Risk assessment for osteoradionecrosis of the jaws in patients with head and neck cancer.

OBJECTIVES: To identify the potential risk factors for the occurrence of osteoradionecrosis (ORN) of the jaws among patients who have been treated with radiotherapy for head and neck malignancy. METHODS: The study comprised of 231 patients treated with radiotherapy for head and neck malignancy at a tertiary referral center. The following details were recorded for each patient: age, gender, histopathological diagnosis, clinical staging, tumor site, treatment modality, radiation dose, radiation field, number of fractions, type of accelerator used, radiation area and duration of follow-up. Patient's tobacco, alcohol habit history, and history of extraction of teeth before/during/after radiotherapy were also noted. RESULTS: Thirteen patients had osteoradionecrosis (frequency 5.62%). Among the radiotherapy variables assessed, increased radiation area was found to be significantly associated with the occurrence of osteoradionecrosis. Among the 13 ORN cases, 10 (76.9%) had a history of tobacco consumption, 8 (61.5%) had a time interval between radiotherapy and occurrence of ORN of less than 1-year duration. CONCLUSIONS: We found a low cumulative incidence of osteoradionecrosis and a tendency to occur within a year of starting radiotherapy. Patients of older age, those with a prior tobacco habit may be considered more liable to develop osteoradionecrosis. A larger radiation field may also put patients at hazard for developing osteoradionecrosis.

Diagnostic Accuracy of Ultrasonography in the Assessment of Facial Fractures

Abstract Objective: To assess the diagnostic accuracy of Ultrasonography (USG) in diagnosing superficial facial fractures. Material and Methods: Patients visiting our facility with facial trauma and suspected fracture of the facial skeleton, those who had undergone CT scans, and conventional radiographic examinations and those who were conscious and cooperative were included in the study. All conventional radiographs, CT scans and ultrasound examinations were done during 0-20 days after trauma in all the patients Results: A total of 20 patients participated in our study, out of which 18 were male (90%) with a mean age of 34.4 years (range of 19-75 years). Eleven sites of the face were examined bilaterally in each patient, i.e., a total of 440 sites. Of these, 84 sites were found to be fractured according to the CT scan examination whereas conventional radiographs detected 59 and ultrasonography detected 74 fractures (of which 70 were true fractures, while 4 were false-positive results). The sensitivity and specificity of USG in all fracture sites were 83.33% and 98.88% respectively. The positive and negative predictive values were 94.59% and 96.17% respectively Conclusion: Ultrasound examination had a better sensitivity when compared to conventional radiography in detecting superficial facial fractures.

Role of salivary malondialdehyde in assessment of oxidative stress among diabetics.

AIMS: To evaluate and compare the salivary content of malondialdehyde (MDA) in patients with type 2 diabetes and control subjects. METHODS: We conducted a cross-sectional study among 30 freshly diagnosed subjects of diabetes mellitus and 30 volunteers with no diabetes mellitus. Serum and salivary MDS levels were evaluated among all the subjects. RESULTS: The mean serum MDA in group controls and diabetics was 0.95 ± 0.13 and 3.11 ± 0.42. The mean salivary MDA in group controls and diabetics was 0.26 ± 0.05 µmol/l and 0.81 ± 0.07 µmol/l. The mean serum and salivary MDA levels were significantly higher in group diabetics than control group (p < 0.001 and <0.001) respectively. There was significant positive strong correlation between serum and salivary MDA levels in both controls and diabetics groups (r = 0.857, p < 0.001 and r = 0.891, p < 0.001) respectively. CONCLUSION: MDA was detectable in saliva in both diabetic and control groups. There was a positive significant correlation between salivary and serum MDA in diabetic and control subjects. Hence, salivary MDA appears to be an indicator of serum MDA concentration.

Maffucci’s Syndrome: report of a case with oral manifestation / Síndrome de Maffucci: relato de caso com manifestação oral

Introduction: Maffucci’s Syndrome is a rare nonhereditary mesodermal dysplasia consisting of multiple haemangioma of the soft tissue and enchondromas, mostly affecting phalanges and long bones. The syndrome can also be associated with a variety of other benign and malignant tumors. Case report: Here we report a case of Maffucci’s Syndrome and haemangioma of lip and palate which is rare in this syndrome. This case report describes an 18 year old boy with multiple nodular soft tissue swellings involving the anterior hard palate and lower labial mucosa and bony abnormalities (enchondromas) involving the lower limb.

Introdução: A Síndrome de Maffucci é uma displasia mesodermal não hereditária rara. Consiste de múltiploshemangiomas de tecido mole e encondromas, a maioria afetando as falanges e os ossos longos. A síndromepode também estar associada a uma variedade de tumores benignos e malignos. Relato de caso: O presente trabalho apresenta um caso de Síndrome de Maffucci e hemangioma de lábio e palato, o que é raro nessa síndrome, descrevendo o caso de um garoto de 18 anos de idade com inchaços nodulares múltiplos de tecido mole envolvendo o palato duro anterior e a mucosa labial inferior, além de anomalias ósseas (encondromas)acometendo um membro inferior.

Recurrent desmoplastic ameloblastoma of the maxilla: a case report.

A case of desmoplastic ameloblastoma recurring within 2 months of curettage is presented. This tumour appeared in the premolar region of the left maxilla with involvement of the antrum. The 24-year-old female patient was initially treated by curettage with wide surgical margins. Later, partial maxillectomy was carried out followed immediately by iliac bone graft. The case was followed with periodic plain radiography and computed tomography. The presence of a pulpally infected premolar and the atypical radiographic appearance obscured the disease. The biologic profile of this tumour is not fully understood because of the limited number of reported cases, coupled with inadequate long-term follow-up. A review of the lesion with emphasis on the pathogenesis of recurrence is discussed.