Correlation of calcification of permanent mandibular canine, mandibular premolars, and permanent mandibular first and second molars with skeletal maturity in Indian population.

CONTEXT: Morphological variation in children can be understood by the knowledge of growth and development. The state of dental development can be used in forensic odontology to ascertain the age of an unidentified child. AIMS: This study aims to investigate the relationship of the stages of calcification of the permanent mandibular canine, mandibular premolars, and permanent mandibular first and second molars with skeletal maturity using panoramic and hand-wrist radiographs. SETTINGS AND DESIGN: This descriptive work was designed as a cross-sectional study. MATERIALS AND METHODS: The study was conducted on 300 healthy subjects (150 males and 150 females) ranging 7-20 years of age. Demirjian's method and Björk, Grave, and Brown's method were used to correlate teeth calcification and skeletal maturity, respectively. STATISTICAL ANALYSIS USED: Descriptive statistics and Spearman's rank correlation coefficient were used. RESULTS: 1. Correlation coefficients between the skeletal maturity stages and the developmental stages of the five teeth ranged 0.461-0.877 for females and 0.480-0.790 for males. 2. The second molar showed the highest and the first molar showed the lowest relationship for female and male subjects in the Indian population. CONCLUSIONS: The findings of this study indicate that tooth calcification stages might be clinically used as a maturity indicator of the pubertal growth period.

Tuberculosis of parotid gland: a rare clinical entity.

Tuberculosis (TB) can affect almost any organ of the body; however, TB of the salivary glands is a rare condition. The purpose of this paper was to report a case of a 14-year-old boy who presented with a painless swelling and discharging sinus in the parotid gland and cervical region on the left side. There was no clinical evidence of systemic signs and symptoms of active TB elsewhere in the body. The combination of clinical suspicion, a positive family history, and the cytological findings confirmed the diagnosis. The patient was successfully treated via antitubercular therapy for six months. This case report suggests that, although primary TB of the parotid gland is an unusual clinical presentation, it should be considered in the differential diagnosis of patients presenting with a parotid gland swelling.

A rare presentation of hybrid odontogenic tumor involving calcifying cystic odontogenic tumor and plexiform ameloblastoma.

A hybrid odontogenic tumor comprising two distinct lesions is extremely rare. We presented a hybrid odontogenic tumor composed of a calcifying cystic odontogenic tumor (CCOT) and a plexiform ameloblastoma. This tumor was observed in the anterior area of the mandible of a 17-year-old Indian male. Masses of ghost epithelial cells with the characteristics of CCOT were seen in the lining of the cyst. The odontogenic epithelia with the features of plexiform ameloblastoma were also observed.

Utility of dermatoglyphics as a non-invasive diagnostic tool inrecurrent aphthous stomatitis / Utilidade da dermatoglifia como ferramenta diagnóstica não invasivapara estomatite aftosa recorrente

Introduction: Dermatoglyphics is an advancing branch of medical science in which the dermal ridge patterns are studied and used in prediction of genetic disorders. Objective: To assess the usefulness of dermatoglyphics, as a non-invasive early predicator in RAS, since genetics plays a role in both. Materials and methods: This case control study comprised of 40 patients with recurrent aphthous stomatitis compared to 30 control subjects of similar age and sex. All subjects were investigated for their dermatoglyphic patterns of both hands, which were obtained by smearing the ink uniformly over the palm and fingers and pressing the hands firmly against the good quality paper. Qualitative analysis of prints was done for arches, loops and whorls and quantitative analysis included Total Finger Ridge Count (TFRC) and atd angle. Fisher’s Exact Tests were used to evaluate the significance between recurrent aphthous stomatitis and the dermatoglyphic features. Results: Among various dermatoglyphic parameters analyzed, recurrent aphthous stomatitis patients showed 9% arches, 62% loops and 29% whorls as the finger ridge configuration. In comparing the results between the two groups, the frequency of arches was observed more in study group while composite whorl and the nar pattern were more frequent in control group, the results were statistically significant (p < 0.05). In addition to this, study group patients demonstrated higher frequency of total finger ridge count, and control group showed higher frequency for atd angle on both hands, statistically significant difference is observed (p < 0.05). Conclusion: The study found significant correlation between palmar dermatoglyphics and recurrent aphthous stomatitis, suggesting that genetics is one of the host risk factor associated with the latter, and could aid in early detection of the disease.

Introdução: Dermatoglifia é um avançado ramo da ciência médica em que os padrões de cristas dérmicas são estudados e utilizados para predizer distúrbios genéticos. Objetivo: Avaliar a utilidade da dermatoglifia, como método de diagnóstico não invasivo para a estomatite aftosa recorrente, uma vez que a genética desempenha um papel em ambos. Materiais e métodos: Estudo caso-controle composto por 40 pacientes com estomatite aftosa recorrente comparados a 30 controles de mesma idade e sexo. Todos os sujeitos foram avaliados quanto a seus padrões dermatóglifos de ambas as mãos. Os padrões dermatóglifos foram obtidos espalhando uniformemente uma tinta sobre a palma da mão e os dedos e pressionada firmemente contra um papel de boa qualidade. A análise qualitativa das impressões foi feita por arcos, laços e espirais e a análise quantitativa pela contagem total da polpa do dedo (TFRC) e ângulo atd. Teste de Fischer foi utilizado para avaliar a significância entre estomatites recorrentes e características dermatoglíficas. Resultados: Entre os vários parâmetros dermatoglíficos analisados, os pacientes com estomatite aftosa recorrente mostraram 9% de arcos, 62% de laços e 29% de espirais na configuração da polpa digital. Ao comparar os resultados entre os dois grupos, a frequência de arcos foi mais observada no grupo de estudo, enquanto verticilos e padrão tênar foram mais frequentes no grupo controle, com resultados estatisticamente significativos (p < 0,05). Além disso, os pacientes do grupo de estudo demonstraram maior frequência de contagem total da polpa digital e o grupo controle apresentou maior frequência para o ângulo atd em ambas as mãos, com diferenças estatisticamente significativas (p < 0,05). Conclusão: O estudo encontrou correlação significativa entre a dermatoglifia palmar e estomatites recorrentes, sugerindo que a genética é um dos fatores de risco de hospedeiro associado com estomatite aftosa recorrente, e poderia ajudar na detecção precoce da doença.

Prevalence of oral mucosal disorders in institutionalized and non-institutionalized psychiatric patients: a study from AVBR Hospital in central India.

Dental treatment is reported to be the greatest unattended health need of people with a disability. The aim of the present study was therefore to quantify the prevalence of oral diseases with a psychosomatic component (recurrent aphthous stomatitis, burning mouth syndrome, and oral lichen planus) in psychiatric patients and to screen these patients for any other oral disorders, so that better care could be provided. In this cross-sectional, single-assessment study, 150 psychiatric patients were evaluated for presence of oral disorders. They were screened based on their socio-demographic profiles, clinical profile, and standardized psychiatric scales. The prevalence of recurrent aphthous stomatitis (RAS), burning mouth syndrome (BMS), and oral lichen planus (OLP) was 19.33%(29 patients), 20.66% (31 patients) and 5.33% (8 patients), respectively, amongst all psychiatric patients. The prevalence of burning mouth syndrome was much higher in patients taking psychiatric medications (25%) than in drug-naïve patients. On screening for other oral disorders, 35.33% of psychiatric patients had at least one other such disorder. We concluded that this patient group experiences a considerable burden of occult oral disorders necessitating thorough oral care. We also described the possible causes of the higher prevalence of oral disorders in psychiatric patients.

Utility of lead thyroid collar in cephalometric radiography.

OBJECTIVE: To investigate whether the application of thyroid collars (TCs) affects the results of cephalometric study. STUDY DESIGN: The Steiner cephalometric analysis of the patients was performed using lateral cephalometric radiographs, which were taken twice for each patient: Once using TCs (TC group; n = 50) and once without using TCs (NTC group; n = 50). A randomized and observer-blinded diagnostic study with head films taken from the two aforementioned groups was performed and results were evaluated with the t-test and Z-test, using GraphPad Prism 4 software. RESULTS: Statistical analysis using t-test was performed. The values of the line angles used in Steiner cephalometric analysis were compared for which values of each angle remained unchanged when done using TCs and without TC to the same samples. CONCLUSIONS: Lead shielding of the thyroid gland does not affect landmark identification or the specific measurements of the angulations traced during cephalometric analysis. TCs should be routinely applied during cephalometric radiography if cephalometric analyses are limited to the structures above the second cervical vertebra.

Utility of digital volume tomography in maxillofacial trauma.

PURPOSE: To assess the diagnostic quality of images generated using the newly developed digital volume tomography (DVT) system and comparing them with conventional images from patients with maxillofacial trauma. MATERIALS AND METHODS: The study population included 22 male patients aged 18 to 60 years with a history of maxillofacial trauma. Each patient had undergone conventional radiographic and DVT examinations to analyze the number of fracture lines in the jaws and to compare the images for their diagnostic quality by an oral radiologist and a general radiologist using the χ(2) test. RESULTS: A statistically significant difference was found between the number of fracture lines evaluated on the conventional radiographs and on DVT, especially for condylar head (7) and the midface (4.41 to 4.57), zygomaticomaxillary complex and Le Fort fractures, respectively. CONCLUSIONS: The detection of fracture lines and visualization within the mandibular-maxillary area using DVT was superior to using conventional radiographs.

Dental considerations in the patient with Wilson's disease.

Wilson's disease was described by Wilson in 1912. It is an autosomal recessive disorder caused by mutations in the ATP7B gene, a membrane-bound copper transporting ATPase. The deficiency of ATP7B protein impairs the biliary copper excretion, resulting in positive copper balance, hepatic copper accumulation, and copper toxicity from oxidant damage. The disease is a form of copper poisoning caused by a defect in the transport of copper that renders the patient unable to handle trace amounts of copper normally present in the diet and hence the clinical manifestations are those typically caused by copper toxicity and primarily involve the liver and the brain. Because effective treatment is available, it is important to make an early diagnosis. In this article, a review of clinical aspects of Wilson's disease, and its impact on dental management and dental considerations are discussed.

Estimation of salivary glucose, salivary amylase, salivary total protein and salivary flow rate in diabetics in India.

Diabetes is known to influence salivary composition and function, eventually affecting the oral cavity. We thus evaluated saliva samples for levels of glucose, amylase and total protein, and assessed salivary flow rate in diabetics and healthy non-diabetics. We also analyzed these parameters with regard to duration and type of diabetes mellitus and gender, and aimed to assess the interrelationships among the variables included in the study. A total of 120 age- and sex-matched participants were divided into 3 groups of 40 each; the uncontrolled diabetic group, the controlled diabetic group and the healthy non-diabetic group. Salivary investigations were performed using unstimulated whole saliva. Mean salivary glucose levels were found to be significantly elevated in both uncontrolled and controlled diabetics, as compared to healthy non-diabetics. There were significant decreases in mean salivary amylase levels in controlled diabetics when compared to healthy non-diabetics. Other than salivary glucose, no other parameters were found to be markedly affected in diabetes mellitus. Further research is needed to explore the clinical implications of these study results.

Evaluation of correlation of serum lipid profile in patients with oral cancer and precancer and its association with tobacco abuse.

BACKGROUND: Cholesterol at either higher/lower level can be troublesome. Health issues related to higher than normal levels have received much public attention because of their relationship to incidence of heart disease, whereas implications of decreased cholesterol levels remain unclear. Present study tried to evaluate and correlate the decreased cholesterol levels in Oral cancer, Oral precancer and in tobacco abuse. METHODS: Total Cholesterol (TC), High Density Lipoproteins (HDL), Very Low Density Lipoproteins (VLDL), Low Density Lipoproteins (LDL) and Triglyceride (Tri) were estimated in 210 subjects. Out of these 210 subjects, 70 subjects were histopathologically confirmed Oral Cancer, 70 subjects were histopathologically confirmed Oral precancer (OPC) and 70, age and sex matched, healthy subjects who are not having Oral Cancer, Oral precancer and who had no history of any major illness in the past. These groups were subdivided into: Subjects with No Habit of Tobacco (NHT) and Subjects With Habit of Tobacco (WHT). RESULTS: There was significant decrease in TC, HDL, VLDL, and triglyceride in Oral Cancer group; and significant decrease in TC, and HDL in Oral precancer group as compared to Control. Mean serum lipid profile levels were not significantly different in subjects between NHT and WHT. CONCLUSIONS: There is an inverse relationship between serum lipid profile and Oral Cancer and Oral precancer. There was no overall significant correlation of serum lipid profile with tobacco abuse.

Utility of color Doppler ultrasound in evaluating the status of cervical lymph nodes in oral cancer.

OBJECTIVE: The aim was to study the utility of color Doppler ultrasound (CDUS) in diagnosis of cervical lymphadenopathy in oral cancer patients. STUDY DESIGN: In a prospective study, 70 cervical lymph nodes in 30 known primary oral cancer patients were evaluated with CDUS during a period of 8 months. The intranodal perfusion sites and vascular resistance were the key CDUS features used to differentiate between reactive and metastatic cervical lymph nodes. Histopathologic confirmations were obtained by excisional biopsy of the lymph nodes. The results of preoperative clinical palpation of cervical lymph nodes and CDUS evaluation were compared with histopathologic outcome. RESULTS: Clinical evaluation suspected 61 cervical lymph nodes to be malignant. According to the CDUS, out of 70 nodes, 49 lymph nodes showed features of benign lymphadenopathy and 21 lymph nodes showed features of malignant lymphadenopathy, whereas histopathologic evaluations were in favor of reactive for 57 (81.42%) and for malignant lymphadenopathy in 13 (18.57%). CONCLUSION: The CDUS evaluation was found to be highly significant with a sensitivity of 92.90% and a specificity of 84.21%, after comparing the CDUS findings with histopathologic findings.

Metastatic involvement of parotid from carcinoma of the breast--a case report.

INTRODUCTION: Involvement of parotid gland by metastases from distant primary malignant tumors is rare. CASE REPORT: A 42-year-old female having right breast cancer had reported to the Department of Oral Diagnosis and Medicine with a chief complaint of a swelling in the left parotid gland region for 2 months. On the basis of clinical findings, the primary malignancy of parotid gland was provisionally suspected. DISCUSSION: Microscopic examination of parotid and breast revealed that parotid gland was involved as a distant metastases from a breast carcinoma, indicating that a swelling in the parotid needs to be assessed and investigated very carefully.

Clinical and radiological findings related to tuberous sclerosis complex: a case report.

AIM: The aim of this report is to present the intraoral and extraoral clinical features of a young female patient with tuberous sclerosis complex (TSC) who exhibited multiple hamartomas of various organ systems including a fibromatous growth on the gingiva. BACKGROUND: TSC is a rare neurocutaneous syndrome exhibiting multiple hamartomatous proliferations that may involve multiple organs such as the brain, kidney, heart, eyes, lungs and skin. Oral manifestations such as enamel pitting and fibromatous growth of the gingiva are commonly seen in patients with TSC. REPORT: A 16-year-old female patient presented with a painless interdental gingival growth in the maxillary left incisor and canine region that bled occasionally. Associated findings were adenoma sebaceum (angiofibromas) on the face, a Shagreen patch on the lumbosacral region, ash leaf spots on the trunk, and subangual fibromas (Koenen's tumor) on the nails of fingers and toes. The final diagnosis of TSC was made on the basis of the clinical findings of the skin, computerized tomography (CT) findings of the brain and kidney, ultrasonographic findings of kidney, and a histopathologic evaluation of the gingival growth which met the major and minor criteria required for a diagnosis of TSC. SUMMARY: This case report is a good example of the complex nature of patients with TSC. The diagnosis and management of these patients varies depending on the specific presentation of the disease. Dentists need to be mindful of the systemic issues as well as oral conditions related to this disease. Dental practitioners are advised to work closely with the patient's physician during treatment.

Drug treatment of trigeminal neuralgia: a systematic review of the literature.

PURPOSE: This study undertook a systematic review of the literature on drug treatment of trigeminal neuralgia. METHODS: An electronic search was carried out for articles published between January 1960 to February 2005. Studies with high level of evidence were included. The levels of evidence of the articles were classified after the guidelines of the Oxford Centre for Evidence-Based Medicine. RESULTS: Of 770 publications, only 21 publications showed a high level of evidence (6 randomized controlled trials and 15 clinical trials/controlled clinical trials), with a total of 348 patients. A total of 749 publications were not included in the review as they showed a low level of evidence. CONCLUSIONS: Anticonvulsants are effective in treating trigeminal neuralgia; however, few studies with high levels of evidence were found. It is quite difficult to compare or even combine their outcomes in a scientifically meaningful manner. Due to insufficient research data, there is a need for high-quality randomized controlled trials in this area of medicine.