Utility of Panoramic Radiographs in the Screening of Individuals with Edentulous Arches: A Need-Analysis Study

Abstract Objective: To evaluate the utility of panoramic radiographs in pre-prosthetic screening of edentulous arches. Material and Methods: Panoramic radiographs taken for three years were retrospectively analyzed. Observations from the radiographs shall be categorized and classified into either of the two categories, namely: 'findings with minimal impact on denture fabrication' and 'findings which affect denture fabrication and require further evaluation.' Anatomic variations, jaw pathologies, and residual ridge resorption patterns were assessed. Results: This study included the initial screening of 23,020 panoramic radiographs, out of which 505 (showing either one or both edentulous arches) were included for the study purpose. The age range of the subjects was from 21 to 94 years. 52.6% of the radiographs showed positive findings. More than half of the radiographs belonged to the males (52.5%). Hyperpneumatization of the maxillary sinus, crestal position of the mental foramen, and retained root fragments were the most common entities noted in the radiographs. Changes in the mental foramen were significantly higher in males than females (p=0.002). Conclusion: Observations from this study showed that panoramic radiographs have high utility for screening edentulous arches, and they should be used in routine clinical practice before denture fabrication.

Radiographic Assessment of Third Molars Agenesis Patterns in Young Adults

ABSTRACT Objective: To determine the prevalence of third molar agenesis and associated characteristics. Material and Methods: A total of 2374 panoramic radiographs were retrieved from the radiological archives and evaluated in a computer monitor under optimum viewing conditions. The basic demographic data (age and sex) and the primary findings regarding the presence or absence of third molars in the maxillary and mandibular arches were recorded systematically in a specially designed proforma. Categorical variables were compared using the Chi-square test. Results: A total of 2000 panoramic radiographs were included in the study, of which 1004 were females (50.2%), and 996 were of males (49.8%). The incidence of third molar agenesis was 486 patients (24.3%). Maxillary third molar showed a higher prevalence of agenesis (28.8%) than mandibular third molars (16.4%). A total of 1514 patients (75.7%) had third molars in all four quadrants, and the remaining 486 patients (24.3%) had agenesis of third molar tooth in at least one of the quadrants. Single tooth agenesis was observed in 219 (11%) patients, two teeth agenesis in 172 (8.6%) patients, three teeth agenesis in 39 (2%) patients, and four teeth agenesis in 56 (2.8%) patients. Conclusion: The present study exhibited a maximum number of single tooth agenesis. It was also observed that maxillary third molar agenesis is more than the mandibular third molar and the right side is more than the left side. Agenesis of the third molar is more prevalent in males as compared to females.

Lamellar Ichthyosis: A Rare Mucocutaneous Disease.

Lamellar Ichthyosis is a rare genodermatotic condition, which occurs due to the mutation in the transglutaminase-1gene. It is a rare disease with a global prevalence of 1 in 300000 live births with no specific . gender predilection It is a rare genetic disorder with a characteristic fish scale appearance of the skin. Here we report one such rare case of Lamellar Ichthyosis in a 7- year-old girl reported to us with difficulty in chewing.

Association of Impacted Mandibular Third Molar with Caries on Distal Surface of Second Molar

Objective: To evaluate the relationship of impacted mandibular third molars (M3M) status with caries on distal surface (CODS) of mandibular second molars (M2M). Material and Methods: A retrospective study on digital panoramic radiographs. Information on age, gender, eruption status of impacted mandibular third molars and mandibular second molars caries on distal surface were recorded. Winters' classification and Pell and Gregory classification were used to classify impacted mandibular third molars. The Chi-square test and Poisson regression were used. A p-value of <0.05 was considered statistically significant. Results: A total of 1497 radiographs were evaluated out of which 2704 sites were recorded. A total of 33.2% M3M were impacted and 1053 (38.9%) M2M had caries on distal surface. Among the total M3M teeth, 39.1% of erupted and 38.6% of impacted teeth had CODS of M2M. However, there was no significant difference in the distribution of CODS of M2M in erupted and impacted mandibular third molars teeth (p=0.796). As per Winters classification, mesio-angular and horizontal impaction types were significantly associated with CODS (p<0.001). Conclusion: All impacted mandibular third molars may not be associated with caries on distal surface of mandibular second molars. But, the angulation like mesioangular and horizontal, class I and II may predispose to caries on distal surface of mandibular second molars.

Assessment of Awareness About Various Dental Waste Management Practices Among Dental Students and Practicing Clinicians

Abstract Objective: To evaluate the knowledge of students and dental practitioners about dental and biomedical waste disposal and to impart emphasis on important aspects such as eco-friendly waste management. Material and Methods: This questionnaire-based study involved 186 participants which comprised of 5 domains, namely laws regarding biomedical waste, steps of waste management, categories of dental waste, general hazards of improper waste disposal and certain material/process specific questions Results: Assessment of the first domain showed that only 58.4% of participants were able to correctly identify the Pollution Control Board of India as the regulatory body for the transport of medical waste. The second domain assessment revealed that 55.9% of subjects were adequately aware of the knowledge handling hospital waste. Assessment of the third domain displayed that the majority of the respondents (91.9%) knew categories of dental waste generated. Evaluation of fourth domain exhibited that 89.8% students agreed that biomedical waste management (BWM) must be made a practical exercise in dental schools to reduce "Know-Do gap" between undergraduates and postgraduates and the last domain demonstrated that only 32.3% of the participants knew the environmentally friendly technique to convert organic waste into commercially useful byproducts Conclusion: It was found that postgraduates had a better awareness of the proper methods to dispose of healthcare waste when compared to students and interns. However, the overall level of awareness was less than adequate. The need for special training in BWM in the clinical set up was highlighted through this study.

Diagnostic Accuracy of Ultrasonography in the Assessment of Facial Fractures

Abstract Objective: To assess the diagnostic accuracy of Ultrasonography (USG) in diagnosing superficial facial fractures. Material and Methods: Patients visiting our facility with facial trauma and suspected fracture of the facial skeleton, those who had undergone CT scans, and conventional radiographic examinations and those who were conscious and cooperative were included in the study. All conventional radiographs, CT scans and ultrasound examinations were done during 0-20 days after trauma in all the patients Results: A total of 20 patients participated in our study, out of which 18 were male (90%) with a mean age of 34.4 years (range of 19-75 years). Eleven sites of the face were examined bilaterally in each patient, i.e., a total of 440 sites. Of these, 84 sites were found to be fractured according to the CT scan examination whereas conventional radiographs detected 59 and ultrasonography detected 74 fractures (of which 70 were true fractures, while 4 were false-positive results). The sensitivity and specificity of USG in all fracture sites were 83.33% and 98.88% respectively. The positive and negative predictive values were 94.59% and 96.17% respectively Conclusion: Ultrasound examination had a better sensitivity when compared to conventional radiography in detecting superficial facial fractures.

Primary Intraosseous Carcinoma of Mandible: A Case Report.

Primary intra-osseous squamous cell carcinoma (SCC) is a rare malignant tumor of the jaw. Th is tumor was fi rst labeled by Loos in 1913. It is more common in adults, in six to seven decades of life with predominant location in posterior mandible. We hereby report a case of intraosseous SCC involving the mandible of a 52-year-old male. Th e absence of any defect, proliferative growth or mass intraorally suggested that the origin of the squamous cells was de novo from within the bone. Understanding of the clinical, radiographic, and histopathological features of this tumor allows accurate diagnosis and appropriate treatment of this rare malignancy.