Ameloblastoma: Retrospective Study and Analysis of 102 Cases Over 10 Years, Single Centre, Institutional Experience.

Objective: The purpose of the study was to analyse the long-term results of ameloblastoma, which was treated at our centre. Study Design: We carried out a retrospective study of 10 years of clinical records from 2007 to 2016 with 102 consecutive cases of ameloblastoma. Data of all patients were collected and analysed with follow-up to 9 years. Results: The data analysis revealed male (59.8%) predominance over female (40.2%) with a mean age of 30.35 ± 15.12 years was observed. We have observed a mandibular (93.1%) than maxilla (6.9%) with left side predominance (54.9%). Anatomically, in the mandible, most of the cases were located in ramus (27.5%). On radiographic analysis, multilocular lesion (66.4%) was observed in association with involvement of impacted mandibular third molar teeth. On histopathological examination, conventional type (63.8%) was most commonly noted. The most frequently performed procedure was segmental mandibulectomy (30.4%). Reconstruction was done in most of the cases by recon plate (41.2%). The recurrence rate was seen at about 20.6%. Conclusion: Ameloblastoma has got mandibular posterior region with male predominance. Follicular ameloblastoma was the most common histological type found. So, Radical approach for adult patients wherein younger and growing patients conservative approach could be a justified as a treatment of choice.

Postanaesthetic Aseptic Palatal Necrosis - A Case Report.

RATIONALE: In dentistry, the most common procedure to be applied is administration of a local anaesthetic agent. It is impossible to practice dentistry without local anaesthesia. In the oral cavity, the palatal mucosa is tightly adherent to the palatal bone and there is little space for anaesthetic solution to be deposited. If local anaesthetic is forcefully injected by the syringe, it creates pressure on blood vessels and causes palatal necrosis. PATIENT CONCERN: Here, we present a case report of a 25-year-old male patient who reported to us with chief complaint of an ulcer on the palate. DIAGNOSIS: Patient was diagnosed with postanaesthetic aseptic palatal necrosis. INTERVENTION: The patient was managed conservatively using copious irrigation and a palatal acrylic splint. OUTCOME: On the 6th month follow-up, the lesion was completely replaced by healthy mucosa. TAKE-AWAY LESSONS: We should avoid forceful injection of local anaesthetic agent to prevent further postoperative complications.

Cavernous sinus thrombosis following dental extraction: a rare case report and forgotten entity.

Prior to the advent of efficacious antimicrobial agents, the mortality rate from cavernous sinus thrombosis (CST) was effectively 100%. There have been very few reports of CST associated with tooth extraction. A 40-year-old female presented to the emergency room with swelling over the right side of the face and history of extraction in the upper right region by an unregistered dental practitioner. The patient presented with diplopia, periorbital ecchymosis, and chemosis of the right eye. A computed tomography scan revealed venous dilatation of the right superior ophthalmic vein. The patient was immediately treated with incision and drainage, intravenous antibiotics, and heparin (low molecular weight). Unfortunately, the patient died two days after surgery due to complications from the disease. CST is a rare disease with a high mortality rate. Therefore, dental health education in rural areas, legal action against unregistered dental practitioners, early diagnosis, and aggressive antibiotic treatment can prevent future mortality resulting from CST.

Prevalence of subnormal testosterone concentrations in men with type 2 diabetes and chronic kidney disease.

BACKGROUND: One-third of men with type 2 diabetes have subnormal testosterone concentrations along with inappropriately normal LH and FSH concentrations. It is not known if the presence of renal insufficiency affects free testosterone concentrations in men with type 2 diabetes. HYPOTHESIS: We hypothesized that type 2 diabetic men with chronic renal disease (CKD; estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m(2)) have lower free testosterone concentrations than men with normal renal function (eGFR ≥ 60 ml/min per 1.73 m(2)). STUDY DESIGN AND SETTING: This is a retrospective chart review of patients attending diabetes and nephrology clinics. Men with type 2 diabetes who had the following information available were included in the study: testosterone (total and free) done by LC/MS-MS followed by equilibrium dialysis, sex hormone binding globulin, LH, FSH and prolactin concentrations. PARTICIPANTS: We present data on T and gonadotropin concentrations in 111 men with type 2 diabetes and CKD (stages 3-5) and 182 type 2 diabetic men without CKD. RESULTS: The prevalence of subnormal free testosterone concentrations was higher in men with type 2 diabetes and CKD as compared to those without CKD (66% vs 37%, P < 0.001). Men with CKD had a higher prevalence of hypergonadotropic hypogonadism (26% vs 5%, P < 0.001) but not of hypogonadotropic hypogonadism (HH; 40% vs 32%, P = 0.22). There was an increase in the prevalence of hypergonadotropic hypogonadism with decreasing eGFR. Fifty-two percent of men with renal failure (CKD stage 5) had hypergonadotropic hypogonadism and 25% had HH. In men with CKD, the hemoglobin concentrations were lower in those with subnormal free T concentrations as compared to men with normal free T concentrations (119 ± 19 vs 128 ± 19 g/l, P = 0.04). CONCLUSIONS: Two-thirds of men with type 2 diabetes and CKD have subnormal free T concentrations. The hypogonadism associated with CKD is predominantly hypergonadotropic.