Prevalence of Zygomatic Air Cell Defect using Orthopantomogram.

AIM: To determine the prevalence, radiographic appearance, variations, characteristics and establishing dominant location and type of zygomatic air cell defect (ZACD) among the North Indian population. MATERIALS AND METHODS: The panoramic radiographs of 2500 dental clinic outpatients were examined for the presence of ZACD for estimating the prevalence and characteristics of the ZACD. RESULTS: ZACD was found in 63 patients with a prevalence of 2.5% with male predominance. Unilateral (70%) and unilocular appearance (78%) of ZACD were the dominant patterns. Patients with ZACD had a mean age of 37.4 years and a range of 19-78 years. CONCLUSION: The prevalence of ZACD among the Indian population is in accordance with the other studies carried out in other populations of the world. So it is important for surgeons to assess location of ZACD before planning any surgical procedure in order to avoid intraoperative complications.

Ameloblastic Carcinoma: A Case Report.

Ameloblastic carcinoma is a rare malignant lesion with characteristic histologic features and behavior that dictates more aggressive surgical approach than that of a simple ameloblastoma. Here we present a case of ameloblastic carcinoma of the mandible in a 30-year-old male patient with a clinical course of typical aggressiveness and extensive local destruction.

Evaluation of masseter muscle hypertrophy in oral submucous fibrosis patients -an ultrasonographic study.

BACKGROUND: Oral submucous fibrosis (OSMF) is a chronic insidious disease of the oral mucosa, commonly seen in South East Asia. It occurs mainly due to the habit of quid or gutkha chewing. There is a clear dose dependent relationship between gutkha chewing and development of OSMF, also due to continuous chewing for larger intervals of time unnecessary forces are exerted on the muscles mainly the masseter muscle. So, the present study was done to evaluate the thickness of masseter muscle in OSMF patients and to compare it with normal patients. MATERIALS AND METHODS: The present study involved 50 subjects, 25 OSMF patients and 25 normal individuals. The thickness of masseter muscle was evaluated by ultrasonography (5-11mHz). RESULTS: There is a positive association between masseter muscle hypertrophy and OSMF (p-value 0.001). Thickness of masseter muscle was found to be more in OSMF patients as compared to control group and also thickness is more during contraction as compared to relaxation in both OSMF patients and normal individuals.

Estimation of serum lipids in patients with Oral Submucous Fibrosis in India.

OBJECTIVES: Oral submucous fibrosis (OSMF) is the most prevalent precancerous condition in India. Low levels of lipids serves as a marker and prognostic indicator in the early detection of oral precancerous and cancerous states. In spite of the high prevalence and its potential to undergo malignant transformation, this condition has not widely been investigated with respect to the serum lipid levels. In the present study, an attempt was made to analyze the complete serum lipid profile, total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and very low density lipoprotein (VLDL) cholesterol in OSMF and controls. MATERIAL AND METHODS: The study was conducted in 45 clinically and histopathologically diagnosed cases of OSMF and 45 age and sex matched controls. The complete lipid profile including TC, TG, HDL cholesterol, LDL cholesterol and VLDL cholesterol was analyzed. RESULTS: The serum lipid levels were significantly lower in the patients with OSMF than in the controls. When the values were compared between different disease stages, the maximum reduction of lipids was evident for stage 3 OSMF. From the present results, it is evident that the level of serum lipids decreases with progression of the disease. CONCLUSIONS: From these findings, it appears that the decrease in the lipid levels may be considered as a useful marker in the early diagnosis of oral premalignant condition like OSMF. Key words:Oral submucous fibrosis, lipids, premalignant condition.

Evidence based dental care: integrating clinical expertise with systematic research.

Clinical dentistry is becoming increasingly complex and our patients more knowledgeable. Evidence-based care is now regarded as the "gold standard" in health care delivery worldwide. The basis of evidence based dentistry is the published reports of research projects. They are, brought together and analyzed systematically in meta analysis, the source for evidence based decisions. Activities in the field of evidence-based dentistry has increased tremendously in the 21(st) century, more and more practitioners are joining the train, more education on the subject is being provided to elucidate the knotty areas and there is increasing advocacy for the emergence of the field into a specialty discipline. Evidence-Based Dentistry (EBD), if endorsed by the dental profession, including the research community, may well- influence the extent to which society values dental research. Hence, dental researchers should understand the precepts of EBD, and should also recognize the challenges it presents to the research community to strengthen the available evidence and improve the processes of summarizing the evidence and translating it into practice This paper examines the concept of evidence-based dentistry (EBD), including some of the barriers and will discuss about clinical practice guidelines.

Hypohidrotic Ectodermal Dysplasia (ED): A Case Series.

ECTODERMAL DYSPLASIA (ED) IS A RARE DISORDER WITH DEFECTS IN TWO OR MORE OF THE FOLLOWING STRUCTURES: the teeth and the skin and its appendages including hair, nails, eccrine, and sebaceous glands. Dental manifestations include hypodontia, complete anodontia or malformed teeth. The most common form of the ED syndrome is hypohidrotic ED and is usually inherited as an X-linked recessive trait. Female carriers may have a variable degree of clinical manifestations. The condition is thought to occur in approximately 1 in every 100,000 live births. Dental treatment for these patients varies on an individual basis. Children with ED are often treated dentally with conventional adult appearing prosthesis which are focused only on the oral manifestations of the syndrome. We are here reporting two classical cases of hypohidrotic ED with a review of the literature.

Knowledge, attitude, and behavior in managing patients with HIV/AIDS among a group of Indian dental students.

With increasing numbers of people with HIV/AIDS receiving oral dental care, dentists should have sufficient knowledge of the disease, and their attitude should meet professional expectations. HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing appropriate education on these topics. Accordingly, the aim of this study was to assess the HIV/AIDS-related knowledge and attitudes amongst the 460 dental students of the Institute of Dental Sciences, Bareilly (UP), India. A self-administered survey consisting of fifty-three structured questions was conducted with the students. Overall, the response rate was 79.7 percent. The total mean knowledge and attitudes scores were 78.8 percent (excellent) and 77.7 percent (positive). There was no statistically significant difference between the knowledge and attitude scores of males and females. Regarding oral manifestations, Kaposi's sarcoma and candidiasis were the most identified. The results indicated that the students' knowledge on HIV/AIDS generally increased as they progressed through the curriculum, but their utilization of all barrier techniques for infection control and clinical protocol lacked consistency and compliance. Hence, there is a need to address, more clearly, the students' misconceptions and attitudes towards the disease.

Oral diagnostics: an integral component to geriatric health care.

Aging is inevitable, every day we live we age. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. Oral health reflects overall well being for the elderly population. Compromised oral health may be a risk factor for systemic diseases commonly occurring in age. Diagnosis and proper treatment is essential for healthy aging. Timely diagnosis, appropriate treatment and regular follow-up of both oral and systemic diseases are a prerequisite for active aging. Oral diagnostics is a revolutionary development with high potential to replace other investigative modalities. Changing demographics, including the increase in life expectancy and the growing numbers of elderly, has focused attention on the need for dental research activities to be expanded for geriatric dentistry. This paper is aimed to shed light on the growing elderly population and their ailments. It also aims to create awareness among health care providers about oral diagnostics and their application in geriatrics.

Kocher debre semelaigne syndrome: a rare case report with orofacial manifestations.

Kocher Debre Semelaigne Syndrome is a rare syndrome with clinical manifestation of hypothyroidism associated with pseudomuscular hypertrophy. Very few cases have been reported on kocher-debre semelaigne syndrome in the literature with the incidence reported to be less than 10%. As per our knowledge; until now, only one case of oro-facial manifestations has been reported. Here we report one such case of Kocher debre semelaigne syndrome in an 11 year old boy, showing features of macroglossia, multiple impacted teeth, puffed lips and anterior open bite.

Hemifacial Hyperplasia: A Case Report.

Hemifacial hyperplasia is a rare developmental anomaly exhibiting asymmetric growth of one or more body parts. It is characterized by hyperplasia of tissues rather than a hypertrophy, so it is better to call it hyperplasia rather than hypertrophy. Hemifacial hyperplasia may be associated with deformities of the skeletal system, including macrodactyly, polydactyly, syndactyly, scoliosis, tilting of the pelvis, and clubfoot. Though the etiology is unknown, various factors have been described. To date, very few cases have been reported thus far, according to the data we have collected. Through literature search, hemifacial hyperplasia was often implicated on the right side compared to the left. In contrast, we describe a case of hemifacial hyperplasia on the left side of the face in this report. This is a rare presentation for the condition which is detailed in this case report of hemifacial hyperplasia in a 50-year-old female who presented with unilateral facial enlargement since birth.

Oral health behavior and HbA1c in Indian adults with type 2 diabetes.

Prevention and treatment of oral diseases and diabetes require persistent daily self-care, as there is a mutual association between periodontitis severity and level of diabetes control. In this questionnaire study, we investigated oral health behavior, attitudes, and knowledge of diabetes-related factors among 500 Indian adults with type 2 diabetes mellitus. The questionnaire asked about oral self-care, dental visits, self-perceived problems, and knowledge of the relationship between diabetes and oral health. The most recent glycosylated hemoglobin (HbA1c) value was obtained from patient medical records. Overall, 22% of participants reported twice-daily toothbrushing; women were more likely than men to brush twice daily (P< 0.001). With respect to age and diabetes control, participants aged 35-44 years with good diabetes control had the highest rate of twice-daily brushing (P< 0.001). Oral self-care and use of dental services were poor among participants. The present results indicate that Indians with type 2 diabetes need further promotion of oral self-care and regular dental checkups to compensate for their increased risk of oral disease.

Burning mouth syndrome: A diagnostic and therapeutic dilemma.

Burning mouth syndrome (BMS) has been considered an enigmatic condition because the intensity of pain rarely corresponds to the clinical signs of the disease. Various local, systemic and psychological factors are associated with BMS, but its etiology is not fully understood. Also there is no consensus on the diagnosis and classification of BMS. A substantial volume of research has been focused on BMS during the last two decades. Progress has been made but the condition remains a fascinating, yet poorly understood area, in the field of oral medicine. Recently, there has been a resurgence of interest in this disorder with the discovery that the pain of BMS may be neuropathic in origin and originate both centrally and peripherally. The aim of this paper is to explore the condition of BMS with the specific outcome of increasing awareness of the condition. Key words:Burning mouth syndrome, stomatodynia, oral dysesthesia, pain management.

Self-reported medical problems among dental patients in Western Uttar Pradesh, India.

Assessing the medical history of patients before any treatment is an essential aspect of the dentist's responsibility; however, many dental practitioners assume that their patients are systemically healthy so their medical history is often overlooked. The objective of this study was to determine the prevalence of self-reported medical conditions among a sample of dental school patients at the Institute of Dental Sciences, Bareilly (Uttar Pradesh), India. Detailed medical histories were taken from 3,786 new dental patients in an outpatient setting. The demographic data, medical status, and use of medications from the charts were analyzed. Thirty-eight percent of the total patients had a positive finding in their medical history for at least one systemic condition. The most commonly reported systemic condition was hypertension (15.2 percent) followed by diabetes (11.4 percent), and 26 percent of the patients were taking at least one medication daily. The results of this study reflect the medical complexity of the increasingly aging population.