Oro-mandibular manifestations of primary hyperparathyroidism.

Aims and Objective : To determine the effects of Primary Hyperparathyroidism on oral cavity in a symptomatic contemporary Indian population by taking note of the following parameters: (1) Radiological alteration of lamina dura, (2) mandibular cortical width, (3) prevalence of brown tumor, and (4) mandibular tori. Study Design : Twenty-six patients of Primary Hyperparathyroidism were examined clinically and radiologically for extra- and intraoral abnormalities. Loss of lamina dura, mandibular cortical width, presence of mandibular tori, and brown tumors were assessed and correlated with serum Calcium, Phosphate, Parathormone, and Alkaline phosphatase. The results were compared with twenty-six age- and gender-matched control subjects. The data was expressed as mean ± SD, and a probability (p) value of < 0.05 was considered significant. Pearson's statistical method was used to assess the significant correlation between radiological measurements and biochemical values. Results : Generalized absence of the lamina dura was the most consistent finding and there was a significant correlation between its loss and altered parathormone, alkaline phosphatase, and inorganic phosphate, but not with serum calcium or the duration of the disease. Mean values (in mm) for the cortical indices were significantly lower in the patients compared to the controls and correlated significantly with parathormone and alkaline phosphatase. None of the patients had mandibular tori and only one patient had a brown tumor. Conclusion : Loss of lamina dura, ground glass appearance, and mandibular cortical width reduction are common findings in primary hyperparathyroidism and these are significantly correlated with elevated parathormone and alkaline phosphatase. However, the presence of brown tumors and oral tori are less commonly encountered features.

Tooth in the line of fracture: Its prognosis and its effects on healing.

Aims and Objective: The aim of this prospective study was to compare the postoperative results of mandibular angle fracture cases treated by open reduction and internal fixation wherein the third molar in the line of fracture was preserved in one group while it was extracted in the second group. Materials and Methods: Group I consisted of 30 patients in which the mandibular third molar in the line of fracture was preserved and group II consisted of 24 patients in which it was extracted following specific criteria. Various parameters like postoperative healing, infection, occlusion, tooth vitality, and mobility were graded numerically. Statistical analysis using a t-test was done. Data were expressed as mean±SD and a probability (P) value of <0.05 was considered significant. Results: The presence of infection with pain and tenderness was higher in group I. Osteogenesis was higher in group I till the end of the third week but the difference was not significant later. Discrepancy in occlusion was more in group II. Mobility of tooth decreased and status of periodontal tissue improved significantly with time. In the tooth involved, the return of vitality and decrease in pain/tenderness was significant after 1 week and continued till 24 weeks to normalcy. Two teeth showed mild root resorbtion and none showed ankylosis. Conclusion: Postoperative occlusal discrepancy is less but infection is higher when the tooth in the line of fracture is preserved as compared to when it is removed. More than half of the teeth in the fracture line show complete recovery within a period of 6 months to 1 year. Despite the risk of an increase in the rate of complications, the tooth in the line of fracture should be preserved for its merits.

Alcohol Dependence Syndrome: One year outcome study.

The major challenge in the treatment of patients with substance use disorders is not only to maintain the follow up but also to prevent relapse. The current study was planned to see the abstinence and relapse rate in patients with Alcohol Dependence Syndrome over a period of one year. A total of 49 patients of alcohol dependence syndrome fulfilling ICD-10 criteria were included in the study. The mean age was 43 years, majority were above 30 years, males (97.9%), employed (81.6%), and from urban (81.6%) background. the mean duration of dependence was 4.3 years, 12.2% had a family history of dependence, 20.4% had a co-morbid affective disorder and 4.0% had a co-morbid non-affective disorder. In total 71.4% received pharmacologist treatment for relapse prevention. At 6 months, abstinence rates were 100% (n = 10/ 10) for disulfiram, 60% (n=6/10) for anticraving agents (Naltrexone and Acamprosate), 30% (n=3/10) for SSRI group. At 12 months, abstinence rates were 66.67% (n=2/3) for disulfiram, 42.9% (n=3/7) for anticraving agents, 0% (n=2) for SSRI group.