White spot lesions in fixed orthodontic treatment: Etiology, pathophysiology, diagnosis, treatment, and future research perspectives.

White spot lesions (WSLs) refer to localized areas of hypo-mineralization limited to the enamel of the teeth surface, which is noticeable clinically to the naked eye on drying of the teeth. During fixed orthodontic treatment, it is very hard for the patient to maintain excellent oral hygiene as the brackets, bands, wires, elastics, and other appliances and attachments worn intra-orally provide a platform for food retention, plaque formation, and then colonization by acidogenic bacteria like Streptococcus mutans and Lactobacillus. This review aims to elaborate and focus on etiology, pathophysiology, diagnosis, treatment aspect, and future scope for research about the WSLs occurring due to fixed orthodontic treatment.

Effectiveness of basic life support training course intervention among dental practitioners and students - An experimental study.

Aim: To determine the level of knowledge and skill of basic life support (BLS) among undergraduate, postgraduate students, and general practitioners with and without regular attendance of the BLS Healthcare Provider course. Methodology: The study was carried out at two intervals with two groups. A random sample involving undergraduate students, postgraduate students, and dental professionals was selected for both study groups. Group 1 with 440 participants had not attended BLS for Healthcare Providers Course in the last two years. Group 2 with 410 participants had attended the BLS for Healthcare Providers course regularly once a year. First, participants in Group 1 were evaluated using an MCQ test with 30 questions about their knowledge and skills in BLS. Then, a well-trained BLS instructor team from Dental College & Hospital offered BLS healthcare provider courses to students and dentists. Subsequently, Group 2 participants who had completed a BLS course for healthcare providers last year were also assessed for their knowledge and skills in BLS using another MCQ test. Results: The marks obtained in the tests were tabulated and analyzed. To determine the association between variables with respect to mean knowledge score, t-test was employed. Multiple group comparison was made using analysis of variance and P < 0.05 was considered statistically significant. The group 1 participants score a mean of 5.7 marks against the Group 2 with a mean score of 27.4 marks out of 30 marks. Knowledge and skill in BLS skills among those in Group 1 without prior BLS training was mainly low. Dental practitioners performed marginally better than students in both groups. Conclusions: Based on the results, we make the following observations. With the introduction of BLS training into the academic curriculum and routine BLS hands-on workshops, all healthcare providers will be familiar with the BLS skills to effectively manage the life-threatening emergencies.

Evaluation of different taste sensations along with body mass index (BMI) in geriatric patients with and without complete dentures.

BACKGROUND: The purpose of this study was to investigate the effect of acrylic full removable dentures on the perception of four primary tastes (sweet, sour, salty, and bitter), as well as to determine if there is a correlation between changes in body mass index (BMI) and taste perception. MATERIALS AND METHODS: A total of 60 patients who wore acrylic removable dentures and 60 controls were included in the study as a convenient sample. Sixteen solutions for basic tastes were prepared, and the patients were asked to identify the taste of each solution from the lowest concentration. Anthropometric measures, such as height and weight, were measured and recorded in an MS-Excel sheet. The data were analyzed using SPSS version 23. RESULTS: The results showed that patients with complete removable dentures had lower taste scores for sourness (P < 0.001) and sweetness (P < 0.001) compared to the control group. However, there was no significant difference in salt taste scores (P = 0.218) and bitterness (P = 0.002) between the two groups. Additionally, the study found a correlation between lower BMI values and higher taste scores among denture-wearing patients, indicating an inverse relationship between total taste scores and BMI. CONCLUSIONS: The study suggests that geriatric patients with complete dentures have reduced taste sensations compared to those without dentures which can have a negative impact on their nutritional status. Therefore, it is crucial to provide adequate nutritional support and dietary counseling for geriatric patients based on health policy to maintain their overall health and well-being.

Evaluation of taste score and fungiform papillae quantification using digital image analysis in COVID-19 patients with smell and taste dysfunction.

Background: The COVID-19 pandemic which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a major global health crisis in recent years. Despite this, there have been few studies that have utilized reliable methods to assess changes in taste and smell perception. Therefore, our study aims at the number of fungiform papillae and objective measures of taste perception relationship among COVID-19 patients with olfactory and gustatory disorders. Materials and Methods: This was a cross-sectional analytical study in which 57 COVID-19 patients were recruited who confirmed the dysfunction of taste and smell. Objective assessment of the sense of taste was evaluated using four different standardized solution preparations, and the scores were given according to the patient's statements. Digitalized quantification of fungiform papillae was counted. The data were analyzed with the Pearson's correlation coefficient using the SPSS version. 23 [Licensed JSSAHER, Mysuru, Karnataka, India], and the level of significance was set at <0.001. Results: In terms of altered or reduced taste and smell, male patients exhibited a higher incidence compared to females. Compared to the sour taste, a substantial number of COVID-19 patients have displayed a notable decrease in their ability to taste sweet, salty, and bitter flavors. However, a statistically significant positive correlation was observed between taste scores and fungiform papillae density (r = 0.518, P < 0.001). Conclusion: Our Study demonstrated that the quantitative evaluation of taste perception and the count of fungiform papillae can serve as important indicators of SARS-CoV-2 infection, and could potentially help in the early detection and treatment of COVID-19 patients, as reduced taste function is a significant marker of the disease.

Comprehensive Preventive and Therapeutic Oral Health Care: A Case Report of Mucopolysaccharidosis Type IV A in a Pediatric Patient.

Mucopolysaccharidosis (MPS) is a metabolic disorder resulting from a deficiency of lysosomal enzymes. It is an autosomal recessive disorder with similar incidences in men and women. Mucopolysaccharidosis type IV A is caused by a deficiency of N-acetylgalactosamine-6-sulfatase, which deficiency is, in turn, caused by alterations in the GALNS gene. It is marked by a short stature, a pigeon chest, frontal bossing, kyphosis, and a flat nasal bridge. Intraorally, macroglossia, hypodontia, dentinogenesis imperfecta, a broad mouth, and an anterior open bite are some of the common features. The present paper reports on a case of MPS in a 5-year-old male patient, along with providing a review of the literature and insight into the oral manifestations related to MPS IV A, also called Morquio A syndrome, and its dental treatment. It aims to highlight the clinical recommendations for oral health care in such cases during different phases of MPS IV A treatment.

Exploring the Changing Diagnostic Criteria of Gorlin-Goltz Syndrome: A Case Report.

Gorlin-Goltz syndrome, also known as Gorlin syndrome, basal cell nevus syndrome, and nevoid basal cell carcinoma syndrome, is an autosomal dominant genetic disorder. Its hallmark is an early onset of basal cell carcinoma. Additionally, the syndrome is characterized by a spectrum of distinct clinical attributes encompassing oral, skeletal, ophthalmic, neurological, and developmental aberrations. This condition arises due to anomalies in the Hedgehog signaling pathway, leading to constant pathway activity and uncontrolled growth of tumor cells. Early identification of the disorder through available diagnostic methods and clinical and radiological findings is crucial for accurate diagnosis, which subsequently leads to the formulation of an effective treatment regimen. The purpose of this case report is to discuss the role of a dentist in early detection based on various author-prescribed criteria and the need for a multidisciplinary approach to the treatment of patients with this syndrome.

Unusual case presentation associated with impacted mandibular molars: Clinicopathological correlation and immunohistochemical analysis.

ABSTRACT: Ewing's sarcoma of bone is a rare malignant round cell tumor of the head and neck. The jaw, particularly the mandible, accounts for 3% of occurrences in the head and neck area. These tumors have been reported more frequently in men than in women, and they are usually between 5- and 20-year-old. It is difficult for clinicians and pathologists to make a diagnosis based solely on clinical and microscopic findings. Immunohistochemistry presents a plausible tool that can help the pathologist to arrive at a confirmatory diagnosis. This jaw tumor has the best prognosis when detected and treated early in the disease course, so the importance of timely, and accurate diagnosis cannot be overemphasized. The highlighting feature of this case report of an 18-year-old male that was primary detected by immunohistochemically as Ewing's sarcoma and is localized to the impacted left mandibular molars.

Apprehensions and Optimism among Dental Professionals during the COVID-19 Pandemic-A Nationwide Cross-Sectional Evaluation.

Globally, the pandemic of the coronavirus disease, which started in Wuhan, China, has become a major issue for public health. The COVID-19 epidemic notably causes health professionals to experience significantly more emotional stress than the general populace. The present study proposes to investigate the fear aspect in dentists in the initiation of clinical practice during these times. An online cross-sectional study was conducted among dental practitioners based on a pre-validated questionnaire. The data were expressed as frequency and percentage analyzed using the chi-square test using SPSS version 25. The data was obtained from 271 participants, where clinical practice after the first wave was mostly by freelancers (p-value = 0.01); most of whom were married (p-value = 0.065); 19.1% attached to institutes did not have changes in earnings; 28.1% of private practitioners had less than 10% reduction in cases. A total of 62% of private practitioners are concerned about the vaccine's preventative effects (p-value = 0.026), and 57% of private practitioners worry about being sued for the delay in treatment (p-value = 0.036). Only 33.1% of employees in institutions worry that becoming sick could endanger their family. As dentists continue to work their way through this pandemic, these pressures only occasionally have an impact on them. According to the researchers, this is the first study that has captured the anxiety and apprehensions that dental practitioners experienced during the height of the COVID-19 outbreak in India in April 2021. The study's findings demonstrate that the study population was generally upbeat and confident that they could quickly overcome their fear.

Delayed Eruption of Tooth Due to Peripheral Giant-Cell Granuloma: An Unusual Presentation and Treatment in 15-Year-Old Child Patient.

Peripheral giant-cell granulomas (PGCGs) are reddish color lesions of the gingiva which are frequently diagnosed on a routine basis by many dentists in the regular dental practice. Most of the lesions of PGCG are slow-growing, nonaggressive with asymptomatic, and tend to recur. Here, we exhibit a case of PGCG of the upper jaw in a 15-year-old girl child. She presented with a chief complaint of a lump on her upper anterior tooth region for 2-3 months. A well-defined painless, sessile exophytic growth, measuring about 1 cm × 0.5 cm in dimension with pinkish red in color with a firm consistency, was noted. Moreover, no secondary changes were seen. On the radiograph also, no changes in the bone/tooth were observed. The provisional diagnosis was identified as benign lesions such as pyogenic granuloma, peripheral ossifying fibroma, and PGCG and was made based on the clinical history and radiographic findings, and the confirmative diagnosis was given after histopathological examination. To improve the esthetic and function of teeth as well as psychological problems in the young patient, we tend to manage the case more simply by conservative surgical procedure at the earliest to prevent a recurrence.

Assessing physical and chemical properties of saliva among tuberculosis patients on anti-tuberculosis treatment - An observational study.

Background: Tuberculosis (TB) is one of the major systemic conditions which is a preventable and curable infection but remains a significant cause of death. The WHO, in its global plan to stop TB reports, that poor treatment has resulted in the evolution of Mycobacterium tuberculosis strains that do not respond to treatment with the standard first-line combination of anti- tuberculosis medicines, resulting in the emergence of multidrug-resistant tuberculosis in almost every country of the world.The present study was aimed to assess the physical and chemical property of stimulated and unstimulated saliva and identify if any association exist with alterations in taste perception in patients with antituberculosis medications. Methods: A total of 30 patients on anti-tuberculosis drugs were considered as cases and 30 healthy volunteers were considered as controls and included in the study. All study subjects were assessed for their physical property like flow rate, viscosity, pH and chemical property like sodium, potassium, calcium, phosphorous of stimulated and unstimulated saliva. All the subjects on Anti-tuberculosis drugs were assessed for change in taste perceptions using the standard questionnaire. Results: There is a significant decrease in the flow rate (0.34 ±â€¯0.06) and pH (5.89 ±â€¯0.37) of unstimulated saliva of patients and the flow rate (0.38 ±â€¯0.07) and viscosity (1.34 ±â€¯0.28) of stimulated saliva among the case group compare to the control group. All the electrolytes' concentrations such as sodium, potassium, calcium, and phosphorous values were significantly altered in stimulated and unstimulated saliva of the case group compared to the control group in which p-value < 0.05 was considered. Conclusion: There are significant changes in physical and chemical properties of both stimulated and unstimulated saliva which has an effect on taste perception inpatient with anti-tuberculosis medications. Hence, salivary flow rate, pH, viscosity, and salivary electrolytes of tuberculosis patients should be considered as important parameters in guiding the diet, so that there will be an improvement in their taste perception and medication protocol, thus maintaining their nutritional status which leads to improving their health.

Lip print patterns: Similarities among the parents and their children.

Background: The wrinkles and grooves visible on the lips form the characteristic pattern of an individual and imprints produced is termed as "lip print." The study of these prints is known as "cheiloscopy." Variations in patterns among males and females could help in sex determination. Lip prints, therefore, can constitute material evidence left at a crime spot, equivalent to fingerprints. These patterns are heritable and are believed to be unique and permanent. The lip prints of parents and children and those of siblings have been shown to have some similarities. The influence of inherited lip print patterns among family members is still a new concept and studies are scanty in literature. Objectives: The objectives are to determine the most common patterns and gender-wise distribution among the study population and to analyze the inherited lip print patterns from parents to their offspring. Materials and Methods: Lip prints of 30 families were obtained using lipstick and cellophane tape. Based on criteria given by Suzuki and Tsuchihashi, patterns were recorded and analyzed from four quadrants of the lips using a magnifying lens. Results: The positive resemblance of lip print patterns from parents to their offsprings showed statistically significant resemblance in one quadrant and rest of the three quadrants showed no significant association between parents and offspring. Conclusion: Positive resemblance among the family members can be attributed to the genetics and inheritance. Lip print can be considered as an auxiliary method of identification.

Dental caries: Impact of tobacco product among tobacco chewers and tobacco smokers.

Objective: Tobacco is the most significant social burden and the leading cause of death. Tobacco is derived from "Nicotiana tabacum" which has nicotine as the main component. There are various disadvantages from tobacco on health which are reported in the medical literature. But the risk of caries among these tobacco users, such as chewers and smokers, is still debatable. Hence, the present study aims to determine the prevalence of dental caries among tobacco chewers and smokers. Materials and methods: In this study, 389 individuals were included. Out of 389 individuals, 304 were men and 85 were women aged between 18 and 60 years. They were classified into two groups. Group A had 207 individuals with habitual tobacco chewing, and Group B had 182 individuals with habitual tobacco smoking and provided a 6 months history. The DMFT index (Decayed, Missing, and filled teeth index-WHO modification 1997) was used to assess caries. Results: The study revealed a higher prevalence of dental caries among tobacco chewers compared to tobacco smokers. The DMFT scores were higher among gutka chewers compared to other types of tobacco use. The lower posterior tooth region showed higher dental caries in tobacco chewers compared to smokers. Conclusion: The higher presence of caries in the tobacco chewing group is due to the presence of sweeteners, which act as cariogenic agents. Similarly, smokers have a thiocyanate component that acts as an anticariogenic agent; therefore, the prevalence of caries was lower in tobacco smokers.

A new technique to resolve Nasal Rhinosporidiosis: A case report with review of literature.

INTRODUCTION AND IMPORTANCE: Rhinosporidiosis is a chronic, localized granulomatous infectious disease caused by Rhinosporidium seeberi that predominantly affects the mucosal membranes of the nose and nasopharynx, conjunctiva, and urethra. Rhinosporidium seeberi is a eukaryotic pathogen that spreads in certain geographical areas, particularly in tropical and subtropical areas, through aquatic exposure. CASE PRESENTATION: We present the case of a young man who had been suffering from a right nasal mass for four months, and whose diagnosis was confirmed after surgical excision and histopathological examination, which revealed distinct pathognomonic findings. Laser-assisted endoscopic excision, in combination with Dapsone, is recommended as a more effective treatment to prevent a recurrence. CLINICAL DISCUSSION: For clinicians, it has been advised to obtain a detailed case history of exposure in patients diagnosed with Rhinosporidiosis. Rhinosporidiosis can be diagnosed with a simple examination of H&E-stained histopathological sections. Because chemotherapy has not been proven to be effective, Laser-assisted endoscopic excision, in combination with Dapsone is the recommended treatment for Rhinosporidiosis. CONCLUSION: One of the differential diagnoses for Rhinosporidiosis in the nasal cavity is masses or abnormal growths without bleeding, which should be kept in mind by clinicians and pathologists.

Classification staging systems on clinical and radiographic features of inverted sinonasal papilloma: A case report.

Inverted sinonasal papilloma is an infrequent tumor that mostly affects the elder group of 40-50 yr. This tumor is distinguished from other sinonasal tumors by three characteristics: a high rate of recurrence, carcinomatous changes, and a high potential for local destruction. In 40% of cases of inverted sinonasal papilloma showed an association with the human papillomavirus and considered as the main etiological agent. Here, we present a case of a 36-year-old male presented with pus discharge from the right upper back teeth region in the past 1 year. Correlating with clinical, radiographical features, a diagnosis of the Inverted sinonasal papilloma.

Unusual case presentation of an aneurysmal bone cyst of maxilla in geriatric patient: A diagnostic challenge.

An aneurysmal bone cyst (ABC) is a non-neoplastic, rapidly expanding pathologic bone lesion that mostly affects the mandible and is most commonly found in the first to third decade of life. The most of the ABC cases are locally aggressive osteolytic lesion with a high recurrence rate. As a result, we present a swelling with pus discharge at the maxillary alveolus in a 68-year-old female who was diagnosed with ABC after a computed tomography scan and histological analysis. The conservative surgical excision was performed without considerable bleeding, and no recurrence was observed even after a five-year follow-up period.

Immunohistochemistry: An indispensable aid in diagnosis and management of infantile myofibroblastoma.

Myofibroma is a benign tumor of myofibroblasts occurring commonly in infants and children. It can occur as a solitary lesion or as multiple lesions in the soft tissues or intraosseously. The presence of the solitary lesion is common in the soft tissues of the head-and-neck region but rare in jawbones. Histologically, it has a biphasic pattern of presentation and mimics spindle cell tumors. Immunohistochemistry is essential for its confirmatory diagnosis. This article describes a case of this rare lesion presenting as a solitary lesion in the left body of the mandible in a 7-month-old boy baby. The diagnostic and therapeutic challenges have been discussed.

Evaluation of Antioxidant Property of Amla on Bond Strength and Color Stability of Power Bleached Teeth: An In vitro Study.

INTRODUCTION: Objective: To assess the antioxidant property of 10% amla extract in reversing the compromised bond strength and to assess the antioxidant property of 10% amla extract and Elsenz on the color stability of power bleached teeth. MATERIALS AND METHODS: Ninty extracted single-rooted maxillary anterior were collected and divided as follows: The labial surfaces of 30 samples were subjected to power bleaching after which the samples were divided into three groups- Group I (control), Group II (antioxidant amla), and Group III (Elsenz) with n = 10 in each which were then stained with a coffee solution for 10 mins. The color difference was recorded with a colorimeter at baseline, after bleaching, after 7, and after 15 days of staining. sixty specimens were randomly divided into six groups (n = 10) as following: Group I (immediate bonding); Group II (bleaching + immediate bonding); Group III (bleaching + antioxidant and immediate bonding); Group IV (bleaching + 1 week storage + antioxidant + bonding); Group V (bleaching + 2 week storage + antioxidant + bonding); Group VI (bleaching + 2 week storage + bonding). All the specimens were tested for shear bond strength in universal testing machine. Statistical analysis was performed using ANOVA and Scheffe's post hoc test. RESULTS: Significantly higher staining was observed in Group II (amla) and least with Elsenz pasteThe highest mean shear bond strength was found in Group I followed by Group V. CONCLUSION: Elsenz showed the least staining followed by artificial saliva. 10% Amla extract neither was effective in preventing staining of power bleached enamel nor in restoring the poor bond strength of power bleached enamel.

Histopathological analysis of apoptotic cell count and its role in oral lichen planus.

AIM OF THE STUDY: To identify and count the number of apoptotic cells in oral lichen planus (OLP) and correlate with the degree of keratinization, thickness of epithelium and thickness of lymphocytic infiltration of OLP. MATERIALS AND METHODS: The study comprised 40 diagnosed cases of OLP. Sections were stained with hematoxylin and eosin to identify and count the number of apoptotic cells. Measurement of other histopathological parameter of OLP such as degree of keratinization, thickness of epithelium and thickness of lymphocytic infiltration was done by using stage micrometer and eyepiece graticule. Statistical analysis was done to understand the correlation between apoptotic cells and histopathological features of OLP. RESULT: The result showed that the number of apoptotic cells increased, with an increase in thickness of lymphocytic infiltration and degree of keratinization, but there was a decrease in the epithelial thickness. CONCLUSION: Further immunological and molecular studies are required for a stronger evidence in correlating apoptotic cell and histological parameters of OLP.

Verruciform xanthoma: A view on the concepts of its etiopathogenesis.

Verruciform xanthoma is a very uncommon papillary growth seen chiefly in the oral mucosa. The presence of foam cells in the connective tissue papillae between the epithelial rete ridges forms the hallmark in its diagnosis. There has been wide speculation and various hypotheses put forth in explaining the etiopathogenesis of verruciform xanthoma and the origin of foam cells. This article aims to update the different hypotheses in understanding the pathogenesis of the lesion.