Rare mandibular condition presenting as trismus: an exploration of IgG4-related disease.

A woman in her 30s presented with a 12-month history of reduced mouth opening and swelling on the right side of her mandible. The swelling was non-tender and firm on palpation. The swelling began to increase in size after the extraction of her carious wisdom tooth. Histopathological and serological examinations confirmed the diagnosis of IgG4-related disease, manifested as a mass in the mandible. The patient was prescribed oral corticosteroids at a tapering dosage over 8 weeks. After 3 months, there was an improvement in the patient's mouth opening and a reduction in the size of the swelling. The patient remains in follow-up care. Including IgG4-related disease in the list of potential diagnoses for oral soft tissue masses is crucial, given their positive response to medical treatment, highlighting the significance of an accurate diagnosis to prevent unnecessary surgery, with oral lesions potentially serving as early indicators before multiorgan complications arise.

Maxillary osteomyelitis in a young female with osteopetrosis: unveiling an uncommon connection.

Osteopetrosis encompasses a spectrum of conditions marked by heightened bone density due to faulty osteoclast-mediated bone resorption, leading to an accumulation of immature bone and thickened cortical structures. This condition gives rise to bone fragility, blood cell irregularities, nerve entrapment and growth challenges, all stemming from disrupted bone remodelling. Craniofacial distinctiveness, encompassing anomalies in the skull and jaw, is a frequent occurrence. Osteopetrosis presents a range of clinical signs, including facial and dental anomalies. The diagnostic process involves thorough clinical and radiological assessments, often obviating the need for genetic testing. Interestingly, few prior reports have delved into the specifics of craniofacial and dental issues in osteopetrosis. The presented case showcases rare occurrence of maxillary osteomyelitis. The diagnosis was established through a combination of history, clinical, radiographic and laboratory findings. The patient declined surgical intervention, leading to the implementation of conservative management involving regular irrigation alongside systemic antibiotic therapy.

Lobular Capillary Hemangioma in a Young Child: Diagnostic Dilemma and Management.

Pyogenic granuloma (lobular capillary hemangioma) is a common reactive tumour-like lesion of the oral cavity arising in response to various stimuli such as chronic local irritation, drug intake, and hormonal changes. The clinical features are similar to other reactive oral lesions such as peripheral giant cell granuloma (PGCG) and therefore the definitive diagnosis depends on histopathologic evaluation. We report a case of a three-year-old Indian boy presenting with a three-month history of a 3.3×1.4×0.8 cm large sessile, lobular, soft-tissue mass of the left mandibular posterior gingival region which was referred to us. An excisional biopsy of the lesion revealed multinucleated giant cells lying in an inflammatory cell infiltrate-rich stroma consisting of plump endothelial cells on histopathologic examination suggestive of lobular capillary hemangioma. The patient was asymptomatic with no new growth on regular follow-up. This is the first reported case of a large pyogenic granuloma in a very young child, which is an uncommon presentation.

The Optimal Hemostasis Duration After Tooth Extraction: A Randomized Controlled Trial.

Background There is a lack of evidence-based practice regarding the duration of pressure pack placement following tooth extraction. This study aimed to compare the incidence of post-extraction bleeding following 60 minutes versus 10 minutes of pressure pack placement. Methodology A randomized controlled trial was conducted at a tertiary care hospital and included patients requiring intra-alveolar tooth extractions. Patients were randomly allocated into the experimental group or control group by a permuted block randomization method. A blinded observer noted the incidence of post-extraction bleeding. Categorical variables were summarized as frequency and percentage. The chi-square test was used for intergroup statistical analysis. P-values <0.05 were considered statistically significant. Results There were 528 participants, 264 of whom were allocated to each group. The incidence of post-extraction bleeding was 8% and 6.8% in the experimental and control groups, respectively. On bivariate analysis, there was no statistically significant difference between the two groups (p = 0.618; relative risk with 95% confidence interval = 1.0). Conclusions In the majority of cases, hemostasis was achieved in 10 minutes. Therefore, removing the pressure pack after 10 minutes may be advised to ensure hemostasis and, ultimately, save chairside time.

Sub-mucosal Dexamethasone for Post-operative Pain and Oedema Control in Lower Third Molar Surgery.

Background: Surgical excision of the problematic mandibular third molars causes substantial tissue damage and an inflammatory response. Discomfort and edema are common postoperative signs and symptoms caused by the latter. To find out whether dexamethasone may help with the edema and pain that come along with the surgical removal of impacted mandibular third molars, researchers have performed clinical studies. Methods: Twenty individuals with bilaterally affected mandibular third molars who were scheduled for extraction participated in a prospective trial. At two separate sessions, teeth were raised and cut after buccal ostectomy. Since the surgical operation on the left foot, both patients were administered a mixture of 4 mg dexamethasone submucosal injection and antibiotics for 3 days. On the 1st, 3rd, and 7th postoperative days, edema and pain were assessed. Results: At the 1st, 3rd, and 7th postoperative days, there was a clinically meaningful decrease in the level of edema and discomfort in both arms. Conclusions: The current report offers empirical proof that administering a 4 mg dexamethasone submucosal injection during surgery greatly reduced post-surgical edema and discomfort.

Oral manifestations associated with COVID-19 disease: An observational cross sectional study.

Objectives: The aim of present study was to investigate oral manifestations associated with COVID-19 disease. Materials and methods: This cross-sectional study comprised 367 suspects with mild/moderate COVID-19 symptoms who reported to a tertiary care hospital's screening OPD. An in-depth case history was taken, and an oral cavity examination was performed to detect any oral findings. All participants were tested for SARS-CoV-2 using a naso-pharyngeal swab and reverse transcription polymerase chain reaction.Oral manifestations and the results of RT-PCR testing were correlated. Statistical analyses were performed using Epi Info and R software. To estimate the prevalence of oral symptoms, the Pearson chi-square test was used. Results: Oral manifestations were found in 58% of the study population. The difference in the prevalence of oral manifestations between RT-PCR positive COVID-19 patients versus RT-PCR negative suspects was statistically significant (p = 0.007) with xerostomia and dysgeusia being significantly higher in positive patients (p = 0.036 and p = 0.044 respectively) while the prevalence of stomatopyrosis and other intraoral signs was insignificant. Conclusion: Xerostomia and dysgeusia are the common oral manifestations of COVID-19.

Comparison of Root Surface Roughness Produced By Hand Instruments and Ultrasonic Scalers: An Invitro Study.

BACKGROUND: Instrumentation on tooth surface for debridement of hard and soft debris forms the basis of periodontal therapy. This involves periodic removal of accumulated material using different methods of instrumentation. An ideal instrument should eliminate all the deposits from the root surfaces with no or minimal alteration of the natural morphology. AIM: To compare the root surface roughness after root planing performed with gracey curette and by ultrasonic scalers (Satelec P-5 Booster) set at different power modes. MATERIALS AND METHODS: The root surface roughness and its surface microtopography resulting from the use of Gracey curette, ultrasonic instrument at low, medium and high power setting on 35 healthy premolars extracted for orthodontic treatment purpose were examined using Optical Profilometer and the surface topography was assessed using Field Emission Microscope. STATISTICAL ANALYSIS: Analysis of variance (ANOVA) test was used to observe the variance in a particular variable is partitioned into components attributable to different sources of variation. Duncan multiple range tests were used to determine whether three or more means differ significantly. RESULTS AND CONCLUSION: The mean roughness was found to be the highest in group where Scaling and Root Planing (SRP) was performed using ultrasonic scaler at low power mode (3.03±1.54 µm) whereas the lowest surface roughness was seen on the samples where SRP was performed using ultrasonic scaler at medium power mode. The surface roughness in group where SRP was performed with ultrasonic scaler at high power mode (2.22±0.74µm) was found to be similar to that of group in which root planing was carried out using curette (2.24±1.71µm).