Volumetric Analysis and Healing Ratio: Refining Prognostic Assessment in Maxillofacial Cysts Using Cone-Beam Computed Tomography.

Introduction: Volumetric analysis with imaging techniques provides clinicians with the capability to visualize the spatial extent of the lesions. CBCT offers images with minimal radiation, facilitating a detailed assessment of cystic dimension's relationships. This crucial information helps in formulating appropriate strategies, including excision, enucleation, or nonsurgical approaches. The "Healing ratio" emerges as a valuable technique for prognostic evaluation. Materials and Methods: This retrospective study focused on outpatient cases with, clinic-radiologically diagnosed cases of odontogenic keratocyst or radicular cysts. Preoperative CBCT was utilized for volumetric analysis through MIMIC Software. Subsequent analyses were performed at 24 and 48 weeks postoperatively. The healing ratio was calculated for further correlation. Results: A total of 21 cases were included in the study, with a mean age of 36.67 years with predominance of males (72.6%, n = 16). Healing ratio estimation revealed minimal or no association with age, gender, and location on point-biserial analysis. Noteworthy implications were observed concerning total cyst volume and the specific diagnosis of the cyst. Results suggested more favorable healing outcomes in smaller cysts and those diagnosed as radicular cysts. Discussion: Proficiency in deciphering three-dimensional CBCT images accurately demands specialized training. The crux of our study lies in the application of volumetric analysis, particularly the "Healing Ratio," as a robust means of evaluating prognoses in management. The Healing Ratio, derived from three-dimensional imaging techniques, offers a comprehensive insight into the spatial dynamics of cystic lesions. Our findings underscore its significance as the optimal technique for prognostic assessment in the context of cyst management. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-024-02168-7.

Squamous cell carcinoma of mandible with unusual clinical presentation: A rare case report and review of literature.

Squamous cell carcinoma (SCC) is commonly seen malignant epithelial neoplasm of the oral cavity, which is characterized by variable clinical manifestations. It arises from dysplastic squamous epithelium. Majority of the spread of oral SCC (OSCC) to mandibular bone occurs by direct infiltration of the tumour through alveolar ridge or lingual cortical plate. Only 6% of the OSCC present with primary tumour; hence, a comprehensive whole body imaging needs to be done for ruling out primary tumour anywhere else in the body along with a proper clinical examination. Here, we present an unusual case of long-standing aggressive primary malignancy with unusual clinical presentation in mandibular anterior region associated with chronic tobacco chewing in a 65-year-old male patient.

Assessment of Relationship of ABO Blood Groups in Oral Cancer Patients - A Retrospective Study.

INTRODUCTION: India is a high-risk region for oropharyngeal cancer (OC) due to high prevalence of tobacco, betel nut, and alcohol and accounts for 30% of all new cases of oral cancer annually. MATERIALS AND METHODS: Records of all 73 diagnosed cases of different types of OC and oropharynx patients were analyzed who reported in "Tobacco cessation center"' of the Institute between January 2017 and December 2019. The patients' demographic details, blood groups, oral habits, and clinicohistological records were obtained from the medical records available in the hospital. RESULTS: OC incidence was 3.75 cases/year with male-to-female ratio 3.29:1. Mean age was 51.25 ± 13.6 years. The most common site of tumour presentation was mandibular alveolar ridge. Combined use of tobacco/betal nut/alcohol constituted the major cause for the development of oral squamous cell carcinoma (OSCC). Majority patients were presented in Stage II (43.8%). Histopathological reports were suggestive of maximally well-differentiated (52.1%) OSCC. People with blood group A+ve had 3.22 times higher risk of developing OSCC compared to people of other blood groups. DISCUSSION: Male: female ratio was reported higher than in most of other studies. Mandibular alveolus was the most frequent site because most of the patients tend to keep the tobacco quid in the buccal vestibule with close proximity to alveolus. The relative downregulation of glycosyl transferase that is involved in the biosynthesis of A and B antigens as seen in association with tumour development could be the reason for increased OC reported in blood group A subjects.

CBCT Evaluation of the Vital Mandibular Interforaminal Anatomical Structures.

BACKGROUND: Oral implants are considered safe in the mandibular anterior region, but complications often occur if vital structures such as inferior alveolar nerve, mandibular incisive canal (MIC), anterior mental loop (AL), or mental foramen (MF) are not properly identified. AIM: The aim was to evaluate vital anatomical structures in the mandibular interforaminal region and to investigate sexual dimorphism and differences with respect to left and right side regions using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Eighty CBCT scans (forty male and forty female) were analyzed for MF position and shape, presence and measurement of AL and MIC (both in mm), emergence patterns of mandibular canal, and symmetry of MF and AL. A pilot study was conducted on five patients to determine interobserver reliability among two oral and maxillofacial radiologists, considered for interpretation of CBCT images. All the scans were taken by CS 9300, CBCT machine adjusted at 80 kVp, 15 mA, voxel size 0.3 × 0.3 × 0.3, and field of view of 10 × 5 (mandible only). The acquired images were reconstructed into multiplanar views (axial, panoramic, and cross-sectional) for evaluation. RESULTS: The mean age of the study population was 42.64 ± 16.22 years, with males noted with slightly higher age. Position 4 of MF (below the apex of the second premolar) was noted the most on the right side, whereas position 3 (between the first and second premolars) was noted on the left side, with 75% of symmetrical MF position. The oval-shaped MF was most common among both genders and sides. The prevalence of MIC was noted in 93.75% of patients with a mean length of 12.09 ± 5.95 mm. The prevalence of AL was 53.13%, with a mean length of 1.07 ± 1.42 mm. No statistically significant sexual dimorphism (P > 0.05) was found between genders or sides for all the evaluated interforaminal parameters. CONCLUSION: CBCT evaluation of vital anatomical structures needs to be elicited before planning an interforaminal placement of implants, and no sexual dimorphism was found regarding them.

Gender determination by morphometric analysis of mandibular ramus in sriganganagar population: A digital panoramic study.

BACKGROUND: Mandible is a dimorphic, dense compact bone that makes it very durable and well preserved in mass disasters for personnel identification. Mandibular ramus morphometric measurements can be used for gender determination using orthopantomogram (OPG) or on dry mandibles. AIM: To determine gender from morphometric analysis of mandibular ramus of 200 digital OPG of patients from Sriganganagar population. MATERIALS AND METHODS: The study was conducted on randomly selected digital OPG of 200 patients of both genders between the ages of 21 and 70 years taken using CS8000C machine from daily OPD. Morphometric analysis of mandibular ramus (maximum ramus breadth, minimum ramus breadth, condylar height, projective height of ramus, and coronoid height) was done twice by single maxillofacial radiologist independently at an interval of 1 day and mean of both the values were considered. The collected data was tabulated and analyzed using SPSS Software version 20 using independent t-test and discriminant function analysis. RESULTS: Out of total 200 subjects, 37% were male and 63% were female. Mean of minimum ramus breadth, maximum ramus height, and projected ramus height was noted significantly more among males while maximum ramus breadth was noted slightly higher in females. The overall accuracy for determining sex from mandibular ramus was found to be 77.6%, whereas for determining male and female, the accuracy was 78.4% and 76.8%, respectively. CONCLUSION: Mandibular ramus can be used for sexual dimorphism by morphometric analysis done on OPG among Sriganganagar population.

Evaluation of mandibular anterior nutrient canals in hypertensive and diabetes mellitus patients: A comparative radiographic study.

OBJECTIVE: Radiographic evaluation of nutrient canals (NCs) in the mandibular anterior region using intraoral periapical radiographs (IOPARs) and to determine whether they can be used as a potential marker for hypertension (HT) and diabetes mellitus (DM). MATERIALS AND METHODS: Randomly selected 600 patients of 21-60 years age group (Group I: 200 HT; Group II: 200 DM; Group III: Healthy subjects) were considered. The case history was recorded including details for DM and HT (duration, type, and medication). Blood pressure was measured, followed by blood examination for blood sugar levels. Selected patients were subjected to IOPARs using CS-2100C machine by the paralleling technique. Selected radiographs were evaluated by two observers independently for the presence/absence, number, and location of NCs between #33 and #43. Data obtained were tabulated and subjected to statistical analysis using SPSS 20.0 statistical software and intergroup reliability was checked using Cohen's kappa test. RESULTS: Evaluation of various parameters of NCs showed an insignificant interobserver bias. The incidence of NCs presence was noted maximum in Group II (93.5%), followed by Group I (88.5%) and III (44.5%). Of total 888 NCs found, maximum were found in Group I, followed by II and III. On comparing the incidence of NCs present among both genders and location in study groups, no statistical correlation was found. CONCLUSION: Statistically significant increase in the incidence and number of NCs in Group I and II compared to controls can act as an adjunct diagnostic marker for the detection of DM and HT; although, no significant correlation was obtained between gender and location of NCs in different study groups. Furthermore, there was no significant correlation was found between the severity of disease and incidence of the presence of NCs.

Evaluation of sexual dimorphism using permanent maxillary first molar in Sri Ganganagar population.

AIM OF STUDY: The aim is to evaluate existence of sexual dimorphism by variation in right and left permanent maxillary molars using buccolingual width (BLW) and mesio-distal width (MDW) measured intraorally and on study casts among Sri Ganganagar population. MATERIALS AND METHODS: Fifty patients (25 males and 25 females) with 17-25 years of age were selected. Impressions of maxillary arch were taken and the BLW and MDW were measured using digital Vernier calipers on study casts and intraorally. RESULTS: Highly significant correlation was found between MDW and BLW of both the maxillary permanent first molars for both genders (P < 0.05) intraorally. The MDW and BLW on study cast of both sides in both gender were more on left side in males while on right side in females. CONCLUSION: Left maxillary permanent first molar showed minimum mean difference of measurements on study cast and introrally than right, thus better predictor for gender dimorphism in forensics.

Frequency and correlation of lip prints, fingerprints and ABO blood groups in population of Sriganganagar District, Rajasthan.

OBJECTIVE: To investigate the frequency and uniqueness of different lip print patterns, fingerprint patterns in relation to gender and ABO Rh blood groups among a semi-urban population of Sriganganagar, Rajasthan. MATERIALS AND METHODS: The study was conducted on 1200 healthy volunteers aged 18-30 years. The cheiloscopic and dermatographic data of each subject were obtained and were analysed according to the Suzuki and Tsuchihashi and Henry systems of classification, respectively. Two forensic experts analyzed the patterns independently. The ABO Rh blood group was also recorded for each subject. The Chi square statistical analysis was done and tests were considered significant when p value <0.001 and Cohen kappa test was applied to analyze inter-observer reliability. RESULTS: The B+ blood group was noted as most common in both genders while least common were A- among males and AB- in females. Type II lip pattern was most predominant while the least common was Type I' in males and Type I' and Type V in females. The UL fingerprint pattern was the most common, while RL was least noted in both genders. All the fingerprint patterns showed correlation with different lip print patterns. A correlation was found between different blood groups and lip print patterns except Type I (vertical) lip pattern. A positive correlation was observed between all the blood groups and fingerprint patterns, except for RL pattern. CONCLUSION: There is an association between lip print patterns, fingerprint patterns and ABO blood groups in both the genders. Thus, correlating the uniqueness of these physical evidences sometimes helps the forensic team members in accurate personal identification or it can at least narrow the search for an individual where there are no possible data referring to the identity of the subject.

Estimation of Salivary and Serum Biomarkers in Diabetic and Non Diabetic Patients - A Comparative Study.

INTRODUCTION: Blood is the gold standard body fluid for diagnosis of Diabetes Mellitus (DM) but saliva offers an alternative to serum as a biological fluid for diagnostic purposes because it contains serum constituents. AIM: The study was conducted to estimate and compare serum and salivary glucose, amylase, proteins, calcium and phosphorus levels in DM and healthy subjects and to evaluate whether saliva can be used as a diagnostic fluid in DM patients. MATERIALS AND METHODS: Study consisted of 120 subjects from OPD of Surendera Dental College, Sriganganagar, Rajasthan, India. The study groups were divided into Group I-60 DM patients (Type I & II) and Group II-60 healthy subjects. The saliva and serum samples were collected from each subject and levels of different biochemical parameters were estimated. RESULTS: Mean serum level of glucose (211.50 ± 43.82), amylase (79.86 ± 16.23), total proteins (6.65 ± 0.84), calcium (7.17 ± 0.91) and phosphorus (3.68±0.65) as observed in Group I while in Group II, glucose (88.81±11.29), amylase (77.67±14.88), total proteins (6.35±0.76), calcium (7.52±0.97) and phosphorus (3.96 ± 0.91) were noted. Mean salivary level of glucose (14.10±6.99), amylase (1671.42±569.86), total proteins (1.33±1.11), calcium (10.06±2.76) and phosphorus (13.75±4.45) as observed in Group I while in Group II, glucose (5.87± 2.42), amylase (1397.59 ±415.97), total proteins (1.36±0.81), calcium (7.73±2.78) and phosphorus (8.39 ± 1.95) were noted. On comparing values in saliva and serum, among two groups, an insignificant difference (p>0.005) was found between few of them. CONCLUSION: Values regarding blood and salivary biochemical parameters were distinctly different between two groups suggesting salivary parameters can be used as a diagnostic alternative to blood parameters for diabetes mellitus.

Morphological Variations and Biometrics of Ear: An Aid to Personal Identification.

INTRODUCTION: The morphological characteristics and dimensions of external ear vary in different human ethnic races which can be utilized in forensics for personal identification of living or deceased. AIM: To determine uniqueness of morphological and biometric variations of both ears for individualization among North East (NE) and North West (NW) subpopulation of India. MATERIALS AND METHODS: The study was conducted on randomly selected 80 students, 40 from each subgroup. Nine ear parameters were recorded twice using digital Vernier's caliper by single investigator and two indices (Ear Index and Lobule Index) were calculated for both the ears. Morphological ear shapes and lobule attachment were also noted. Pearson's coefficient correlation test was performed on cross-tabulations to evaluate significant relationship between different variables. RESULTS: Of the total 35% free and 65% attached ear lobes were noted in both population groups. Oval ear shape was most commonly noted followed by triangular, rectangular and round in both populations. On comparing anthropometric measurements of ears in two populations it was found that except the tragus length and lobule index all other values were noted more in NW population. No statistical difference was found in ear and lobular indices of males and females although the left ear index and lobule index were found to be higher than right in both populations except in NW females where right lobule index was recorded more than left. CONCLUSION: The results obtained can be used in anthropological and forensic sciences for the inclusion and exclusion of persons for identification on the basis of ear variations.

Radiographic Evaluation of the Status of Third Molars in Sriganganagar Population - A Digital Panoramic Study.

BACKGROUND: Third molar (M3) agenesis and impaction are associated with evolution, changed dietary habits, and human jaw growth. The aim of the study was to radiographically evaluate the prevalence of M3s agenesis, impacted M3s with different impaction patterns, and the approximation of Inferior Dental Canal (IDC) with impacted mandibular M3s roots among the Sriganganagar population. METHODS: The study included 700 randomly selected subjects from OPD with an age range of 25-45 years. Digital OPGs were taken for all subjects using Kodak 8000C digital OPG machine. The M3 impaction patterns were evaluated using Winter's classification. RESULTS: The prevalence of subjects with at least one M3 agenesis was found to be 34.1% and with 95% confidence interval was 30.6% to 37.6%. The overall M3s agenesis was 16.8% with more prevalence in the males. The patients with agenesis of one M3, two M3s, three M3s, and four M3s were 14.4%, 11.3%, 3.7% and 4.7%, respectively. M3 agenesis was more in the upper jaw and on the left side. The total impacted M3s were 21.11% with more prevalence in mixed diet subjects. Mesioangular was most common impaction pattern, and notching was most prevalent IDC relationship with impacted mandibular M3s roots. CONCLUSION: This study highlighted the evolutionary increasing M3 agenesis and the importance of diagnostic OPG for seeing the status of M3s in jaws.

Attitude of Indian dental professionals toward scientific publications: A questionnaire based study.

BACKGROUND: Due to competitiveness and academic benefits, most dental professionals feel an urgent need to increase their publications. Hence, we explored the attitude of students and faculty members toward scientific publications through a questionnaire. MATERIALS AND METHODS: A questionnaire consisting of 13 questions was sent by e-mails and posting the printed copies to dental postgraduate (PG) students (second and third year) and faculty members (n = 500 each). The returned completed questionnaires were analyzed. RESULTS: About 37% of dental PG faculty and 35.6% PG students responded to the questionnaire, with overall response of 72.6%. Among the PG faculty, professors (P) had more scientific publications, followed by senior lecturers (SL) and readers (R). The publications as first or corresponding author were less among both faculty and PG students while co-authorship was more among PG students compared to faculty members. Awareness about the term "plagiarism" was overall high and relatively highest among R, followed by SL, P and PG students. The percentage of publications in fee charging journals was more among PG students than faculty members and self-funding for publication was observed in 86.4% of PG students and 94-100% among faculty members. CONCLUSION: About 72.6% of dental professionals were involved in publishing of their research work and the number of publications increased steadily with an increase in their academic experience. All the dental professionals concurred publications as the criteria for academic excellence.

Combined use of frontal sinus and nasal septum patterns as an aid in forensics: a digital radiographic study.

BACKGROUND: Skull radiographic examination is a potentially useful procedure for the personal identification in cases where fragments of skull persist with no likelihood of identification based on dental arch. AIMS: The study was to determine the uniqueness and reliability of combined frontal sinus (FS) and nasal septum (NS) patterns as observed on posterioanterior (PA) cephalograms for personal identification. MATERIALS AND METHODS: The randomly selected 149 digital PA cephalograms taken on Kodak 8000C Digital Panoramic and Cephalometric system were evaluated for patterns of FS and NS. Also the distribution of lobulations, area, and ratio of height/width of FS was calculated. The data obtained was statistical analyzed using Pearson's coefficient correlation. RESULTS: FS symmetry was observed in 78.5% and asymmetry in 7.3% subjects. Bilateral aplasia was noticed in 5.3% and unilateral aplasia in 8.7% of subjects. The total lobulation of FS was noted more in males on both sides while center lobes were observed slightly more in females. The straight NS was maximally seen followed by reverse sigmoid. The mean ratio of width/height of FS was observed more in males and highly significant correlation was observed with both sexes. The mean area of FS was noted more in males. There was significant correlation found between patterns of NS and FS except in right dominated asymmetrical FS. CONCLUSION: The combined use of FS and NS patterns could be used as method for identification by exclusion in forensics.

Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity.

Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to primary or secondary hyperparathyroidism resulting in a local destructive phenomenon. The differential diagnosis based on histological examination is only presumptive. Clinical, radiological and laboratory data are necessary for definitive diagnosis. Here, we report a very rare case of brown tumor involving maxilla and mandible, which is the result of secondary hyperparathyroidism in 30-year-old female patient with chronic renal disease.

Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: A digital cephalometric study.

PURPOSE: The present study was aimed to investigate the variation of soft palate morphology in different age and gender groups. The correlations of radiographic velar length (VL), velar width (VW), pharyngeal depth (PD), and Need's ratio with soft palate variants were also studied in the North Indian subpopulation. MATERIALS AND METHODS: The study sample consisted of 300 subjects aged between 15 and 45 (mean: 31.32) years. The velar morphology on lateral cephalograms was examined and grouped into six types. The results obtained were subjected to a statistical analysis to find the correlation between variants of the soft palate with gender and different age groups. RESULTS: The most frequent type of soft palate was leaf shaped (48.7%), and the least common was crook shaped (3.0%) among both the genders and various age groups, showing a significant correlation. The mean VL, VW, and PD values were significantly higher in males and significantly correlated with the types of soft palate. A significant correlation was observed between the mean VL, VW, PD, and Need's ratio with various age groups, showing an inconsistent pattern with an increase in age. The types of soft palate, gender, and Need's ratio were also significantly correlated, with an overall higher mean value of the Need's ratio among female subjects and the S-shaped soft palate. CONCLUSION: The knowledge of a varied spectrum of velar morphology and the variants of the soft palate help in a better understanding of the velopharyngeal closure and craniofacial anomalies.

Facial talon cusp on mandibular incisor: a rare case report with review of literature.

Talon cusp is a relatively rare developmental dental anomaly thought to arise as a result of evagination on the surface of a tooth crown before calcification has occurred. It is characterized by cusp-like projections from the cingulum area, or cemento-enamel junction of maxillary or mandibular anterior teeth, in both the primary and permanent dentition, usually observed on the lingual surface of the affected tooth. The cusp may or may not contain an extension of the pulp. The etiology remains unknown. The incidence is 0.04-8%. Any tooth may have a talon cusp but most of the cases involve maxillary lateral incisors. The anomaly has been reported to be rare especially when it occurs on mandibular teeth. This article reports a case of talon cusp on permanent mandibular central incisor that too on facial aspect which makes it a rare entity.

Pleomorphic adenoma of cheek: a rare case report and review of literature.

Pleomorphic adenoma (PA) is the most common tumor of the salivary glands. About 90% of these tumors occur in the parotid gland and 10% in the minor salivary glands. The most common sites of PA of the minor salivary glands are the palate, followed by lips and cheeks. Throat, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity are rarely involved. Here, we report a case of PA of the cheek in a 42-year-old female. The mass was excised and the patient was followed for 3 years post operatively with no recurrence.

A comparative study of fluoride ingestion levels, serum thyroid hormone & TSH level derangements, dental fluorosis status among school children from endemic and non-endemic fluorosis areas.

The study was undertaken to determine serum/urinary fluoride status and comparison of free T4, free T3 and thyroid stimulating hormone levels of 8 to 15 years old children with and without dental fluorosis living in an endemic and non-endemic fluorosis area. A sample group of 60 male and female school children, with or without dental fluorosis, consuming fluoride-contaminated water in endemic fluoride area of Udaipur district, Rajasthan were selected through a school dental fluorosis survey. The sample of 10 children of same age and socio-economic status residing in non endemic areas who did not have dental fluorosis form controls. Fluoride determination in drinking water, urine and blood was done with Ion 85 Ion Analyzer Radiometer with Hall et al. method. The thyroid gland functional test was done by Immonu Chemiluminiscence Micropartical Assay with Bayer Centaur Autoanalyzer. The significantly altered FT3, FT4 and TSH hormones level in both group1A and 1B school children were noted. The serum and urine fluoride levels were found to be increased in both the groups. A significant relationship of water fluoride to urine and serum fluoride concentration was seen. The serum fluoride concentration also had significant relationship with thyroid hormone (FT3/FT4) and TSH concentrations. The testing of drinking water and body fluids for fluoride content, along with FT3, FT4, and TSH in children with dental fluorosis is desirable for recognizing underlying thyroid derangements and its impact on fluorosis.

Correlation of Lip Prints with Gender, ABO Blood Groups and Intercommissural Distance.

BACKGROUND: In forensics, the mouth allows for a myriad of possibilities. Lip print on glass or cigarette butt found at crime scenes may link to a suspect. Hence, a dentist has to actively play his role in personal identification and criminal investigation. AIMS: To investigate the uniqueness of the lip print patterns in relation to gender, ABO blood groups and intercommissural distance (ICD). MATERIALS AND METHODS: The study was conducted on 208 randomly selected students. The lip print of each subject was obtained and pattern was analyzed according to Tsuchihashi classification. The blood group and ICD at rest position was recorded for each. RESULTS: The study showed that Type II (branched) lip pattern to be most prominent. The B+ blood group was the most common in both genders and the ICD is higher in males. The lip print pattern does not show any correlation between ABO blood groups, gender, and ICD. CONCLUSIONS: The lip print pattern shows no correlation with gender, ABO blood groups, or ICD. Further studies with larger samples are required to obtain statistical significance of this correlation.