Solitary Intraosseous Myofibroma of the Zygomatic Bone: A Case Report.

Myofibroblasts have been implicated in most fibro-contractive diseases and even in developing and specialized normal body tissues. Myofibroma denotes benign neoplasms composed of contractile myoid cells arranged around thin-walled blood vessels affecting the soft tissue, bone, or internal organs at all ages with the intraosseous variant being an uncommon entity. Histologically, these tumors are characterized by being circumscribed masses of spindle cells, which may lead to confusion in diagnosis with more aggressive soft tissue spindle cell tumors. A case is reported of a 7-year-old female patient who presented with a solitary intraosseous myofibroma in the inferolateral aspect of the left orbit. This article describes the clinical, radiographic, histopathologic, and immunohistochemical features of an intraosseous myofibroma in a female child.

A Non-healing Ulcer with Unilateral Facial Palsy

Introduction: Oral cavity is a hub for millions of microorganisms which are non pathogenic, but in immunocompromised states, plethora of diseases emerge which may be the most rarest and fatal. Mucormycosis has emerged as one such disease due to rise in the incidence of immunosuppressive conditions such as uncontrolled diabetes. It manifests as rhinocerebral, gastrointestinal, pulmonary and cutaneous forms. Presentation of Case: A 53 year old female patient reported with a chief complaint of noticing a painless large ulcer in the palate. There was also history of swelling associated with continuous burning sensation only on the right middle third of face with difficulty in closing right eye, raising right eyebrow, speaking and inabilty to smile. Bell’s sign was positive. She also had recurrent episodes of fever and vomiting. Imaging with CT and MRI showed no bony destruction but a wide spread soft tissue lesion from palate upto the cavernous sinus. Culture and histopathology confirmed mucormycosis. Discussion: Mucormycosis is the third most common opportunistic fungal infection caused by a saprophytic fungus Mucor. This invasive infection can spread rapidly to intracranium causing various morbidities. Facial nerve palsy is one such rare complication reported in the present case. Explicit investigations including imaging, serology, histopathology and culture are crucial for appropriate diagnosis. Treatment includes parenteral and oral antifungals. Conclusion: Mucormycosis is a rare encounter in dental practice especially with initial presenting intraoral symptom. The present paper presents one such rare extensive case of Mucormycosis in a compromised patient with extensive investigations and management.

Report of rare palatal expression of Nevus of Ota with amendment of Tanino's classification.

Nevus of Ota, a benign melanocytic pigmentary disorder with rare malignant transformation potential, affects 0.014-0.034% of the Asian and Black population and has a strong predilection for females. It occurs in the area innervated by the first and second division of the trigeminal nerve. Oral manifestation is rarely noted with only 14 cases reported till date. This report documents a case of Nevus of Ota with the infrequently noted oral involvement, in an Indian lady. Since oral manifestation is not acknowledged in Tanino's classification, the authors propose a modification to the same.

Eruption times and patterns of permanent teeth in school children of India.

Aim: To study the eruption pattern of permanent teeth excluding third molars in school children of Mysore, South India. Objectives: To compare the eruption times determined with previous studies. To determine range of variation of the eruption time of each tooth and evaluate if any preponderance exists in the eruption timings of maxillary and mandibular teeth and between boys and girls. Materials and Methods: This was a descriptive cross sectional study. A random sample of 5007 school children in the age group of 5-14 years was selected. The mean age of eruption of individual permanent teeth was recorded and results were analyzed using Probit analysis. Results: The study population included 2371 boys constituting 47.26% and 2636 girls constituting 52.65% of the total sample. In the age group of 5 years, one of the permanent teeth was found to be erupted. In the age group of 14 years, all the permanent teeth except third molar had erupted. Girls showed early tooth eruption compared to boys. Mandibular teeth erupted earlier than maxillary teeth in both the sexes. Right and left sided teeth erupted at the same time in both the arches. Conclusion: The mean ages of eruption obtained from the present study are strikingly comparable with those of other investigators in different populations across the world. Since the current study involves a large sample of children, the data reported in this study could be used as standards when assessing permanent tooth eruption in Indian children.

A comparative evaluation of film and digital panoramic radiographs in the assessment of position and morphology of impacted mandibular third molars.

Background and Objective: Digital photo stimulable phosphor (PSP)-based radiography has many known theoretical advantages over conventional film radiography but its diagnostic efficacy has to be assessed clinically. This study compared the efficiency of conventional film-based panoramic radiographs with that of digital PSP-based panoramic radiographs in the assessment of position and morphology of impacted mandibular third molars. Materials and Methods: We selected a total of 80 impacted mandibular third molars that fulfilled the inclusion and exclusion criteria of this study. Both conventional film-based panoramic radiographs and digital PSP-based panoramic radiographs were taken of all the study samples and the teeth were later surgically removed. Conventional film-based and digital PSP-based panoramic radiographs were compared for their relative efficiencies in the assessment of impaction status, position of tooth, number of roots, root morphology, and proximity to mandibular canal of impacted mandibular third molars. An oral surgeon graded these same factors during/after surgical exploration and this assessment was considered the gold standard. The data obtained were statistically analyzed using descriptive statistics, chi-square test, and McNemar's test. Results: There was no statistically significant difference between conventional film-based radiographic assessment and digital PSP-based panoramic radiographic assessment of impaction status, position of tooth, number of roots, and proximity to mandibular canal of impacted mandibular third molars (P>0.05). However, there was significant difference between the two methods with regard to assessment of root morphology of impacted mandibular third molars (P=0.00). Interpretation and Conclusion : Conventional film-based panoramic radiographs and digital PSP-based panoramic radiographs were comparable in their accuracy in the preoperative study of impacted mandibular third molar with regard to impaction status, tooth position, number of roots, and proximity to the mandibular canal. Digital PSP-based panoramic radiographs were more accurate than conventional film-based panoramic radiographs in the assessment of root morphology of impacted mandibular third molars. Hence, we conclude that digital PSP-based panoramic radiographs can be used as an effective alternative to conventional film-based panoramic radiographs for assessment of position and morphology of impacted mandibular third molars.

Localization of impacted permanent maxillary canine using single panoramic radiograph.

Background and Objectives : The objective in localization is selection of a suitable technique which has minimal radiation dose, cost and maximum details. Panoramic radiograph, being a screening radiograph, can satisfy the above needs. Taking this into consideration, the present study was done to evaluate the reliability of panoramic radiograph in localization of impacted permanent maxillary canines by applying the criteria suggested by Chaushu et al. and by comparing it with Clark's rule. Materials and Methods : The study comprised of 114 subjects in the age group of 13-30 years of both the genders with 150 impacted canines visiting Department of Oral Medicine and Radiology during the study period. The study subjects were examined for clinically missing canine, and then confirmed with intra-oral peri-apical radiograph (IOPAR). Panoramic radiographs (for application of Chaushu et al. criteria) and IOPAR's (for application of Clark's rule) of the subjects were made and interpreted for parameters pertaining to the impacted canines. The data obtained was tabulated and subjected to statistical analysis using the statistical package for social sciences (SPSS) software. Results : Determination of the bucco-palatal position from panoramic radiographs, by applying Chaushu, et al. criteria, showed that localization in bucco-palatal position was possible for 96 of the 102 impacted canines placed in the middle and coronal zones. The remaining six impacted canines, three each in the middle and coronal zones, could not be localized as they showed overlapping in their range. By excluding them, the overall agreement worked out to be 94.11%. Localization was not possible for 48 impacted canines that lied in the apical zone. Conclusion : A single panoramic radiograph can serve as a reliable indicator for determining the bucco-palatal position of the impacted canines when they lie in the middle and coronal zones. When they lie in the apical zone it is recommended to explore their presence with other conventional or advanced imaging modalities.

Rhinolith.

Rhinoliths are rare entities encountered in clinical practice. They are calcified masses found within the nasal cavity. Which lesions can be encountered incidentally upon a routine dental radiograph. This article reports a case of such an incidental finding of rhinolith on a dental radiograph.

Stature estimation using odontometry and skull anthropometry.

OBJECTIVE: To investigate the possibility of estimating height from odontometry and anthropometric data of the skull for the positive identification of height in forensic investigations concerned with fragmentary human remains. MATERIALS AND METHODS: The study was carried out on 100 Mysorean patients, 50 males, and 50 females. Measurements of mesiodistal widths of the six maxillary anterior teeth, circumference of the skull, and height were made directly on each patient. Anteroposterior diameter of the skull was obtained on the lateral cephalograph. The data collected were subjected to statistical methods. The known heights of the combined data, data for males, and females were regressed against the odontometric and anthropometric variables using linear regression analysis. RESULTS: Significant sexual dimorphism was observed for the parameters studied ( P 0.05). Highly significant correlation was found between height and other parameters when combined data and data for males were regressed. The equation relating height to the combined mesiodistal width of maxillary anterior teeth was derived as height = 982.421 + 13.65 x combined mesiodistal width of maxillary anterior teeth ( P 0.0001). Similarly equations were obtained by regressing height to head circumference and skull diameter ( P 0.0001 for both). The above findings may hence provide reliable method of estimation of height from skeletal remains in the forensic setup.

Klestadt's cyst: a rarity.

Klestadt's cyst, more commonly known as the nasolabial cyst is an uncommon, non-odontogenic, soft tissue cyst characterized by its extra osseous location in the nasal alar region. Following its description first by Zukuerkandl in 1882, only 267 cases have been found in English literature. A case of nasolabial cyst in a 30-year-old female patient is presented.

Malignant peripheral nerve sheath tumour: an elusive diagnosis.

Malignant peripheral nerve sheath tumour (MPNST) also termed as spindle cell malignancy of the peripheral nerve Schwann cells or neurogenic sarcoma, represents approximately 10% of all soft tissue sarcomas. This tumour is usually found in the lower extremities and only 10-12% of all lesions occur in the head and neck region, which makes it a rare entity. The diagnosis of MPNST has been described as one of the most difficult and elusive diagnosis in the soft tissue diseases because of its non-specific presentation both clinically and histopathologically. This was overcome by the use of immunohistochemistry. A case of MPNST of the left maxillary antrum in a 45 -year -old male patient is reported.

Extragingival pyogenic granuloma.

Pyogenic granuloma is a well-known localized granulation tissue overgrowth in reaction to mild irritation. Although it is known to show a striking predilection for the gingiva, it can be found extragingivally with varying clinical features that sometimes may mimic more serious lesions such as malignancies. The clinical diagnosis of such an uncommon extragingival pyogenic granulomra can be quite challenging. The purpose of this article is to report an unusual case of extragingival pyogenic granuloma occurring on the lower lip, which presented as a cutaneous horn.

Palatal rugae pattern in Mysorean and Tibetan populations.

OBJECTIVES: To compare the palatine rugae pattern of Mysorean and Tibetan subjects, to assess the predominant palatine rugae pattern in Mysorean and Tibetan population, and to determine the uniqueness of palatine rugae pattern in an individual. MATERIALS: Maxillary study models of 60 subjects each (30 males and 30 females) of age group 17-23 years, of Mysorean population and Tibetan population were assessed for the length, shape, and unification of rugae based on the classification by Lysell et al. The palatine rugae were compared for the above mentioned parameters. 2 way ANOVA and Chi square tests were used for statistical analysis. RESULTS: Statistical analysis showed that males had significantly more number of total rugae on the right compared to the left side in both populations. Indian males had more primary rugae on the left side as compared to females and vice versa for the Tibetan population. Also, Indian males had more number of curved rugae on both right and left sides than Tibetan males and Tibetan females had more wavy rugae on right and left sides than Indian females. In other aspects, no significant difference or association was found. CONCLUSIONS: A statistically significant association between the total number of rugae and the gender in both the study populations exists. Parameters like the length and shape of the rugae show racial differences.