The Reliability of a New Device for Measuring the Maximum Bite Force.

OBJECTIVE: To test the inter- and intraexaminer reliability of a recently developed instrument for measuring the maximum bite force (MBF). Material and Methods. Sixty patients who were clinically confirmed as having Oral Submucous Fibrosis (OSMF) and 60 healthy controls were included in this study. For each subject, age, gender, weight, height, and body mass index (BMI) were recorded. The maximum bite force was recorded in alternate order with a bite force sensor (D1) and an occlusal force meter (D2). Bite force was measured in the first molar region. Pearson's correlation coefficient and kappa statistic were applied to assess the reliability between D1 and D2 in the assessment of maximum bite force. The independent t-test was performed to find the statistical significance between the two study groups. The paired t-test was applied to find out the difference between the right and left disease in groups of two devices separately. The one-way analysis of covariance (ANOVA) was performed to find the significant difference between grades of OSMF. RESULTS: The results of the kappa values were 0.8531 ± 0.0724 and 0.7336 ± 0.0737 for interdevice reliability in OSMF patients in right and left sides. Similar findings were obtained in right and left sides of healthy individuals (0.7549 ± 0.0816 and 0.9440 ± 0.0806) and in the total sample (0.8132 ± 0.0544 and 0.8303 ± 0.0538). Pearson's correlation coefficient between two devices revealed a high and significant positive correlation between D1 and D2 separately and in the whole sample. CONCLUSION: The observations of the present study suggest that the bite force sensor can be used as a reliable device for measuring bite force.

Multiple fibro-osseous lesions of the jaws: A report of a rare case with a literature review.

Fibro-osseous lesions are a poorly defined category of conditions affecting the jaws and craniofacial bones, and include developmental lesions, reactive or dysplastic lesions, and neoplasms. Fibrous dysplasia and ossifying fibroma are the 2 main types of fibro-osseous lesions affecting the jaw, and ossifying fibroma is a true benign neoplasm of the bone-forming tissues with several well-recognized variants ranging from innocuous to extensively aggressive lesions. However, multiple simultaneous fibro-osseous lesions of the jaw bones involving all quadrants are exceedingly rare. One such case diagnosed by conventional radiography and computed tomography is discussed here.

Dentinogenic ghost cell tumor-a rare case report with review of literature.

Dentinogenic ghost cell tumors (DGCT) are very rare tumors considered as solid variants of calcifying epithelial odontogenic cysts (CEOC). They are locally invasive neoplasms and their main characteristic features are ameloblastoma like odontogenic epithelial proliferation, an aberrant keratinization in the form of ghost cells and dysplastic dentin. DGCT occur as two forms intraosseous (central) and extra osseous (peripheral), of which more aggressive intraosseous variety requires careful monitoring and aggressive local resection to prevent recurrence. This paper discusses a case of a 14-year-old male patient with a complaint of swelling in his right mandibular premolar molar region since 4 months and missing permanent right mandibular canine and first premolar was also observed. The lesion was diagnosed with radiological, cytological and histopathological investigations which revealed it to be rarest entity.

Botulinum toxin in the management of head and neck disorders.

Botulinum toxin is a polypeptide protoxin synthesized by Clostridium botulinum that results in localized reduction of muscle activity by inhibiting acetylcholine release at the neuromuscular junction. In 2004, the US Food and Drug Administration approved its application in the treatment of various medical conditions, such as facial wrinkles, strabismus, cervical dystonia, blepharospasm, and hyperhidrosis. Later, its application extended to improving dental esthetics and gummy smile. It was found to be a safe and effective alternative to medical therapy to treat various head and neck disorders that have a neurologic component. In this review, we will highlight the mechanism of action and therapeutic benefits of botulinum toxin in the management of head and neck disorders.

Diverse imaging characteristics of a mandibular intraosseous vascular lesion.

Intraosseous vascular lesions of the maxillofacial region are rare, and the differential diagnosis of intraosseous vascular malformations from other jaw lesions can be challenging. In the present case, magnetic resonance imaging and three-dimensional computed tomographic angiography (CTA) was used for diagnosis, and the lesion was treated wih surgical excision. Diverse characteristics such as the "honeycomb" and "sunburst" radiographic appearances and the absence of major peripheral feeder vessels in the CTA were noted. Intraosseous vascular malformations have a varied radiographic appearance, and the nomenclature of these lesions is equally diverse, with several overlapping terms. Pathologists do not generally differentiate among intraosseous vascular lesions on the basis of histopathology, although these lesions may present with contrasting immunohistochemical and clinical behaviors requiring varied treatment strategies. This case report highlights the need for multiple imaging modalities to differentiate among vascular lesions, as well as to better understand the behaviors of these unique lesions.

Oral lesions and immune status of HIV infected adults from eastern Nepal.

OBJECTIVE: To document the prevalence, age and gender distribution of oral lesions in HIV infected adults and the influence of highly active antiretroviral therapy and correlate them to the immune status of the patients. MATERIALS AND METHODS: Oral lesions were diagnosed by a detailed physical examination by trained and calibrated examiners according to the case definitions established by the Oral HIV/AIDS research alliance. Demographic details, risk behavior patterns and oral symptoms and habits were collected by a questionnaire. RESULTS: 81 patients; 54 men and 27 women aged between 20 - 55 years participated in the study. A total of 49 patients; 60.5% had some oral lesion when examined. Oral candidiasis (21 %) and oral melanosis (21%) were the most common lesions, followed by linear gingival erythema, oral hairy leukoplakia, necrotizing ulcerative periodontitis/gingivitis, herpes labialis, parotid gland enlargement and reccurent apthous ulcers. Oral hairy leukoplakia was exclusively seen in men (p=0.018). All six cases of herpes simplex lesion were seen in non - anti retro viral group (p=0.073) while oral candidiasis was commonly noted in the anti retro viral group (p=0.073). Lowering CD4 counts had the strongest association with the prevalence of oral candidasis (p=0.012), pseudomembranous candidiasis (p=0.014) and oral hairy leukoplakia (p= 0.065). CONCLUSION: This study shows a high prevalence of oral candidiasis, melanosis, linear gingival erythema and oral hairy leukoplakia in the patients. Key words:HIV, AIDS, oral lesions, prevalence.

Schwannoma of the tongue: an unusual presentation in a child.

Schwannomas are benign tumors of nerve sheath and quite uncommon in the oral cavity. In contrast to the earlier reports in the literature, a confounding case of a lingual schwannoma presenting as a symptomatic and exophytic growth on the ventral surface of the tongue in a 12-year-old boy is discussed here.