A Comparative Study to Evaluate the Efficacy of Curcumin Lozenges (TurmNova®) and Intralesional Corticosteroids with Hyaluronidase in Management of Oral Submucous Fibrosis.

AIM AND OBJECTIVE: This study aims to compare the efficacy of TurmNova® lozenges and its active ingredient "curcumin" as a low-cost, safe, and noninvasive chemopreventive agent with intralesional corticosteroids (with hyaluronidase) in the management of oral submucous fibrosis (OSMF). MATERIALS AND METHODS: A total of 80 patients with group III OSMF (Khanna JN and Andrade NN classification) visiting the dental outpatient clinic of the Department of Oral Medicine and Radiology Rama Dental College Hospital and Research Center, Kanpur, were selected for the study. A total of 80 patients were randomly divided into two groups (40 participants each): group A to whom TurmNova® lozenges containing turmeric extract 100 mg along with clove oil 10 mg three times daily for 3 months were given and group B to whom intralesional infiltration of 2 mL dexamethasone (4 mg/mL) + hyaluronidase 1500 IU dissolved in 0.5 mL of 2% lignocaine twice a week for 3 months was given. Data were analyzed using the IBM SPSS Statistics, version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, version 21.0. Armonk, New York: IBM Corp.) Results: Statistical analysis revealed that there was significant clinical improvement in mouth opening and subjective symptoms, like burning sensation/pain associated with the lesion and tongue protrusion in the group A as compared to group B. CONCLUSION: Curcumin (100 mg) in an innovative delivery system of lozenge results in a higher level of plasma curcumin level. The aforementioned dosages prevent its biotransformation and inactivation by the liver enzymes. Because of these properties, curcumin lozenges are safer, low-cost, and effective alternative treatment in contrast to the present traditional treatment. Further long-term, prospective, large-scale studies need to be done. CLINICAL SIGNIFICANCE: Curcumin has a role in the treatment of oral premalignant conditions and acts as a very effective chemopreventive agent in the prevention of cancer.

Psychological consequences of lockdown on dental professionals during the early phase of the COVID-19 pandemic.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19, mainly spreads through respiratory droplets. The dental profession is particularly at risk. Routine dental care was suspended after the announcement of the first lockdown in India. This makes the group vulnerable to psychosocial consequences. The present study aims to evaluate the psychosocial issues among dental professionals during COVID-19 pandemic. MATERIALS AND METHODS: A cross-sectional study was conducted among 627 dental professionals of India, using online Google Forms from April 23, 2020, through April 30, 2020. Participants were evaluated using self-constructed and self-administered personal and professional hardship and fear checklist specifically developed for this study. The 9-item Patient Health Questionnaire (PHQ-9) Depression Scale and 7-item Generalized Anxiety Disorder Scale and PHQ-15 were used to assess the depression, anxiety, and somatic symptoms. RESULTS: Fear had a remarkable impact on 80.7% of responders. Among the participants, 40.5%, 24.5%, and 30.6% reported symptoms of depression, anxiety, and somatic symptoms, respectively. Somatic symptoms were significantly associated with gender (P = 0.000). Work setting was significantly associated with depression (P = 0.011) and anxiety symptoms (P = 0.001). Concern, worry, and fear due to COVID-19 were significantly associated with depression (P = 0.000), anxiety (P = 0.033), and somatic symptoms (P = 0.009). There was a positive correlation between depression and anxiety symptoms (P = 0.01) and between age and somatic symptoms (P = 0.5). CONCLUSIONS: This group reported a high level of depression, anxiety, and somatic symptoms. Female dental professionals and private practitioners had more depression, anxiety, and somatic symptoms. Immediate and special intervention is needed for this group. Further exploration into the nature and its effects of the psychological symptoms may be required.

Perception and outcome of oral cancer awareness among clinical undergraduate dental students of Tertiary health care centre at Kanpur city: A cross-sectional study.

BACKGROUND: The International Agency for Research on Cancer has predicted that India's incidence of cancer will increase from 1 million in 2012 to more than 1.7 million in 2035. Lack of knowledge about oral cancer among general dental practitioners leads to delay in the diagnosis and treatment of such lesions. The aim of the present study was to investigate the awareness and knowledge of prevention and early diagnosis of oral cancer among dental undergraduate students. MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted. A total of 139 undergraduate students who received teaching on oral diseases including oral cancer in their clinical postings in the department of oral medicine and radiology were included in the study. All the students were subjected to evaluation using structured questionnaires with multiple choices. Data collected were subjected to statistical analysis using the Statistical Package for the Social Sciences (SPSS) software version 18. Chi-square test was done to evaluate the statistical significance. RESULTS: The present study showed that the participants had average awareness and knowledge of oral cancer and its clinical presentations. The awareness and knowledge toward oral cancer protocols revealed a decreasing trend from final-year students to 3rd-year and interns. Nearly 66.2% of the undergraduates felt less well informed regarding oral cancer. All the undergraduates (100%) requested further information about oral cancer. CONCLUSION: The present study concluded that knowledge and awareness of undergraduate dental students with respect to early detection and prevention of oral cancer was satisfactory. It is recommended that the syllabus of dental courses should be expanded to provide knowledge regarding the prevention and early diagnosis of oral cancer.

Evaluating the stress and its association with stressors among the dental undergraduate students of Kanpur city, India: A cross-sectional study.

BACKGROUND: Dental education can be a critical wellspring of stress among dental students, and studies have observed higher levels of stress among dental students than in the all-inclusive community. The present study aims to evaluate the perceived stress among dental undergraduate students, the sources of stress, and an association of perceived stress with sociodemographic characteristics and various stressors. MATERIALS AND METHODS: A cross-sectional study was conducted among 380 undergraduate dental students (from 1st year to final year) in a private dental college, Kanpur. A self-administered questionnaire was used to collect data regarding sociodemographic profile, perceived stress using Perceived Stress Scale-14, and academic, psychosocial, and environmental stressors. Data were analyzed using IBM SPSS Statistics-Version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA: IBM Corp.). RESULTS: The mean perceived stress score was 30.25 ± 1.914. The median perceived stress score was 30. Statistically significant (P < 0.001) values were found for higher age group and year of studying Bachelor of Dental Surgery (BDS) were important sociodemographic determinant of stress. Vastness of academic curricula, frequency of examination (P < 0.05), and fear of failure/poor performance in examinations were important academic determinants of stress. High parental expectations and family problems were important psychosocial stressors. Accommodation away from home was an important predictor of stress (P < 0.001). CONCLUSION: This study revealed that there are various sociodemographic (age and year of study in BDS), academic (curricula, frequency of examination, and performance level) determinants and predictors of stress (type of accommodation), along with psychosocial stressors (parental expectation and family problems). Dental colleges should develop stress management programs to promote gender and social equity and strategies to improve psychological support services. The stress management programs reported either helped to reduce the number of stressors or enhance stress coping skills, using relaxation techniques such as deep breathing, yoga, and stress management programs.

Prevalence of oral premalignant lesions and conditions among the population of Kanpur City, India: A cross-sectional study.

BACKGROUND: The habit of smoking and chewing tobacco is associated with various types of oral mucosal lesions and conditions, many of which pose a potential threat to cancer growth. The present study aims to evaluate the prevalence of potentially malignant lesions (PML) and oral cancer in North India and to identify the associated risk factors. MATERIALS AND METHODS: A cross-sectional study was carried out in the Department of Oral Medicine and Radiology Rama Dental College Hospital and research center Kanpur over a period of 5 years with1,10,625 patients. Participants were divided into study group with a positive history of the chewing habit as well as oral lesions and control group who had a positive history of habits with no oral lesions. Detailed case history and clinical examination were carried out under visible light by trained professionals to assess any oral mucosal changes. RESULTS: The study group consisted of 76.31% males and 23.69% females. In total, 84.34% participants in the study group were literate. However, 57.56% subjects were having oral submucous fibrosis, 23.7% were having leukoplakia, 13.12% were having Lichen planus, and 5.62% were having oral cancer. CONCLUSION: Results from the present study indicate that tobacco smoking, chewing of betel quid with and/or without tobacco chewing are the major risk factors for PML and oral cancer.

Prevalence of oral submucous fibrosis in patients visiting dental OPD of a dental college in Kanpur: A demographic study.

BACKGROUND: Oral submucous fibrosis (OSMF) is now globally accepted as an Indian disease. It has one of the highest rates of malignant transformation among potentially malignant oral lesions and conditions, therefore, a cause of concern for oral healthcare professionals. The present study aims to evaluate the prevalence of OSMF among betel nut chewers in different age groups in patients visiting Dental College and Hospital Kanpur city, India. MATERIALS AND METHODS: A total of 860 patients of OSMF visiting the dental outpatient clinic of the Department of Oral Medicine and Radiology Rama Dental College Hospital and research center, Kanpur over a period of 24 months (1 January 2016 to 31 December 2018) were selected for the study. A detailed case history and clinical examination was carried out under visible light. The diagnosis of OSMF was based on difficulty in opening the mouth and associated blanched oral mucosa, with palpable fibrous bands. Other diagnostic features included burning sensation, salivation, tongue protrusion, habits, and associated malignant changes. Study was done on the basis of age group, habit duration, frequency of habit, and type of habit. Simple correlation analysis was performed. RESULTS: Of the 860 cases of OSF studied, 390 (46.42%) cases were stage II, 290 (34.52%) were stage III, 90 (10.73%) stage I, and 70 (8.33%) stage IV. Based upon age group, group III (30--40 years) showed more prevalence than the others. Areca nut (gutkha) was a significant etiological factor (55.8%) as compared with other etiological factors. CONCLUSION: The high prevalence of OSMF requires significant awareness and management of these lesions among general population. Primary healthcare professionals and dentists should be knowledgeable and familiar with the etiopathogenesis, clinical presentation, diagnosis, and management of these lesions.

Radiographic Evaluation of Anterior Loop of Inferior Alveolar Nerve: A Cone-Beam Computer Tomography Study.

BACKGROUND: A well awareness of the variation of inferior alveolar canal is mandatory to avoid iatrogenic complication. This study was conducted among 90 patients to determine variation in inferior alveolar nerve (IAN) loop through cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: CBCT images of 90 patients were involved in this study. All images were studied by the expert radiologist to see Type I, Type II, and Type III pattern of IAN canal (IANC). Results were subjected to statistical analysis for correct inferences. RESULTS: Forty males and 50 females were included in the study. The difference was statistically nonsignificant (P = 0.5). Type I pattern was seen in 26 patients, Type II in 19, and Type III in 45 patients. The difference was statistically significant (P < 0.05). The most prevalent pattern was Type III (males - 15 and females - 30), followed by Type I (males - 14 and females - 12) and Type II (males - 11 and females - 8). There was statistical significance difference between males and females in Type II (P < 0.05). CONCLUSION: The anterior loop of IAC is quite common and IANC may show variation in structure. The most common pattern recorded was Type III. CBCT is very useful in the detection of IANC.

Cryotherapy for Treatment of Mouth Mucocele.

A mucocele is a common salivary gland disorder that most commonly affects young adults. A 35-year-old female patient reported to the Department of Oral and Maxillofacial Surgery, with the chief complaint of swelling on the left side of floor of mouth. The aim of this case report is to present the management of mucocele present in floor of the mouth in a young female patient using liquid nitrogen cryosurgery. The present case report has also discussed mechanism of action, current protocol of cryosurgery with emphasis on clinical pros and cons along with the clinical outcomes.

Comparative Evaluation of Pediatric Patients with Mental Retardation undergoing Dental Treatment under General Anesthesia: A Retrospective Analysis.

INTRODUCTION: Behavioral management of patients forms one of the foremost components of pediatric dental treatment. Some children readily cooperate with dental treatment, while others require general anesthesia as a part of treatment protocol for carrying out various dental procedures. Hence, we evaluated the pediatric patients with and without mental retardation, who underwent dental treatment under general anesthesia. MATERIALS AND METHODS: The present study analyzed the record of 480 pediatric patients reporting in the department of pedodontics from 2008 to 2014. Analysis of the records of the patients who underwent dental treatment under general anesthesia was done and all the patients were divided into two study groups depending upon their mental level. For the purpose of evaluation, the patients were also grouped according to their age; 4 to 7 years, 8 to 12 years, and 13 to 18 years. Measurement of decayed, missing, and filled teeth and scores for both deciduous and permanent dentition was done before and after the commencement of the dental treatment. Chi-square test and independent t-test were used for evaluating the level of significance. RESULTS: While comparing the patients in the two groups, maximum number of patients is present in the age group of 13 to 18 years. While comparing the indices' score between the two study groups in various age intervals, no statistically significant results were obtained. Restorative treatment and dental extractions were the most common dental treatments that were seen at a higher frequency in the intellectual disability study group. CONCLUSION: In patients with mental retardation, a higher frequency of restorative treatment and extractions occurs as compared to healthy subjects of similar age group. Therefore, they require special attention regarding maintenance of their oral health. CLINICAL SIGNIFICANCE: Special attention should be given for maintaining the oral health of patients with special health care needs as compared to their physically and mentally normal counterparts.

Progressive systemic sclerosis with intraoral manifestations: A case report and review.

The word scleroderma comes from two Greek words, "sclero" meaning hard and "derma" meaning skin. Scleroderma or progressive systemic sclerosis (PSS), a rare condition, was first characterized as a single condition in 1752 by Curzio of Naples. It generally affects woman between 30 and 50 years of age and has a low prevalence. Scleroderma is a disease of the immune system, blood vessels, and connective tissue. Dermal manifestations include stiff, tight, and shiny skin usually of the hands and feet due to swelling and thickening of the connective tissue as they become fibrotic or scarred. Other symptoms include difficulty in swallowing, bloating, abdominal pain, tiredness, lack of energy, weight loss, aching muscles, joints, and bones. The vital organs that may get involved are lungs, heart, and kidneys. We present a case report of PSS in a 45-year-old female patient with characteristic systemic and oral manifestations.

Detection of human immunodeficiency virus using oral mucosal transudate by rapid test.

CONTEXT: On the cusp of the fourth decade of the acquired immunodeficiency syndrome epidemic, the world has turned the corner - it has halted and began to reverse the spread of human immunodeficiency virus (HIV). Oral fluid-based Rapid tests have potential advantages over blood-based tests hence the time is ripe for their use to scale up HIV screening and testing programmes. AIMS AND OBJECTIVES: To detect HIV using oral mucosal transudate (OMT) and to assess the sensitivity and specificity of the HIV Rapid test using OMT. SETTINGS AND DESIGN: OraQuick Rapid HIV-1/2 Diagnostic test was evaluated in sera and oral fluids from 83 subjects. MATERIALS AND METHODS: The study group comprised of 50 HIV seropositive subjects and the control group comprised of 33 seronegative subjects. Serum samples were collected using the standard phlebotomy technique and oral samples were collected using OraQuick Rapid HIV 1/2 Antibody test OMT collecting device. STATISTICAL ANALYSIS USED: The statistical analysis was done using statistical package for social sciences version 16.0, SPSS Inc., 233 South Wacker Drive, 11(th) Floor, Chicago, IL 60606-6412. The Sensitivity, specificity, positive predictive value, negative predictive value were used. RESULTS: All the subjects who tested either positive/reactive or negative/non-reactive with Western blot/enzyme-linked immunosorbent assay (ELISA) produced similar results with Rapid test using OMT in study, our study also revealed that the subjects whether on anti-retroviral therapy or not had 100% sensitivity and specificity with the Rapid test using OMT. CONCLUSIONS: The Rapid test using OMT is highly accurate as the diagnostic efficacy in our study was 100% for HIV antibody detection and produced similar results to that of conventional Western blot/ELISA tests.

Oral splint for temporomandibular joint disorders with revolutionary fluid system.

Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD). The purpose of this article is to review the Aqualizer™, an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient's pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world-wide web and pubmed/medline.