Antibiotic prophylaxis before invasive dental procedures for patients at high risk of infective endocarditis - A systematic review.

Background: Clinical use of antibiotics prophylaxis (AP) for preventing infective endocarditis (IE) after invasive dental procedures is controversial. Expert consensus guidelines are inconsistent, either restricting its use to high-risk individuals or advising its use again. Objectives: To determine whether there is a genuine need for AP to prevent IE in high-risk patients undergoing invasive dental procedures. Methods: Online search was performed on PubMed, Science Direct, British Dental Journal and Cochrane Register of Controlled Trials. The methodological quality of each study was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen (17) clinical trials were included in the final analysis recruiting 2,410 patients (AP = 1,366; placebo = 1,044). Bacteraemia was detected in 302 AP patients (22.1%) and 362 placebo patients (34.7%). AP reduced the risk of bacteraemia by 49% (risk ratio: 0.51; 95% CI; 0.45 to 0.58; P = 0.0001). Conclusion: Although using AP for IE may be pragmatic and justified for high-risk patients undergoing invasive dental procedures, the evidence is inconclusive because post-procedural bacteraemia may not be a good surrogate marker for IE. Moreover, trials investigating the direct association between AP and IE are lacking due to low disease prevalence and high-cost challenges.

Gorham disease involving the maxillofacial bones: A perplexing entity.

Gorham disease is a rare disorder with progressive osteolysis which leads to the vanishing of bones. Its etiology and ideal management strategy are still an enigma. A case of Gorham disease involving the maxillofacial region in a 25-year-old male with an emphasis on etiology and diagnosis is discussed.

Betel quid oral lichenoid lesions: a hospital based cross-sectional study.

OBJECTIVE: The aim of this study was to assess the prevalence and risk indicators of betel quid oral lichenoid lesions in chewers. METHODS: A total of 1209 chewers were identified and categorized into three main groups based on the type of lesion: betel quid oral lichenoid lesions only, betel quid oral lichenoid lesions in association with quid-induced other oral mucosal lesions, and no lesions. Multinomial regression analyses were used to determine associations between dependent and independent variables. RESULTS: Betel quid oral lichenoid lesions were more common in individuals who chewed quid comprising both tobacco and areca nut, and in those who chewed it two to three, or greater than three, times a day. Betel quid oral lichenoid lesions + quid-induced other oral mucosal lesions were more likely to occur in females, and in individuals who chewed quid containing both tobacco and areca nut, in their processed and unprocessed forms, and greater than three times a day. CONCLUSION: The prevalence of betel quid oral lichenoid lesions was higher than that reported in previous studies conducted in India. Increase in the frequency and duration of quid chewing was associated with increased likelihood of developing these oral lichenoid lesions.

Carcinoma of Maxillary Sinus Masquerading as Odontogenic Infection.

Malignant tumours of maxillary sinus are rare. They are usually diagnosed in the late stages when they perforate the sinus walls. The presence of large air space in the maxillary sinus facilitates asymptomatic growth of the sinus malignancy. The clinical presentation of these tumours depends on the sinus wall involved by the disease. The medial wall is usually the first to become eroded, leading to nasal obstruction, epistaxis or discharge. Rarely, symptoms of maxillary sinus carcinoma can resemble dental infection and the affected patients may visit dental clinic seeking treatment. This report presents a case of carcinoma of maxillary sinus mimicking odontogenic infection. Computed tomographic findings explained the reason for the present lesion to masquerade as an inflammatory condition. The importance of advanced imaging modalities for prompt identification of such lesions is discussed.

Usefulness of salivary alpha amylase as a biomarker of chronic stress and stress related oral mucosal changes - a pilot study.

INTRODUCTION: Salivary biomarkers are suggested to provide a reliable, noninvasive and objective measurement of chronic psychosocial stress and helps in assessment of pivotal role of stress in causation or precipitation of multitude of health problems. OBJECTIVES: To evaluate the usefulness of salivary alpha amylase activity as an objective indicator of chronic stress and to find out any correlation between stress- related mucosal complaints and its levels. STUDY DESIGN: Study was conducted among 50 subjects suffering from chronic stress related problems and 50 non-stressed individuals who were screened with a psychometric questionnaire. Brief case history and oral examination was carried out and about one ml of unstimulated saliva was collected. Salivary alpha amylase levels estimated were compared between study and control group and between subjects with and without oral mucosal changes using non parametric Mann Whitney U test. RESULTS: There was statistically significant higher salivary alpha amylase levels in study group (p =.002) and salivary alpha amylase between the oral mucosal complaints group and without oral mucosal complaints group within the total study population were found to be statistically significant (p=0.045). CONCLUSIONS: Salivary amylase activity increases in patients with chronic psychosocial stress and may be used as a biomarker of chronic stress, but it may not be an indicator to suggest the development of stress related oral mucosal changes. Key words:Salivary biomarker, salivary alpha amylase, psychosocial stress, sympathetic nervous system, oral mucosal changes.

Hypoglossia Type 1A: report of a case and review of literature with focus on clinical investigations.

Hypoglossia is a rare entity which is reported sporadically. Hypoglossia has often occurred in an association with limb anomalies and, therefore, these cases have been grouped together as hypoglossia-hypodactylia within oromandibular limb hypogenesis syndromes. The literature on this condition is reviewed, and a case of hypoglossia has also been presented. An investigative protocol to aid in the treatment planning of a patient with hypoglossia has also been suggested.

Remodeling of the antegonial angle region in the human mandible: A panoramic radiographic cross–sectional study

Objectives: This study analyzed changes in the antegonial region in relation to age, gender, and dental status.Study design: A total of one thousand patients (five hundred males and five hundred females), who were prescribed panoramic radiograph for various purposes were included in the study. The patients were categorized according to age, gender and dentition status. Panoramic radiographs were traced and antegonial angles and depths were measured.Results: A trend of decrease in the antegonial angle and increase in antegonial depth with age was observed in both males and females. Furthermore there were differences between right and left side antegonial angle and depth, with left side angle more than right and right side depth more than left. There was a significant decrease in the values of antegonial angle and significant increase in the values of antegonial depth as the dentition status changed from completely dentulous to partially dentulous and from partially dentulous to completely edentulous state. Conclusions: The antegonial angle decreases with the advancing age and there by increases the antegonial depth.Similar trends are seen when teeth are lost. Further more there is an inherent asymmetry in the antegonial region in right and left side (AU)

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Oro-facial aspects of leprosy: Report of two cases with literature review

Leprosy is a chronic infectious disease affecting primarily the skin, peripheral nerves, respiratory system andthe eyes. Leprosy induces various types of clinical presentation affecting the patient´s immune response. Cellmediatedimmunity is considered to be the crucial defence against the disease and the magnitude of this immunitydefines the extent of the disease. The article presents two case reports of manifestations of leprosy inthe oro-facial region, with a brief review of various other important oro-facial manifestations of leprosy. Thefirst report deals with granulomatous nodules in the palate while the second report presents bilateral facialpalsy in leprosy patients. Both the reports gain importance due to rare oral manifestation in a borderline leprosypatient in the first case, while the second case presents a rare bilateral Bell´s sign. The role of the dentalprofession and especially the Oral Medicine specialist is of great importance in early diagnosis of oral lesions (AU)

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Remodeling of the antegonial angle region in the human mandible: a panoramic radiographic cross-sectional study.

OBJECTIVES: This study analyzed changes in the antegonial region in relation to age, gender, and dental status. STUDY DESIGN: A total of one thousand patients (five hundred males and five hundred females), who were prescribed panoramic radiograph for various purposes were included in the study. The patients were categorized according to age, gender and dentition status. Panoramic radiographs were traced and antegonial angles and depths were measured. RESULTS: A trend of decrease in the antegonial angle and increase in antegonial depth with age was observed in both males and females. Furthermore there were differences between right and left side antegonial angle and depth, with left side angle more than right and right side depth more than left. There was a significant decrease in the values of antegonial angle and significant increase in the values of antegonial depth as the dentition status changed from completely dentulous to partially dentulous and from partially dentulous to completely edentulous state. CONCLUSIONS: The antegonial angle decreases with the advancing age and thereby increases the antegonial depth. Similar trends are seen when teeth are lost. Furthermore there is an inherent asymmetry in the antegonial region in right and left side.

Oro-facial aspects of leprosy: report of two cases with literature review.

Leprosy is a chronic infectious disease affecting primarily the skin, peripheral nerves, respiratory system and the eyes. Leprosy induces various types of clinical presentation affecting the patient's immune response. Cell-mediated immunity is considered to be the crucial defence against the disease and the magnitude of this immunity defines the extent of the disease. The article presents two case reports of manifestations of leprosy in the oro-facial region, with a brief review of various other important oro-facial manifestations of leprosy. The first report deals with granulomatous nodules in the palate while the second report presents bilateral facial palsy in leprosy patients. Both the reports gain importance due to rare oral manifestation in a borderline leprosy patient in the first case, while the second case presents a rare bilateral Bell's sign. The role of the dental profession and especially the Oral Medicine specialist is of great importance in early diagnosis of oral lesions.

The prevalence of oral mucosal lesions in patients visiting a dental school in Southern India.

The purpose of the present study was to evaluate the prevalence of oral mucosal lesions in Manipal, Karnataka State, India. A total of 1190 subjects who visited the department of oral medicine and radiology for diagnosis of various oral complaints over a period of 3 months were interviewed and clinically examined for oral mucosal lesions. The result showed the presence of one or more mucosal lesions in (41.2%) of the population. Fordyce's condition was observed most frequently (6.55%) followed by frictional keratosis (5.79%), fissured tongue (5.71%), leukoedema (3.78%), smoker's palate (2.77%), recurrent aphthae, oral submucous fibrosis (2.01%), oral malignancies (1.76%), leukoplakia (1.59%), median rhomboid glossitis (1.50%), candidiasis (1.3%), lichen planus (1.20%), varices (1.17%), traumatic ulcer and oral hairy leukoplakia (1.008%), denture stomatitis, geographic tongue, betel chewer's mucosa and irritational fibroma (0.84%), herpes labialis, angular cheilitis (0.58%), and mucocele (0.16%). Mucosal lesions like tobacco-related lesions (leukoplakia, smoker's palate, oral submucous fibrosis, and oral malignancies) were more prevalent among men than among women. Denture stomatitis, herpes labialis, and angular cheilitis occurred more frequently in the female population.

Large erupting complex odontoma: a case report.

Odontomas are the most common odontogenic tumours. They are usually asymptomatic and are often discovered during routine radiography. We report a case of a large erupting complex odontoma that caused pain, infection and facial asymmetry. This case is significant as there are few reports of complex odontoma erupting in the oral cavity.

Idiopathic cervical resorption: a diagnostic dilemma.

UNLABELLED: Idiopathic cervical resorption is a rare form of external resorption, usually with no external signs, and can be misdiagnosed as dental caries or other types of tooth resorption. Here we report a case in which, during routine radiography, an asymptomatic lower right molar presented with a radiolucency at the cervical region, with no obvious aetiologic factor identified. CLINICAL RELEVANCE: This paper emphasizes the aetiopathogenesis and differential diagnosis of this rare and asymptomatic form of pathologic resorption, which can be encountered in dental practice.