ABSTRACT
Oral lichen planus (OLP) is a common inflammatory, autoimmune disorder that affects stratified squamous epithelium. The exact etiopathogenesis of this mucocutaneous disease is still uncertain. Although OLP has been associated with altered Quality of Life and considerable morbidity, with important note for erosive type of OLP, its treatment is often disappointing and controversial. Though corticosteroids remained the first line of treatment for OLP, the associated adverse effects of corticosteroids are not acceptable. Hence, there is a need of drugs with steroid sparing effect. Use of immunomodulators is systemic pathologies is widely encountered. However, their use in oral lesions is not frequently seen. Use of hydroxychloroquine (HCQ), an age-old disease-modifyinganti-rheumatic-drug, has been widely used in various autoimmune diseases; however, it received little attention in treatment of OLP. This article presents a case series of three patients with erosive OLP which were managed with HCQ. The results presented allow the authors to consider systemic HCQ as a newer therapy for atrophicerosive lichen planus.
ABSTRACT
Background Oral submucous fibrosis (OSF), a potentially malignant disorder, is a chronic, inflammatory, progressive debilitating disease of the oral cavity with a multifactorial etiology. As an inflammatory response, more fibrinogen and its degradation products are produced by the body in OSF patients. Detection of these plasma fibrinogen degradation products (FDP) in OSF patients has contributed a new direction to enlighten the etiopathogenesis of OSF. Objectives To ascertain the role of FDP of OSF patients in betel nut chewers and in control subjects and also to estimate serum levels of proteins in the patients. Materials & Methods The study included 25 clinically diagnosed oral submucous fibrosis patients with betel nut chewing habit & 25 healthy controls without any deleterious habits. All the patients were evaluated for fibrinogen degradation productions and total serum protein concentration (TSP) by agglutination and Biuret method respectively. The results were analysed using unpared ttest and Pearson chi square test. Results The study revealed an increased FDP level in all the betel nut chewers with OSF when compared with the healthy individuals. There was a marginal increase in Total serum Protein concentration levels in OSF patients, thus inferring to a positive correlation between FDP and TSP in all OSF cases. Conclusion This study validates the relationship of plasma FDPs in the etiology of OSF and can be used to measure the prognosis of the disease. Plasma FDP may also be useful as a nonsurgical diagnostic tool in suspected OSF cases without necessitating a histopathological confirmation. However, further studies with a larger sample size may be required to elucidate the precise role of plasma FDP levels and detailed fractional analysis of protein in OSF, thus facilitating to obtain more conclusive results. It can be suggested that biochemical assessment of patients with areca nut chewing habit may help in the earlier diagnosis of OSMF and thus may lead to a better prognosis of these lesions.
ABSTRACT
Objectives Intra oral radiographic imaging is the most widely used method for obtaining information about root canal anatomy and working length determination. Measuring exact working length is the most essential step for the success of root canal treatment. Bisecting angle technique (BAT) is the most widely used technique for this purpose. However, zygomatic superimposition over the apices of maxillary molars makes it difficult for the dentist to estimate exact working length. The present study made certain modifications in BAT to overcome these undiagnostic shadows. The aim of the study is to compare three techniques, namely paralleling cone technique (PCT), BAT and modified bisecting angle technique (MBAT) to prevent such superimposition over molar apices. Materials and Methods A total of 53 patients requiring endodontic treatment for maxillary molars were included in the study. Three radiographs one with each PCT, BAT, MBAT were made. Each radiographic image was recorded acceptable or unacceptable based on the zygomatic superimposition. The data thus collected was subjected to statistical analysis using chi-square test. Results The percentage of acceptability in MBAT was 56.6% (n = 30) when compared with BAT which was only 28.3% (n = 15) and PCT was 58.3% (n = 31) indicating statistically significant difference between BAT and MBAT. But no statistically significant difference was found between MBAT and PCT. Conclusion In the present study, MBAT was found to be more accurate than BAT, and it was relatively as accurate as PCT in eliminating zygomatic superimposition over the apices of maxillary molars.