed significant change in intensity of pain as per VAS score ( P ≤ 0.0001) and tenderness as per digital pressometer ( P ≤ 0.0001). Conclusion : MENS could be used as an effective pain-relieving adjunct to TENS in the treatment of masticatory muscle pain due to bruxism.