Efficacy of Aloe Vera and Clobetasol Propionate in the Management of Oral Lichen Planus: A Randomized Parallel Clinical Trial.

Objectives: The purpose of this randomized parallel clinical trial was to assess and compare the efficacy of 97% Aloe Vera (AV) gel and 94.7% AV juice against an active control (0.05% Clobetasol Propionate) in the treatment of oral lichen planus (OLP). Materials and Methods : Age and sex matched patients with histologically proven OLP were divided into two groups. One group received 97% AV gel for topical application and 10ml 94.7% AV juice to consume twice daily. The active control group received topical 0.05% Clobetasol Propionate ointment twice daily. Treatment lasted two months followed by four months of observation. Monthly evaluation of various clinical features of OLP was done using the OLP disease scoring criteria. Burning sensation was evaluated using Visual Analog Scale (VAS). Mann Whitney-U (followed by Bonferroni adjustment) and Wilcoxon's signed-rank tests were used for intergroup and intragroup comparisons, respectively. Interclass correlation-coefficient test was applied to assess the intra-observer variation (P<0.05). Results: In total, 41 females and 19 males participated in this study. The most common site was the buccal mucosa followed by the gingivobuccal vestibule. The reticular variant was most frequently encountered. Wilcoxon's signed-rank test showed significant differences in both groups between baseline and end-of-treatment for VAS, site-score, reticular/plaque/papular score, erosive/atrophic score and OLP disease score (P<0.05). Mann-Whitney revealed significant difference between both groups in the 2nd, 3rd and 4th months (P<0.0071). Conclusion: Clobetasol Propionate is more effective for OLP management but in our study AV proved to be a safe treatment alternative for OLP management.

Canalicular adenoma of the tongue: report of a unique case.

Canalicular adenoma (CA) is a rare, unique benign salivary gland neoplasm, which usually involves the minor salivary glands of the upper lip, buccal mucosa and palate. It is usually seen in middle-aged or older individuals, has a female predilection, and commonly presents as a painless, slow-growing, non-ulcerated nodule or swelling. Its treatment involves surgical excision or enucleation. This case report describes a case of CA of the ventrum of the tongue diagnosed in a 41-year-old male patient, which could possibly be the first reported case of this lesion involving the tongue.

Assessment of Hypoxia and Physiological Stress Evinced by Usage of N95 Masks among Frontline Dental Healthcare Workers in a Humid Western Coastal Region of India-A Repeated Measure Observational Study.

AIM: To assess the oxygen saturation in DHCWs using N95 and 3 ply surgical masks and determine the presence of any other subjective discomfort in them. SETTINGS AND DESIGN: A repeated measure observational study conducted at the Tertiary Care Dental Institute situated in Goa, a western coastal region of India recording humid conditions year around. METHODS AND MATERIAL: Participants constituted 60 frontline DHCWs wearing N95 masks and 60 DHCWs working in non-clinical setting wearing surgical masks. After completion of a self-administered questionnaire their oxygen saturation and pulse rate were monitored at baseline, 60mins and 120mins using pulse oximetry. Statistical Analysis: Mann Whitney u test compared oxygen saturation between the two groups. Friedmann and Wilcoxon signed rank test with Bonferroni correction computed differences within group at various time intervals. Binary logistic and linear regression was used to compare the study variables with outcome measure. p value was set at < 0.05. RESULTS AND CONCLUSION: Oxygen saturation reported a significant drop post one hour of wearing N95 masks which increased in the second hour. Prolonged use of N95 mask in humid environment adds to the body's physiological burden or perceptions of discomfort and exertion. Efforts need to be taken to address this for better compliance to the use of these protective gears.

A Case Report on Acanthomatous Ameloblastoma of the Anterior Mandible with Brief Review on Advanced Imaging Diagnosis.

Ameloblastoma is the most common benign odontogenic tumor of epithelial origin. It exhibits a locally aggressive behavior and high recurrence rate with multitude of factors involving in its molecular pathogenesis. This article reports a case of acanthomatous ameloblastoma involving the mandible in a 60-year-old male patient with peculiar imaging characteristics. The role of computed tomography and magnetic resonance imaging in diagnosis of conventional ameloblastoma has been elaborately emphasized in the discussion. Although the final diagnosis is based on histopathological features, physicians should be aware of the role of advanced imaging for diagnosis of ameloblastoma and for better surgical management.

Chronic Diffuse Sclerosing Osteomyelitis of the Mandible.

Chronic diffuse sclerosing osteomyelitis (CDSO) is a disease that presents a rather unusual clinicoradiographic picture creating diagnostic and therapeutic problems. Involvement of the temporomandibular joint is not frequently observed in CDSO. We report a unique case of a 37-year-old male with cyclic episodes of insidious swelling and progressive trismus for the past 4 years. Each episode was followed by spontaneous remission after 2 weeks. Radiographic examination detected unilateral coarse trabeculae with ground-glass appearance of the left hemimandible and resorption of ipsilateral condyle. Computed tomography demonstrated endosteal sclerosis, cortical thickening, and condylar resorption, while magnetic resonance imaging revealed altered marrow intensity with postcontrast enhancement of the surrounding musculature. Bone histopathology was consistent with the diagnosis of osteomyelitis. Palliative antibiotic therapy and regular follow-up were recommended. Of particular interest in the present case is ipsilateral condylar resorption not associated with any dermato-skeletal conditions, which is uncommon in CDSO of the mandible.

Pycnodysostosis: Clinicoradiographic Report of a Rare Case.

Pycnodysostosis is an uncommon autosomal recessive sclerosing bone disorder which is characterized by short stature and generalized diffuse osteosclerosis. Patients usually have a large head with separated sutures, open fontanels, aplasia of frontal sinuses, obtuse mandibular gonial angle, and acroosteolysis of the distal phalanges. This case report showed a 25-year-old female with features pathognomonic of pycnodysostosis. The emphasis is mainly on the early diagnosis as it has an important role in the general health of such patients and prevention of complications.

Glandular odontogenic cyst of the maxilla: a case report and literature review.

Glandular Odontogenic Cyst is a relatively rare cyst of odontogenic origin, which shows glandular or salivary features that are thought to indicate the pluripotentiality of odontogenic epithelium. It is seen in middle-aged adults, and commonly involves the anterior region of the jaws, especially the mandible. It shows non-specific clinico-radiographic findings which may resemble other lesions, but has characteristic histopathologic features which help in its diagnosis. This paper reports an unusual presentation of a glandular odontogenic cyst which was diagnosed in a 64-year old female in the posterior maxilla, along with a literature review of this cyst, especially the cases reported in India in the past.

Unicystic Ameloblastoma Presenting as a Multilocular Radiolucency in the Anterior Mandible: A Case Report.

Ameloblastomas are tumors of odontogenic epithelial origin. The term unicystic ameloblastoma is used to describe cystic lesions with clinico-radiographic features resembling an odontogenic cyst, but histologically showing the presence of ameloblastomatous epithelium lining part of the cyst cavity. A large majority of lesions are found in the mandible, and usually cause a painless swelling of the jaws. They can be radiographically subdivided into 'dentigerous' and 'non-dentigerous' types. The unicystic ameloblastoma is believed to be less aggressive than a solid/multicystic ameloblastoma, and thus has a more favorable response to enucleation and curettage. This case report presents a case of unicystic ameloblastoma with a multilocular radiographic appearance in the anterior mandible of a 45-year-old female patient, along with a literature review of the topic.

Fibrous Ankylosis of the Temporomandibular Joint in a Young Child.

Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disccondyle complex to the temporal articular surface that restricts mandibular movements, including fibrous adhesions or bony fusion between the condyle, disc, glenoid fossa, and articular eminence. The leading causes include trauma and infection. It can be a serious and disabling condition that leads to difficulties in mastication, swallowing, speaking, esthetics and oral hygiene. Disturbances of facial and mandibular growth and acute compromise of the airway invariably result in physical and psychological disability. Treatment should be initiated as soon as the condition is recognized, with the main objective of re-establishing joint function and harmonious jaw function. The purpose of this report is to describe a case of unilateral fibrous ankylosis of the right TMJ in a three-year-old girl.

Myxosarcoma of the maxilla - a case report.

Myxosarcoma is a rare malignant neoplasm of connective tissue which is characterized by tissue that resembles primitive mesenchyme, and contains relatively undifferentiated cells that show rapid growth and invasion. The cells are stellate or spindle-shaped and are present in a loose matrix which contains mucoid material, reticulum, and collagen fibers. This paper reports a rare case of a myxosarcoma of the left maxilla in a 50-year-old male, which clinically presented as a soft-tissue mass on the buccal gingiva and radiographically showed a mixed radiolucent-radiopaque appearance.

Gender determination from pulpal tissue.

OBJECTIVE: To evaluate the diagnostic performance of X (Barr body [BB]) and Y (F body [FB]) chromosomes observed in dental pulp tissue for gender determination of an individual. MATERIALS AND METHODS: The study was carried out on 100 teeth (50 male and 50 female), which were indicated for extraction. The teeth were sectioned at various intervals (within 12 h to 49 days post-extraction), and the pulpal tissue was obtained. Two slides for each pulp tissue were prepared, one for 5% Quinacrine dihydrochloride stain (FB) and the other for Hemotoxylin and Eosin stain (BB). The slides were then observed under the fluorescent microscope for FB and under the light microscope for the BB respectively. RESULTS: Gender determination from human pulp is possible up to 7 weeks. The percentage of FB and BB decrease gradually as the time interval increases. Further, an equation was derived from the data based on the canonical discriminant function coefficients. CONCLUSION: The determination of gender based on a joint search for the presence or absence of X (BB) and Y (FB) Chromosome is a reliable and cost-effective technique.

Ameloblastoma: A clinicoradiographic and histopathologic correlation of 11 cases seen in Goa during 2008-2012.

OBJECTIVES: The purpose of this case series was to compare the clinical, radiographic, and histopathologic features of 11 cases of ameloblastoma that reported to the Goa Dental College and Hospital over a period of 4 years from January 2008 to December 2012. STUDY DESIGN: Data with respect to the patients' ages, sex, location of lesions, radiographic features, histopathologic features and surgical treatment and follow-up, was analyzed. RESULTS: The mean age in males was 23.25 ± 6.99 years, while that in females was 43.43 ± 17.13 years. Seven (63.63%) of the 11 subjects were females, and four (36.36%) were males. 10 (90.9%) of the 11 ameloblastomas were located in the mandible. Swelling was noted in all 11 patients. 10 cases showed radiographic findings, while one case was a peripheral soft-tissue variant. Seven (70%) of the 10 tumors were multilocular with a well-demarcated corticated border, and three cases (30%) were unilocular. Two cases showed a soap-bubble appearance. Histologically, five cases were unicystic, four were multicystic, one was desmoplastic and one was a peripheral variant. Follow-up ranged from 12 to 34 months and there were no signs of recurrence in any of the patients. CONCLUSIONS: Ameloblastomas more commonly occur in females at an older age, as compared with males. Radiographic features that could help in diagnosing ameloblastomas include its predominant occurrence in the mandible, multilocular radiolucency with well-defined, corticated, scalloped margins, expansion of buccal and lingual cortical plates, root resorption and tooth displacement.

Accuracy of age estimation methods from orthopantomograph in forensic odontology: a comparative study.

Changes related to chronological age are seen in both hard and soft tissue. A number of methods for age estimation have been proposed which can be classified in four categories, namely, clinical, radiological, histological and chemical analysis. In forensic odontology, age estimation based on tooth development is universally accepted method. The panoramic radiographs of 500 healthy Goan, Indian children (250 boys and 250 girls) aged between 4 and 22.1 years were selected. Modified Demirjian's method (1973/2004), Acharya AB formula (2011), Dr Ajit D. Dinkar (1984) regression equation, Foti and coworkers (2003) formula (clinical and radiological) were applied for estimation of age. The result of our study has shown that Dr Ajit D. Dinkar method is more accurate followed by Acharya Indian-specific formula. Furthermore, in this study by applying all these methods to one regional population, we have attempted to present dental age estimation methodology best suited for the Goan Indian population.