Pattern of tumor invasion, stromal inflammation, angiogenesis and vascular invasion in oral squamous cell carcinoma - A prognostic study.

INTRODUCTION: Oral cancer is one of the leading causes of mortality, and its worsening impact on the society has revealed the danger it poses in the coming future. Several researchers proposed and investigated the prognostic implications of various clinicopathologic and histopathologic parameters. AIM AND OBJECTIVES: The aim of this study--assessing significance of histopathological features like pattern of tumor invasion, stromal inflammation, angiogenesis and vascular invasion on the clinical outcome of oral squamous cell carcinoma any possible correlations between the parameters, TNM Staging and prognosis were assessed and evaluated for a 5-year period. MATERIALS AND METHODS: This study includes description of 50 diagnosed cases (mean age: 61.40, 29 males, and 21 females) of oral squamous cell carcinoma and their characteristics collected at baseline and at a 12-month follow up. The cases were grouped on the basis of their histological grade (well-differentiated, moderately differentiated, and poorly-differentiated). RESULTS: All the data collected was tabulated in a baseline descriptive table, and all the parameters were compared between the 3 different histological groups. On cross-tabulations we found statistical significant difference the parameters of stromal inflammation with recurrence, clinical stage with T-stage, T-stage with N-stage, and N-stage with clinical stage. On analysis of the follow up we found 16 patients (32%) with recurrence and 9 patients (18%) succumb to the disease. CONCLUSION: This study provides a significant insight on the importance of a combined histopathological analysis and clinical staging process to deliver an accurate prognostic opinion and also subsequently effect the treatment protocol.

Assessment of the anterior and caudal extent of inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of submandibular fossa using computed tomography.

BACKGROUND: A well-versed knowledge of the precise location of various anatomical landmarks is necessary to avoid complications during surgery. The study was conducted for the assessment of the anterior and caudal extent of the inferior alveolar nerve canal, location of inferior alveolar canal and mental foramen, and the depth of the submandibular fossa using computed tomography (CT). MATERIALS AND METHODS: One hundred CT scans were randomly selected for this study accounting for 200 hemimandibles. Both axial and coronal images were obtained and evaluated concurrently. Results were subjected to statistical analysis for correct inferences. RESULTS: A total of 200 hemimandibles (n = 200) from 100 patients with a mean age was 23.89 ± 1.75 years ranging from 21 to 33 years were evaluated. The mean length of the anterior loop was 0.95 mm for all of the observation combined and measurement range from 0 to 5.1 mm. The total frequency of type I, type II, and type III of mental nerve was found as 71%, 4.5%, and 24.5%, respectively. At the level of the first molar, the mean distance from the center of the inferior alveolar canal to the external surface of the buccal cortex (Q) was 5.44 ± 1.38 mm ranging from 2.4 to 10.4 mm. Furthermore, there was no statistically significant difference in MF-IMB (mental foramen to the inferior border of mandible) between the right and left sides of the mandible. (P = 0.87). CONCLUSION: Our study demonstrates that analyzing CT scans using the methods described in this study can be a useful tool in avoiding the iatrogenic injuries to inferior alveolar nerve and arteries during various maxillofacial surgical procedures.

Assessment of primary stability of the implant placed in prepared infected extraction sockets.

BACKGROUND: Dental conditions like periodontal, periapical pathologies and failed endodontically treated teeth are one of the commonest reasons for tooth removal. These conditions also contraindicate replacement of such teeth with immediate implant procedures. AIM: This study aimed to evaluate the clinical and radiological fate of immediately placed dental implants in debrided infected dentoalveolar sockets. MATERIALS AND METHODS: A total of 24 implants were immediately placed into prepared infected sockets. The pathology at the receptacle sockets included subacute periodontal infection, perio-endo infection, chronic periapical infection, periodontal cyst and traumatic infected teeth. The treatment protocol emphasized on meticulous debridement of the infected sockets under pre- and post-surgical antibiotic therapy. Follow up of at least 24 months was done to evaluate the survival of implants. RESULTS: At the end of follow up time period of 24 months, all 24 implants were stable with no signs of clinical mobility and infection. However, on radiological examination, crestal bone loss was observed during the osseointegration periods which settled at the level of first thread. CONCLUSION: Survival of immediately placed implants in infected sockets is predictable and depends on the meticulous debridement of dentoalveolar sockets along with adequate pre- and post-operative antibiotic coverage.

Use of implant retained splint for vestibuloplasty: alternative to conventional technique.

It is generally agreed that firmly attached keratinized mucosa surrounding the implant and abutment is thought to provide additional protection against mechanical trauma. Inflammation of soft tissue can result in peri-implantitis [1] with marginal bone loss or hyperplasia of surrounding mucosa. The purpose of this article is to describe our experience in using the two dental implants placed in the canine region in completely edentulous mandible and implant retained denture as a stent for vestibuloplasty.

Necrotizing cervical fasciitis: a case report and review of literature.

Necrotizing cervical fasciitis is a rare, fulminating infection causing extensive necrosis of the subcutaneous tissue and fascial planes with resultant skin gangrene. To reduce the morbitity and mortality from this condition, it requires early recognition and aggressive surgical debridment with appropriate antibiotic therapy. The origin is generally odontogenic and presents more often in immunocompromised patients. This article presents a case with typical clinical features and appropriate management of this condition. An review of literature was carried out for microbiology, pathogenesis, clinical features, diagnosis, management and prognosis of this condition.