Prevalence of oral mucosal lesions among chewing tobacco users: A cross-sectional study.

CONTEXT: The increasing use of chewing tobacco (CT) in the last 10-12 years has led to an increased incidence of potentially malignant oral disorders and frank oral malignancies. AIM: To determine the frequency of oral mucosal lesions and to correlate the dose-response relationship among CT users of Bengaluru North province. SETTINGS AND DESIGN: This population-based cross-sectional study was conducted among a randomized cluster sample of adults in low-income group (slums), of Bengaluru North, Karnataka state, India. MATERIALS AND METHODS: Nine hundred and one subjects, all CT users were surveyed in this cross-sectional study. A prestructured questionnaire which included information on type and amount of CT used, duration and frequency of use, and location of placement of tobacco in the oral cavity was used for assessment, which was followed by oral examination for the presence of lesions. STATISTICAL ANALYSIS USED: Chi-square and Fisher's exact tests were used to assess the statistical significance. RESULTS: Of the 901 subjects with CT habits, 55.8% revealed no clinically detectable oral mucosal changes and 44.1% showed mucosal changes of which 63.8% were males and 36.1% were females. The most common finding was chewers mucositis (59.5%) followed by submucous fibrosis (22.8%), leukoplakia (8%), lichenoid reaction (6.5%), oral cancer (2.7%), and lichen planus (0.5%). CONCLUSION: This study provides information about different CT habits and associated mucosal lesions among this population.

Comparison of the efficacy of conventional radiography, digital radiography, and ultrasound in diagnosing periapical lesions.

OBJECTIVES: The aim of this study was to evaluate the efficacy of conventional radiography, digital radiography and ultrasound imaging in diagnosing periapical lesions. STUDY DESIGN: Twenty-one patients aged between 15 and 45 years with well defined periapical radiolucency associated with anterior maxillary or mandibular teeth requiring endodontic surgery or extraction were selected and consented to the study. Preoperative intraoral periapical radiographs and digital images using charge-coupled device obtained by paralleling technique were assessed by 3 specialist observers who gave their diagnosis of the periapical lesions. Then ultrasound examination was performed and the images were assessed for size, contents, and vascular supply by 3 ultrasonographers. It was followed by curettage of periapical tissues to enable histopathologic investigation, which is the gold standard in diagnosis. The data were statistically analyzed using SPSS, analysis of variance, and kappa statistics. RESULTS: The percentage accuracy of diagnosing periapical lesions using conventional radiography was 47.6%, digital radiography 55.6%, and ultrasound 95.2%. Ultrasound had the highest sensitivity and specificity: 0.95 and 1.00, respectively. CONCLUSION: Conventional and digital radiography enable diagnosis of periapical diseases, but not their nature, whereas ultrasound provides accurate information on the pathologic nature of the lesions, which is of importance in predicting the treatment outcome. Therefore ultrasound can be used as an adjunct to conventional or digital radiography in diagnosing periapical lesions.