Prevalence, Habit Pattern, and Awareness on Harmful Effects of Tobacco/Areca Nut Use among Patients Visiting a Tertiary Care Center in Sri Lanka.

S.P. Kalpana Jeewanthi SubasingheBackground The carcinogenicity of tobacco and areca nut is well established worldwide. Areca nut is the fourth most common psychoactive substance identified recently. The effects of areca nut on the autonomic nervous system make the users dependent on the habit which has been an emerging health issue among Sri Lankan adults and adolescents. This study aimed to evaluate the prevalence and patterns of these risk habits among the patients attending a tertiary care center in Sri Lanka, and their awareness of the harmful effects of the habit. Method A hospital-based cross-sectional study was conducted among 512 patients using an interviewer-administered questionnaire. Results The sample consisted of 167 (33%) tobacco consumers. The average age of the initiation of tobacco consumption was 23.66 years (standard deviation ± 8.04). Age ( p = 0.001), gender ( p = 0.001), income ( p = 0.005), and educational level ( p = 0.001) are significantly associated with tobacco consumption. There is a strong likelihood for tobacco consumers to consume areca nut (odds ratio [OR] 30.58, 95% confidence interval [CI] 17.05-54.88) and alcohol (OR 11.16, 95% CI 6.91-17.98) at any stage in their lives. The majority of the tobacco consumers (61%) were smokeless tobacco users. Areca nut consumers are 0.44 times more likely to know its carcinogenic effects than nonconsumers (95% CI 0.28-0.69). Tobacco consumers are more likely to be aware of the harmful effects of tobacco consumption than nonconsumers (OR 1.11, 95% CI 0.45-2.74). Sixty percent have made at least one attempt to quit the habit. Sixty-two percent of the unsuccessful quitters reported the reason as "addiction." Conclusion Prevalence of smokeless tobacco consumption prevails at a high level among Sri Lankans. Tobacco and areca nut users are more likely to be aware of its harmful effects than the nonconsumers but unable to quit the habit due to the psychoactive properties of tobacco and areca nut.

Delayed Diagnosis of Unilateral Mandibular Condylar Fracture in a Posterior Edentulous Patient.

BACKGROUND: Fractures of the mandible are common in elderly patients, and among them, condylar fractures are the most frequent type. A change in occlusion is the most common physical finding in patients with fractures of the mandible. Therefore, it is challenging to identify mandibular fractures in posterior edentulous patients due to the lack of posterior occlusal contacts. It is crucial to do radiological investigations in such patients to exclude fractures. Case Presentation. This article describes a case of delayed diagnosis of a unilateral mandibular condylar fracture for a week's duration and treating the condition as temporomandibular pathology in a posterior edentulous, 52-year-old patient. CONCLUSION: This clinical case highlights the importance of radiological investigations and occlusal analysis for early diagnosis of condylar fractures, particularly in posterior edentulous patients, lacking posterior occlusal contacts.

Linear and Volumetric Analysis of Maxillary Sinus Pneumatization in a Sri Lankan Population Using Cone Beam Computer Tomography.

OBJECTIVE: The objectives of this study were to evaluate the linear and volumetric measurements of the maxillary sinus in relation to sex and side on cone beam computer tomographic (CBCT) images in a Sri Lankan population. METHODS: A total of 20 sets of CBCT images selected from the database at the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka, were evaluated. Linear measurements were obtained in a craniocaudal (height), anteroposterior (length), and mediolateral (width) dimensions. Volume was computed by using the same data using a computerized 3D modeling software developed for 3D measurements and calculations. RESULTS: The maximum mean craniocaudal dimension was at the level of the 1st and the 2nd molar tooth bilaterally. The largest average craniocaudal, mediolateral, and anteroposterior extensions of the maxillary sinus using CBCT were 31.71 ± 5.44 mm, 21.28 ± 5.09 mm, and 32.92 ± 4.31 mm, respectively. The differences between the sides and sex showed no statistical significance (P > 0.05), except for the maximum average value in craniocaudal dimension which showed a statistically significant difference in relation to gender (P = 0.02). CONCLUSION: There is no significant difference in the largest average craniocaudal, mediolateral, and anteroposterior extensions of the maxillary sinus when gender and side were compared. However, the maximum average value in craniocaudal dimension had a statistically significant difference in relation to gender. This study provides valuable knowledge of the anatomical dimensions of the maxillary sinus which may help clinicians in treatment planning.

Evaluation of the styloid process in a Sri Lankan population using digital panoramic radiographs.

OBJECTIVE: The objectives of this study were to evaluate the normal radiographic length of the styloid process (SP), prevalence and type of elongation, and angulation of the styloid process in relation to sex and side on digital panoramic radiographs in a Sri Lankan population. METHODS: A total of 100 digital panoramic images selected from the database at the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka were evaluated for the radiological features of the styloid process. Lengths greater than 30 mm were consider as elongated. Elongated styloid processes were also classified into three types based on Langlais classification (elongated, pseudo articulated; and segmented). RESULTS: The mean radiological length of the SP on the right and left side was 25.8 mm ±â€¯7.5 mm and 23.2 mm ±â€¯9.0 mm respectively. The prevalence of elongated styloid process in males and female were 34.9% and 24.6%. The maximum length observed on right and left sides were 43.2 mm and 41 mm respectively. However, the differences between the genders and the sides were statistically not significant (P = 0.199). The most frequently observed type of elongation was type I (elongated) according to the Langlais classification. CONCLUSION: This study provides valuable knowledge of the anatomical variations of the SP which may help clinicians from various specialties to diagnose the Eagle syndrome.

Morphology of palatally impacted canines: A case-controlled cone-beam volumetric tomography study.

INTRODUCTION: The aim of this study was to investigate the relationships between an apical curvature or a hook and the crown/root ratio in subjects with and without palatally impacted maxillary canines. METHODS: An experimental group of 44 patients (17 boys, 27 girls; mean age, 13.6 years) with 59 palatally impacted maxillary canines was selected from the records of patients referred to a radiology practice for cone-beam imaging. If a patient had bilateral palatally impacted canines, 1 canine was randomly selected for analysis. The palatally impacted canine group was matched for age and sex with 49 normal subjects (25 boys, 24 girls; mean age, 13.2 years) with 98 canines. Cone-beam DICOM files were imported into In Vivo imaging software (version 5.3; Anatomage, San Jose, Calif) for analysis. The angulations and linear variables of the maxillary canines were measured by using the software measurement tools. Chi-square and independent t tests were used to test for differences between the groups. RESULTS: The presence of a hook at the apical third and other root curvature were significantly different between the 2 groups (P <0.001 and P <0.05, respectively). Of the 44 palatally impacted canines, 16 (36.4%) had an apical hook and only 1 canine in the control group had an apical hook (1.0%). The mean root length of the palatally impacted canines was 2.66 mm shorter (P <0.001), and the mean crown/root ratio was significantly greater for the palatally impacted canines compared with the nonimpacted group (P <0.001). CONCLUSIONS: Palatally impacted canines have a greater tendency to develop apical hooks and are less likely to develop other root curvatures than are nonimpacted canines. Also, they have shorter roots resulting in larger crown/root ratios compared with the control group.

Comparison of topical tacrolimus and clobetasol in the management of symptomatic oral lichen planus: A double-blinded, randomized clinical trial in Sri Lanka.

AIM: Oral lichen planus (OLP) is a common, chronic inflammatory disease of the oral mucosa. Although several studies have shown the efficacy of different treatment modalities, a definitive cure has not yet been established. The present trial compares the effectiveness of topically-applied clobetasol and tacrolimus in the symptomatic management of OLP. METHODS: A randomized, comparative, double-blind study with 68 patients (43 females, 25 males; mean age: 46.76 years) was undertaken. Patients were randomly divided into two groups of 34 patients each to receive topical tacrolimus 0.1% cream or clobetasol propionate 0.05% cream for 3 weeks. RESULTS: After 3 weeks of treatment, the mean pain score dropped by 1.59 (right) and 1.53 (left) in the tacrolimus group, while in clobetasol group these values were 0.94 and 0.85, respectively. The mean scores for clinical appearance reduced by 1.18 (right) and 1.0 (left) in the tacrolimus group compared with a reduction of 0.5 and 0.26, respectively, in the clobetasol group. These reductions were statistically significant (P < .05). CONCLUSION: The results suggest that tacrolimus 0.1% cream is an effective alternative to topical steroid and can be considered a first-line therapy in OLP. However, further studies are needed to confirm the effectiveness of this treatment before it is recommended for use in clinical practice.