Assessment of efficacy of ultrasonography in cervical lymphadenopathy in oral malignancies.

AIMS AND OBJECTIVES: To substantiate the use of ultrasonography in diagnosis of cervical lymphadenopathy in oral malignancies and to assess if ultrasonographic examination done prior to lymph node (LN) biopsy can yield important information regarding the diagnosis. MATERIALS AND METHODS: Twenty subjects with histopathologically confirmed oral malignant lesions with clinically palpable and untreated cervical LNs included into study. These patients were subjected to clinical examination (number of LNs, shape, size, location, overlying temperature, overlying skin, tenderness, consistency, and fixity to the underlying structures), and ultrasonographic evaluation (number of LNs, shape, size (mm), location, borders, matting, peripheral halo, hilum, calcification, necrosis, reticulation, and echogenicity) of the LNs, and finally, histological assessment was done after surgical excision during the course of treatment. RESULTS: Predominantly male (65%) patients were having with malignant LN involvement with age group of 60-69 years, i.e., 35%. Ultrasonogram is superior to clinical examination as it detected additional 49 nodes. Malignant nodes tend to have longest axial diameter (17 mm with standard deviation of 8.7 mm). Over all 52 malignant nodes were round, whereas 35 nodes were oval in shape. Most of the nodes were detected in submandibular region. Around 61 (70.9%) nodes had sharp borders and 26 (29.9%) had smooth borders. Loss of echogenic hilus is a common feature of malignancy showing 70% sensitivity and 67% specificity. Most of malignant nodes were hypoechoic. Around 51 (58.6%) of nodes showed intranodal necrosis, whereas it was absent in 36 (41.4%) nodes. Matting and edema were present 25 (28.7%) nodes. Intranodal calcification was present in 37 nodes. Sensitivity of USG was 90%, whereas specificity was 100%. CONCLUSION: Ultrasonographic examination of cervical LNs can yield important information regarding the diagnosis. Ultrasound examination should be done prior to FNAC and ideally an ultrasound-guided FNAC.

Age estimation in Indian adults by the coronal pulp cavity index.

BACKGROUND: Age estimation from tooth coronal index (TCI) using intraoral periapical radiographs by paralleling technique based on a reduction in the size of the dental pulp cavity with advancing age as a result of secondary dentin deposition. AIM AND OBJECTIVES: The aim of this study is to estimate age for Indian adults using radiographs of mandibular first molar and second premolar teeth using coronal pulp cavity index. MATERIALS AND METHODS: The study material consists of 400 intraoral periapical radiographs of mandibular second premolar and mandibular first molar from enrolled participants of either gender in the age group of 20-60 years. STATISTICAL ANALYSIS: Data analysis was done using SPSS (Statistical Package for Social Sciences), and Pearson's correlation coefficient (r) was used to find the correlation between age (years) and TCI. RESULTS: TCI was computed for each tooth and regressed on the real age of the sample. The correlation coefficient "r" was -0.865 (for premolar combined sample) and -0.850 (for molar combined sample). The obtained equations were tested on test sample of fifty teeth and age was determined. The absolute mean error between actual and predicted age for premolars was 6.72 months and for molars, it was 9 months. CONCLUSION: Age estimation using TCI is a precise, noninvasive, less time-consuming, and an inexpensive method.

Evaluation of Osseointegration in Implants using Digital Orthopantomogram and Cone Beam Computed Tomography.

INTRODUCTION: Accurate assessment of osseointegration in dental implants requires precise radiographic visualization of pathologic conditions as well as anatomical structures. The present study aimed to evaluate the formation of bony tissue (osseointegration) using digital orthopantomogram (OPG) and cone beam computed tomography (CBCT) immediately after implant insertion (within 7 days) and 3 months postinsertion. MATERIALS AND METHODS: Twenty single-implant sites on mandi-bular posterior regions were selected on patients irrespective of their gender. Both digital OPG and CBCT were done within a week and again after 3 months of implant insertion surgery, using the same exposure parameters. RESULTS: Three of the 20 implants were submerged and were excluded as the crestal bone height could not be measured. The participants were recalled for radiographic measurements after 3 months of implant placement. On an average, there was 0.03 mm of osseointegration at the apical portion after 3 months of implant insertion on digital OPG; 0.04 mm of osseointegration at the crestal bone height after 3 months on digital OPG; and 0.01 mm of osseointegration at the apical portion after 3 months on CBCT. No change or ≤0.02 mm of osseointegration at crestal bone height after 3 months on CBCT. CONCLUSION: Both digital OPG and CBCT are significant for the assessment of osseointegration in implants, and hence, endow definite benefit for accurate assessment in terms of the success of the implant placement. CLINICAL SIGNIFICANCE: However, CBCT is a better mode of evaluating dental implants but one should keep in mind that radiographic examination must be conducted to the benefit of the patient by application of the lowest achievable dose.

Sjögren's Syndrome: A Case Study.

Sjögren syndrome is chronic, systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands. It is an elaborate involvement of the lacrimal and salivary glands, which eventually lead to keratoconjunctivitis sicca and xerostomia. It may occur in two forms - Primary and secondary, which is associated with another autoimmune disease, most commonly rheumatoid arthritis. Numerous criteria were proposed for diagnosis of Sjögren syndrome. Most widely accepted are American and European group developed international classification criteria for Sjögrens syndrome. These criteria include ocular symptoms, oral symptoms, ocular signs, histopathology, salivary gland involvement and sialography. The classification requires four of the six items, one of which must be positive minor salivary gland biopsy or a positive antibody test. Early diagnosis is important to prevent further complications. The aim of this paper is to emphasis on oral changes, advanced diagnosis, and management of Sjögren's syndrome.

Recurrent idiopathic gingival fibromatosis with generalized aggressive periodontitis: A rare case report.

Gingival fibromatosis is an enlargement of the gingival tissue, which may be localized or generalized, characterized by hypertrophy and proliferation of the connective tissue, predominantly Type I collagen, with occasional presence of an increased number of cells, supposedly fibroblasts. Gingival fibromatosis occurs more commonly as a side- effect of systemic drugs, such as phenytoin, cyclosporine, nifedipine, or due to hereditary factors. However, in some cases, it is idiopathic. We report one such case in 30 -year- old - female who presented with a complaint of swelling of gums since 2 months. This case appears to be of special interest because of the recurrent nature of gingival enlargement along with excessive osseous destruction.