Dentists Role in Psychological Screening and Management of Head-and-neck Cancer Patients Undergoing Radiotherapy - Narrative Review.

Objectives: Head-and-neck cancer management primarily involves surgery and chemoradiotherapy. Recurrent radiotherapy (RT) sessions are often linked to social, physical, and psychological burdens. Oral physicians are part of the palliative care team and play a pivotal role in decimating the physical side effects associated with disease and its treatment. There is a need to familiarise dentists with the psychological aspect of the treatment. Material and Methods: Various libraries were searched from the year 2012 to 2022. A total of nine studies that had head-and-neck RT patients exclusively were included in the study. Results: Anxiety and depression are patients' most prevalent psychological problems during and after the RT regimen. A few most used psychological screening tools were identified. Conclusion: Dental professionals are uneducated about the holistic approach to managing RT patients. The current narrative review details the various psychological screening tools and care measures that can be incorporated into the dental setup to help these patients.

Co-Occurrence of Taurodontism in Nonsyndromic Cleft Lip and Palate Patients in Subset of Indian Population: A Case-Control Study Using CBCT.

The present study aimed to assess the co-occurrence of taurodontism in nonsyndromic cleft lip and palate (NSCLP) patients in a subset of Indian population using cone beam computed tomography (CBCT).The study was a retrospective case-control kinds assessing 1500 CBCT scans over a period of 2 years; 67 scans out of 1500 showed cleft lip and palate (CLP). After fulfilling the inclusion and exclusion criteria, 38 subjects out of 67 comprised the case group; 80 randomly selected subjects constituted the control group. The first and second permanent molars in both the arches (8 teeth) of each subject were assessed for the presence and severity of taurodontism using the objective criteria. Statistical analysis was done using the χ2 test. Inter and intraobserver agreement was evaluated by Kappa statistics.71.05% subjects showed taurodontism in case group, while 45% subjects showed its presence in control group; results being significant for both the groups. However, the comparison of number of teeth with taurodontism in the 2 groups came out to be statistically insignificant. Also no significant association of taurodontism was seen with gender or the different types of cleft (P = .437). Hypotaurodontism was the most prevalent type.There was a higher prevalence of taurodontism in both groups which had been underestimated in the previous studies. This emphasizes the significance of the use of CBCT in detection of dental anomalies which would otherwise go undetected.

Imaging characteristics of Gubernacular Tract on CBCT- A pictorial review.

The Gubernaculum Dentis (GD) is an anatomical structure connecting the dental follicle of the permanent tooth to the overlying gingiva. It is composed of Gubernacular cord (GCo) and a surrounding bony canal called as Gubernacular canal (GC) or Gubernacular Tract (GT). GD is a physiologic structure that has claimed to play some role in the eruption of teeth. GCo is a histologic structure, however, the surrounding GT can be identified radiographically. But due to its infinitesimal appearance, its differentiation with normal bone marrow spaces on conventional radiographs is extremely difficult and is the reason for its sporadic reference in the oral radiology literature. The advent of advanced imaging modalities such as Cone Beam Computed Tomography (CBCT) has led to its distinct identification in the recent studies not only in the normal erupting teeth but in teeth with altered eruption pattern, impacted teeth, supernumerary teeth, odontogenic cysts and tumors as well. The identification of GT on CBCT is usually an incidental finding and because of its physiologic nature, the imaging characteristics of GT have not been studied extensively. This pictorial review aims to demonstrate the imaging characteristics of GT in diverse relations with the normal teeth, impacted teeth, supernumerary teeth, odontomas and odontogenic cysts and tumors. This will help in understanding the various presentations of GT and will serve as a teaching guide for oral and maxillofacial radiologists for their easy identification and their possible causal association with various eruptive pathologies.

Stafne's bone defect with bicortical perforation: a need for modified classification system.

Stafne's bone defect (SBD) or salivary gland-related bone defects are asymptomatic bone cavities in the mandible caused by impingement by the salivary glandular tissue. The major salivary glands, particularly the submandibular gland, are in close relation with the mandible and their impingement can produce radiolucent defects on the lingual cortical surface of the mandible. Submandibular gland-related bone defects or depressions are referred as posterior lingual variant of SBD. These are asymptomatic and appear as well-defined radiolucent areas that are incidentally discovered on panoramic radiographs. Three-dimensional imaging may be required to evaluate the extent of cortical involvement and to determine the content of the cavity or defect. Usually, these defects are seen in the lingual cortices and are lined by cortex that causes a smooth radiopaque periphery. The involvement of both the buccal and lingual cortices by the defect is extremely uncommon. Literature has classified cases with buccal cortical expansion but buccal cortical perforation has not been described and classified. This case report describes this uncommon presentation of the salivary gland bone defect and through an in-depth literature review proposes a modification in the existing classification system.

Asymptomatic Radio-Opacity at the Floor of Nasal Cavity.

Asymptomatic pathologies are usually discovered incidentally on radiographs. Sometimes, the presentation is characteristic and diagnosis is easily arrived. For uncharacteristic presentations, numerous differential diagnosis can be made and multiple investigations may be required by the radiologist. The present manuscript discusses the differential diagnosis of a commonly presenting asymptomatic radio-opacity at the floor of the nasal cavity and an unusual outcome of the investigation.

Is focal melanotic lesion potentially malignant? A case report.

Malignant melanoma is a lesion of melanocytes that is commonly observed on cutaneous surfaces. In 35-50% of cases, it originates from a pigmented precursor. Although oral melanocytic pigmentation is very common, melanocytic malignancies such as melanoma, are rare. Oral melanoma may arise from pre-existing pigmentation, but definitive precursor lesions have not been identified. Common sites for oral melanoma are the maxillary gingiva and palate. We report a case of malignant melanoma that transformed from a long-standing, focal, pigmented lesion on the mandibular gingiva and vestibular mucosa, suggesting the potentially malignant nature of focal oral melanotic lesions.

Comparison of chemiluminescence and toluidine blue in the diagnosis of dysplasia in leukoplakia: a cross-sectional study.

AIMS: The early diagnosis and treatment of oral cancer at a potentially-malignant stage would reduce morbidity and improve the survival rates and quality of life of patients. Leukoplakia is the most common potentially-malignant disorder. Clinical examination alone cannot differentiate between dysplastic and non-dysplastic leukoplakia. Chemiluminescence and toluidine blue are adjuncts to conventional examination for the early detection of dysplasia. The present study was conducted to compare the efficacies of chemiluminescence and toluidine blue for the diagnosis of dysplasia in leukoplakia. METHODS: One hundred patients with leukoplakia were subjected to conventional oral examination, chemiluminescent examination with ViziLite and toluidine blue test, followed by histopathological confirmation of dysplasia. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of chemiluminescence was 84.84%, 41.17%, 73.68%, 58.33%, and 70%, respectively. For toluidine blue it was 42.4%, 88.23%, 87.50%, 44.11%, and 58% respectively. CONCLUSIONS: Both the techniques have adjunctive utility in the diagnosis of dysplasia in leukoplakia, but toluidine blue was more effective in identifying the more severe grades of dysplasia, and thus it effectively discriminated high-risk from low-risk lesions.