Prevalence and pattern of proximity of maxillary posterior teeth to maxillary sinus with mucosal thickening: A cone beam computed tomography based retrospective study.

Context: Odontogenic sinusitis is a prevalent but frequently unrecognized condition, and periapical pathologies of maxillary posterior teeth are accused as one of the main causative factors. Aim: This study aimed to evaluate the relationship between the periapical status of maxillary posterior teeth and its proximity to the maxillary sinus floor in the occurrence of incidental sinus pathologies using cone-beam computed tomography (CBCT). Methodology: CBCT scans of 118 patients of age range 18-77 years were evaluated retrospectively to determine the relationship of maxillary posterior teeth to sinus floor in which vertical relationship was assessed using modified Kwak's classification and periapical status using CBCT periapical index. Statistical analysis was performed using SPSS statistics software. Results: Of all 227 sinuses examined, 56.8% showed pathological changes, with mucosal thickening being the most common. More than 50% (50.2%) of sinuses were associated with periapical lesions of at least one maxillary posterior tooth based on evidence of pathological mucosal thickening. The presence of pathologic mucosal thickening was also significantly related (P < 0.05) to the presence of periapical pathologies. There was a significant association between tooth position and pathological sinus mucosal thickening, especially with second molars, first molars, and second premolars, respectively (P < 0.05). Second molar involvement was the most significant (P < 0.05). Conclusion: The present study established a positive association between periapical disease status of maxillary posteriors and maxillary sinus mucosal thickening. Maxillary second premolar and first and second molars pathologies can significantly affect the maxillary sinus compared to other maxillary posterior tooth. CBCT proved to be an efficient imaging modality in detecting these changes.

Résumé Contexte: La sinusite odontogène est une affection fréquente mais souvent méconnue, et les pathologies périapicales des dents postérieures maxillaires sont accusés comme l'un des principaux facteurs causals. Objectif: Cette étude visait à évaluer la relation entre le statut périapical du maxillaire dents postérieures et sa proximité avec le plancher du sinus maxillaire dans la survenue de pathologies sinusales accidentelles à l'aide du calcul par faisceau conique tomographie (CBCT). Méthodologie: Les scans CBCT de 118 patients âgés de 18 à 77 ans ont été évalués rétrospectivement pour déterminer la relation entre les dents postérieures maxillaires et le plancher sinusal dans laquelle la relation verticale a été évaluée à l'aide de la classification de Kwak modifiée et état périapical à l'aide de l'index périapical CBCT. L'analyse statistique a été réalisée à l'aide du logiciel de statistiques SPSS. Résultats: Sur les 227 sinus examinés, 56.8 % présentaient des modifications pathologiques, l'épaississement de la muqueuse étant le plus fréquent. Plus de 50 % (50.2 %) des sinus étaient associée à des lésions périapicales d'au moins une dent postérieure maxillaire sur la base de preuves d'un épaississement pathologique de la muqueuse. La presence d'épaississement muqueux pathologique était également significativement lié (P < 0.05) à la présence de pathologies périapicales. Il y avait un important association entre la position des dents et l'épaississement pathologique de la muqueuse des sinus, en particulier avec les deuxièmes molaires, les premières molaires et les deuxièmes prémolaires, respectivement (P < 0.05). L'atteinte de la deuxième molaire était la plus importante (P < 0.05). Conclusion: La présente étude a établi un bilan positif association entre l'état de la maladie périapicale des postérieurs maxillaires et l'épaississement de la muqueuse du sinus maxillaire. Deuxième prémolaire maxillaire et les pathologies des premières et deuxièmes molaires peuvent affecter de manière significative le sinus maxillaire par rapport aux autres dents postérieures maxillaires. Le CBCT s'est avéré être une modalité d'imagerie efficace pour détecter ces changements. Mots-clés: Tomodensitométrie à faisceau conique, épaississement de la muqueuse du sinus maxillaire, sinusite odontogène, pathologie périapicale.

Macroglossia Associated With Primary Systemic Amyloidosis - Case Report With Unusual Clinical Presentation.

BACKGROUND: Amyloidosis is characterised by the deposition of fibrillar insoluble proteinaceous material called amyloid in the extracellular spaces. It may present as localized form which is rare and systemic form. Systemic amyloidosis involves many organs like kidney, heart and liver. Manifestations of both types may vary based on the age of onset, degree and extension of the deposition. Understandably, the diagnosis is challenging but the early identification of the condition and the type of amyloidosis can increase the efficiency of treatment. Positive Congo red staining is the gold standard for demonstration of amyloid in tissue sections. Here we are presenting a case of a 77-year-old female patient who presented with the complaint of difficulty in swallowing for 2 years due to bilateral symmetrical enlargement of the tongue which was subsequently diagnosed as systemic amyloidosis.

Knowledge and attitude toward COVID-19 and dental treatment - Its availability and treatment satisfaction during the pandemic among adult population - An online survey.

BACKGROUND: Corona virus disease 2019 (COVID-19) is a highly infectious disease primarily spreading through droplet infection which require significant restriction and modification in dental treatment. This study aims to assess the knowledge and attitude of adult population toward COVID-19 and dental treatment and to assess the availability of dental treatment and patient satisfaction during the time of pandemic. MATERIALS AND METHODS: An online survey was conducted using self-designed electronic questionnaire consisting knowledge and attitude about COVID-19 and dental scenario and questions regarding availability of dental treatment received during the time of pandemic. Knowledge scores were assessed on a maximum total score ranged from 0 to 8, and descriptive statistics were done for questions related to attitudes and dental treatment availability. RESULTS: A total of 495 participants with mean age of 36.6 years participated in the study. The mean knowledge score was 7.12 ± 0.99 and the participants were found to have good awareness and positive attitude regarding COVID-19 were as considerable number of participants were unaware about the risk associated with dental treatment as well as restrictions imposed on dental procedures. About 18% of participants experienced one or other form of dental complaints during the lockdown period. 4% of participants had no accessibility to any form of treatment. CONCLUSIONS: Public awareness is to be improved regarding risk of cross infection that can be associated with dental treatment and public should be motivated to use virtual facilities like tele-dentistry so that no dental emergencies is left untreated, at the same time avoiding any sort of unnecessary hospital visit during the pandemic time.

High prevalence of oral mucosal lesions in elderly: Call for revolutionizing geriatric dental care strategies.

CONTEXT: World'spopulation is ageing and increase in geriatric population demands improved oral health care. Previous epidemiologic studies in general population of India and particularly in Kerala (state with maximum proportion of elderly) provided very little information about oral mucosal lesions in elderly. AIMS: To find out the prevalence, pattern and distribution of oral mucosal lesions in geriatric patients and to explore their association with different study variables. SETTINGS AND DESIGN: A descriptive, hospital-based, cross sectional study was conducted for a period of 9 months in the out-patient clinic, Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (tertiary healthcare centre in Kerala, India). METHODS AND MATERIALS: Participants aged 60 and above were selected by consecutive sampling. Data were collected through clinical examination and by using a structured proforma. STATISTICAL ANALYSIS USED: Descriptive statistics with tests of significance of associations were done. RESULTS: The geriatric population (N=750, 66.89 ± 6.07, M: F=1.4:1), was recruited by screening 43,180, and 447 (67.29 ± 6.15, M: F=2:1) were identified having oral mucosal lesions withprevalence of 59.6% (95% CI=56.05-63.05). Most common lesion group was red and white (73.2%), followed by pigmented (15.5%). Oral mucosal lesions were significantly associated with age over 65, male gender, presence of habit and denture usage (P < 0.05). CONCLUSIONS: The prevalence of oral mucosal lesions in geriatric people is high. Hence setting up of geriatric dental clinics, with appropriate preventive and palliative intervention strategies is mandatory.

Oral Health Status of Tibetan and Local School Children: A Comparative Study.

INTRODUCTION: India has seen a large influx of refugee populations throughout history and the Tibetan immigration is one among them. Understanding the health status and needs of immigrants is imperative because of their growing numbers and their input to the health of the nation. The oral health professionals face many challenges while confronting refugees and immigrants from cultures different from their own. Earlier studies have shown that children, especially refugees and immigrants have had a higher prevalence of unmet oral health needs. AIM: The purpose of this study was to assess and compare the oral health status of 11-13 year old Tibetan and non-Tibetan school children in Bylakuppe, Karnataka, India. MATERIALS AND METHODS: A stratified cluster sampling of 11-13 year old Tibetan and non-Tibetan school children (431 and 434 respectively) formed the study participants for this study. Assessment of dental caries, periodontal disease and malocclusion was done in accordance with criteria laid down by WHO in oral health assessment survey basic methods, 1997. Data was collected by a single trained examiner. The results obtained were analyzed by SPSS version 18. The data was statistically analyzed by using chi-square test and independent t test. The level of significance was set at 5%. RESULTS: The prevalence of caries was found to be higher among the Tibetan school children when compared to the non-Tibetan school children (71% and 53.9% respectively). The mean number of sextants with healthy gingiva (2.49±2.40) and calculus (1.63±2.28) was higher among the non-Tibetan school children. The mean Dental Aesthetic Index score was found to be higher for Tibetan school children than the non-Tibetan school children (26.57±4.62 and 23.52±4.36 respectively). CONCLUSION: The prevalence of caries, periodontal disease and malocclusion were found to be higher among immigrant Tibetan school children as when compared to non-Tibetan school children. The high level of unmet needs in the study population highlights the need for a comprehensive dental care programme in Bylakuppe.