Clinicopathological Evaluation of Tobacco-related Oral Mucosal Lesions.

AIM: To clinically evaluate the nature of precancerous and cancerous lesions associated with tobacco consumption habit and to correlate clinical profile with the histopathological findings of clinically suspected precancerous and cancerous lesions. MATERIALS AND METHODS: These included the examination of patients who visited the outpatient department (OPD) of the institute that includes 1,500 patients who had tobacco chewing habits were classified into the following two groups according to their characteristics. The study group comprised 270 patients, of which 170 gave consent for biopsy and 100 patients who not gave consent were counseled for tobacco cessation. RESULTS: Among 270 patients, the highest number of patients, 146 (54.07%) patients, were found to be smokeless tobacco consumers followed by 65 (24.07%) patients who were smoked tobacco consumers while 59 (21.85%) patients were found to have both the habits. Wide variation was noted in duration and frequency of habit. Most prevalent site was the buccal mucosa affected in 138 (51.11%) patients who consumed both smoked as well as smokeless tobacco. And on clinical examination, 138 (51%) patients had leukoplakia followed by 54 (20%) patients with oral squamous cell carcinoma and 40 (15%) patients with oral submucous fibrosis (OSMF). Other patients were tobacco pouch keratosis 17 (6%), smoker's melanosis 8 (3%), smoker's palate 7 (3%), and erythroplakia 6 (2%). The patients who gave consent (170 patients) were evaluated histopathologically to correlate with clinical findings. CONCLUSION: Tobacco-related oral lesions are also high, which brings an alarming signal toward the development of cancer. Our contribution as healthcare providers can be made by conducting more oral health education programs and educating the general population about the adverse effects of tobacco. The appropriate clinical assessment and categorization of all these lesions aided us in motivating patients to undergo necessary treatments and also to discontinue their habits in order to prevent deterioration of their conditions. CLINICAL SIGNIFICANCE: Set up de-addiction centers in dental colleges and help tobacco users in discontinuing their habits. Interestingly, this study also served as a mirror for those patients who were unaware of the lesions they were giving abode to in their oral cavities.

Quantitative Assessment of apically Extruded Bacteria using different Instrumentation Techniques and Preparation Taper.

BACKGROUND: Cleaning and shaping of the pulp canal is one of the most important steps of endodontic therapy. Serious complications occur by the apical extrusion of bacteria during the instrumentation procedures. Both crown-down (CD) and full-length linear motion (FM) techniques are routinely used as a component of taper rotary instrument procedures for achievement of thorough cleaning and shaping of the pulp canal space. Hence, we aimed for this study to assess the change in the amount of apically extruded bacteria using CD and FM instrumentation techniques produced by differences in taper between the instruments used during biomechanical preparation of root canals. MATERIALS AND METHODS: The present study included assessments of 132 extracted maxillary central incisor teeth. To achieve a uniform teeth length of 21 mm, the height of the tooth crown was reduced for preserving the coronal portion of teeth. A modified glass vial model was constructed for the estimation of amount of bacterial extrusion through the apical region. For filling of each pulp canal specimen, 20 mL of Enterococcus faecalis suspension was used followed by the use of a number 10 K-file for carrying the bacteria down the lengths of pulp canals. All the contaminated teeth specimens were divided into six study groups with groups I to III containing specimens prepared in the CD manner, while groups IV to VI contained specimens prepared in the FM manner. Six teeth were taken as negative control with three specimens with each technique, and another six specimens were taken as positive controls. Cultivable bacterial counts were determined by evaluating 100 mL saline solution from each vial followed by its inoculation on blood agar. All the colony-forming unit (CFU) values were log-transformed (base 10), and the results were analyzed by Statistical Package for the Social Sciences software. RESULTS: A significantly lower quantity of CFU values was observed during CD instrumentation procedures with 0.02 files in comparison with all other study groups. However, while comparing both the instrumentation procedures when different taper files, other than 0.02 taper, were used for biomechanical preparation of root canal, nonsignificant results were obtained. CONCLUSION: With 0.02 taper preparations, significantly less amount of extrusion of bacteria is associated when done with CD technique. CLINICAL SIGNIFICANCE: No change in the amount of apical extrusion of bacteria will be seen by changing the type of instrumentation procedures. Amount of bacteria extruded can be minimized using 0.02 taper. Key words: Bacteria, Instrumentation, Taper.