Angular cheilitis: A clinical and microbial study.

AIMS: The aim of the present study was to examine clinical types and microbiological flora isolated from angular chelitis. MATERIALS AND METHODS: An eroded and/or erythematous, with or without fissure formation, nonvesicular lesion radiating from the angle of the mouth was considered to be angular chelitis. A sample of the present study comprised of 40 patients having unilateral or bilateral angular chelitis and 20 healthy individuals without any lip lesions. Clinical examination was done. In both test and control groups, the sample for microbial analysis was obtained from angle of the mouth. RESULTS: Clinically, four types of angular cheilitis lesions were found, Type I, II, III, and IV. The most common type of lesion found was Type I lesion. Microorganisms isolated from the lesion were Staphylococcus aureus, Candida or Streptococci in 33 (82.5%) cases either in pure culture or mixed culture. Among these 33 patients, S. aureus was found in 25 (75.5%) cases, Candida in 16 (48.4%) cases, and Streptococci in 5 (13.5%) cases, respectively. Out of 16 cases positive for Candida, in 13 cases further isolation of Candida was possible. Candida albicans was found in 6 cases and Candida stellastodia in 7 cases. In majority of the dentulous and edentulous patients, S. aureus showed profuse growth. CONCLUSIONS: There are microorganisms associated with angular cheilitis.

Keratin metaplasia in the epithelial lining of odontogenic cysts.

OBJECTIVE: To find the prevalence of keratin metaplasia and its relation with clinico-pathological profile of the odontogenic cyst. MATERIALS AND METHODS: Odontogenic cysts were studied histologically with special stains to identify the presence of keratin and compared with various parameters such as underlying connective tissue inflammation, average epithelial thickness, and site of the cyst, type of the cyst, age and the sex of the patient. RESULTS: Of 71 cases of various odontogenic cysts, 26 (36.6%) cases exhibited keratinization in the epithelial lining. In cysts with severe inflammation there is absence of keratinization. CONCLUSIONS: This study reveals higher prevalence of keratin metaplasia in the odontogenic cysts. Furthermore, inflammation is found to be one of factor influencing keratin metaplasia.

Comparison and correlation of candidal colonization in diabetic patients and normal individuals.

BACKGROUND: Diabetes mellitus is a common universal endocrine disorder with decreased host immunity towards infections. In these people the most common opportunistic infection is oral candidiasis. Oral candidiasis is most commonly caused by yeast like fungus Candida albicans. In healthy individuals these microorganisms are believed to be commensals but in diabetic patients, it forms severe colonization, even in the absence of any clinically evident oral candidiasis. This type of subclinical colonization can make them more prone to develop deeper mucosal colonization with further dissemination via blood. The aim of this study is to compare the frequency and severity of oral candidal colonization in diabetic patients with normal individuals through cytological method. METHODS: 30 cases of diabetic patients and 30 cases of normal healthy individuals were examined to determine the oral candidal colonization through oral exfoliative cytological methods. Statistical analysis was done using the Chi - square test. RESULTS: A statistically significant increase in the candidal colonization was observed in diabetic patients as compared to normal individuals. CONCLUSIONS: Oral exfoliative cytological method is an easy and effective chair side technique to assess the oral candidal colonization in the diabetic group.

Evaluation of serum and salivary lipid profile: A correlative study.

CONTEXT: The correlation of serum and salivary lipid profile has been poorly characterized. The most commonly used laboratory diagnostic procedures for lipid profile involve analysis of cellular and chemical constituents of blood/plasma. As a diagnostic aid, saliva offers many advantages over serum. AIMS: To evaluate and compare the serum and salivary lipid profile levels in healthy individuals and to validate the role of saliva as a non-invasive diagnostic tool for assessing lipid profile. SETTINGS AND DESIGN: The present study was a prospective study. MATERIALS AND METHODS: A total of 100 healthy study subjects who had no complaint or any major illness in recent past were selected. The parameters assessed included serum and salivary: total cholesterol (TC), high-density lipoprotein-cholesterol (HDLC), low-density lipoprotein-cholesterol (LDLC), very low-density lipoprotein-cholesterol (VLDLC) and triglycerides (TGL). STATISTICAL ANALYSIS USED: Evaluation of results and statistical analysis was carried out using descriptive, correlation and regression analysis. RESULTS: There was a moderate level of correlation between serum and salivary TC, TGL, HDLC and VLDLC and there was a low and quite small correlation between serum and salivary LDLC. For all the five parameters assessed as a part of lipid profile, the correlation coefficients were highly significant statistically and also, with an increase in the serum mean values, corresponding increase in the saliva mean values for all the five parameters was noted. CONCLUSIONS: From the present study we conclude that saliva can be used as a non-invasive diagnostic tool for assessing lipid profile.

Salivary creatinine estimation as an alternative to serum creatinine in chronic kidney disease patients.

Context. Sampling blood for serum analysis is an invasive procedure. A noninvasive alternative would be beneficial to patients and health care professionals. Aim. To correlate serum and salivary creatinine levels and evaluate the role of saliva as a noninvasive alternative to serum for creatinine estimation in chronic kidney disease patients. Study Design. Case-control study. Methods. Blood and saliva samples were collected from 37 healthy individuals and 105 chronic kidney disease patients. Serum and salivary creatinine levels were estimated using automatic analyser. Statistical Analysis. The serum and salivary creatinine levels between controls and cases were compared using t-test. Correlation between serum and salivary creatinine was obtained in controls and cases using Pearson correlation coefficient. Receiver operating characteristic analysis was done to assess the diagnostic performance of salivary creatinine. Cut-off values were established for salivary creatinine. Results. Serum and salivary creatinine levels were significantly higher in CKD patients than controls. The correlation was negative in controls and positive in cases. Area under the curve for salivary creatinine was found to be 0.967. A cut-off value of 0.2 mg/dL gave a sensitivity of 97.1% and specificity of 86.5%. Conclusion. Saliva can be used as a noninvasive alternative to serum for creatinine estimation.

Osteosarcoma of the mandible: A case report with an early radiographic manifestation.

Osteosarcoma is a classical malignant bone-forming neoplasm which usually presents with an aggressive clinical course. The current case is presented with the radiographic feature of widening of the periodontal ligament space of the involved teeth, which is considered to be the earliest radiographic manifestation of osteosarcoma involving the jaw bone. The main aim of this case report was to focus on the importance of early diagnosis of this tumor based on clinical and radiographic examinations, and confirmation by histopathology. Considering the rarity of the disease type and particularly taking into account the fast progression and aggressiveness of this neoplasm, it is clear that the presentation of a clinical case represents a major contribution to better understanding of osteosarcomas involving the jaw bone.

Granular cell ameloblastoma mimicking oncocytoma.

Granular cell ameloblastoma is a variant of ameloblastoma where cells located in the central portion of the follicles have granular eosinophilic cytoplasm and the peripheral cells resemble ameloblasts. A case of granular cell ameloblastoma of the mandible having very similar histopathological features of oncocytoma (oxyphilic adenoma) is reported where tumor cells were arranged in cords, sheets and follicles and their cytoplasm was full of eosinophilic granules.

Glucose estimation in the salivary secretion of diabetes mellitus patients.

AIM: Saliva is one of the most abundant secretions in the human body and its collection is easy and noninvasive. The aim of this study was to find a medium that can be used to diagnose and monitor diabetes. In this, saliva could play a major role. To substantiate the role of saliva as a diagnostic tool, we compared saliva samples with blood glucose and glycated hemoglobin (HbA(1c)) in healthy and diabetic subjects. MATERIALS AND METHODS: Included in the study were 106 patients, newly diagnosed with type 2 diabetes mellitus and 15 healthy control subjects. The patients and control subjects were asked to come to the clinic in the morning, after an 8-hour fast. At that time, 5 mL of venous blood was collected, 2 mL of which was collected in an ethylenediaminetetraacetic acid (EDTA)-containing blood collection tube and sent for HbA(1c) estimation. Unstimulated saliva was collected from both groups as well. The saliva and sera from the blood samples were subjected to glucose estimation. RESULTS: The correlation coefficient between serum glucose and salivary glucose in the control group was calculated and the r value was found to be 0.5216, which was statistically significant (P < 0.05). The correlation coefficient between serum glucose and salivary glucose in the patient group was also calculated and the r value was found to be 0.7686, which was highly significant (P < 0.01). Finally, the correlation coefficient between HbA(1c) level and salivary glucose in the patient group was calculated and the r value was found to be 0.5662, which was also highly significant (P < 0.01).

An unusual mode of injury-implantation of a broken toothbrush medial to ramus: report of a case.

Impalement injury and implantation of a foreign body in the oral cavity is common in young children. Typically the child falls with the foreign body in the mouth resulting in implantation of the object at various sites in the oral cavity. It is quite unusual to have the head of a toothbrush with bristles implanted fully in the soft tissue medial to the ramus, in the region of pterygomandibular space, following an injury with a cricket ball without a history of fall. A case of an unusual foreign body implanted at an unusual site by an unusual injury is being presented.