Giant arteriovenous malformation of the face and upper lip.

A 35-year-old male patient reported with the chief complaint of a large swelling in the right side of the upper lip. The lesion measured 6.5 cm measuring from the infraorbital region to the lower border of mandible on the right side of the face and 7.5 cm from the right ear lobule to the contralateral commissure of the left side of the face. On palpation, the swelling was soft, fluctuant and compressible. Pulsations were felt, and on auscultation, bruit was also heard. Computed tomography angiogram of the neck and circle of Willis showed serpiginous hyperdense vascular channels causing significant soft-tissue thickening of the upper lip, right cheek region and philtrum. Hence, the diagnosis of diffuse subcutaneous facial arteriovenous malformation involving the right cheek and philtrum was given. The entire lesion was excised. In the postoperative 2nd month, secondary cosmetic correction or lip reconstruction was done. The patient was reviewed after 3 years; there was no recurrence of the lesion.

Nonsyphilitic occurrence of mulberry molars: A rare case report.

Developmental defects of enamel may range from slight abnormalities of the tooth's color, shape and size to a complete absence of the enamel. Permanent first molar may show large variations in their morphological features and forms. Such changes may be in the form of anomalous cusps or variations in the occlusal surface showing globular shaped additional cusps and also increased in number of roots. However, to the best of our knowledge, this is the first nonsyphilitic case with the occurrence of multiple globular cusps. In the present case, occlusal anatomy is abnormal, with numerous disorganized globular projections involving all four permanent first molars. The projections of 2 mm × 2 mm in size and globular in shape were seen in the maxillary and mandibular cast. The features resemble the surface of mulberry and hence diagnosed as mulberry molars.

Stress recognition in dental students using smartphone sensor and a software: A pilot study.

AIMS AND OBJECTIVES: A dental student in his/her life goes through several academic stresses. Mild stress may be beneficial in cognitive tasks and performance, while persistently high stress may lead to anxiety and depression. Thus, the aim is to compare the stress levels in students appearing for previva and postviva during university examinations. MATERIALS AND METHODS: The study was carried out on 70 3rd year Bachelor of Dental Surgery students who were appearing for their university practical examination. Heart rate, oxygen saturation and stress levels were measured using Android S-HEALTH software. The data were compared and tabulated. Results obtained were statistically analyzed using paired "t"-test. RESULTS: Heart rate, oxygen saturation and stress levels were statistically high in previva of all the students. CONCLUSION: It can be concluded that examination is a situational stress resulting in anxiety due to increased levels of plasma cortisol reflected by an increased heart rate, oxygen saturation and stress levels. It is important for students to use stress-reducing measures or to reduce them as much as possible to avoid factors that can affect themselves and their patients in stressful way.

Significance of micronuclei in buccal smears of mobile phone users: A comparative study.

AIMS AND OBJECTIVES: The present study was designed to evaluate the frequency of micronuclei (MN) in the buccal exfoliated cells of mobile phone users. In addition, comparison of MN frequency between high and low mobile phone users was also done. MATERIALS AND METHODS: A total of 30 male and 30 female participants between the age group of 20-28 years were selected from the Outpatient Department of Navodaya Dental College and Hospital, Raichur, Karnataka. The participants were divided into two groups: Group A - low mobile phone users and Group B - high mobile phone users. Cell sampling and preparation was done on the slide. All the slides were observed for a total of 1000 cells for the presence and number of MN in each cell. RESULTS: There was a significant increase in the mean MN count in Group B in comparison to the Group A. There was highly significant difference in the mean MN count of participants using (code division multiple access) CDMA than (global system for mobiles) GSM mobile phones. The MN mean count was found to be significantly increased in nonheadphone users in comparison to headphone users. In Group B, the MN count on the side of mobile phone use was found to be statistically significantly elevated in comparison to the opposite side. CONCLUSION: Mobile phone radiation even in the permissible range when used for longer duration can cause significant genotoxicity. The genotoxicity accentuates when mobile phones are frequently used on the same side which may be due to more amount of radiation and increase in the temperature. Headphone usage reduces the genotoxicity of mobile phone radiation to some extent.

Assessment of reactive gingival lesions of oral cavity: A histopathological study.

BACKGROUND: In the literature, many studies were attempted to analyze the distribution of oral reactive lesions in terms of age, gender and location. However, very few studies have focused on the detailed histopathological features of these reactive lesions of oral cavity. Thus, the purpose of this paper is to document the occurrence, distribution and various histopathological features of reactive gingival lesions. MATERIALS AND METHODS: This study is a retrospective archival review of reactive gingival lesions of oral cavity such as irritational fibroma (IF), inflammatory gingival hyperplasia (IGF), pyogenic granuloma (PG), peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma involving gingival tissues. All the cases were histopathologically reviewed on some microscopical parameters according to the criteria given by Peralles et al. RESULTS: Regarding epithelial morphology, atrophy, ulceration and hyperplasia were found predominantly in PG. Connective tissue was predominantly dense in IGF and IF with fibroblastic proliferation; whereas loose connective tissue was seen in PG. Vascular proliferation, especially capillary, was commonly present in PG and inflammatory gingival hyperplasia (IGH). Inflammatory cell infiltrate was intense in both PG and IGH. Mineralization showed a marked affinity for peripheral cement-ossifying fibroma, and bone/bone-like areas were found in about ten cases of them. The Foreign body type of multinucleated giant cells was found exclusively on PGCG. CONCLUSION: Despite their clinical similarities, the findings of this study reports that all reactive gingival lesions show some differences in age, type, location, duration and histopathological features. Nevertheless, the differing histological pictures are a range of a single lesion in diverse stages of maturation. Essential in the treatment of reactive lesions is the total removal of the lesion with local irritants such as defective restorations or calculus formation.

A Rare Case of Twinning Involving Primary Maxillary Lateral Incisor with Review of Literature.

Twinning is referred to the development of two separate teeth that arose from the complete separation of one tooth bud. To the best of our knowledge very few cases of twinning in primary or permanent dentition have been previously reported. Here, we report an additional case of twinning involving primary maxillary left lateral incisor and a literature review of clinical and radiographic findings of previous reported cases of gemination and twinning is also discussed. A six-year-old male patient reported to the dental clinic with the complaint of decay in the left front teeth region of the upper jaw. On clinical examination, dentinal caries was observed on the labial surface of primary maxillary left lateral incisor. The tooth showed a deep groove present in relation to the labial surface and incisal edge and continued cervically as a shallow groove. The patient had normal compliment of teeth for his age. The intra-oral periapical radiograph of the maxillary anterior region revealed large crown and a radiolucent notch was observed in relation to the incisal edge of the maxillary left primary lateral incisor. Relatively one pulp chamber and two root canals were observed in relation to the primary maxillary left lateral incisor, which was suggestive of a case of twinning involving primary maxillary left lateral incisor. This present case is the first case report of twining seen in primary dentition.

Angiosarcoma of Anterior Mandibular Gingiva Showing Recurrence - A Case Report with Immunohistochemistry.

Angiosarcomas of oral cavity and salivary gland represent 1% of all cases reported in the literature and are therefore considered as extremely rare. To the best of our knowledge very few cases of angiosarcomas involving mandibular gingiva have been reported previously. Here, we report a case of angiosarcoma occurring in the gingiva with review of literature on clinical features. A 30-year-old female patient presented with a complaint of a small growing mass in relation to lower front teeth. Intraoral examination revealed a soft sessile growth arising from the labial gingiva in relation to 31 and 41 on the labial aspect extending distally to 32. The lesion was locally excised. Histolopathological analysis showed that the tumour was composed of spindle shaped to polygonal cells with hyperchromatic nuclei, conspicuous nucleoli and intracytoplasmic vacuoles, mitotic figure were also scattered. Immunohistochemical staining revealed that the tumour cells was positive for factor VIII-related antigen, CD31 and CD34. An excisional biopsy showed a diagnosis of angiosarcoma. After two months patient reported back with the same chief complaint. This present case is a 17(th) case report of angiosarcoma arising in anterior mandiblular gingiva.

Role of human papillomavirus and tumor suppressor genes in oral cancer.

The incidence of oral cancer remains high and is associated with many deaths in both Western and Asian countries. Several risk factors for the development of oral cancer are now well known, including smoking, drinking and consumption of smokeless tobacco products. Genetic predisposition to oral cancer has been found in certain cases, but its components are not yet entirely clear. In accordance with the multi-step theory of carcinogenesis, the natural history of oral cancer seems to gradually evolve through transitional precursor lesions from normal epithelium to a full-blown metastatic phenotype. A number of genomic lesions accompany this transformation and a wealth of related results has appeared in recent literature and is being summarized here. Furthermore, several key genes have been implicated, especially well-known tumor suppressors such as the cyclin-dependent kinase inhibitors, TP53 and RB1 and oncogenes such as the cyclin family, epidermal growth factor receptor and RAS. Viral infections, particularly oncogenic human papillomavirus subtypes and Epstein-Barr virus, can have a tumorigenic effect on oral epithelia and their role is discussed, along with potential therapeutic interventions. A brief explanatory theoretical model of oral carcinogenesis is provided and potential avenues for further research are highlighted.

Comparison of honey with ethanol as an oral cytological fixative: A pilot study.

INTRODUCTION: The fixation of cytological smears using ethanol is the gold standard. But, there exists a quench to search a new alternative for it due to it being expensive, carcinogenic and not freely available. Honey has various properties, like dehydrant, anti-bacterial and antioxidant. The use of honey as a preservative in funerary practices is well documented. A thorough search in the literature did not reveal any matter for the utility of honey as a fixative in cytological smear, but its use in histopathology is well recognized. AIMS: To analyze the efficacy of cytological smears fixed in ethanol and 20% unprocessed honey and to compare the efficacy between the two fixatives. MATERIALS AND METHODS: The study group comprised of 30 normal healthy individuals who willingly gave written consent. Prior to the collection of buccal cells, subjects were asked to rinse their mouth with water. Buccal cells were collected using a wooden ice cream stick. Two smears were collected from each subject. One smear was fixed in ethanol and the other was fixed in unprocessed 20% honey. The slides were washed in tap water for about 30 s, following which they were subjected to the conventional Papanicolaou staining procedure. The slides thus fixed were evaluated separately for ethanol and honey. The cytoplasmic and nuclear details were scored for 50 cells in each slide. Data were statistically analyzed using the chi-square test and P < 0.05 was considered statistically significant. RESULTS: Ninety percent of the ethanol-fixed (EF) smears were adequately fixed as compared with the honey-fixed (HF) smears, which were 80% adequate. The P-value obtained was 0.47 and the data were statistically insignificant. CONCLUSION: Both EF and HF smears were at par with each other, and honey can be safely used as a substitute to ethanol.

Squamous cell carcinoma of submandibular salivary gland: A rare case report.

Malignant tumors of submandibular salivary gland are rare in occurrence. Squamous cell carcinoma of salivary glands accounts for about 0.9-4.7% of all salivary gland tumors with a predilection to occur in parotid gland due to perinodal involvement. Primary squamous cell carcinoma of submandibular salivary gland accounts to about 2% of the tumors and hence it is being represented for its rarity.