Maxillary sporadic Burkitt's lymphoma associated with neuro-orbital involvement in an Indian male.

Burkitt's lymphoma (BL) is the fastest growing malignancy of the lymphoreticular system to affect humans and has a potential ability to double in size every day. A case of maxillary sporadic BL (sBL) associated with neuro-orbital involvement in an Indian male is presented. sBL initially presented as maxillary swelling with no obvious dental and periodontal changes. Histological specimen from incisional biopsy revealed a round cell malignant tumor and immunohistochemistry reactions favored nonHodgkin's lymphoma consistent with BL. Four weeks later, patient presented with orbital involvement as diplopia, sixth cranial nerve palsy, and medial rectus palsy. Chemotherapy regimen according to LMB 89 protocol was started. During chemotherapy regimen patient showed bradycardia and Babinski response, suggestive of central nervous system involvement. sBL associated with orbital involvement is extremely rare and only seven cases have been reported. Our case showed unusual presentation; despite the aggressive tumor did not show any common clinical, radiological, and hematological findings. We also discussed the role of oral medicine specialist, importance of early diagnosis, and prompt referral in management of maxillary sBL.

Glanzmann thrombasthenia associated with human immunodeficiency virus-positive patient.

Glanzmann's thrombasthenia (GT) is an autosomal recessive inherited platelet function defect characterized by normal platelet count, prolonged bleeding time and abnormal clot retraction. This disease typically presents in infancy or early childhood and has proven to have very good prognosis. In this case study, a 22-year-old GT patient who also developed human immunodeficiency virus (HIV) infection after sometime is reported. The patient showed oral manifestations of gingival hyperplasia and petechial lesions. Unfortunately the detection of both thrombasthenia and HIV were done at considerably late stages which contributed to a poor prognosis. The patient died of cardiopulmonary arrest secondary to HIV, thrombasthenia and thrombocytopenia. The importance of early detection, supportive care and communication between the general and oral physician in management of the GT is also discussed.

Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health.

BACKGROUND: Corticosteroids (Cs) are used widely for their anti-inflammatory and immunosuppressive properties. They have the potential to cause dramatic improvement as well as produce equally dramatic adverse effects. The clinical misuse like over prescription of the drug should be avoided. Long-term administration may cause many adverse effects leading to impaired oral health. Oral health is usually not considered during management of patients on long-term corticosteroid therapy. The aim of this study was to assess the oral health status and radiological changes in the jaw bones of the patients under long-term corticosteroid therapy. MATERIALS AND METHODS: Oral health of 100 patients under long-term corticosteroid therapy with a minimum of 3 months duration was compared with sex- and age-matched 100 healthy controls. The clinical examination included complete examination of the mouth and periodontal status. Radiographic evaluation of bone with the help of intra oral periapical radiograph and digital orthopantomograph and levels of serum calcium, alkaline phosphatase, and random blood sugar were assessed. 'Chi-square test', 'Kolmogorov-Smirnov test' and 'Mann-Whitney U test' were used for statistical analysis. P > 0.05 was considered significant. RESULTS: Patients on steroids exhibited significantly higher levels of candidiasis and clinical attachment loss of the periodontal ligament, probing pocket depth. Bone density was significantly lower in the study group than that in the control group. Random blood glucose was significantly higher and significant lower levels of calcium were observed in patients on steroids. CONCLUSION: Long-term use of Cs may affect oral health adversely leading to candidiasis as well as impair bone metabolism leading to a considerable decrease in the mandibular bone mineral density.

Basal cell adenocarcinoma of the minor salivary glands involving palate and maxillary sinus.

Basal cell adenocarcinoma (BCAC) is a rare neoplasm accounting for only 2.9% of all salivary gland neoplasms. BCAC involving palatal minor salivary glands are exceedingly rare, and only 10 cases have been reported in the literature. The treatment of choice is surgical excision. Here, we report a case of a 55-year-old male patient with massive BCAC of palatal minor salivary gland extending into the maxillary sinus. This is the first case of BCAC treated by radiotherapy followed by chemotherapy. A follow-up check conducted after 14-months showed good prognosis.

Adenoid cystic carcinoma of sublingual salivary gland obstructing the submandibular salivary gland duct.

Sublingual salivary gland malignancies are extremely rare and account for only 0.3-1% of all epithelial salivary gland tumors. Here, we report a case of adenoid cystic carcinoma (ACC) of the sublingual salivary gland that presented as a swelling in the right anterior floor of the mouth obstructing the submandibular duct. Sublingual salivary gland ACC obstructing the submandibular duct is rare and only three cases have been reported in the literature until date. We discuss the different patterns of ACC seen during the pathologic investigations and its radiologic features.

An Assessment of Antibacterial Activity of Four Endodontic Sealers on Enterococcus faecalis by a Direct Contact Test: An In Vitro Study.

Aim. To evaluate the antibacterial activity of four endodontic sealers on Enterococcus faecalis by a direct contact test. Material and Methods. Enterococcus faecalis was used as a test organism. Direct contact test which is based on measuring the effect of close contact between test bacteria and tested material on the kinetics of bacterial growth was performed to overcome the disadvantages of agar diffusion test. The sealers tested were zinc oxide eugenol-based sealer, glass-ionomer-based sealer, polydimethyl-siloxane-based sealer, and urethane dimethacrylate resin-based sealer. Data was collected by recording the optical density with the help of a spectrophotometer. Results. The sealers exhibited different inhibitory effects. The results obtained were subjected to statistical analysis by Kruskal Wallis analysis of variance and Dunn's multiple comparison test. Group comparison showed very highly significant difference between the groups. Conclusion. Zinc oxide eugenol-based sealer was the most effective and urethane dimethacrylate resin-based sealer was the least effective against Enterococcus faecalis, whereas glass-ionomer-based and polydimethyl-siloxane-based sealers were effective only for a short period. Inhibition of the bacterial growth is related to the direct contact of the microorganism with the sealer.

Odontogenic myxoma of the mandible.

Odontogenic myxomas are benign but locally aggressive neoplasms found almost exclusively in the jaws and arise only occasionally in other bones. We present a rare case of odontogenic myxoma occurring in the mandible of a 19-year-old male patient with a brief review of clinical and radiological features, and diagnostic and operative dilemmas in managing the same.