"Introducing Modified Dakkak and Bennett Grading System for Indian Food in Oral Submucous Fibrosis": A Dharwad Study.

Oral submucous fibrosis (OSMF) is one of the "diseases of civilization" because of the large differences in prevalence among races, geographic areas, and individuals at different socioeconomic levels. It is a premalignant condition strongly associated with the habit of chewing areca nuts. This study is to compare the scoring system in relation to the burning sensation of mouth and dysphagia using the visual analog scale (VAS) and Dakkak and Bennett grading system for Indian food, respectively, in OSMF patients. This study was a randomized clinical trial incorporating a total of 50 cases of OSMF divided into a control group (antioxidant therapy) and pentoxifylline test cases. Values for burning sensation of the mouth using the VAS and modified Dakkak and Bennett grading system for Indian food were recorded. Statistical analyses were done using t test, Mann -Whitney U test, and one-way analysis of variance (ANOVA) test. Patients subjected to pentoxifylline when compared to the control group showed significant reduction in dysphagia for Indian food. Burning sensation was recorded according to the visual analogue scale. Significant reduction in burning sensation was seen in the pentoxifylline group when compared to the control group. This grading system provides quantitative and qualitative parameters in patients with OSMF.

Hemifacial spasm secondary to vascular loop compression: a rare case report.

Hemifacial spasm (HFS) is characterised by brief, persistent, involuntary paroxysmal contractions of the facial muscles innervated by the facial nerve. Broadly its aetiology is portrayed as primary and secondary. Primary HFS is a result of vascular compression of the ipsilateral facial nerve at its root exit zone, and secondary HFS can occur after any injury to the facial nerve from the internal auditory canal to the stylomastoid foramen, which may be a result of a cerebellopontine angle tumour, schwannoma, fusiform aneurysm, or demyelinating lesion such as multiple sclerosis. We report a rare case of HFS in a 40-year-old female patient, who presented with a 4-year history of twitching of the left eye and deviation of the mouth towards the left side. An MRI of the brain revealed a vascular anomaly at the root exit zone of the left facial nerve. The present report aims to highlight MRI as a single, non-invasive diagnostic investigation to confirm the diagnosis of HFS.

Prevalence of oral mucosal lesions among smokeless tobacco usage: A cross-sectional study.

BACKGROUND: Tobacco use is one of the most prevalent forms of habit and associated with development of potential malignant disorders. The aim of the present study was to investigate the prevalence and distribution of oral mucosal lesions (OMLs) among smokeless tobacco users. MATERIALS AND METHODS: This is a hospital-based cross-sectional study. All the patients with the history of smokeless tobacco habit were included in the study. The patients were interviewed using the preformed questionnaire, including the patient's demographic details, the type of habit, duration, frequency, and the associated oral mucosal pathology. Further, patients were clinically examined and recorded on tobacco-related oral lesions. RESULTS: Prevalence of OML was 54.18%, and 91.50% being among male and with higher frequency at the age of second and fourth decade. The prevalence of oral submucous fibrosis, leukoplakia, carcinoma, lichen planus, and erythroplakia was 26.95, 10.35, 9.94, 5.5, and 0.66%, respectively. Smokeless tobacco habit was prevailing among males (98.79%) compared to females (9.37%). Frequency of habit-associated OML was statistically significant with odds ratio 0.24. CONCLUSION: The study proves a definite association between smokeless tobacco habit and OML. The data necessitate to correlate and follow up the individuals with smokeless form of tobacco habits to establish the definite correlation between the habit and oral mucosal lesions.

The Efficacy of Topical Hyaluronic Acid 0.2% in the Management of Symptomatic Oral Lichen Planus.

INTRODUCTION: Oral lichen planus (OLP) is a condition frequently referred to the specialist dental clinic for diagnosis and management. It is a disease of the skin and mucous membranes with oral manifestations too. It varies in appearance from keratotic to erythematous and ulcerative form. Immunosuppressants are frequently used for patients but some of these drugs could be implicated in malignant transformation, thus there is a clear need to find an alternative therapy for OLP. AIM: To evaluate the relief of symptoms and reduction in the size of the lesions of lichen planus with 0.2% hyaluronic acid topical application and to compare the efficacy of topical hyaluronic acid (0.2%) with that of patients on placebo. MATERIALS AND METHODS: A randomized controlled study was conducted on 50 symptomatic and biopsy proven patients with lichen planus. The subjective symptoms like Visual Analogue Scale (VAS) and the objective symptoms like degree of erythema and mean area of the lesion were recorded preoperatively and on day 7, day 14, day 21 and day 28. The selected patients were divided randomly into group-I comprising of 25 patients who received topical 0.2% hyaluronic acid therapy for 14 days and group-II comprising of 25 patients who received topical application of placebo for 14 days. The statistical tests used were Mann-Whitney U test, t-test, Wilcoxon matched pairs test by ranks and paired t-test. RESULTS: Symptomatic effect of soreness evaluation- there was a significant reduction in VAS scores in the test group as compared to placebo, similarly there was also significant reduction in the degree of erythema, change in the size of the lesion and area of the lesion in the test group. There was significant improvement in relief of symptoms, in the degree of erythema and mean area of the lesion in Group-I when compared with group-II. CONCLUSION: Topical application of 0.2% Hyaluronic acid showed a significant clinical response when compared to topical placebo. It is easy to use; hence a frequent application scheme should be advised to improve the efficacy of hyaluronic acid.

Role of Depression, Anxiety and Stress in Patients with Oral Lichen Planus: A Pilot Study.

CONTEXT: Lichen planus is a psychosomatic disease. Higher frequency of psychiatric symptoms, poor quality of life, higher level of anxiety and neuroendocrine and immune dysregulations, all these factors, will enhance the exacerbation of the disease. AIMS: The present study was to assess depression, anxiety and stress levels in patients with oral lichen planus. MATERIALS AND METHODS: The psychometric evaluation using the Depression Anxiety Stress Scale (DASS)-42 questionnaire was carried out, by the same investigator on all members of group 1 (Oral Lichen Planus) and group 2 (Control). DASS-42 questionnaire consists of 42 symptoms divided into three subscales of 14 items: Depression scale, anxiety scale, and stress scale. STATISTICAL ANALYSIS USED: The Student t test was used to determine statistical difference for both the groups and to evaluate for significant relationships among variables. RESULTS: Psychological assessment using DASS-42 reveals lichen planus patients showed higher frequency of psychiatric co morbidities like depression, anxiety and stress compared to control group. CONCLUSIONS: This study has provided evidence that the DASS-42 questionnaire is internally consistent and valid measures of depression, anxiety, and stress. Psychiatric evaluation can be considered for patients with oral lichen planus with routine treatment protocols are recommended. DASS-42 Questionnaire can also be used to determine the level of anxiety, stress and depression in diseases of the oral mucosa like recurrent apthous stomatitis, burning mouth syndrome and TMD disorders.

Anatomy and morphology of the nasopalatine canal using cone-beam computed tomography.

PURPOSE: This study was performed to evaluate the general anatomy and morphology of the nasopalatine canal using cone-beam computed tomography (CBCT) and to determine the human anatomic variability of the nasopalatine canal in relation to age and gender. MATERIALS AND METHODS: The study included 100 subjects aged between 20 and 86 years who were divided into the following 3 groups: 1) 20-34 years old; 2) 35-49 years old; 3) ≥50 years old. The subjects were equally distributed between the genders. CBCT was performed using a standard exposure and patient positioning protocol. The data of the CBCT images were sliced in three dimensions. Image planes on the three axes (X, Y, and Z) were sequentially analyzed for the location, morphology and dimensions of the nasopalatine canal by two independent observers. The correlation of age and gender with all the variables was evaluated. RESULTS: The present study did not reveal statistically significant differences in the number of openings at the nasal fossa; diameter of the nasal fossa openings; diameter of the incisive fossa; shape, curvature, and angulation of the canal as viewed in the sagittal sections; antero-posterior dimensions and length of the canal in the sagittal sections; or the level of division of the canal in the coronal plane by age. However, males and females showed significant differences in the length of the canal in the sagittal sections and level of the division of the canal in the coronal plane. CONCLUSION: The present study highlighted important variability observed in the anatomy and morphology of the nasopalatine canal.

Evaluation of osteoporosis in diabetic individuals using digital intra oral periapical radiographs / Avaliação de osteoporose em indivíduos diabéticos utilizando radiografias periapicais digitais

Introduction: Osteoporosis is a major cause of fractures in middle aged individuals. There has been drastic increase in the number of osteoporotic patients over the past two decades. The relationship of osteoporosis and diabetes continues to be a topic of debate among research workers. Detection of osteoporosis is very important for oral diagnostics as it can bring changes in treatment plan and modifications in oral procedures. Current literature is directed at diagnosing this condition on dental radiographs. Objectives: The present study was aimed at detecting osteoporosis using digital dental radiographs of premolar and molar region using Adobe Photoshop CS2 software. Materials and methods: A total of 40 patients visiting the dental department who were already diagnosed with type II diabetes for minimum of 1 year Arch Oral Res. 2011 May/Aug.;7(2)169-75 Mutalik S, Goyal M, Sanghamesh B, Guttal SK, Naikmasur VG, Mutalik VS. 170 obesity, hyperglycemia and advanced glycation end products. Albright and Reifenstein were first to report low mineral density and risk of fracture in diabetic subjects in 1948 (3). The relationship between diabetes and osteoporosis continues to be debated among the research workers. A recent meta-analysis showed that diabetic patients had higher hip bone mineral density (BMD) than non-Diabetic controls suggesting that BMD values may not reflect bone fragility in diabetic patients (4). Bone density is determined by several modalities ranging from quantitative computed tomography (qCT) to dual energy x-ray absorptiometry (DEXA) or peripheral ultrasound measurement. Each modality has been shown to be independently predictive of fracture risk, yet each has its own limitations (5). Introduction Osteoporosis is a systemic skeletal disease characterized by reduced bone mineral density and micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. It is one of the most common...

Introdução: A osteoporose é uma das principais causas de fraturas em indivíduos de meia idade. Houve aumentodrástico no número de pacientes com osteoporose nas duas últimas décadas. A relação entre osteoporosee diabetes continua a ser um tema de debate entre os pesquisadores. A detecção da osteoporose é muitoimportante no diagnosticador bucal, uma vez que ela pode refletir em mudanças no plano de tratamento emodificações nos procedimentos bucais. O diagnóstico dessta condição por meio de radiografias dentais temsido discutido na literatura atual. Objetivos: O presente estudo teve como objetivo detectar a osteoporose utilizandoradiografias digitais dentais da região de pré-molar e molar utilizando o software Adobe PhotoshopCS2. Materiais e métodos: Um total de 40 pacientes que visitaram o departamento de odontologia e já previamentediagnosticados com diabetes tipo II no período mínimo de um ano foram selecionados aleatoriamentepara o estudo. Radiografias digitais intra-orais periapicais orais da região inferior de pré-molar e molar foramobtidos pela técnica de paralelismo. As imagens foram então convertidas em formato de arquivo bitmap eavaliadas usando o software Adobe Photoshop CS2. O número de trabéculas em uma área específica foi contadoe comparado com indivíduos saudáveis de mesma idade e sexo e controle glicêmico normal. Resultados:A média do número de trabéculas/mm2 em indivíduos normais foi 0,1987 ± 0,0244, e de 0,1737 ± 0,0279 parao grupo diabético, sendo a diferença estatisticamente significativa (p < 0,05). Conclusão: Este estudo confirmouque o número de trabéculas/mm2 em indivíduos diabéticos foi menor em comparação aos observados emindivíduos normais.

Frequency of developmental dental anomalies in the Indian population.

OBJECTIVES: To evaluate the frequency of developmental dental anomalies in the Indian population. METHODS: This prospective study was conducted over a period of 1 year and comprised both clinical and radiographic examinations in oral medicine and radiology outpatient department. Adult patients were screened for the presence of dental anomalies with appropriate radiographs. A comprehensive clinical examination was performed to detect hyperdontia, talon cusp, fused teeth, gemination, concrescence, hypodontia, dens invaginatus, dens evaginatus, macro- and microdontia and taurodontism. Patients with syndromes were not included in the study. RESULTS: Of the 20,182 patients screened, 350 had dental anomalies. Of these, 57.43% of anomalies occurred in male patients and 42.57% occurred in females. Hyperdontia, root dilaceration, peg-shaped laterals (microdontia), and hypodontia were more frequent compared to other dental anomalies of size and shape. CONCLUSIONS: Dental anomalies are clinically evident abnormalities. They may be the cause of various dental problems. Careful observation and appropriate investigations are required to diagnose the condition and institute treatment.

Lingual ulceration in disseminated histoplasmosis.

Histoplasmosis is a rare systemic fungal infection commonly presenting as mucosal ulceration of the oral cavity. It has been increasingly reported in India as disseminated disease with lesions in the oral cavity as a consequence of rapid spread of HIV infection. The authors report a case of disseminated histoplasmosis with oral manifestation in a 40-year-old male patient.

Hemifacial microsomia. A report of two cases.

Hemifacial microsomia (HFM) is an asymmetrical congenital deformity of the head and face caused by anomalous development of the structures derived from the first and second branchial arches. Oral and maxillofacial malformations present diagnostic and treatment challenges unique to the dental profession. The etiology, a report of two cases and a brief description of treatment modalities are discussed in this article.

Trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle: case report and brief overview.

Trigeminal neuralgia (TN) is a paroxysmal shock-like pain restricted to the innervations of the areas of one or more trigeminal branches, often set off by light stimuli in a trigger zone. Pain attacks occur spontaneously, and can also be triggered by a nonpainful sensory stimulus to the skin, intraoral mucosa surrounding the teeth, or tongue. The pathogenesis of TN is uncertain and typically is idiopathic, but it may be due to a structural lesion. Various proposed causes include traumatic compression of the trigeminal nerve by neoplastic or vascular anomalies, infectious agents such as human herpes simplex virus, and intracranial tumors or demyelinating conditions such as multiple sclerosis. Here we report a case of a young patient diagnosed with trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle.

Soft occlusal splint therapy in the management of myofascial pain dysfunction syndrome: a follow-up study.

BACKGROUND AND OBJECTIVES: Myofascial Pain Dysfunction Syndrome (MPDS) has been recognized as the most common, nontooth-related chronic orofacial pain condition that confronts dentists. A variety of therapies has been described in literature for its management. The present study is a prospective study carried out to evaluate the efficacy of occlusal splint therapy and compare it with pharmacotherapy (using analgesics and muscle relaxants) in the management of Myofascial Pain Dysfunction Syndrome. MATERIALS AND METHODS: Forty patients in the age range of 17-55 years were included in the study and randomly assigned to one of two equally sized groups, A and B. Group A patients received a combination of muscle relaxants and analgesics while Group B patients received soft occlusal splint therapy. All the patients were evaluated for GPI, VAS, maximum comfortable mouth opening, TMJ clicking and tenderness during rest and movement as well as for the number of tender muscles at the time of diagnosis, after the 1 st week of initiation of therapy and every month for three months of follow-up. RESULTS: There was a progressive decrease in GPI scores, number of tender muscles, TMJ clicking and tenderness with various jaw movements and significant improvement in mouth opening in patients on occlusal splint therapy during the follow-up period as compared to the pharmacotherapy group. CONCLUSION: Occlusal splint therapy has better long-term results in reducing the symptoms of MPDS. It has better patient compliance, fewer side effects, and is more cost-effective than pharmacotherapy; hence, it can be chosen for the treatment of patients with MPDS.

Tumoral calcinosis with dental manifestations--a case report.

UNLABELLED: Tumoral calcinosis (TC) is a rare entity causing abnormal periarticular calcifications in the affected joint observed in the first two decades of life. It is also known to affect the teeth. Few case reports on TC talk about the dental findings. This article presents the clinical, radiological and histological appearance of dental abnormalities in a 23-year-old female with TC. The differential diagnosis and dental management are discussed. CLINICAL RELEVANCE: Tumoral calcinosis should be considered in the differential diagnosis of abnormally short roots with complete or partial obliteration of pulp chambers in a young patient.